March 2017 Vital Records News

MARCH 2017

Vital Records News

Paper Cut deadline coming soon

Minnesota to require cause and manner of death entry by physician or physician designate

On or before September 30, 2017, Office of Vital Records (OVR) staff will enter the last paper cause of death worksheet. This is a primary goal of the Paper Cut Project.

Paper registrations outside of the statewide electronic vital records system, Minnesota Registration & Certification (MR&C), place an unnecessary administrative burden on funeral staff, physicians, medical examiners and coroners, and vital records staff. Paper registrations also often result in death certificates that are less timely for families, delayed authorizations for cremation, and health-related death data that is less complete and more inaccurate than that of death registration done through the MR&C System.

Last year OVR embarked on an ambitious two-year quality improvement project after it received funding from the CDC’s National Center for Health Statistics. Through this “Paper Cut Project,” OVR is improving the timeliness and quality of Minnesota’s death records by maximizing use of the electronic death registration system. Because of this effort, cause of death is entered into MR&C by physicians or their designated staff more than 93 percent of the time—up 15 percentage points from when the Paper Cut Project began.

OVR's phased approach with Paper Cut builds on having a solid foundation in place to support the push for online use, inviting change, collaborating with partners to change the paper-based culture, securing and strategically allocating resources to meet partners’ needs and industry demands. Policy decisions from both the Ramsey County and Hennepin County Medical Examiners helped Paper Cut gain momentum by requiring requests for cremations and cremation authorizations to be done through MR&C. This resulted in more physicians than ever before becoming users of MR&C so that they could file the cause of death information electronically.

OVR is currently in phase two of Paper Cut, which involves externally focused improvements and activities. “We’re preparing changes to MR&C that will make death registration easier and more intuitive for all users,” said Heidi Granlund, Deputy State Registrar who is overseeing the project. OVR is now setting expectations, building awareness, informing, and preparing the way for improved death registration to be fully online. “We want to make sure that there are no technical barriers when we go ‘paperless’ in phase three,” Granlund added. In the final months of 2017, OVR expects all physicians or their designated staff to provide the cause and manner of death for every Minnesota death record directly in MR&C.

For questions about the Paper Cut Project, or to request training or access to MR&C in order to complete the cause and manner of death electronically, call the OVR Help Desk at 651-201-5970 or email health.MRCAdmin@state.mn.us.


Legislative session holds possible changes for vital records

This is the season for legislative change. The Minnesota Department of Health (MDH) put forward ideas to the Governor for policy changes and the House and Senate have introduced bills that, if they pass, will affect vital records. These include:

  • Reducing security risk and preventing fraud by limiting access to birth and death certificates. Removing “the party responsible for filing the vital record” from the list of people who have tangible interest to get certificates protects individuals. Other small changes allow morticians and funeral directors to continue to order and receive death certificates on behalf of families. 
  • Adding advanced practice registered nurses to the list of professionals who register vital events and deferring authority to provide the cause and manner of death to rulemaking. 
  • Allowing a court to order changes to a death record when the court finds the record to be incomplete or inaccurate. 
  • Providing for end of life options that allow a qualified patient to request and obtain a prescription for medication to be self-administered for a peaceful death and listing the underlying terminal illness as the cause of death. 
  • Clarifying the definition of an individual eligible to receive the credit for parents of stillborn children.
  • Modifying provisions governing access to original birth records and other adoption-related information; modifying provisions related to affidavits of disclosure and nondisclosure; providing for a contact preference form for birth parents. 
  • Clarifying parent contact information for birth certificates as private data on individuals.

MDH had secured the Governor’s approval for language that would remove barriers and promote health equity by sharing birth record information with Native American tribes in Minnesota. However, the Senate and House chairs confirmed that this policy proposal will not be scheduled for a hearing this session. 


Methodist Hospital process improvement for birth registration

Information from vital records is key to public health and the Office of Vital Records (OVR) supports efforts to improve the completeness, accuracy, timeliness and overall quality of birth and death data as reported by hospitals, funeral homes, physicians and medical examiners. Some of the data is obvious and easy to gather, but other important vital record data elements are harder to find.

To improve their workflow, consistency and accuracy, Birth Registrars/Health Unit Coordinators (HUC) from Park Nicollet Methodist Hospital in St. Louis Park recently got together to assess their birth registration process and look for ways to improve. Anna Peterson, the lead HUC and Birth Registrar at Methodist, coordinated the meeting “to instill in our team the importance of collecting accurate statistics” for birth records because “we will have better statistics and I think we will also make better HUCs.”  Each birth registrar completed the NCHS eLearning course, Applying Best Practices for Reporting Medical and Health Information on Birth Certificates. This free eLearning course is available at https://www.cdc.gov/nchs/training/BirthCertificateElearning/. Because medical records have multiple areas where information is duplicated, or potentially conflicting, the birth registrars also studied a sample medical record together to find the best source for each bit of medical information reported on a birth record.  

Methodist Hospital is the first hospital in Minnesota to have each birth registrar take the NCHS eLearning course and notify the Office of Vital Records. OVR expects that each facility will have their new and experienced staff take the course, and is pleased to commend the birth registrars at Methodist Hospital and their manager for their compliance, best practices and commitment to vital records. 


MR&C tip for county vital records offices

Save keystrokes and time by using a single customer service request for all certificates or vital records documents sold to the same person.

For example, if a parent requests a birth certificate for each of her three children, or someone wants a death certificate for his parent and a birth certificate for himself, it is not necessary to create separate customer service requests for the different documents. Here’s how:

  1. Create the customer service request.
  2. Select “Add request item” and select the first desired document from the drop down menu.
  3. Enter the requester information and “Save” to stay on the same page.
  4. Select “Add request item” again and select the next desired document.
  5. “Save” to stay on the page and add more items, or “Continue” to complete the rest of the request.
  6. Record payment for all items.
  7. Link the appropriate record to each request item type using the “select” button on each line.
  8. Complete the request as usual.


BRIEFLY SPEAKING

After September 30, 2017, the Office of Vital Records will no longer process paper worksheets to enter cause and manner of death for physicians.


UPCOMING EVENTS

March 21, 2017, 8:15-9:45 a.m.,  OVR all staff meeting. Responses to voice and email messages will be made after 9:45 a.m.

April 2-4, 2017 - OVR exhibit at Minnesota Hospice and Palliative Care Conference in Bloomington, MN.


CONTACTS

State Registrar
Molly Mulcahy Crawford
651-201-5972
molly.crawford@state.mn.us

Deputy State Registrar
Heidi Granlund
651-201-5987
heidi.granlund@state.mn.us

Issuance Unit Supervisor and Anti-Fraud Coordinator
Brenda Shinaul
651-201-5959
brenda.shinaul@state.mn.us

Registration & Amendments Supervisor
Krista Bauer
651-201-5937
krista.bauer@state.mn.us


Birth & Death
Amendments, Adoptions & Paternity Adjudications
651-201-5990

Birth Certificates
651-201-5980

Death Certificates
651-201-5980

Local Issuance Help
651-201-5998

MR&C Help
651-201-5993