A smartphone app that lets medical examiners upload their autopsy findings is the latest move by New Hampshire to speed up sharing of medical information in hopes of more quickly spotting patterns of disease or other health issues.
The National Electronic Certification of Death or NeCOD – available for both Apple and Android systems although only verified accounts can it – is being used via tablets in the office of the Chief Medical Examiner and the 30 assistant deputy medical examiners who investigate deaths that are violent, untimely or of unknown cause. Physicians can certify cause of death in more obvious cases.
“Although we cut our teeth in medical examiners office because of the diversity and complexity of issues they face, we are rolling out this technology to all the certifying family physicians this year, through a series of in-house training opportunties,” said Stephen Wurtz, state registrar and director of the division of vital records. “Ultimately we’re going away from paper, and this is one of the first steps.”
New Hampshire has been one of the leading states in a push for electronic vital records. Wurtz said his office and counterparts from Utah and Washington, D.C., will demonstrating programs at the National Center for Health Statistics annual meeting in June as part of efforts to create national standards for such programs – and, Wurtz added, increase the state’s chances for more federal funding to develop programs.
New Hampshire will be presenting material this week at the Centers for Disease Control’s Medical Examiners Implementers Workgroup. In particular, Wurtz said, New Hampshire’s application programing interfaces (APIs), which can promote interoperability among systems, are of interest in the field.
“The driving force behind this is the opiate crisis,” said Wurtz The surge in deaths related to drugs brought home the need to have better surveillance methods for public health.
The app not only makes it easier and faster for health officials to see the cause of death in a case, to see if it correlates with other cases, it also provides an opportunity for more information to eventually be shared about the many factors that can lead to the end of a life.
“Right now you go into the doctor and he takes all sorts of notes and your file is maybe two inches thick, but when it comes to the death record, all the doctor can think of is one line,” said Wurtz. “This can give doctors the ability to mine their own records and report back the incidents, life events, that may have led up to the cause of death.”
“We know the immediate cause – it’s the other conditions that have led up to the death that we lack. I may drop dead because of a heart attack, but that doesn’t mean I didn’t have diabetes and everything else, that led up to the immediate cause,” he said. “This can improve the timeliness of reporting and the quality of reporting.”
Digitizing the process through apps will make it easier for death certificates and other medical data to be shared between states, since health problems don’t stop at the border.
“From the CDC standpoint, they’re excited about being able to get their hands on this data … to mine down to what really is happening in the field,” Wurtz said.