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The National Vital Statistics System “Moving Forward……….”

The National Vital Statistics System “Moving Forward……….”. Delton Atkinson, MPH, MPH, PMP Division Director Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS) Division of Vital Statistics (DVS) NAPHSIS Conference June 11, 2014 . Change Is….. .

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The National Vital Statistics System “Moving Forward……….”

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  1. The National Vital Statistics System“Moving Forward……….” Delton Atkinson, MPH, MPH, PMP Division Director Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS) Division of Vital Statistics (DVS) NAPHSIS Conference June 11, 2014

  2. 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)

  3. Presentation Agenda • Changes in the staff • Where have we been? • Where are we going? • Challenges and Opportunities

  4. Changes in Leadership • Associate Director for Science

  5. Changes in Leadership • Associate Director for Science Hanyu Ni, Ph.D.

  6. Changes in Leadership • Chief of the Reproductive Statistics Branch

  7. Changes in Leadership • Chief of the Reproductive Statistics Branch Amy Branum, Ph.D.

  8. Changes in Leadership • Chief of the Information Technology Branch

  9. Changes in Leadership • Chief of the Information Technology Branch Rajesh Virkar, MS., ABD

  10. Staff New to DVS • Mrs. Laci Banks, MS (Survey Statistician) • Mr. Matt Rowe, MBA (Supervisor , Medical Classification and Evaluation Team)

  11. Internal Staffing Actions • Holly Lambert (Senior Medical Classification Specialist) • Mia Jones (Senior Medical Technician) • Adrienne Rouse (Statistician—Medical Cause of Death)

  12. 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.)

  13. National Vital Statistics System Over 6 million vital events reported annually National Vital Statistics System

  14. 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

  15. NVSS Performance ---Births

  16. NVSS Performance ---Deaths

  17. NVSS Performance ---Deaths

  18. Issues Affecting 2011 Medical Data

  19. Category of Issues • DVS IT System Issues • Internal business processes and practices • State file issues

  20. 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

  21. 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

  22. NVSS Performance ---Deaths

  23. Priorities for 2014, 2015 and 2016 • 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?

  24. Priorities for 2014, 2015 and 2016 (cont.) • 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?

  25. 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?

  26. Priorities for 2014, 2015 and 2016 (cont.) • 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

  27. Challenges/Opportunities for “Greatness” • 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

  28. “I will go anywhere---------provided that it is forward!” • Thank You!

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