AUTOMATIC CODING SYSTEMS FOR MORTALITY DATA Prague, Czech Republic, June 3 – 5 2004

1. AUTOMATIC CODING SYSTEMS FOR MORTALITY DATAPrague, Czech Republic, June 3 – 5 2004

2. Electronic registration in Great Britain: Scottish perspective Graham Jackson General Register Office for Scotland

3. Civil registration in Scotland • Compulsory civil registration started in 1855 following the setting up of the General Register Office for Scotland (GROS) by Act of Parliament in 1854 • Responsibility for administering civil registration is divided between the head of GROS (the Registrar General) and the local councils

4. Civil registration in Scotland ctd. • The Registrar General, has overall responsibilty for any legislative change, the range of information collected, and the fees collected. • The 32 councils employ some 360 registrars and provide premises and IT equipment. The local registrars deal with births, stillbirths, deaths and marriages.

5. Legislative background • The main laws relating to registration in Scotland are • Registration of Births, Deaths and Marriages (Scotland) Act 1965 • Marriages (Scotland) Act 1977 • Legislation is now the responsibility of the Scottish Parliament (which was reconvened on 1 July 1999 after 292 years).

6. The computerisation of local registration offices - COLRO • Project commenced in 1988 • Drew on experience in England and Wales but … • … was a completely separate system • An initial trial site in Edinburgh went live in 1991. • By 1996 some 85% of events were handled electronically; by 2003 this had risen to 99%.

7. Scottish Registration Software • Deals with births, deaths and marriages • Information is keyed by the Registrar • Pop-up help and prompts • The details entered can be checked on-screen by the informant

8. Technical aspects • A relatively ‘low-tech’ approach had to be adopted. • SRS was developed as a DOS system that could run on low specification PCs ( e.g. 386 with 4Mb) • Mainly written in CA-Clipper; a number of third party products for the Clipper environment were also used.

9. SRS - data transfer • Data are submitted by post on diskettes • Files are encrypted • Provision for rapid supply of a back-up file • Manual offices submit paper returns by post; these are keyed by skilled data preparation staff

10. Death registration - information collected • Forename(s), surname, sex, date of birth, marital status, occupation, usual residence, country of birth • date, time, and place of death; full cause of death text, post-mortem indicator, pregnancy indicator, • Name and address of certifying doctor and, if different, deceased’s own doctor • Details about parents and, where appropriate, spouse

11. The benefits of electronic data capture of cause of death etc. • Input to automatic coding • Output for medical enquiries • Output for research studies • Ability to carry out text searches on cause of death • specific cause e.g. hypothermia • specific drug e.g. methadone • to analyse terminology on certificates

12. Recent developments – the Forward Electronic Register (FER) • A central application - which allows simple updating of systems • Accessed with a web browser – has the look and feel of a web site • A central repository - with instantaneous data transfer • Allows electronic distribution of supporting registration material • Scheduled for full implementation during 2004

13. FER – Technical aspects • FER is a web application, written in Java. • The interface is a mixture of HTML and Java Server Pages • Pilot running has shown the need for some system upgrades at the centre

14. Future developments- electronic certification • Benefits of electronic certification would include • rapid transfer of information to registrars • guidance for physicians could be integrated with the system • automatic spell-checkers • physicians could retain an electronic copy of information supplied

15. AUTOMATIC CODING SYSTEMS FOR MORTALITY DATAPrague, Czech Republic, June 3 – 5 2004