Strategies for Improving Civil Registration and Vital Statistics Systems: The Canadian Experience Presentation to the United Nations Expert Group Meeting on International Standards for Civil Registration and Vital Statistics Systems June 27-30, 2011 Jeff Latimer, Ph.D. Director, Health Statistics Division, Statistics Canada Co-Chair, Vital Statistics Council for Canada & Josée Dubé Director and Registrar General, Vital Statistics Branch, Service New Brunswick Co-Chair, Vital Statistics Council for Canada

12/10/2015 Statistics Canada Statistique Canada 2 The Canadian Model  The cornerstone of Canada’s national system of vital statistics is the cooperation and collaboration between the thirteen provincial and territorial vital statistics registrars and the federal government of Canada represented by Statistics Canada  The registration of births, deaths, still-births, and marriages is a provincial responsibility (divorce registration is a federal responsibility)  The collection and dissemination of vital statistics is a federal responsibility fulfilled by Statistics Canada under the federal Statistics Act

12/10/2015 Statistics Canada Statistique Canada 3 The Vital Statistics Council of Canada  The VSCC is comprised of all thirteen provincial/territorial registrars and the federal government represented by Statistics Canada  The mission of the VSCC is to:  Further the evolution of the vital statistics system and public health surveillance  Support the exchange of vital statistics between the federal and provincial / territorial governments, pursuant to the federal Statistics Act  Assist jurisdictions to fulfill their legislated mandates effectively and with excellence by sharing ideas and innovations  The current priorities of the VSCC are focused on accuracy, confidentiality and privacy, and relevance

12/10/2015 Statistics Canada Statistique Canada 4 Registry Training Best Practices  Full cross training of registry staff allows for the segregation of duties when dealing with the issuance of identity documents  The segregation of application acceptance and issuance responsibilities is recommended  Typically, training is guided by documented procedural manuals by transaction type  Timely and accurate training information is readily available to all staff

12/10/2015 Statistics Canada Statistique Canada 5 Medical Coding Training  Trainees complete NCHS computer-based modules on anatomy, physiology and medical terminology and an introduction to ICD-10 as a pre-classroom component to both underlying and multiple causes training  All coders take the Basic ICD-10 Underlying Cause of Death Classification and the Basic ICD-10 Multiple Causes of Death Classification courses  For new coders, the process is generally to double code 100% of cases in the beginning and then follow a progressively reduced monitoring process until discrepancies are at an acceptable level

12/10/2015 Statistics Canada Statistique Canada 6 Outreach: Passport Canada  Passport Canada’s proposed changes to acceptable ID documents for passport issuance would significantly impact vital statistics registries  Collaborative effort between Passport Canada and the VSCC council  Passport presentation to VSCC highlighted the changes under consideration  Discussion paper including feedback from meeting was sent to VSCC members for formal input  Additional discussions held with individual jurisdictions to allow for differences in provincial/territorial legislation  Negotiations ensued on the appropriate timing for implementation of the proposed changes  A communications strategy and accompanying outreach materials (press release, posters, etc.) were developed collaboratively

12/10/2015 Statistics Canada Statistique Canada 7 New Information Technologies  The National Routing System is a distribution system for vital event data:  The traditional bulk file transfer of accumulated records is replaced by a messaging system that transmits record level data  As soon as the registration of a birth or death is “official”, information related to that registration is distributed in almost real-time  All data providers and data consumers use the same data format and technology  Creates opportunities for timely data analysis  Electronic Death Registration and Electronic Birth Registration  Drop-down menus and mandatory fields improve data accuracy  Creates a reduction in paper consumption and storage  Reduces staff time in processing applications

12/10/2015 Statistics Canada Statistique Canada 8 Medical Coding Performance Monitoring  There are a number of best practices currently being used within Canada to ensure that the medical cause of death coding is of high quality  Querying death certifiers in order to clarify coding issues  Pre-release review of selected causes of death  Correlating age with cause of death and sex with cause of death for anomalies  Monitoring the quality of the automated coding tools

12/10/2015 Statistics Canada Statistique Canada 9 Service Bundling  Birth bundling is popular with parents as registration includes the automatic application for:  Social insurance number  Medical insurance  Child tax benefits  Birth certificate  For Federal departments it has provided cost savings, greater data integrity and timely death notifications  Proposed ‘bereavement bundle’ will allow funeral directors to electronically submit death registrations to Vital Statistics registrars  Bundling allows for common communication to citizens on services provided by the Government

12/10/2015 Statistics Canada Statistique Canada 10 Future Priorities  Increased access to vital statistics data:  Pilot project to include vital data in Research Data Centers  Provide historical birth and death data free on website  Improve Statistics Canada website to provide easier access  Improved timeliness of vital statistics data:  release preliminary data 6 to 9 months after the end of the reference period and develop a revision policy for final data  Work towards 100% of vital events transmitted to Statistics Canada through NRS  Improved quality of vital statistics data:  review existing data standards and develop an annual review process  develop mechanism to audit the quality of the cause of death coding  develop service standards to improve the quality and timeliness of data