1. Meeting the Demands for Vital Statistics: The Challenges of Collecting, Preparing, and Promoting Baltimore, MD May 31 st – June 4 th, 2009 Improving Physician Access to Electronic Death Registration Jeff Duncan, Director Utah Office of Vital Records and Statistics

2. Meeting the Demands for Vital Statistics: The Challenges of Collecting, Preparing, and Promoting Baltimore, MD May 31 st – June 4 th, 2009 EDEN Electronic Death Entry Network Operational August, 2006 LAMP environment—Linux, Apache, MySQL, PHP 15,000 deaths annually

3. Meeting the Demands for Vital Statistics: The Challenges of Collecting, Preparing, and Promoting Baltimore, MD May 31 st – June 4 th, 2009 EDEN Users 228 funeral directors (100%) 445 physicians (< 10%) 62% of deaths in last three months registered electronically Pressure from funeral directors to achieve 100%

4. Meeting the Demands for Vital Statistics: The Challenges of Collecting, Preparing, and Promoting Baltimore, MD May 31 st – June 4 th, 2009 The Pareto Principle

5. Meeting the Demands for Vital Statistics: The Challenges of Collecting, Preparing, and Promoting Baltimore, MD May 31 st – June 4 th, 2009 Two solutions Pan-flu grant from CDC to develop two solutions: Certification through EMR of a large regional health care organization Single sign-on through the website of Utah’s RHIO

6. Meeting the Demands for Vital Statistics: The Challenges of Collecting, Preparing, and Promoting Baltimore, MD May 31 st – June 4 th, 2009 Intermountain Healthcare (IHC) Large not-for-profit healthcare delivery system Over 50% of Utah’s healthcare delivery market 21 inpatient facilities 700+ affiliated physicians

7. Meeting the Demands for Vital Statistics: The Challenges of Collecting, Preparing, and Promoting Baltimore, MD May 31 st – June 4 th, 2009 Current process Death FD Initiates EDEN Record Is MD an EDEN user? MD Certifies in EDEN LHD Registers death Yes FD prints paper certificate MD signs paper certificate LHD keys paper certificate into EDEN FD delivers to MD FD delivers To LHD Drop-to-paper process No

8. Meeting the Demands for Vital Statistics: The Challenges of Collecting, Preparing, and Promoting Baltimore, MD May 31 st – June 4 th, 2009 New IHC Process UDOH HL7 Message Server (Rhapsody) EDEN Master Database EDEN Cause Of Death Table Record Matching HL7 over VPN Tunnel Cause of Death Certification Intermountain HL7 Message Server Intermountain EMR (cause of death) Funeral Directors (fact of death)

9. Meeting the Demands for Vital Statistics: The Challenges of Collecting, Preparing, and Promoting Baltimore, MD May 31 st – June 4 th, 2009 IHC Advantages and Disadvantages Advantages Physicians will have access to EMR to complete cause of death fields Built-in decision support for conditions such as pregnancy, tobacco use Disadvantage Only available to IHC physicians

10. Meeting the Demands for Vital Statistics: The Challenges of Collecting, Preparing, and Promoting Baltimore, MD May 31 st – June 4 th, 2009 Utah Health Information Network (UHIN) Utah’s RHIO Not-for-profit coalition of insurers, providers, UDOH and others Links 90% of Utah medical providers for claims data

11. Meeting the Demands for Vital Statistics: The Challenges of Collecting, Preparing, and Promoting Baltimore, MD May 31 st – June 4 th, 2009 Single sign-on through UHIN EDEN user table UHINet web Interface Hyperlink to EDEN EDEN Web Interface https redirect with UHIN login, password, physician ID and security hash

12. Meeting the Demands for Vital Statistics: The Challenges of Collecting, Preparing, and Promoting Baltimore, MD May 31 st – June 4 th, 2009 UHIN Advantages and disadvantages Advantage: Available to 90% of physicians Disadvantage: Physicians need an Eden account to use

13. Meeting the Demands for Vital Statistics: The Challenges of Collecting, Preparing, and Promoting Baltimore, MD May 31 st – June 4 th, 2009 Implementation Solutions are in development Pilots scheduled August 2009 Marketing campaign through IHC Collaboration with Utah Medical Association and Utah Funeral Directors Association in marketing to non-IHC physicians