1. Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 The Impact of EDRS on registration timeliness: Utah, Nebraska and California's perspective Jeff Duncan, Utah Mark Miller, Nebraska David Fisher, California

2. Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Does EDRS improve timeliness? What is timeliness? The civil registration view In Utah, 72 hours to certify 5 days to register The public health view How fast is data available?

3. Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Death Registration in Utah 15,000+ deaths per year Eden, rolled out in 2006 100% FD users 60% of dc’s all-electronic Local participation in registration process

4. Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Timeliness of registration

5. Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Effect of late certification on late registration 87% of deaths certified on time (<72 hrs) were registered on time 67% of deaths certified late were registered late. Late certification strongly predicts late registration (OR=12.4)

6. Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Timeliness of certification

7. Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Modeling late certification Logistic regression using 2009 death data excluding deaths certified by OME Age, gender, place of death and registration method had minimal effect on certification timeliness Non-residents more likely to be certified on time (OR = 2.2)

8. Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Late certification vs. day of week of death % on-time% lateOR Sun79%21%1 Mon69%31%1.6 Tue55%45%3.1 Wed57%43%2.9 Thu60%40%2.6 Fri66%34%1.9 Sat73%27%1.4

9. Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Timeliness in EDEN

10. Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Another definition of timeliness Availability of data Transmission to NCHS Availability of coded COD statistics Use of cause of death literals for surveillance

11. Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Data timeliness Data available

12. Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Improving timeliness Enable physicians Rapid notification of death Electronic medical records for certification Reduce processing time