May 2016 Vital Records News

MAY 2016

Vital Records News

Streamlining electronic death registration next for continuous improvement

On April 15, the Centers for Disease Control, National Center for Health Statistics awarded funding to the Office of Vital Records (OVR) for the Minnesota Paper Cut Project—a two-year effort to improve the timeliness and quality of death registration. The award provides an operational framework and assigns a high priority to increasing electronic death registrations through the Minnesota Registration and Certification (MR&C) System.

Despite a long history of electronic death registration since 1997, and recent successes in improving death registration, OVR has not achieved full participation among physician communities in using MR&C. This project provides the traction OVR needs to change the death registration culture in Minnesota.

Together with partners, federal programs, and state staff, OVR will use a multi-phased approach to assure that the infrastructure is in place to support and sustain improved performance. The goals of the Paper Cut Project are:

  • Receive at least 80% of mortality records electronically through MR&C
  • Transmit death information collected through MR&C to the National Center for Health Statistics within 10 days of the date of death for at least 80% of deaths
  • Share data about deaths related to state-specified causes of deaths (Influenza, Methicillin-resistant Staphylococcus aureus (MRSA), and Methicillin-Susceptible Staphylococcus aureus (MSSA)), with MDH State Epidemiologists within one day of the cause of death being filed.

Ingrained paper processes waste valuable time and consume limited resources because of redundant activities to provide cause of death information. Statutory requirements for final disposition authorization can be completely met and death registration can be completely accomplished through MR&C. Paper complicates, competes with, and prevents full use of the MR&C System.

The Paper Cut Project comes at a time when others see the need for death registration improvement and are sensitive to the burden that paper registrations outside of MR&C place on all partners. In February, the Ramsey County Chief Medical Examiner, Dr. Michael McGee, established a no-paper policy for cremation authorizations; his office is using MR&C to approve requests for cremation. The move has had a cascading effect among clinics and hospitals in the 16-county jurisdiction. In March, OVR staff recruited 116 new physician users, nearly triple the number from the same time last year.

The Paper Cut Project does not require new laws or rules. Within the current legal framework, OVR can focus resources on MR&C enhancements and specifically on increasing physician use of MR&C. OVR will continue to support new users of MR&C, one record and one physician at a time, while expanding to a facilities-wide approach. In addition, Paper Cut Project funding will:

  • Create a new OVR call center and help desk to support partners in the vital records system
  • Expand training efforts for new and existing MR&C users
  • Enable a death record to be started with the cause of death information (as opposed to the funeral home starting the death record).

OVR welcomes quality improvement efforts initiated by external partners and will support them as part of the effort to eliminate paper and unnecessary processes. “Precious resources are pushed to the limit when business practices perpetuate paper when a fully functional electronic death registration system exists,” said Molly Crawford, State Registrar. “Having a solid foundation in place to support the push for online use and inviting change will be important. Breaking the improvements into phases beginning with the OVR framework will assure a strong infrastructure to support the change and that resources are allocated appropriately to meet our partners’ needs and industry demands as the project progresses.”


OVR Finalizes 2015 Data Reporting to NCHS

The National Center for Health Statistics (NCHS) contracts with 57 states and jurisdictions to collect birth, death and fetal death data. NCHS standards for data quality require states to review data that may be unlikely, incorrect, or inconsistent. All quality issues must be resolved according to NCHS standards to close out a data year. 

The Office of Vital Records (OVR) works with birth registrars, physicians, and funeral directors to resolve any outstanding data issues. Finalized data is then submitted to NCHS to meet the reporting deadlines.  The National Vital Statistics Reports are a result of this effort.

In 2015, there were 69,095 birth records filed in Minnesota. OVR, after working with birth registrars to correct or verify data highlighted by NCHS for review, submitted final 2015 birth record data to NCHS before the March 1, 2016 deadline.

Death records must also meet NCHS data quality standards. 42,711 death records were filed in Minnesota for the 2015 reporting year. OVR staff worked with funeral directors, physicians, and medical examiners to verify and correct data quality issues that NCHS flagged, and met the May 1, 2016 reporting deadline.

NCHS also has data quality standards for fetal death reports. Data items flagged for review by NCHS were reviewed with birth registrars or medical examiners. In 2015, there were 390 fetal death reports filed in Minnesota; finalized fetal death report data was submitted to NCHS to meet the May 1, 2016 deadline.

