December 2014

Incomplete registration worksheets: do YOU have the answer?

Professionals who register Minnesota’s vital events play a critical part in monitoring our nation’s health.  Each piece of information you provide on a birth, fetal death or death record is an important part of the public health picture. Entering data to answer a question “right” may skew data results or mask a problem.  When “unknown” is entered for a data item, it doesn’t provide any meaningful information or direction.  In addition, guessing and providing inaccurate answers could point to a problem where none exists.   The data reaches far beyond each of our individual pieces to create a complete picture.

"The data you collect on worksheets and provide on a record is part of our nation’s official vital statistics." - Gloria Haluptzok, OVR Data Quality Unit

If data pieces are missing or if they are inaccurate, statistical analysis and other examinations may not reflect a true picture. The impact can be huge. Resources may be misdirected and programs important to population health may not get the funding or attention they need. The data you collect on worksheets and provide on a record is part of our nation’s official vital statistics. When you register a record, the Office of Vital Records maintains the individual record and it shares civil and medical information with the National Center for Health Statistics at the CDC. Through this data and statistical analysis, we can see local, regional, and national trends, tables, charts and point to the topics of public health importance.

So who really uses this data anyway? The answer is all of us. Policymakers track implementation of health policies and programs, set priorities for research and prevention programs, and evaluate outcomes. Epidemiologists and researchers better understand trends in health, health care delivery, risk factors, and outcomes.

Businesses use data to support the health-related activities of manufacturing, marketing, and consulting firms and trade associations. Advocacy groups raise awareness of issues such as heart disease, cancer, diabetes, child nutrition, Alzheimer’s disease, and health disparities. And Public Health professionals use data to identify and monitor health problems, risk factors, and disease patterns, and to assess the impact of interventions. This information will guide actions and policies to improve the health of the American people.

You may want to take a look at the National Center for Health Statistics website to see the many ways your work is incorporated in collaboration with others to promote and create public health.

Best Practice: Accounting for all certificates, old and new

In Sept. and Oct. 2014, the Office of Vital Records (OVR) was busy training county vital records staff who work in local issuance offices. Among the training topics discussed was fraud prevention and the importance of securing documents. As part of that training, OVR asked counties to focus on accounting for all of their certificate paper, both old and new.

Each sheet of security paper that is used for birth and death certificates is uniquely numbered. When a certificate is issued, the unique number for that sheet of security paper - known as a "document control number" (DCN) - is assigned to the record being issued. Assigning the DCN takes a few steps in the electronic system. Although infrequent, sometimes staff forget to assign the unique number to the record. Additionally, sometimes a printer damages paper or certificate paper isn’t aligned nicely and the sheet must be voided and the certificate reprinted. When that happens, staff must account for each sheet of paper in the MR&C system. When certificates are not linked to the document control number, they become unaccountable.  Unaccounted certificates are a security risk. A blank certificate opens the door to identify theft or worse.

As part of a statewide clean-up effort and initiative to start 2015 fresh, OVR audited unassigned certificate paper and required every county to investigate the outcome for each document. In early September, OVR identified 76,018 unused document control numbers existing in the electronic vital records system. Some unassigned documents were recent and some dated back more than a decade.  Eight counties routinely reconciled their records and didn’t have a report from OVR. For the 79 other counties that received reports, nearly all have looked up their papers and linked them to the appropriate records or they have voided the paper. Clean up efforts must be complete by December 31, 2014.

“Most county staff review their paper and assure that document control numbers are assigned," said State Registrar Molly Crawford. "For some counties the clean-up effort demonstrated that regular reconciliation, weekly or monthly, is a best practice and a reasonable expectation. We want to assure that both state and county vital records workers do all they can to prevent fraud and reduce Minnesota’s security risks.”

OVR also wants to remind hospital registrars, funeral establishment staff, and local issuers to build awareness of the importance of protecting the birth and death certificates that get issued. Birth certificates, in particular, are legal documents that provide a gateway to other important documents such as driver’s licenses and passports as well as benefits and services. Parents, family members and others who purchase vital record certificates should be informed and encouraged to secure the certificates to protect themselves and others.

As part of that initiative, OVR improved the reporting tools available through MR&C. Future system enhancement will involve new reporting and performance management tools for other MR&C users.

Less is More: When funeral homes search for medical certifiers

When registering a death, funeral establishment staff are required to enter the name of physician who will medically certify the cause of the death. Many physicians are entered into the MR&C System, but not all. Staff who register deaths, should search the system for a medical certifier. Using all three search fields at the same time may result in the medical certifier not appearing in the drop-down menu.

The best practice is to use one or both of the name search fields, entering only the first few characters of the last and first names to allow for spelling variations.

Searching by license number may locate the correct physician, but consider the following:

• Most physicians in the MR&C database have 5-digit Minnesota license numbers
• Some physicians may be licensed in Minnesota and another state and the license number of the other state may be in MR&C
• The physician may have an MR&C-assigned license number, for example : WI0003, ND0019 or IA0008 (he/she isn’t licensed in Minnesota)

Another best practice is to call the MR&C Help Line at 1-888-692-2733 before manually entering a medical certifier’s information. Our office will:

• Verify that the medical certifier is a physician before adding a name 
• Add the physician to MR&C to minimize problems with manually entered physician information.