WELCOME TO TENNESSEE VITAL RECORDS Quality Mortality Data

1. WELCOME TO TENNESSEE VITAL RECORDS Quality Mortality Data

2. DEATH CERTIFICATE FAMILY ARCHIVE MEDICAL STATISTICS ·Diseases Kill Our Citizens ·$ To Treat and Prevent

3. GOOD MEDICAL STATISTICS Program: Gets Good Data In ·Education – IYF ·Query Program – Paula Taylor --Rebecca Groves

4. NCHS Manual

5. NCHS Manual – Categorizes Bad Data Good Data: Small Cell Cancer of the Lung Diabetes Gun Shot Wound to the Head Bad Data:Six Levels: E X A M P L E S Level 1.1.b. Site of Cancer a - g1.c. Symptom (gangrene) 1.d. Improbable Sequencea. HIV b.Pneumonia Level 3.MoreLiver Disease – Alcohol? Hep C?

6. NCHS Manual – Write to the Certifier Problem: Translate for Clerks

7. CERTIFICATESAYSWEMUSTKNOWSOWRITE Anemia An Underlying Cause U L Cardiac Arrest An Underlying Cause U L Cancer Where It Started P S AmputationSurgery?WhyD C Dementia Need Special Information M S ParalysisUnderlyingCauseandWhyU E Pending Create a Delayed Form M S Trauma More Details About It E C

8. CERTIFICATESAYSWEMUSTKNOWSOWRITE AnemiaAnUnderlyingCauseU L Cardiac Arrest An Underlying Cause U L Cancer Where It Started P S Amputation Surgery? Why D C Dementia Need Special Information M S Paralysis Underlying Cause and Why U E Pending Create a Delayed Form M S Trauma More Details About It E C

9. Chuck this is a death certificate “anemia”

10. U L Letter STATE OF TENNESSEE DEPARTMENT OF HEALTH Office of Vital Records 421 5th Avenue North, 1st Floor Central Services Building Nashville TN 37247 January 10, 2004 John Smith M.D. Re: Death Certificate 123 Fourth Street Mary Carter Mary Carter Nashville, TN 37206 DOD Jan-1-2004 Dear Doctor Smith: We love you but you blew it! (Paraphrased). Please provide the Underlying Cause of Death:________________________________ __________________________________________________________ (signature) John Smith M.D Date Signed

11. CERTIFICATESAYSWEMUSTKNOWSOWRITE Anemia An Underlying Cause U L Cardiac Arrest An Underlying Cause U L Cancer Where It Started P S Amputation Surgery? Why D C Dementia Need Special Information M S Paralysis Underlying Cause and Why U E Pending Create a Delayed Form M S Trauma MoreDetailsAboutItE C

13. E C Letter STATE OF TENNESSEE DEPARTMENT OF HEALTH Office of Vital Records 421 5th Avenue North, 1st Floor Central Services Building Nashville TN 37247 January 10, 2004 John Jones M.D. Re: Death Certificate 123 Fourth Street Mary Carter DOD Jan 1, 2004 Nashville, TN 37206 Dear Medical Examiner Jones: In order to classify this death more accurately, please provide information about the injury: Date of Injury_______________ Place of Injury ________________ Location (Address)____________________ Was Injury at Work?___ Describe How the Injury Occurred____________________________ (signature) John Jones M.D Medical Examiner Date Signed

14. AdditionalDetails Highway Safety Reports • Seat Belt • Type of Road • Driver or passenger

15. CERTIFICATESAYSWEMUSTKNOWSOWRITE Anemia An Underlying Cause U L Cardiac Arrest An Underlying Cause U L CancerWhereItStartedP S Amputation Surgery? Why D C Dementia Need Special Information M S Paralysis Underlying Cause and Why U E Pending Create a Delayed Form M S Trauma More Details About It E C

17. P S Letter STATE OF TENNESSEE DEPARTMET OF HEALTH Office of Vital Records 421 5th Avenue North, 1st Floor Central Services Building Nashville TN 37247 January 10, 2004 John Smith M.D. Re: Death Certificate 123 Fourth Street Mary Carter DOD Jan-1-2004 Nashville, TN 37206 Dear Doctor Smith: In order to determine the cause the death, please specify the Primary Site of the Cancer :____________________________ (signature) John Smith M.D Date Signed ________________ ___________

18. 2003 Death Certificates Updated: 4851 Improved: 8% Silver Lining: Education

19. Tennessee Vital Records Quality Data e.g. Heart Disease 31%----Cancer---22%---Viral Hepatitis ½% OurStateTaxesOurFederalTaxes TN Health Depart CDC Recommends to Recommends to Congress Legislature Health Prevention Programs Disease Treatment Programs