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