New York State REVISED CERTIFICATE OF LIVE BIRTH

New York State REVISED CERTIFICATE OF LIVE BIRTH Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

PRESENTERS Peter Carucci Vital Records, NYS DOH Terry Sowinski Bureau of Biometrics, NYS DOH Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

NYS BIRTH REGISTRATION SYSTEM w 131, 000 Births Registered Each Year w 110 Birthing Hospitals w 90 Registration Districts Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

REENGINEERING NYS BIRTH REGISTRATION SYSTEM w w Started In Late 1990’s Part Of Statewide Perinatal Data System (SPDS) – – Web Based Birth Registration Is The Core Of The SPDS Was Mandated By NYS Commissioner Of Health Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

SPDS OBJECTIVES INCLUDE w Vital Records Registration w Perinatal Regionalization w Public Health Surveillance & Reporting w Hospital Quality Improvement (QI) w Medicaid Infant Enrollment w Immunization Registry Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

TO REENGINEER, OR NOT? w PC Based Software For A Decade – Data Is Not Timely – Technology Not Current • Dot Matrix Printers • File Downloads Of Encrypted Data Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

TO REENGINEER, OR NOT? w NCHS – Implementation Date For The New U. S. Standard Certificate • January 1, 2003 • Possibly Allow States To Implement As Late As 2004 or 2005 Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

DECISION TIME! DO WE DESIGN THE WEB SYSTEM AROUND THE OLD U. S. STANDARD REVISION? Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

PROS: w Less Design w Less Testing CONS: w Will Have To Revise As Soon As Web System Is Completed w Hospitals Would Have 2 Major Changes – – Switch From PC To Web System Adapt To New U. S. Standard Items Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

CONSIDERATIONS w Would State Have Fiscal Resources For 2 nd Major Revision? – Unlikely And Funding Uncertain w Delay Implementation For One Year? – Hospitals And Registrars Would Face Only One Major Change w Can Current Staff Accomplish Reengineering And U. S. Standard Revision? Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

AND THE ANSWER IS… w Planned To Implement Web Birth Certificate On January 1, 2003 w Decision Made To Reengineer And Revise To Comply With New U. S. Standard Certificate – January 1, 2003 Implementation Date Is Unrealistic – Mid-Year Implementation Considered – January 1, 2004 Feasible Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

FORGING AHEAD

Compare Current NYS Data Dictionary To Vital Statistics Birth Edit Specs Item By Item Review w Determine If NCHS Proposed Changes Will Meet Needs Of NYS DOH – Internal DOH Program Areas w Determine If NYS Law Requires Certain Items Be Collected Or Not Be Collected – NYS Law Prohibits Asking About the Marital Status Of The Parents – NYS Law Mandates Serological Testing And Date Questions Be Asked Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

STILL FORGING AHEAD w Determine What Items We Want To Accept Completely or Modify – Apgar Scores 1 -5 -10 Minute • Left 1 Minute Score • Added 10 Minute Score – Eliminate Special Interest Items • Another Tool Should Be Used – Removed Poorly Reported Items Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

REVISIONS w NYS Accepted U. S. Standard Revisions Completely For: – Race – Ethnicity – Education – Smoking Questions – Breast Feeding – Date Of Last Prenatal Visit Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

REVISION EXAMPLES Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

REVISION EXAMPLES - EDUCATION w Change From Number Of Years Of Education To Specific Levels And Degrees – Changes Are Driven By: • Decreased Importance Of Exact Measure Of Elementary Years • Increased Importance Of Post-secondary Education Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

w Selections Available In Drop-down List: – 8 th Grade Or Less – 9 -12 th Grade: No Diploma – High School Grad Or GED – Some College Credit, But No Degree – Associate Degree – Bachelor’s Degree – Master’s Degree – Doctorate Degree – Unknown Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

REVISION EXAMPLES - OTHER Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

WORK BOOKLETS Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

Completely Revised w Includes NCHS Changes w Includes QI Questions w Matches Screen Flow w Collect Information From Best Source – Mother And Medical Staff w Available In English And Spanish Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

WORK BOOKLETS w Hospitals Should Not Modify – Modifications Lead To Data Quality Issues w Hospitals Should Use The Workbooks Provided To Ensure The Data Collection Process Is Accurate And Consistent Statewide Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

COMMUNICATION, AND LOTS OF IT w Choose Beta Test Sites – Large, Small, Urban and Rural – Requires Double Entry – Requires Feedback From Beta Testers Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

COMMUNICATION, AND LOTS OF IT w Letters to All Birthing Hospitals – New System Will Be Put In Place • Old Certificates Will Not Be Accepted – Hardware Requirements – Minimum Computer Configuration – Software Requirements Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

COMMUNICATION, AND LOTS OF IT w Letters To Local Registrars – Newspaper Announcement No Longer Offered In SPDS • HIPAA – New System Put In Place • Old Certificates Will Not be Accepted – Sent A Supply Of New Work Books – Sent FAQ’s – Training Details Given Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

COMMUNICATION, AND LOTS OF IT w Letters To County Health Departments – Old System Will Become Obsolete – How New System Will Affect Them – Training Details Given w Meetings With DOH Data Users – Explain And Help Prepare Them For Changes Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

TRAINING SESSIONS FOR HOSPITALS AND LOCAL REGISTRARS

Statewide Training Via Videotaped Satellite Teleconference w Approximately 20 Sites w Live Panel Discussion w Phone Calls And Faxed Questions From Audience Members Accepted w Mailed Video Tapes To All Hospitals For Training Of Future Employees Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

TRAINING SESSIONS – COUNTY DOH w Three, One Hour Live Video-Conference Training Sessions Held To Accommodate All 57 Counties Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

RECOMMENDATIONS FOR HOSPITALS TO PREPARE FOR IMPLEMENTATION w Get Up To Date With Filing Records w Review New Workbooks And Guidelines w Make Arrangements To Ensure New Data Items Will Be Available For Entry Into New System Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

USER HELP w Hyperlink For Each Item Leads To Expanded Text w On Screen Documentation w Help Desk To Support Hospitals With A Variety of SPDS Related Problems Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

ON-SCREEN HELP Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

USER DOCUMENTATION w Available Online In PDF Format – Hospital Instruction Manual – County Instruction Manual – FAQ’s – Medical Guidelines And Glossary – Work Books, English And Spanish – Contact Listing Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

Support Desk w Toll Free Number w Support Desk E-mail Address w Two Person, Full Time For First Three Months w One Person, Half Time For Next Nine Months w Plus Additional Help After Major Revision Is Released w Tracking System For Every Call – From Initiation To Resolution Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

RECOMMENDATIONS TO OTHER STATES w If Possible, Implement U. S. Standard Certificate Changes Prior To Developing Web Based System – Consider: • Time • Money • Human Resources - With the Right Skill Sets Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004

MISSED OPPORTUNITIES (MISTAKES MADE) w Develop ‘Demo’ System That Hospitals Can Practice On Prior To Going Live. w Adequate Staff with Right Skill Sets – Or YOU Will Become The Expert! w Elaborate Testing Plan Strengthening Partnerships: Shaping the Future Portland, OR June 6 th – 10 th, 2004