Vital Records Birth and Fetal Death Reporting
0.1.0 - STU 1 Ballot
Vital Records Birth and Fetal Death Reporting
0.1.0 - STU 1 Ballot
This page is part of the Vital Records Birth and Fetal Death Reporting (v0.1.0: STU 1 on FHIR R4 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions 
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This implementation guide supports five use cases for communicating information from the electronic health record system to the jurisdictional Vital Records Offices and to the national statistical agency, the Centers for Disease Control and Prevention/ National Center for Health Statistics (CDC/NCHS):
This implementation guide also supports two uses cases for returning information from the national statistical agency to the jurisdictional Vital Records Office:
These information flows are illustrated in the Birth and Fetal Death Reporting Process figure:
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Information flows are supported by the FHIR Composition resources indicated in the following table:
| Use Case | FHIR Composition | Data Source | Data Receiver |
|---|---|---|---|
| Provider Live Birth | Composition - Provider Live Birth Report | EHR | Jurisdictional Vital RecordsOffice |
| Provider Facility Live Birth | Composition - Provider Facility Live Birth Report | EHR | Jurisdictional Vital Records Office |
| Provider Mother’s Live Birth | Composition - Provider Mother’s Live Birth Report | EHR | Jurisdictional Vital Records Office |
| Provider Fetal Death | Composition - Provider Fetal Death Report | EHR | Jurisdictional Vital Records Office |
| Provider Facility Fetal Death | Composition - Provider Facility Fetal Death Report | EHR | Jurisdictional Vital Records Office |
| Provider Mother’s Fetal Death | Composition - Provider Mother’s Fetal Death Report | EHR | Jurisdictional Vital Records Office |
| Jurisdiction Live Birth | Composition - Jurisdiction Live Birth Report | Jurisdictional Vital Records Office | National Statistical Agency |
| Jurisdiction Fetal Death | Composition - Jurisdiction Fetal Death Report | Jurisdictional Vital Records Office | National Statistical Agency |
| Void Live Birth Certificate | Composition - Void Live Birth Certificate | Jurisdictional Vital RecordsOffice | National Statistical Agency |
| Void Fetal Death Report | Composition - Void Fetal Death Report | Jurisdictional Vital Records Office | National Statistical Agency |
| Coded Race and Ethnicity | Composition - Coded Race and Ethnicity | National Statistical Agency | Jurisdictional Vital Records Office |
| Coded Cause of Fetal Death | Composition - Coded Cause of Fetal Death | National Statistical Agency | Jurisdictional Vital Records Office |
This use case represents live birth information that is recorded and communicated to the jurisdicational Vital Records Office.
For the most part, labor and delivery takes place at a healthcare provider site. When a baby is delivered at home, or on the way to the hospital, the mother and baby are typically taken to the hospital for evaluation and possible treatment. Personal and pregnancy information is collected from the mother or an informant, while information regarding labor and delivery and the condition of the newborn is collected from the responsible party at the healthcare facility. The information from these two sources may be communicated to the jurisdiction vital records office at the same time (using the Composition - Provider Live Birth Report) or separately (using the Composition-provider-mothers-live-birth-report and Composition-provider-facility-live-birth-report).
The data requirements for provider supplied live birth information are based on the Edit Specifications for the 2003 Revision of the U.S. Standard Certificate of Birth, the 2016 US Standard Facility Worksheet for the Live Birth Certificate, the 2016 US Standard Attachment to the Facility Worksheet for the Live Birth Certificate for Multiple Births, and the 2016 US Standard Mothers Worksheet for Child’s Birth Certificate. The jurisdiction may have additional data requirements and edit specifications that will be addressed at the jurisdictional level.
The Provider Live Birth use case is represented by the Composition - Provider Live Birth Report.
This use case represents information for labor and delivery and the condition of the newborn collected by healthcare provider staff, as primarily defined using the Facility Worksheet, that is managed independently for communication to the jurisdictional Vital Records Office.
The Provider Facility Live Birth use case is represented by the Composition - Provider Facility Live Birth Report.
This use case represents information collected from the mother, as primarily defined using the Mother’s Worksheet, which is managed independently for communication to the jurisdictional Vital Records Office.
The data requirements for live birth mother’s information are based on the Mother’s Worksheet for Child’s Birth Certificate. The jurisdiction may have additional data requirements and edit specifications that will be addressed at the jurisdictional level.
The Provider Mother’s Live Birth use case is represented by the Composition - Provider Mother’s Live Birth Report.
This use case represents information about a live birth and the issuance of a Birth Certificate to be recorded and communicated to NCHS.
The data requirements for jurisdictional reporting of live births are based on the Birth Edit Specifications for the 2003 Proposed Revision of the U.S. Standard Certificate of Birth.
The Jurisdication Live Birth use case is represented by the Composition - Jurisdication Live Birth Report.
The Provider Fetal Death use case is represented by the Composition - Provider Fetal Death Report.
The Provider Facilty Fetal Death use case is represented by the Composition - Provider Facility Fetal Death Report.
This use case represents information collected from the mother, as primarily defined using the Patient’s Worksheet, and managed independently for communication to the jurisdictional Vital Records Office.
The data requirements for fetal death mother’s information are based on the 2004 US Standard Patient’s Worksheet for the Report of Fetal Death. The jurisdiction may have additional data requirements and edit specifications that will be addressed at the jurisdictional level.
The Provider Mother’s Fetal Death use case is represented by the Composition - Provider Mother’s Fetal Death Report.
This use case represents information of a fetal death and the creation of a jurisdictional file to be recorded and communicated to NCHS.
The data requirements for jurisdictional reporting of fetal deaths are based on the Fetal Death Edit Specifications for the 2003 Revision of the U.S. Standard Report of Fetal Death.
The Jurisdiction Fetal Death use case is represented by the Composition - Jurisdiction Fetal Death Report.
This use case represents the communication of void live birth certificates from appropriate jurisdictional vital statistics agencies to the national statistical agency. In many jurisdictions, birth certificate identifiers are directly linked to the printed certificate. As a result, in some cases it becomes relevant to indicate that a particular certificate number is not to be used, that the certificate is to be “voided”.
The Void Live Birth Certificate use case is represented by the Composition - Void Live Birth Certificate.
This use case represents the communication of void fetal death certificates from appropriate jurisdictional vital statistics agencies to the NCHS. In many jurisdictions, fetal death report identifiers are directly linked to the printed certificate. As a result, in some cases it becomes relevant to indicate that a particular certificate number is not to be used, that the certificate is to be “voided”.
The Void Fetal Death Report use case is represented by the Composition - Void Fetal Death Report.
This use case represents the communication of coded race and ethnicity information to the appropriate jurisdictional Vital Records Office. It contains data that are a coded form of the race and ethnicity data that has been submitted to the NCHS. Two sets of codes will be used to address two objectives. These objectives are:
In addition, when the coding process has led to duplication of data, the duplicates will be eliminated.
Coded race and ethnicity data is communicated for both the mother and father in the case of live birth and only for the mother in the case of fetal death.
The Coded Race and Ethnicity use case is represented by the Composition - Coded Race and Ethnicity.
This use case represents the communication of coded cause of fetal death information to appropriate jurisdictional Vital Records Offices. Cause of death on a fetal death report comes from the provider as choices from a defined list of possible causes along with free text entries that further specify those choices. The information is transformed into one or more ICD 10 codes at NCHS, and returned using this Composition.
The Coded Cause of Fetal Death use case is represented by the Composition - Coded Cause of Fetal Death.
IG © 2020+ HL7 International - Public Health Work Group. Package hl7.fhir.us.bfdr#0.1.0 based on FHIR 4.0.1. Generated 2020-12-16
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