If You Build It, Will They Come?

1. If You Build It, Will They Come? Kathlene A. Mueller, Manager Office of Data, Statistics and Vital Records South Dakota Department of Health

2. Overview • EDRS Project • Partnership • Project Defined • Funding • Outcomes • Lessons Learned

3. Electronic Death Registration • South Dakota implemented an Electronic Death Registration System on January 1, 2004. • South Dakota implemented a split certificate. • Funeral Director submits the Fact of Death Record electronically to the Department of Health. Record is assigned a Fact of Death Number. • The Funeral Director’s entry of the record places the record in the work queue of the assigned certifier. If the certifier is not electronic, the funeral director prints out a paper copy and delivers or sends it to the certifier • If the certifier is electronic, the certifier enters their portion of the record into the system. If they are paper, the complete the Medical Certificate and submit it directly to the Department of Health. • Upon completion of both parties, the record is assigned a state file number.

4. Electronic Death Registration • EDRS was implemented in a Phase by Phase approach. • Phase I - January 1, 2004 • 270 Funeral Directors/Clerks (representing 83 of the 104 funeral homes • 62 Coroners and Deputy Coroners (representing approximately 25 counties) • 1 Physician • Phase II – May 1, 2004 • 320 Funeral Directors and Clerks • 95 County Coroners or Deputy Coroners • 1 Physician • Phase III –July 1, 2004 • Began Physician Program

5. Partnership • Physician’s have long been recognized as a challenge for system implementation and usage. • Needed an innovative way to target the physician group to get them to use the system. • Lacked the expertise and time to work with the physician group. • Needed to find assistance.

6. Partnership • Sought assistance the EVRSS Workgroup Member who was represent the South Dakota State Medical Association (SDSMA). • After developing the project concept, they recommended the University of South Dakota Office of Continuing Medical Education (OCME) • Three way partnership between the Department of Health, the OCME and SDSMA was developed. • Contract signed Spring of 2004.

7. Project Defined • Objective of Project was two fold. • Train Physicians to complete the Cause of Death appropriately. • Training on completing a death certificate is poor or non existent • Train Physicians to use the EDRS.

8. Project Defined • Contract includes • Marketing • Online Tutorial – Worth One CME • http://www.sdevrss.org Password = DSF463 • Educational Sessions – Worth One CME • Grand Rounds • Staffing • Staff to conduct Physician Buy-in, training and follow-up. • Speaker – Dr. Randall, Minnehaha County Coroner

9. Funding • The Funding for the contract came from • SSA - $84,000 • Bioterrorism dollars $16,000 • Total $100,000 • Amendment to contract • Fee Fund $ 20,000 • Looking at Renewing Contract

10. Current Usage of System • Current usage • 295 Funeral Directors/clerks (representing all but 2 SD Funeral Homes. • 49 Physicians/Clerks • 124 Coroners – Representing 50 of the 64 county coroners offices. • Records signed Electronically. • 98% of Fact of Death Records • 19% of Medical Certificates

11. Will they come? – The lessons learned • Yes – There is not a week that goes by where physicians do not inquire about using the system. We have not gone door to door looking for users. • Why – We are riding the electronic medical records wave. As the number of clinics and hospitals investing in electronic medical records increases, so will the usage of EDR.

12. Steps to Success • Find your advocates – • Dr. Randall • Dr. Allison • Develop your relationships with facilities and organizations. Medical Association, big hospitals, big clinics. • Develop your relationship with physicians – Split Certificate. • User your funeral directors as advocates. • Talk, Talk, Talk