Division of Vital Records Administration

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New Hampshire Department of State

• Division of Vital Records Administration
• http//www.sos.nh.gov/vitalrecords

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New Hampshires Use of Literal Causes of Death

• VSCP Project Directors Annual Meeting 2008
• May 14th, 2008

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New Hampshire Numbers

• Population of 1.3 million
• Total Annual Deaths 10,000
• Number of Funeral Directors 231
• Annually, approximately 1,100 certifiers (changes
  year to year)
• ARNPs can pronounce and certify death
• Since 01/01/2008, 650 certifiers (both physician
  and ARNPs) have filed contact preference
• 234 Local Registrars
• One state central office in state capital

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New Hampshire History

• Version 1 1988-92, in-house development of
  AVRIS
• Clipper-written application
• VR users uploaded data into VR maintained BBS
• Integrated birth, death, marriage, divorce and
  fetal death data collection
• Issuance of certificates
• Fee collection
• Internally maintained

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New Hampshire History

• Version 2 1996-98, VRV2000 developed by ManTech
  International
• Phased implementation including development of
• Strategic business plan
• Business process re-design
• Information strategy plan
• Detail specifications
• Client/Server Power Builder front end Oracle DB
• Fully integrated VR data collection and issuance
• Full business backend with financial reports and
  accounting
• Automated federal file generation
• Many tailor-made reports with ability to do
  ad-hoc queries on the database side

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New Hampshire Present

• Version 3 2004, NHVRIN developed by CNSI
• Web based accessible anywhere .NET web app.
• Oracle 10g backend database
• Enhanced version control single app. means
  immediate and less expensive dissemination of
  software versions
• Full functionality as provided by VRV2000 plus
• Incorporation of OVS software for real time SSA
  verification of SSNs
• Adoption of 2003 NCHS standard certificate
  revisions for birth, death and fetal death

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New Hampshire Present

• Version 3 2004, NHVRIN developed by CNSI
• NCHS rules for all mandatory elements on the web
  forms, Cause of Death, Age Calculations etc.
• Same Look and Feel as legacy, minimizing user
  training and transition to new application
• Built in HIPAA/NAPHSIS compliant security
• Online Certification of Cause-of-Death by
  Physicians

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Benefits Weve Seen

• Improved Quality
• Reduction in queries
• Process going paperless
• Rapid TAT between date of death and completely
  filed record
• Rapid statistical file generation and ease of
  data linkages

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Benefits Weve Seen

• Rapid TAT between date of death and completely
  filed record
• 2004 2.6 days (80 completed in 3 days or less)
• 2005 2.8 days (79 completed in 3 days or less
  despite 4 records being reported gt220 days after
  event. One was reported at 871 days)
• 2006 2.7 days (79 completed in 3 days or less
  despite 3 records being reported gt300 days after
  the event)
• 2007 2.7 days (78 completed in 3 days or less)

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Benefits Weve Seen

• Rapid statistical file generation/certificate
  issuance and ease of data linkages
• Facilitates fraud prevention through linkages
• Faster birth/death linkages
• Online SSA verification
• Facilitates public health linkages
• Bioterrorism reporting for DHHS (since 2001)
• Real-time reporting of deaths of public health
  significance
• Influenza death reporting
• Facilitates web-based query systems
• NHVRINweb for data from 1995 forward
  (http//nhvrinweb.sos.nh.gov)
• Near real-time availability of death (birth,
  marriage, divorce) data

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Benefits Weve Seen

• Bioterrorism reporting for DHHS (since 2001)
• Daily BT reporting partners well with syndromic
  surveillance
• Included CDC bioterrorism agents
• Queries specific words, and groups of words
• Queries conditions
• Initial report was emailed internally to BT
  coordinator, then placed on secure website for
  daily retrieval
• Current report in Access for widespread use
• Real-time reporting of deaths of public health
  significance

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Death Surveillance Conditions
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Benefits Weve Seen

• Facilitates web-based query systems
• NHVRINweb for data from 1995 until yesterday
• http//nhvrinweb.sos.nh.gov
• Near real-time availability of death (birth,
  marriage, divorce) data
• Turned on near the end of last year
• Over 2,600 registered users
• All 50 states plus the District of Columbia
• 4 countries (Germany, France, Canada)
• Universities, researchers, news purveyors,
  municipalities, general public
• We own code and maintain it internally
• Future enhancements include using literal cause
  of death to query
• Use of IJE file format for birth and death
• Facilitates use of reporting literal causes
  without reworking database

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Questions?
William R. Bolton, Jr. william.bolton_at_sos.nh.gov 6
03-271-4505