1. The National Vital Statistics System “Moving Forward……….”
Delton Atkinson, MPH, MPH, PMP
Division Director
Centers for Disease Control and Prevention (CDC)
National Center for Health Statistics (NCHS)
Division of Vital Statistics (DVS)
NAPHSIS Conference
June 11, 2014

2. Change Is….. “…..the law of life,
and those who look only to the past or the present,
are certain to miss the future. “
(John F. Kennedy)

3. Presentation Agenda Changes in the staff Where have we been?
Where are we going?
Challenges and Opportunities

4. Changes in Leadership
Associate Director for Science

5. Changes in Leadership
Associate Director for Science
Hanyu Ni, Ph.D.

6. Changes in Leadership
Chief of the Reproductive Statistics Branch

7. Amy Branum, Ph.D. Changes in Leadership
Chief of the Reproductive Statistics Branch
Amy Branum, Ph.D.

8. Changes in Leadership
Chief of the Information Technology Branch

9. Rajesh Virkar, MS., ABD Changes in Leadership
Chief of the Information Technology Branch
Rajesh Virkar, MS., ABD

10. Staff New to DVS Mrs. Laci Banks, MS (Survey Statistician)
Mr. Matt Rowe, MBA (Supervisor , Medical Classification and Evaluation Team)

11. Internal Staffing Actions
Holly Lambert (Senior Medical Classification Specialist)
Mia Jones (Senior Medical Technician)
Adrienne Rouse (Statistician—Medical Cause of Death)

12. Recruitment Actions or Internal Changes
Vital Statistics Specialist (NC)
Medical Classification Specialist (NC)
Senior Nosologist (NC)
2 Computer Scientists (NC)
Chief, D.A.C.E. Branch (NC)
Deputy Director, Division of Vital Statistics (Md.)

13. National Vital Statistics System
Over 6 million vital events reported annually
National Vital Statistics System

14. NVSS Performance ---Births and Fetal Deaths
Improved release of data
2012 final data released w/n 12 months of end of data year
2013 preliminary data released w/n 5 months of end of data year
Released 6 years of Fetal deaths (2006 – 2012) in 10 months
Implemented new reports
Released “new birth” data for and accompanying report
Source of Payment of the delivery which will be useful for ACA

15. NVSS Performance ---Births

16. NVSS Performance ---Deaths

17. NVSS Performance ---Deaths

18. Issues Affecting 2011 Medical Data

19. Category of Issues DVS IT System Issues
Internal business processes and practices
State file issues

20. State Issues Affecting 2011 Medical Data
Duplicate file names
Duplicate records within a file
Incorrectly numbered records where age-gender mismatches occurred
Records with incorrect data year
Transmissions submitted out-of-sequence

21. Federal Issues with 2011 Medical Data
ACME Editor Bug--injury literal invisible to coder Bug in Transax Table Creation Program
File Tracker file repository did not support files with duplicate filenames.
Franken-records
ICD Codes not synchronized between applications
Incorrect auto-coding where records were coded to generic codes by default
Lack of quality control
Manner of death and other data not being persisted through the MMDS application
MMDS could not code certain literals to ERN; however it was not rejecting them
Redactor bug caused missing data due to truncation
Miscoding of 2011 records using MMDS applications meant only for 2009 or 2010
State/internal updates/corrections sometimes blocked by the activation log
WebMMDS/Micar200 bug -- blank line mishandled

22. NVSS Performance ---Deaths
Proportion of Mortality Records Received Within 10 days of
the Date of the Event in 2013 and in First Quarter of 2014
Percent of Records received
Jurisdictions in
w/n 10 days of date of event
CY 2013
1st QTR
80% or more 2
60 to 79
30 to 59 9 13
5 to 29 19 18
0.1 to 4 4
None
U.S. Average (%)
17.69%
27.92%

23. Priorities for 2014, and 2016
Publishing 2011, 2012, and 2013 death data in 2014
Building a State-based network of EDRS
Funding of states this summer to enhance timeliness
Possible PCOR for more substantial enhancements;
12 states using FY14 funds and 10 states using FY15 funds
Monitor/evaluate the 7 states already funded. Lessons learned?
Building our EDRS partner network
Designing and implementing VIEWS II System
Plan/develop/pilot new system in 2014/2015
Can rare cause verifications be done with VIEWS II?
Can VIEWS II improve the quality of submitted COD information?
Retooling our Automated Coding System
Evaluation of IRIS. Possible pilot in Implement in 2016?
Re-engineering of the MMDS? Is this feasible?

24. Priorities for 2014, 2015 and 2016 (cont.)
Planning the next generation collection/analysis tools
Electronic reporting of deaths (HHS Entrepreneurs Award)
Electronic reporting of fetals
Data visualization and surveillance tools
Enhancing the National Death Index
Implementing NDI Early Release
Addition of military records. Maybe State department?
Linking NDI with state records for fraud purposes?
Enhancing Medical Quality Assurance
Implementing statistical reviews on current flow basis
Feasibility of joint federal/state quality control reviews?
Implementing system and manual quality reviews
Nosological training and training of state staffs?

25. Priorities for 2014, 2015 and 2016 (cont.)
Using electronic health records
Finalizing national birth and death standards and implementing nationally
Piloting HL-7 EHR and EDRS systems (Possible funding in Fall 2014)
Piloting/implementing HL-7 electronic health records and electronic birth systems
Expanding Mortality Surveillance
Pneumonia and influenza surveillance. Collaboration w/ Influenza
Rare Vaccine Preventable. Collaboration with NCIRD
RSV. Collaboration with NCIRD
Drug-related mortality. Collaboration w/ FDA
Suicide. Collaboration with NIMH
Others?

26. Priorities for 2014, 2015 and 2016 (cont.)
Improving vital statistics data and its utility
E-Learning for medical/health data for births
Completion/analysis of data quality studies
Revising birth and fetal death data elements
Expanded statistical/research studies, incl. Federal/state studies
Mortality Indicators Project (CDC Award)
Improving the VSCP Program
Achieving the VSCP timeliness and quality standards
Increasing state awareness & education about the contract
Negotiating the VSCP contract; Enhancing contract IQ.
Rethinking “joint-ness” in the Joint NAPHSIS/NCHS Annual Meeting
Marketing vital statistics.
Developing a strategic plan for the Division

27. Challenges/Opportunities for “Greatness”
Embracing timelines and quality ---- why can’t we?
Building “lean” vital records/statistics agencies---local, state & Federal
Developing an informatics-savvy workforce
Effectively marketing our worth to others
Establishing/Coalescing in new and non-traditional partnerships
Embracing “controlled” innovation

28. “I will go anywhere---------provided that it is forward!”
Thank You!