April 2017 Vital Record News

APRIL 2017

Vital Records News

The BABE Story

Community engagement, health equity, and quality improvement intersect in birth registration project

In early 2016, the Office of Vital Records (OVR) was wrestling with what to do about birth records with certain incomplete data. Performance reports from the CDC’s National Center for Health Statistics showed Minnesota in a three-year quality decline for mother’s self-reported answers to her race, ethnicity, education level and cigarette use before and during pregnancy. At the same time, Minnesota Department of Health (MDH) leadership was pushing OVR and other programs to engage communities—to move from simply providing outreach and instruction to “communities”, to consulting, involving, collaborating and possibly even sharing leadership through bidirectional relationships. OVR embraced the challenge and initiated the Beginnings and Beyond Engagement (BABE) project.

Vital records activities are essential to public health; health data collected for the birth record is critical to many MDH programs such as immunization, birth defects, home visiting, and others. Public health professionals use health information and other data collected on birth records to monitor health problems, assess the impact of interventions, and provide at-risk families the services and resources they need statewide. These specific self-reported data—race, ethnicity, education level and cigarette use—are relevant to the determinants of health (including social, economic and behavioral factors) and are important to advancing health equity—a priority at MDH.

OVR set out to improve the completeness of data reported by the mother, but quickly realized that it had a lot to learn. Regions, St. Joseph’s, St. John’s, and Woodwinds hospitals accepted OVR’s invitation to be part of the BABE Project. With their help, OVR dove deeper: to gather information, investigate the current state of hospital birth registration, expand relationships, question assumptions and explore standard practices. OVR took the time necessary to understand and approach the problem of birth data completeness holistically.

OVR met with the facilities, interviewed and shadowed the committed and dedicated staff, mapped processes, and gleaned information about each organization's mission, leadership involvement, and own use of data from vital records for the customers they serve. Together we discussed the birth registration process and the challenges faced in collecting the data, changes facilities had made to be more successful, the relationships and collaboration between birth registrars and nurses. We also talked about the interaction among departments such as medical records, social services, and the delivery and post-partum areas, and tools related to data collection and registration—specifically, the Mother’s Worksheet.

While working with hospitals to answer key questions about how the need for this data and the importance of the data is conveyed to mothers, how staff use OVR’s worksheets and mothers’ attitudes towards providing this data, OVR was also investigating how our public health partners use the race, ethnicity, education and cigarette use data. 

The BABE project expanded its reach to all hospitals by surveying birth registration staff about their practices, observations, and experiences. In addition, OVR leveraged the hospital’s direct access to mothers. After completing the worksheet, mothers were surveyed to capture their immediate thoughts and reservations. Engaging the source, the partners in registration, and the users and consumers of data informed the project and those involved, generating excitement and energy.

OVR applied what it learned to revise and pilot an improved Mother’s Worksheet. Staff at Woodwinds, St. Joseph’s, St. John’s, and Regions circulated the pilot worksheet in their birth registration process over a two-week period in December. No one was afraid to share feedback or was surprised to see conflicting responses. OVR learned that some data, such as the child’s date of birth, which was removed from the pilot worksheet (because it is data available in the health record), was important to the hospital process when connecting paper documents with health records and entering data into MR&C.

OVR is drafting a final BABE report to document project activities and make recommendations for process improvements. OVR will use findings from the BABE project to revise and launch a new Mother's Worksheet, highlight best practices, consider going upstream to start the data conversation at prenatal clinics, inform training and set outreach priorities.

Taking the time to gather information, investigate the current state, expand relationships, question assumptions and standard practices before jumping into a fix mode, created a solid foundation to develop a future quality improvement project with true partner collaboration.

The potentially high cost of online vital records service companies

The fastest and least expensive way to buy a Minnesota birth or death certificate is to go to a Minnesota county vital records office with acceptable identification and the appropriate fee. Staff at county vital records offices can supply the required application, check the customer’s identification, verify tangible interest and print a certificate within a matter of minutes. Although certain offices and certain times are busier than others are, in-person service will probably always be faster than the methods described below.

