the national vital statistics system “moving forward……….” delton atkinson, mph, mph, pmp...

The National Vital Statistics System

“Moving Forward……….”

Delton Atkinson, MPH, MPH, PMPDivision Director

Centers for Disease Control and Prevention (CDC)National Center for Health Statistics (NCHS)

Division of Vital Statistics (DVS)

NAPHSIS ConferenceJune 11, 2014

Change Is…..

I

“…..the law of life,

and those who look only to the past or

the present,

are certain to miss the future. “

(John F. Kennedy)

Presentation Agenda

Changes in the staff

Where have we been?

Where are we going?

Challenges and Opportunities

Changes in Leadership

Associate Director for Science


Associate Director for Science

Hanyu Ni, Ph.D.


Chief of the Reproductive Statistics Branch


Chief of the Reproductive Statistics Branch

Amy Branum, Ph.D.


Chief of the Information Technology Branch


Chief of the Information Technology Branch

Rajesh Virkar, MS., ABD

Staff New to DVS

Mrs. Laci Banks, MS (Survey Statistician)

Mr. Matt Rowe, MBA (Supervisor , Medical

Classification and

Evaluation Team)

Internal Staffing Actions

Holly Lambert (Senior Medical Classification

Specialist)

Mia Jones (Senior Medical Technician)

Adrienne Rouse (Statistician—Medical Cause

of Death)

Recruitment Actions or Internal Changes

Vital Statistics Specialist (NC)

Medical Classification Specialist (NC)

Senior Nosologist (NC)

2 Computer Scientists (NC)

Chief, D.A.C.E. Branch (NC)

Deputy Director, Division of Vital Statistics

(Md.)

National Vital Statistics System

National Vital Statistics System

Over 6 million vital events reported annually

NVSS Performance ---Births and Fetal Deaths

Improved release of data 2012 final data released w/n 12 months of end of data

year

2013 preliminary data released w/n 5 months of end of

data year

Released 6 years of Fetal deaths (2006 – 2012) in 10

months

Implemented new reports Released “new birth” data for 2009-2012 and

accompanying report

Source of Payment of the delivery which will be useful for

ACA

NVSS Performance ---Births

180 180 180 180 180

105 90 75

426

554

435 411

334

260210

180

939

698663

579538

360300

270

0

100

200

300

400

500

600

700

800

900

1000

1100

2007 2008 2009 2010 2011 2012 2013* 2014*

Da

ys A

fte

r E

nd

of

Da

ta Y

ea

r

Data Year (*Estimated Closing/Report)

Birth File

VSCP Contract Due Date NCHS File Closing

NCHS Final Report Publication

NVSS Performance ---Deaths


180 180 180 180 180 165 150 135

660

788

614

462

349

540

330270

860

1057

719

848

930

630

418360

0

100

200

300

400

500

600

700

800

900

1000

1100

2007 2008 2009 2010 2011* 2012* 2013* 2014*

Da

ys A

fte

r E

nd

of

Da

ta Y

ea

r

Data Year (*Estimated Closing/Report)

Death File

VSCP Contract Due Date NCHS File Closing

NCHS Final Report Publication

Issues Affecting 2011 Medical Data

Category of Issues

• DVS IT System Issues

• Internal business processes and practices

• State file issues

State Issues Affecting 2011 Medical Data

• Duplicate file names

• Duplicate records within a file

• Incorrectly numbered records where age-gender mismatches

occurred

• Records with incorrect data year

• Transmissions submitted out-of-sequence

Federal Issues with 2011 Medical Data

ACME Editor Bug--injury literal invisible to coderBug in Transax Table Creation Program

File Tracker file repository did not support files with duplicate filenames. Franken-records

ICD Codes not synchronized between applications Incorrect auto-coding where records were coded to generic codes by default Lack of quality control Manner of death and other data not being persisted through the MMDS application

MMDS could not code certain literals to ERN; however it was not rejecting them Redactor bug caused missing data due to truncation Miscoding of 2011 records using MMDS applications meant only for 2009 or 2010 State/internal updates/corrections sometimes blocked by the activation log WebMMDS/Micar200 bug -- blank line mishandled


Proportion of Mortality Records Received Within 10 days of the Date of the Event in 2013 and in First Quarter of 2014

Percent of Records received Jurisdictions in Jurisdictions in w/n 10 days of date of event CY 2013 1st QTR. 2014

80% or more 2 2

60 to 79 0 2

30 to 59 9 13

5 to 29 19 18

0.1 to 4 9 4

None 18 18

U.S. Average (%) 17.69% 27.92%

Publishing 2011, 2012, and 2013 death data in 2014

Building a State-based network of EDRS Funding of states this summer to enhance timeliness Possible PCOR for more substantial enhancements;

• 12 states using FY14 funds and 10 states using FY15 funds Monitor/evaluate the 7 states already funded. Lessons

learned? Building our EDRS partner network

Designing and implementing VIEWS II System Plan/develop/pilot new system in 2014/2015 Can rare cause verifications be done with VIEWS II? Can VIEWS II improve the quality of submitted COD

information? Retooling our Automated Coding System

Evaluation of IRIS. Possible pilot in 2015. Implement in 2016?

Re-engineering of the MMDS? Is this feasible?

Priorities for 2014, 2015 and 2016

Planning the next generation collection/analysis tools Electronic reporting of deaths (HHS Entrepreneurs

Award) Electronic reporting of fetals Data visualization and surveillance tools

Enhancing the National Death Index Implementing NDI Early Release Addition of military records. Maybe State department? Linking NDI with state records for fraud purposes?

Enhancing Medical Quality Assurance Implementing statistical reviews on current flow basis Feasibility of joint federal/state quality control reviews? Implementing system and manual quality reviews Nosological training and training of state staffs?

Priorities for 2014, 2015 and 2016 (cont.)

Using electronic health records Finalizing national birth and death standards and

implementing nationally Piloting HL-7 EHR and EDRS systems (Possible funding in

Fall 2014) Piloting/implementing HL-7 electronic health records and

electronic birth systems Expanding Mortality Surveillance

Pneumonia and influenza surveillance. Collaboration w/ Influenza

Rare Vaccine Preventable. Collaboration with NCIRD RSV. Collaboration with NCIRD Drug-related mortality. Collaboration w/ FDA Suicide. Collaboration with NIMH Others?


Improving vital statistics data and its utility E-Learning for medical/health data for births Completion/analysis of data quality studies Revising birth and fetal death data elements Expanded statistical/research studies, incl. Federal/state

studies Mortality Indicators Project (CDC Award)

Improving the VSCP Program Achieving the VSCP timeliness and quality standards Increasing state awareness & education about the

contract Negotiating the 2017-2021 VSCP contract; Enhancing

contract IQ. Rethinking “joint-ness” in the Joint NAPHSIS/NCHS

Annual Meeting Marketing vital statistics.

Developing a strategic plan for the Division


Embracing timelines and quality ---- why

can’t we?

Building “lean” vital records/statistics

agencies---local, state & Federal

Developing an informatics-savvy workforce

Effectively marketing our worth to others

Establishing/Coalescing in new and non-

traditional partnerships

Embracing “controlled” innovation

Challenges/Opportunities for “Greatness”

“I will go anywhere---------provided that it is

forward!”

• Thank You!

the national vital statistics system “moving forward……….” delton atkinson, mph, mph, pmp...

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