Each year, you, our partners in vital records, collect the data needed to file vital events in Minnesota; in 2015, 112,194 birth, death and fetal death report records were filed using the Minnesota Registration & Certification System (MR&C).

We in OVR thank our partners in vital records sincerely for their continued service, commitment and dedication to provide accurate and timely records. One record at a time, our work informs public health and improves lives.


OVR to examine self-reported birth data with health equity lens

Advancing health equity is an essential goal for the Minnesota Department of Health (MDH) and initiatives to engage communities in program work is a priority for MDH. For these reasons and the rising trend of ‘unknown’ responses to data elements collected for birth records, the Office of Vital Records (OVR) launched a project to increase the completeness of birth record data. The Beginnings and Beyond Engagement (BABE) project specifically aims to improve self-reported data from mothers because a “health in all policies” approach to public health relies on complete and reliable vital records data.

BABE looks at the birth registration process and its critical impact beyond the beginning of a newborn’s life. The project looks beyond ‘going through the motions to collect data’, good or bad, and beyond simply reporting data to National Center for Health Statistics (NCHS), but starting to improve it. For OVR, BABE is an opportunity to engage facilities and data sources in new thoughtful and purposeful ways to improve processes and encourage data sources to provide complete and reliable data.

Over the next few months, OVR will examine hospital birth data, gather information about data collection and birth registration operations, and compare practices with outcomes. Staff from OVR will reach out to selected facilities and others to invite participation in the project and targeted improvement discussions and activities.

Education, race, ethnicity and cigarette use before and during pregnancy are four important data elements reported by mothers at the time of their child’s birth. For the last three years, in Minnesota, responses of ‘unknown’ for these data elements have trended upward.

Typically, the woman who gives birth completes the Mother’s worksheet for naming your baby and creating a birth record on paper as part of the birth registration process. The worksheet contains data fields for reporting education, race, ethnicity and cigarette use before and during pregnancy along with other items needed to complete the birth record.

The information supplied by the mother along with the health data collected during birth registration become elements of the birth record. When de-identified birth record data is shared with the National Center for Health Statistics, it becomes part of our nation’s official vital statistics. Public health professionals use vital records data and statistics to identify and monitor health problems, risk factors and disease patterns, and assess the impact of interventions.

The four data items that OVR is examining contribute to an understanding of health inequities within Minnesota. Mother’s cigarette use (a behavioral factor) and her education level (a socio-economic factor) are considered high risk factors and are reviewed by MDH and local public health programs to identify resources for, and intervention needs of, mothers and newborns. The pie chart shows the significance that social and economic factors and health behaviors have on population determinants of health.

determinants of health

Further, this information along with race and ethnicity are important data that factor into the determinants of health. In fact, mother’s race and ethnicity as reported on her child’s birth record is often used as her child’s race and ethnicity. Birthplace is also an important data element used in geocoding and assessing the health of communities such as the County Health Rankings & Roadmaps tool which provides a useful visual display of data about health outcomes.


OVR Help Desk/Call Center Positions Posted

The Office of Vital Records announces three job openings for the new OVR Help Desk. Incoming phone calls and emails to OVR are being centralized to provide better partner/MR&C user support and customer service to the public. The job posting closes on May 11, 2016 Find the posting here: Office of Vital Records (OVR) Help-Desk Representative

MR&C Tip

Update your email address by clicking on Manage Profile on the Home tab of MR&C.

MR&C Support Line

Tuesday, May 17, 2016: Office of Vital Records All Staff Meeting, 8:15 a.m. - 9:45 a.m. We'll respond to voice messages and emails following the meeting.


OVR Exhibits
2016 Hospital Update (HealthPartners Institute for Education and Research
and Park Nicollet Institute), May 19-20, Minneapolis.

Minnesota Funeral Directors Association Annual Meeting and Conference, May 23-25, Red Wing.


State Registrar
Molly Mulcahy Crawford

Deputy State Registrar
Heidi Granlund

Issuance Unit Supervisor and Anti-Fraud Coordinator
Brenda Shinaul

Registration & Amendments Supervisor
Krista Bauer

Birth & Death
Amendments, Adoptions & Paternity Adjudications

Birth Certificates

Death Certificates

Local Issuance Help

MR&C Help