Electronic Death Registration and Injury Mortality Surveillance

With the increasing implementation of electronic death registration systems (EDRS), real-time monitoring of injury mortality becomes possible, potentially resulting in faster dissemination of information for preventive action. Mortality surveillance pilot projects using death certificate data from EDRS and traditional systems have demonstrated the tremendous potential for near real-time monitoring of certain causes of death, such as those from influenza and severe weather. This presentation will describe the current capacity for mortality surveillance emphasizing application to injury mortality, such as deaths from drug overdose, suicide, or firearms. Currently, EDRS is implemented to some level in 38 states, in development in 6 states, and in planning stages in 5 states. States without EDRS also enter data from death certificates into electronic databases. Data are processed and coded as the certificates are received. While the potential for near real-time surveillance exists, there are many unique barriers to using EDRS for mortality surveillance for injury as compared to natural causes. Injury deaths are often investigated by medical examiners or coroners and require more time for investigation. Based on findings from the current preliminary mortality estimates, certain injury mechanisms need a longer lead time to monitor than others. For example, there may be differences in timely receipt of cause of death for different mechanisms of suicide (e.g. firearm, hanging, poisoning). EDRS shows potential for timely injury mortality surveillance; however, methods to provide reliable and valid mortality surveillance for injury causes with longer lead time and incomplete registration are being developed for the states and nation.