1. “The Death Worm”: A SMART-on-FHIR, Clinical Decision Support Tool for Mortality Reporting
Paula Braun
Entrepreneur-in-Residence
CDC’s National Center for Health Statistics
ITdotHealth: SMART Decisions Panel on Getting Data and Services to the Point of Care at Harvard Medical School
June 25, 2017

3. Mortality Surveillance

4. Electronic Death Registration System
Leverage SMART-on-FHIR to Help Physicians Determine Chain of Events that Led to Death
+ Integrate Into Physicians’ Workflow: Certify Deaths in the EHR & Send Electronically to State
+ Save Time: Provide Medical History & Pre-Populate Demographic/Basic Health Information
+ Improve Accuracy: Use Advanced Computing to Help Determine Cause-of-Death Sequence
+ Advance Medical Research & Improve Care: Send Coded Data Back to EHR
REST API
State’s
Electronic Death Registration System

5. Tool Provides History & Probable Causal Links
Salient plan-text history, with final progress note if available
Basic patient information, to give context. Seamless return to EHR for more info.
Hover over events for more details
Scroll-able, scale-able timeline for comprehensive view
Rupture of Cardiac Wall
Time: 6/25/17 02:05
Time to death: D−13 m
Clicking on a proposed timeline pre-populates the chain of events
Familiar chain-of-events layout, allowing changes if needed
Validate Data Before Sending to State

6. Demo

7. flee, for this is the place where death delights to help the living."
“Let conversation
cease, let laughter
flee, for this is the place
where death delights to help the
living."
Giovanni Morgagni (translated from Latin)
Inscribed on the wall of the NYC Medical Examiner’s Office

8. Questions?
Paula A. Braun
Phone: