1. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 New Jersey Mandatory EDRS Fax Hybrid - Interim Option for Physician Compliance Presented by Joseph A. Komosinski, State Registrar 609.984.3445 joseph.komosinski@doh.state.nj.us

2. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 Phased Approach to Training Pilot – Completed May 2007 Training of Registrars, Funeral Directors and 3 medical facilities in the pilot county. Medical Examiners statewide were trained during the pilot Phase I – June 2007, Concurrent training of: 566 Local Registrar Offices Training by State Registrar Target completion by Oct 2007 800 + Funeral Homes Training by the New Jersey Funeral Directors Association Target completion by Oct 2008

3. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 Phased Approach to Training (continued) Phase II – Training of Medical Facilities Hospitals, Long Term Care, Nursing Homes, Hospice 1200 Medical facilities to be trained in total Training by State Registrar & Director of Health Statistics Medical Facilities who have approached the Department will receive training in Fall 2007 Remaining Medical Facilities will receive training beginning Spring of 2008 Phase III – Training of Private Practice Physicians Training to commence upon the conclusion of Phase II Physicians can self-register and utilize on-line tutorials

4. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 Physician Self-Registration

5. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007

6. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 Fax Hybrid Compliance Physician has not been trained and has not self registered to use the EDRS Physician completes the paper death certificate The Funeral Director obtains the paper death certificate when the body is picked up Funeral Director completes Demographic Information in the EDRS Funeral Director selects to process manual medical information and the Fax Hybrid begins The EDRS prints a bar coded cover sheet that corresponds to the death certificate being processed. The Funeral Director faxes the cover sheet and the paper death certificate completed by the physician to the EDRS server

7. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007

8. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007

9. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007

10. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007

11. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007

12. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 Back End Processing Fax Hybrid document is electronically transmitted to the State Registrar The State staff enters the medical information into the EDRS and the completely electronic record becomes the permanent record on file. The record is accessible by the State and Local Registrar to print a paper copy for the archives and for certified copies.

13. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007

14. The NAPHSIS/NCHS Collaboration Past Successes and Future Challenges Salt Lake City, UT June 3 rd – 7 th, 2007 Measurable Success Prior to implementation of Fax Hybrid Option Since they were forced to re-enter all the data on the paper certificate Funeral Directors utilization of the system within the pilot county dropped to an all time low of less than 1% Many began to view the system as optional and legislation to make participation voluntary was introduced Following implementation of Fax Hybrid Option Funeral Directory participation soared to an all time high of 82% within the pilot county The proposed legislation was pulled The Funeral Director’s Association dedicated staff, funding and training to the statewide deployment Medical facilities and physicians are requesting training