Page 30 - Driving Public Health in the Fast Lane

In another example, when Hurricane Sandy caused record-breaking storm surge on
the coast of New Jersey and New York City, the infrastructure of EDRS was successfully
leveraged to collect near real-time mortality data despite major disruptions to power
and displacement of public health staff. The existing EDRS structure allowed for
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the flexibility to rapidly reconfigure the collected information so it would capture
immediate information on hurricane-related deaths that otherwise would not have
been possible through a paper-based system. In any natural disaster, preparedness
and continuity of operations are critical to ensure the continued and uninterrupted
collection of vital statistics.

EDRS also have advantages over paper-based systems in that vital record registrars are
able to take laptops out into the field, input information into the system, and issue the
necessary certificates in the matter of minutes instead of days. Close to the source of
information collection, electronic systems also increase accuracy in data collection and
provide real-time information on death tolls.

With federal support, 49 of the 57 vital statistic jurisdictions have implemented
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EDRS, as of December 2018. However, these funding initiatives have been mostly
focused to enhance death data quality and timeliness for statistical and administrative
uses of death data—not surveillance and more immediate or real-time decision making
at the federal, state, territorial, local, and tribal level. A fully functional vital records
infrastructure that supports real-time surveillance and is interoperable with other
surveillance systems requires concerted investment and attention to upgrade legacy
systems that have been in place for almost two decades and to keep pace with the rapid
evolution of technology.

Paper-based death registration quickly hit

the limits of its utility when funeral homes

could not reach the deceased because

parts of the island were physically

unreachable and isolated due to flooding.

18 Howland RE, Li W, Madsen AM, et al. Evaluating the Use of an Electronic Death Registration System for Mortality Surveillance During and After Hurricane
Sandy: New York City, 2012. Am J Public Health. 2015;105(11):e55–e62. doi:10.2105/AJPH.2015.302784
19 Information Systems for Vital Records Stewardship. naphsis.org. https://www.naphsis.org/systems. Published 2014. Accessed May 11, 2019.

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