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Death-on-FHIR: Using HL7® FHIR® to Help Improve Mortality Reporting

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Presentation on theme: "Death-on-FHIR: Using HL7® FHIR® to Help Improve Mortality Reporting"— Presentation transcript:

1 Death-on-FHIR: Using HL7® FHIR® to Help Improve Mortality Reporting
National Center for Health Statistics Death-on-FHIR: Using HL7® FHIR® to Help Improve Mortality Reporting Presented at HL7® FHIR® Applications Roundtable Paula Braun, Entrepreneur-in-Residence Centers for Disease Control and Prevention, National Center for Health Statistics Steven Wurtz, Registrar, State of New Hampshire September 2018 HL7® and FHIR® are registered trademarks of Health Level Seven International. The use of these trademarks do not constitute a product endorsement by HL7.

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3 Age-Adjusted Death Rates for Drug Poisoning by County United States: 1999
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

4 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2000
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

5 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2001
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

6 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2002
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

7 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2003
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

8 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2004
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

9 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2005
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

10 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2006
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

11 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2007
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

12 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2008
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

13 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2009
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

14 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2010
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

15 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2011
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

16 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2012
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

17 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2013
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

18 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2014
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

19 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2015
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

20 Age-Adjusted Death Rates for Drug Poisoning by County United States: 2016
per 100,000 Population SOURCE: National Center for Health Statistics, National Vital Statistics System, mortality data (

21 Drug Overdose Deaths Arrive in Waves
SOURCE: National Center for Health Statistics,

22 FHIR-in-Action: Using HL7 FHIR to Help Improve Mortality Reporting

23 Vision Make it easier for Mortality Data Providers to
Provide more specific and up-to-date mortality information to public health and public safety partners In a coordinated, consistent, and secure way Across jurisdictional boundaries With the ability for the data providers to get more value out of the data they collect Without workflow disruption to data providers or data requestors

24 Medical Demographic Interjurisdictional Exchange
EHR STEVE Physicians Medical History Interjurisdictional Exchange Analyses and Reports Death Scene EDRS NCHS NVSS Mortality ME/C Case Management Systems Autopsy Registrar Director of Division of Vital Statistics Medical Examiners & Coroners Toxicology Demographic Funeral Home System RIP EVVE Surveillance, Public Use, and Restricted Data Funeral Home Directors Demographic Data Verification of Vital Events

25 Implementers Community

26 Overarching Goals Connect the disconnected
Identify critical pieces of information that need to be woven together from disparate systems and devices Lay the conditions so that information can securely flow where it needs to go without reinventing the wheel Start small, set priorities, and conduct multiple “build -> test -> learn” feedback loops

27 Map Death Certificate Data Elements to FHIR® Resources

28 Death Record Profile Development Underway

29 SMART-on-FHIR®App for Death Reporting

30 http://deathdatahub3.hdap.gatech.edu/ and https://youtu.be/WWFHqEKKyPc
FHIR® Mortality Reporting App Requests Veterans’ Health Data from VA’s API Management Platform and

31 Testing and Development Underway to Take These FIHR® Apps into Production

32 Public Health and Public Safety Mortality Reporting
Data Needed to Determine Cause and Manner of Death Death Scene Death Certificate Data Elements Autopsy Toxicology ME/C Case Management System State Death Certificate Registry Medical History

33 Approach for Implementers Workgroup: Work Collaboratively With Stakeholders
What are the most important needs to be addressed? How can we work together to promote as much coordination and consistency as early as possible in the process? What do electronic systems currently have the capacity to do? What functionality could be added to core products? What options do we have to bridge any gaps? How can mortality data collection better fit within data providers’ workflow? Don’t try to solve every problem. Focus on the common 80%, set priorities, and build strong collaborations.

34 Questions? Paula Braun Phone:


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