Modernizing Data Systems

Key points

  • Modernizing data systems requires reshaping them to create connected, real-time resources.
  • Modernized systems can reduce burden on medical examiners and coroners.
  • These systems can make the data from medical and legal (medicolegal) death investigations more accessible for medical examiners, coroners, and others who use death data.
Electric blue wheel shows icons of data charts, links, users, forms, and other related ideas.

Data modernization

Data modernization helps to make data systems more modern, connected, and timely. Modernization helps create data systems that are interoperable, adaptable, and sustainable. Modernization is not just about technology, but also about putting the right people, processes, and policies in place. These improvements can help solve problems before they happen and reduce problems that may occur.

Goals

Data modernization goals for the Medicolegal Death Investigation (MDI) Office include—

  • Decreasing data entry for death certification
  • Reducing effort exchanging data between systems
    • This includes sharing data with the National Violent Death Reporting System (NVDRS), organ procurement organizations, and state health departments
  • Increasing access to data for use in MDI office research and operations
  • Allowing comparisons with other MDI offices that use these practices

Modernization also can benefit MDI data users by improving data exchange and standardizing data elements between MDI offices.

Experiences from the field

"One of the most exciting things that we have been involved in this year is interoperability solutions with vital records. We have streamlined the process of certifying death certificates. We put in the death certificate information into our case management system. There is one button you click and you finalize the death certificate."
—Gail Parker, Office Manager, DeKalb Co. Georgia Medical Examiners Office

"The collaboration across organizations resulted in something greater than the individual parts and is a model for death certification."
—R. Ross Reichard, M.D., Chief Medical Examiner & Forensic Pathologist, Southern Minnesota Regional Medical Examiner's Office

"There is much value in gaining interoperability. Information does not have to be retyped into the electronic death registration system. Since going live, we have had zero internal clerical-based death certificate amendments, which is huge for us. Another major benefit is that our QA review is being done in real-time instead of quarterly. [These] changes [have] allowed access to accurate real-time data that can be pulled on demand."
—Monica Kendall, Death Investigations Supervisor, Southern Minnesota Regional Medical Examiner's Office

Modernization terms and concepts

The ability of different information systems, applications, and databases to share and use data across organizational and geographic boundaries. Interoperability provides timely and seamless information flow. Data can be accessed and shared, within all applicable settings and with relevant stakeholders.

Software-based systems that MDI offices use to manage case-related data. These can be standard software systems developed by the individual office or a commercial product. The functionality of specific MDI Case Management Systems (CMSs) varies but typically enables—

  • Systematic management of case-related procedures
  • Standardized data entry
  • Query and data searching
  • Report generation
  • Simplified sharing of case materials
  • Secure user permissions and audit trail
See Also: Landscape Study of Electronic CMS for Medical Examiners and Coroners

Allows services and products to communicate with each other. Application programming interfaces (APIs) leverage each other's data and functionality through a documented interface. APIs offer security by design. HL7® FHIR® is an example of an API.

Standardizing data is a key element for data modernization. Variation exists in the information that medical examiners and coroners maintain on a death investigation. Common data elements ensure that information from different offices can be compared and combined. Work toward a minimum set of common data elements began in 1995 in a report from CDC. The Organization of Scientific Area Committees (OSAC) reported on data collection in MDI Data Commonly Collected and Exchanged. The MDI Data Exchange Work Group updated the minimum list, reported in Data Exchange Practices of Medicolegal Death Investigation.

The standards being used to enable interoperability in vital statistics reporting. HL7® FHIR®(pronounced "fire") standards enable health systems to communicate information using a common framework. FHIR standards help break complex health information into small, reusable elements to meet various information needs.

Guidance is available to help MDI offices use FHIR resources. The Medicolegal death investigation FHIR implementation guide (MD FHIR IG) lays a foundation for expanding automated, standards-driven information exchange. The current version was developed to define data exchanges between CMS and electronic death registration systems to certify deaths.

Raven is an open-source, proof-of-concept platform that provides testing tools for interoperability between CMS and other external entities. In this situation, the external entities are data sources communicating with the CMS to exchange MDI data. Data sources may include electronic death registration systems and forensic toxicology laboratory information management systems.

Raven helps implement the MDI FHIR record format by validating FHIR messages against MDI IG guidelines and FHIR-based extended API operations. Raven resources include detailed documentation and the Raven Dashboard.

Additional resources

National Vital Statistics System Modernization Community of Practice‎

Connect with others working to modernize vital statistics.
Print
Content Source:
National Center for Health Statistics