The federal government wants a searchable electronic database of every death in the United States
Uncle Sam keeps a record of your birth. Now he wants to keep an electronic record of your death.
Although death certificates are collected by the states and available on paper and microfilm in towns and cities across the country, no federal information repository keeps death statistics in a searchable database. The federal government wants to change that by collecting death certificates electronically for official use.
Electronic death reporting, or e-Vital, is one of 24 e-government initiatives promoted by Mark Forman, associate director of information technology and e-government at the Office of Management and Budget. But as officials are discovering, gathering the data into a comprehensive format and making it available to federal, state and local officials is a challenge.
"We want to know the fact of death anywhere it happens in the United States," said Delton Atkinson, executive director of the National Association for Public Health Statistics and Information Systems, speaking March 20 at an e-Vital statistics seminar at the FOSE trade show in Washington, D.C.
The goal is to create a timely and accurate database at the Social Security Administration that would enable officials to verify a person's death and stop benefits or provide them to survivors. The database also would prevent identity theft and fraud, and help health officials spot an epidemic or health crisis if a cluster of certificates listed the same cause of death.
"One of the issues for the statisticians and epidemiologists is the collection of data more quickly. Right now, the collection of death data is almost two years behind," said Maryann Carroll, director of government affairs for the New Jersey State Funeral Directors Association, which serves the New York metropolitan area.
SSA launched a pilot project on the electronic collection of death certificates last September in New Hampshire and Washington, D.C. The project will continue to collect data until 2003.
At the end of this year, officials will decide whether to take the project nationwide, collecting data from funeral homes, doctors, hospitals and coroners, making it possible for officials to verify a person's death online. The service would only be available to authorized personnel whose identities had been authenticated, according to SSA officials.
"What usually happens is that a funeral home prints a paper document, takes it to a doctor, who completes it, then takes it to a registrar, who certifies it — a process that takes at least 120 days before we get death information on tape," said Brian Cronin, director of the division of payment policy at SSA's Office of Program Benefits.
In many communities, the procedure is provincial at best. In one city, Cronin said, funeral officials send two people to City Hall to record a death — one to file the death certificate and a second person to drive the car around the block because there is no parking. In many communities, the only form filed is a handwritten document that may be hard to read. Nevertheless, even efforts to eliminate these problems have their pitfalls, according to Marsha Rydstrom, SSA's project manager for e-Vital, who spoke recently on interoperability and data sharing at a breakfast hosted by the Bethesda, Md., chapter of the Armed Forces Communications and Electronics Association.
"The states jealously guard their vital statistics data. They see it as an appropriate state role, and they are not used to having the feds dictate to them how to manage and collect data," Rydstrom said.
State laws on privacy and the collection of data are big hurdles to this proj.ect, as is funding. Authentication is also a major issue, Rydstrom said.
"Internal politics between different agencies within individual states" is another big problem, she said. "States need to find the courage to change the way they manage their internal processes and their public service. Many states see their birth and death records as local property, not national property."
The cost of building a project in a state would range from $500,000 to $5 million, depending on how far along a state already was in its e-government initiatives, according to SSA's Cronin.
SSA estimates that it will save $52 million a year, mostly by eliminating the thousands of checks sent out after recipients die.
"For a lot of people, the checks keep coming and they keep taking them. If you can put electronic systems in place, you can save tremendous amounts of money," Atkinson said.
How it works
1. Funeral directors file a standard death certificate online.
2. Doctors, coroners and state medical examiners sign the certificate online.
3. The certificate is filed with the state.
4. The state electronically sends the information to the Social Security Administration.
5. SSA develops a database of death certificates available to official agencies such as health departments, Department of Veterans Affairs benefits divisions or military pension offices.