Georgia Breaks New Ground with FHIR Pilot for Funeral Home Data Exchange

Death certificate data are a cornerstone of the National Vital Statistics System (NVSS) and for national surveillance and monitoring disease trends. Yet for decades, the process has relied on manual entry, complex workflows, and outdated technology.

The state of Georgia is changing that. In early 2025, the Georgia Department of Public Health (DPH) launched a pilot project that used Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) to transmit death certificate data directly from funeral homes to the state’s electronic death registration system. This project is believed to be the first of its kind in the nation and is already demonstrating the potential to transform how mortality data flow from funeral service providers to vital records systems.

Closing a Critical Gap in Data Exchange

The project emerged from CDC’s NVSS Modernization Community of Practice, where the Georgia DPH State Office of Vital Records launched a subgroup exploring ways to improve electronic death record exchange with funeral homes. Using CDC’s Epidemiology and Laboratory Capacity Data Modernization funding and building on earlier FHIR projects, Georgia tested whether funeral home data could be transmitted the same way.

At the outset, Georgia gathered requirements, collaborated with the subgroup, and worked with potential partners and their software developers. Georgia quickly determined they could reuse and build on the FHIR workflows developed with medical examiners and coroners. The HL7 FHIR Vital Records Death Reporting Implementation Guide defined the death record content, and many earlier successes could be repurposed, greatly reducing the effort compared to starting over.

For public health, this addressed a critical bottleneck in mortality reporting: the initial entry of demographic and biographical data. By streamlining the reporting process, eliminating duplicate entry, and reducing transcription errors, Georgia created the foundation for more accurate, complete, and timely data to flow into state and national systems.

How It Works

When a funeral director enters demographic information, the data are formatted as FHIR resources and transmitted to Georgia’s electronic death registration system with a single click. The record is then available for review and certification by coroners, medical examiners, or physicians. Funeral home users can submit updates if new information becomes available, and each transaction includes audit trails and user authentication to preserve data integrity.

The difference was immediate. Whitfield Funeral Home and Crematory reported that its funeral directors no longer had to retype the same information into multiple systems.

“We’re all human, and when we transcribe information between one system and another there’s a large amount of error that can happen,” said Everett of Whitfield Funeral Home and Crematory, noting that the new system removes that opportunity for error.

“It has cut down on the time frame for us and expedited the process for families.” For the state, data began arriving faster and with fewer errors—an improvement that directly benefits the timeliness and quality of vital statistics for surveillance.

Results and Lessons Learned

Since its launch in February 2025, Georgia has successfully onboarded 75 funeral homes and there are plans to expand access to additional providers.

The team reported several key lessons—

• Training matters. Early testers needed better user documentation, highlighting the importance of preparing participants before launch.
• Data review is critical. Carefully reviewing data elements in advance and throughout the project reduced errors and minimized missing information.
• Ongoing communication is essential. Regular meetings between state staff, vendors, and funeral homes helped resolve issues quickly and kept progress on track.
• Expectations should be realistic. Participants balanced this pilot with other responsibilities, underscoring the need for phased timelines and clear priorities.

Public Health Impact

For public health surveillance, the potential gains are substantial. Faster submission of death certificates makes mortality data available sooner, strengthening NVSS’s ability to detect emerging health threats, monitor trends, and inform timely interventions. Improved data accuracy reduces the downstream need for corrections and enhances confidence in analyses used by policymakers, researchers, and health officials.

Georgia’s pilot demonstrates that modern interoperability standards like FHIR can deliver data that is not only faster but also cleaner and more reliable. This benefits DPH, its state and local partners, and grieving families who experience fewer delays while waiting to receive completed death certificates.

A Model for the Future

Georgia’s work illustrates what is possible when federal, state, local, and private-sector partners work together to modernize vital records. By demonstrating that FHIR can successfully connect funeral homes to vital records systems, the project offers a roadmap for other jurisdictions.

As Cynthia Buskey, State Director of Vital Records, emphasized, the initiative is about more than technology—it’s about strengthening the foundation of public health surveillance through partnerships and innovation to improve the timeliness and accuracy of mortality data.

With continued expansion and adoption, this approach could become a national model, advancing NVSS modernization and ensuring that mortality data keeps pace with the demands of 21st-century public health.