Public health surveillance using death data is critical for tracking the impact of diseases such as influenza. However, utility of such systems is compromised by delayed reporting, particularly when it is paper based. In Nebraska, funeral directors are encouraged to initiate death certificates electronically by an electronic death registration system (EDRS). Although paper-based or mixed (electronic followed by paper) registration is still accepted statewide, EDRS usage has gradually increased over time. Fact of death (FOD) data that includes time and place of death, and a deceased person’s identity are usually recorded by a funeral director. Cause of death data in the medical portion are provided by physicians or medical examiners at a later date. FOD data entered into EDRS are immediately available, whereas paper-based data must first be mailed to vital records whereupon staff enter it into EDRS. Although implemented in 2006, epidemiology surveillance staff did not have realtime access to EDRS data until early 2009, when a collaboration was formed between the Office of vital records and the Office of epidemiology within the Nebraska Department of Health and Human Services. Daily electronic access by surveillance staff to death certificate data was established enabling the conductance of public health death surveillance.
Objective
This report describes use and evaluation of a near real time, novel electronic influenza mortality surveillance system developed in Nebraska.