For people unable to appear in person, the Minnesota Department of Health (MDH) Office of Vital Records (OVR) and county vital records offices offer mail-in service, and many offices can accept certificate applications by fax. Because everyone must prove they have a right to the certificate (called tangible interest), requesters must sign their applications in front of a notary before submitting it. The notary verifies the identity of the person buying the certificate.

Some county vital records offices have contracted with VitalChek to process credit card payments and this company offers Minnesota certificates online for the cost of the certificate plus an additional $7. This authorized external vital records processor helps county vital records offices accept credit card payments and directs online certificate orders through county vital records offices. Certificates purchased through VitalChek avoid OVR processing times and this may be the least expensive and the quickest way to get a certificate without appearing in person at the county vital records office.

Another way to buy a Minnesota birth or death certificate is through a vital records service company like VitalChek. The internet is full of offers to “help” customers buy vital records – for an additional cost. And those additional costs can add up. A quick Google search for Minnesota birth certificates revealed eight companies that will assist customers in obtaining Minnesota birth certificates for $33 - $103, with the appeal that their sites are “faster” or “easier” or even “cheaper” ways to get a certificate. Because a Minnesota Birth Certificate Application is required, most of these services fax or email the form to the customer who applies online. The customer fills out the application, gets their signature notarized, and then returns the application to the service with the fees. The vendor forwards the application with $26 to OVR or one of several county vital records offices for fulfillment.

Yes. Vital records service companies buy certificates through OVR or Minnesota county vital records offices.

Minnesota vital record laws apply whenever and wherever certificates are issued. Everyone requesting a certificate must complete an application, show identification, and report their tangible interest. Because vital records service companies forward everything to OVR or county vital records offices for certificate issuance, online purchases are usually slower and more expensive than buying direct from county offices or OVR. The best way to help customers, patients and families who need birth and death certificates is to send them to the local county vital records office or to the MDH website.

Required Training for New Birth Registrars

Your role as a birth registrar is very important for your facility and the families you serve. With every infant you register in the Minnesota Registration & Certification system (MR&C), you are entering information that establishes their identity and follows them throughout their lives.  We thank you for the work you do!

To assure your success as a birth registrar, the Minnesota Department of Health, Office of Vital Records expects you to complete both training sessions below within 6 months of becoming a new MR&C user.

Applying Best Practices for Reporting Medical and Health Information on Birth Certificates

The National Center for Health Statistics (NCHS) at CDC, collaborating with the National Association for Public Health Statistics and Information Systems (NAPHSIS) and several individual jurisdictions developed Applying Best Practices for Reporting Medical and Health Information on Birth Certificates. This 45 minute to one-hour eLearning course is for clinical and non-clinical providers of medical/health information for the birth certificate or the report of fetal death.

Continuing education and certificates of completion are available and will provide documentation of your facility’s participation in this training course and enable state vital statistics agencies to better understand the training needs at your facility.

Minnesota Vital Records Birth Registration 101 training 

Birth Registration 101 will help you build your knowledge, skills and ability to serve the families and health professionals you work with. You will learn to navigate MR&C effectively and efficiently, and meet state requirements for MR&C security and training. Watch Vital Records News and the MDH Birth and Fetal Death Registration webpages for class sign-up information.

Birth 101 Classes coming up:

Tuesday July 11, 2017, 8 a.m. -- Noon, St. Paul

Tuesday November 7, 2017, 8 a.m. -- Noon, St. Paul 

Please contact the Office of Vital Records with any questions you may have at 651-201-5970


Office of Vital Records efforts with the Minnesota Department of Revenue on operationalizing the Credit for Parents of Stillborn Children, and the BABE Project's community engagement work, will be featured at the Minnesota Department of Health Town Hall Meeting on April 4, 2017.


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

April 20, 2017 - OVR presenting results of BABE project at Open Forum for Quality Improvement (QI) in Public Health in New Orleans, LA.

April 24, 2017 - OVR exhibit at Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) Conference in St. Paul, MN.

April 26-27, 2017 - OVR at Minnesota Health Information Management Association (MHIMA) Annual Meeting in Prior Lake, MN.


State Registrar
Molly Mulcahy Crawford

Deputy State Registrar
Heidi Granlund

Issuance Unit Supervisor and Anti-Fraud Coordinator
Brenda Shinaul

Registration & Amendments Supervisor
Krista Bauer

Office of Vital Records

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