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Tribal Health 101 State Perspective

Tribal Health 101 State Perspective . Formally organized in 1933 to represent the State Registrars in all 57 vital records jurisdictions (50 states, 5 territories, DC, NYC)

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Tribal Health 101 State Perspective

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  1. Tribal Health 101 State Perspective

  2. Formally organized in 1933 to represent the State Registrars in all 57 vital records jurisdictions (50 states, 5 territories, DC, NYC) Name changed in 1958 to include support of public health statistics functions in addition to vital records/civil registration In 1996 became the National Association for Public Health Statistics and Information Systems NAPHSIS History

  3. Vision: An accurate, timely, and secure record of all vital events in the nation Our Mission: NAPHSIS provides national leadership for both vital records and related information systems in order to establish and protect individual identity and improve population health. NAPHSISNational Association for Public Health Statistics and Information Systems

  4. 9 member Board of Directors - 2 year terms 7.5 FTE staff + consultants Organization

  5. Annual Meeting Program Awards By-Laws Communications Corporate Members Data Quality eHealth EVVE Fact of Death Good-to-Great Committees/Work groups • Inter-Jurisdictional Exchange • Mass Fatality • Membership • Nominating • Registration • Security • Social Security Admin. • Statistics

  6. Provide National Advocacy for Member Jurisdictions Develop and Deliver Quality Products and Services Expand and Strengthen NAPHSIS Identity and Visibility Expand & Strengthen Member Involvement & Strategic Partnerships Central Challenge Strengthen NAPHSISOrganizational Effectiveness Grow and Diversify Financial Resources Strategic Priorities Strategic Map 2013-2016 Establish NAPHSIS as the proactive leader for developing, protecting, and using Vital Records and Statistics Systems Cross-Cutting

  7. Electronic Verification of Vital Events (EVVE) State and Territorial Exchange of Vital Events (STEVE) Comprehensive Vital Statistics Standards Security Guidelines Vital Statistics Improvement Cause of Death eLearning Module for Physicians Proposed Vital Statistics Model Law Revisions Definition of “Government agency” means a unit of local, state, federal, or tribal government Key Projects

  8. TOTAL – BIRTHS (57) Open 8 Closed 44 Closed w / limited access (old records) 1 Unknown 4 TOTAL – DEATHS (57) Open 13 Closed 30  Closed w / limited access (old records) 10 Unknown 4 State Diversity

  9. 1990-2001 Oklahoma Death Certificate Linkage to IHS database Findings Before Recode: 19,257 [4.2% of total deaths] After Recode: 28,491 [6.2% of total deaths] Change: Increase of 48.0% Higher frequency among older populations Highest percent increase among younger pop’l [5-14 (89%) and 15-24 (66%)] Almost 50% increase in the number of disparities among rankable causes of death Results Quantified the problem OK2SHARE integration of linked data in death and cancer modules Inclusion of linked data in reports Continued linkages, thanks to Melissa Jim, NDI… Education for other PH programs and PH partners Example

  10. Oklahoma Age Adjusted Mortality Rates

  11. Oklahoma Age Adjusted Mortality Rates

  12. Choctaw Nation Health Services Death Linkage Project What is their patient population dying from Resource Patient Management System (RPMS) data limited Cause of Death field missing many times Indian Health Service linked data sometimes not readily available to tribal health organizations. Still often hard to identify the major causes of mortality at the Service Unit Level Example

  13. Benefits • The information can be used to improve data quality and reveal real mortality data at the service unit level. • The project has high potential to help the Choctaw Nation determine the actual causes of death among those served by the Choctaw Nation Health Services. • This data will assist health planners in developing future direction for the CNHSA. • The development of a trust relationship on health data sharing • Ultimately work at sharing hospital / health services data with the OSDH to improve the state-wide health information data.

  14. Opportunities • Create/join NAPHSIS workgroups / user groups • State/Jurisdictional and National level • Investigation of disparities • Develop of best practices or templates • Bring understanding regarding cultural considerations • Bring understanding around complexities of the various health (or political) systems • Assist with educating facilities and partners on the importance & use of vital records • Data quality • Timeliness

  15. Considerations • Encourage ongoing support for NDI IHS linkage • NDI data linkage sharing part of IJE agreement? • EVVE?

  16. Open door to exchange other data (Discharge) Health system linkage to other public health data systems Increased capacity for additional linkages Networking Joint effort to modify state legislation to allow data sharing Other Possibilities

  17. Questions

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