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Electronic Death Registration Never Sign a Death Certificate Again Presented by Texas Department of State Health Services Texas Vital Statistics www.texasvsu.org.

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Presentation on theme: "Electronic Death Registration Never Sign a Death Certificate Again Presented by Texas Department of State Health Services Texas Vital Statistics www.texasvsu.org."— Presentation transcript:

1 Electronic Death Registration Never Sign a Death Certificate Again Presented by Texas Department of State Health Services Texas Vital Statistics

2 Electronic Death Registration is Required By Law Health and Safety Code § requires the person in charge of interment or in charge of removal of a body from a registration district for disposition to file death certificates electronically as specified by the State Registrar. Likewise, Health and Safety Code § requires that medical certifiers on a death certificate submit the medical certification and attest to its validity using an electronic process (currently Texas Electronic Registrar) approved by the State Registrar.

3 Fast Facts As of October 10, 2009: There are 1,364 funeral homes registered to use TER There are 1,364 funeral homes registered to use TER There are 8,114 physicians registered to use TER There are 8,114 physicians registered to use TER There are 319 local registrars registered to use TER There are 319 local registrars registered to use TER All 13 County Medical Examiners offices registered to use TER All 13 County Medical Examiners offices registered to use TER 44.67% of all death certificates are fully electronic % of all death certificates are fully electronic. 92% of all Social Security numbers are successfully validated using TER 92% of all Social Security numbers are successfully validated using TER

4 Texas Electronic Registrar Is: Internet Application Accommodates all levels of participation Initiates social security verification process Edits, cross-checks, SSN verification – all reduce potential errors Result – a faster, more efficient, more accurate process

5 What about my Signature? When Funeral Directors and Medical Certifiers (Physicians, JPs, MEs) are entered as users in TER, they are assigned a temporary PIN (Personal Identification Number). The first time each Funeral Director or Medical Certifier verifies/certifies a record, they will be required to change the PIN to a number only they will know. This PIN must be kept confidential; therefore, each Funeral Director and each Medical Certifier MUST verify/certify their own records (in other words, the signature process cannot be delegated to office staff). The PIN holds the same legal standing on the electronic death certificate as a signature has traditionally held on the paper certificate.

6 Computer Specifications 1.0 gigabyte processor speed or faster with 512MB of RAM or more Adobe Acrobat Reader Pentium 4 or equivalent Windows XP Operating System Web browser with Flash Player (7.0 or greater) Internet access at 56K or better 1024 x 768 resolution color monitor

7 How can do I register to use TER? Go Texas Electronic Registration Page: Complete the online Registration Form

8 Enroll By Going Here

9

10 Once Enrolled You Will Receive an from that will include: Welcome to Texas Electronic Registrar Death Registration Computer specifications Resources and website information Service Level Agreement Confidential and Non-disclosure Agreement User ID, Password and PIN number or Password Guidance document Remote Access Security Policies document

11 Example of the Start up from

12 User Setup *see back of TER brochure VSU will set up one Local Administrator who will Add, Remove, and Modify Users in TEDR, Medical Certifiers and other staff.

13 Lets get started.

14 The notification prompt will be in the form of an , or can be sent to any other electronic device that uses an address (pager, PDA, etc). The basic information about the deceased The contains the name of the funeral home And the unique EDR #

15 Accessing The Record Access the Internet by clicking on the icon. Copy https://ter2.dshs.state.tx.us/edeath to the address bar. Select Enter or icon. https://ter2.dshs.state.tx.us/edeath

16 This is Called The Portal Page. Click on Thin Client Application

17 Enter User Name Password Click Login Select Location Click OK Dr. Kilgore Logging into TER

18 This screen is called the Main Menu Under Functions, click Medical Data Entry or click on icon

19 Lets retrieve the record. This is the Medical Data Entry screen From the Medical Data Entry screen, click the Search Record icon

20 or, select Search from the registration menu

21 You can search with any combination of items This is the Search Record screen

22 Enter your search information or EDR # Click Find

23 The system will retrieve all records matching the search criteria

24 Click on the desired record or records – the row(s) will become highlighted Click Select Records

25 The selected record will be displayed

26 or, click to choose Filter Option

27 Choose desired filter option

28 Click to access records in queue

29 Select record to complete

30 The selected record will be displayed The Demographic Information that has been entered by the Funeral Home will pre-populate in the corresponding fields in Medical Tab 1

31 Start entering data on Medical 1 tab

32 The Medrec field and the MECase Number Field are optional. However you still have to tab through the fields to resolve them. If you do not wish to enter a Medical Record number, tab, with your Tab button. When the Soft-Check Alert Appears, select No if you do not wish to complete this item at a later time or Yes if you do.

33 If there is no middle name, press TAB to skip to the next field. MEs and JPs: If your information is different from the Demographic your can add, edit, or delete the information that is different.

34 A box will appear that will indicate that your information is different from what the Funeral Home has put in the System.

35 Medical Certifiers will have to indicate the date of death type.

36 If there is more than one Medical Certifier with your particular facility, you can select another physician if the physician that was assigned is unable to sign the death certificate. i.e. Attending Physician is out and an Associate Physician Has Approval by the Attending Physician in Accordance to HSC § (c) to complete the medical certification.

37 Review the time of death and make that it is accurate in accordance to your records. You may edit this if you need to. 24 hour clock (military time) is acceptable.

38 We are now on the Medical 2 Tab

39 Complete each item by selecting the appropriate response from the pull- down lists

40 Quick tip – TER Death will not allow a physician to certify a manner of death other than Natural. A message will be displayed notifying the physician, who should then DECLINE the record. The funeral home can re-designate the record to the appropriate JP or ME for certification.

41 Why Cant A Doctor Put the Manner of Death as Accident? Code of Criminal Procedure Art DEATHS REQUIRING AN INQUEST. (a) A justice of the peace shall conduct an inquest into the death of a person who dies in the county served by the justice if: –(1) the person dies in prison under circumstances other than those described by Section (b), Government Code, or in jail; –(2) the person dies an unnatural death from a cause other than a legal execution; –(3) the body or a body part of a person is found, the cause or circumstances of death are unknown, and: (A) the person is identified; or (B) the person is unidentified;

42 Why Cant A Doctor Put the Manner of Death as Accident? Art DEATHS REQUIRING AN INQUEST (cont.). –(4) the circumstances of the death indicate that the death may have been caused by unlawful means; –(5) the person commits suicide or the circumstances of the death indicate that the death may have been caused by suicide; –(6) the person dies without having been attended by a physician; –(7) the person dies while attended by a physician who is unable to certify the cause of death and who requests the justice of the peace to conduct an inquest; or –(8) the person is a child younger than six years of age and an inquest is required by Chapter 264, Family Code.

43 Why Cant A Doctor Put the Manner of Death as Accident? Art DEATHS REQUIRING AN INQUEST (cont.). (b) Except as provided by Subsection (c) of this section, a physician who attends the death of a person and who is unable to certify the cause of death shall report the death to the justice of the peace of the precinct where the death occurred and request that the justice conduct an inquest. (c) If a person dies in a hospital or other institution and an attending physician is unable to certify the cause of death, the superintendent or general manager of the hospital or institution shall report the death to the justice of the peace of the precinct where the hospital or institution is located.

44 Why Cant A Doctor Put the Manner of Death as Accident? Art ORDERS AND DEATH CERTIFICATES. –The justice of the peace or other person who conducts an inquest under this subchapter shall sign the death certificate and all orders made as a necessary part of the inquest.

45 Responding NO to the Injury question will disable the rest of the injury questions and not allow entry NO

46 This is an example of a cross-check The Manner of Death implies that an injury did occur

47 Changing the response to Yes will resolve the conflict Click OK to continue

48 Complete each item by entering information requested or selecting responses from pull-downs

49 We are now on the Medical 3 Tab

50 If the cause of death has not yet been determined, check the Cause of Death Pending box You must also type PENDING on Line A

51 If the cause of death is known, enter the information on lines A – D, as appropriate, TABBING from field to field until complete

52 With certain wording TEDR will give medical certifiers alerts to give additional assistance in writing good Cause of Death statements

53 If there are no contributing conditions, TAB past this field and select No in the Soft- Check Alert.

54 Cause-of-Death Statements WHATS SO IMPORTANT ABOUT THAT?

55 Information Guidelines Certification should represent your Best Medical Opinion -This means that your expertise, experience, and knowledge are valuable and necessary to provide useful information. -If for any reason your Best Medical Opinion changes, the death certificate can be amended to reflect that change ( there would be no legal repercussions from the change)

56 Probable and presumed are allowed Be as specific as possible about conditions reported Provide as much information as possible Avoid such terms as old age, senescence, or infirmity If multiple morbid conditions are present and the underlying cause is uncertain, construct a logical sequence for Part I and then list other conditions in Part II Tips and Pointers

57 Avoid abbreviations Do not report only mechanisms or modes of dying Cardiac or respiratory arrest Cardio-pulmonary or cardio-respiratory arrest Asystole (cardiac arrest) Indicate explicit information with regard to specificity, etiology, or if the cause of death is unknown

58 Why Its Important Two key vital statistics uses: DATA RESEARCH

59 Why We Need You DATA - Data needs to be accurate, complete, detailed and uniform across the state. - Data needs to be useful to other physicians – pertinent to current health issues.

60 DATA… Mortality statistics by county and statewide Health issues specific to geographic area, socio-demographic, age, gender, ethnic characteristics Leading causes of death Infant and maternal mortality rates Trends in the effect of current health issues on mortality

61 RESEARCH Assess the general health of the population Comparison of medical issues at the county and state level Indicate areas in which medical research may have the greatest impact on reducing mortality Allocate medical services, funding, and other resources Why We Need You

62 Example Approximate interval between onset and death Part I. Diseases, injuries, or complications that caused the death. Part II. Other significant conditions contributing to death but not resulting in the underlying cause d. Immediate cause a. Due to (or as a consequence of) b. Due to (or as a consequence of) c. Due to (or as a consequence of) Sequentially list antecedent causes, if any, leading to the immediate cause with underlying cause last Condition which directly preceded death Antecedent condition Underlying cause

63 Example Part I. Diseases, injuries, or complications that caused the death Approximate interval between onset and death Immediate cause Pneumonia 1 week Sequentially list antecedent causes, if any, leading to the immediate cause with underlying cause last b. c. Renal Failure Cerebral Thrombosis 4 weeks 7 weeks a. Due to (or as a consequence of) Part II. Other significant conditions contributing to death but not resulting in the underlying cause Hypertension

64 Cause-of-Death Statements CDCs website provides several links to aid in writing cause-of-death statements Multiple links on CDCs National Vital Statistics System page Recommended tutorial: NYC Department of Health and Mental Hygiene online training on improving causes of death reporting

65 Who Can Certify Deaths? Physicians Certify natural deaths Primary care physician would have best knowledge of patient medical Medical Examiners and Justices of the Peace Certify un-natural deaths May request autopsy See handbook for list of cases requiring a medical examiner / JPs

66 YOU ARE THE KEY The data provided by the TER system is only as good as the information provided on the death certificate You are not just signing a death certificate – you are investing in the future of improved medicine!

67 I Have Completed the Death Record How Do I Sign the Death Certificate? How Do I Get Something for My Files? How Do I let the Funeral Home Know I am Done?

68 The system will bring you back to Medical 1 tab Click the SAVE icon before continuing

69 Your information is now stored in the system

70 Click the MEDICAL CERTIFICATION icon to electronically sign the record

71 Click Yes to continue

72 If a field was not completed, you will see this message

73 Quick tip – Using the Unresolved List feature can help quickly identify missing information.

74 Any unresolved fields will be indicated Close Unresolved List screen by clicking the red X

75 Incomplete or Unresolved fields will be displayed in bright yellow

76 Enter the appropriate response And click the SAVE icon to store the information

77 Click the MEDICAL CERTIFICATION icon to electronically sign the record

78 Click Yes to continue

79

80 The basic information is displayed The type of certifier is checked and the appropriate certification statement is displayed

81 Click Preview to view the entire medical certification portion of the death certificate

82

83

84 Or, click Certify to electronically sign the death certificate

85 The first time you Medically Certify a record you will need to verify the PIN number given to you by VSU and assign a new one.

86

87

88 Click Certify again to electronically sign the death certificate

89 Enter your PIN Click OK

90 Success! You are now finished with this record

91 The information locks down and cannot be changed

92 Notifying the Funeral Home Once the record is electronically signed, TER automatically sends an to the funeral director listed filing the death certificate that the medical certifier has completed their portion of the record.

93 Quick tip – The certifier can make changes to the record only until the record has been electronically accepted by the Local Registrar. If changes are needed on a record that has been electronically certified, the record must first be de-certified.

94 Click the De-Certify icon

95

96 The record is now De-certified Click OK

97 The record is now open and information can be corrected as needed

98 After all changes are made, the record must be electronically certified again

99 Questions? Comments? Please your questions and comments to:


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