Vital Records Death Reporting (VRDR) FHIR Implementation Guide
3.0.0 - STU3 United States of America flag

This page is part of the Vital Records Death Reporting FHIR Implementation Guide (v3.0.0: STU3) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

VRDR Forms Mapping

This page provides the mapping from standard forms and worksheets used to exchange death information to the FHIR resources as defined in this IG.

This IG supports communicating information from an EHR system to the jurisdictional vital records offices and to NCHS for standard reporting forms:

Information on updates to the death forms can be found at NVSS Revisions of the U.S. Standard Certificates and Reports

U.S. Standard Certificate of Death Mapping

Item # Form Element FHIR Profile FHIR Field
1 Decedent's Legal Name Decedent name
2 Sex Decedent extension:NVSS-SexAtDeath
3 Social Security Number Decedent identifier:SSN
4a Age DecedentAge value
4b Under 1 Year DecedentAge value
4c Under 1 Day DecedentAge value
5 Date of Birth Decedent birthDate
6 Birthplace Decedent extension:birthPlace
7a Residence-State Decedent address.state
7b County Decedent address.district
7c City or Town Decedent address.city
7d Street and Number Decedent address.line
7e Apt No Decedent address.extension:unitnumber
7f Zip Code Decedent address.postalCode
7g Inside City Limits? Decedent address.extension:withinCityLimitsIndicator
8 Ever in US Armed Forces? DecedentMilitaryService value
9 Marital Status at Time of Death Decedent maritalStatus
10 Surviving Spouse's Name DecedentSpouse name
11 Father's Name DecedentFather name
12 Mother's Name Prior to First Marriage DecedentMother name , name.use = maiden
13a Informant's Name Decedent contact.name
13b Informant's Relationship to Decedent Decedent contact.type.text
13c Informant's Mailing Address Decedent contact.type.address
14 Place of Death DeathDate component[placeOfDeath].value
15 Facility Name FuneralHome name
16 City or Town, State, and Zip Code FuneralHome address
17 County of Death DeathLocation address.district
18 Method of Disposition DecedentDispositionMethod value
19 Place of Disposition DispositionLocation name
20 Location-City, Town, and State DispositionLocation address
21 Name and Complete Address of Funeral Facility FuneralHome name, address
23 License Number FuneralHome identifier:NPI
24 Date Pronounced Dead DeathDate component[datetimePronouncedDead ].valueDateTime
25 Time Pronounced Dead DeathDate component[datetimePronouncedDead ].valueDateTime
27 License Number PractitionerVitalRecords identifier:NPI
28 Date signed DeathDate effective
29 Actual or Presumed Date of Death DeathDate value
30 Actual or Presumed Time of Death DeathDate value
31 Was Medical Examiner or Coroner Contacted? ExaminerContacted value
32Part1 Cause of Death Line a CauseOfDeathPart1 value.text, component[lineNumber] = 1
32Part1 Cause of Death Line b CauseOfDeathPart1 value.text, component[lineNumber] = 2
32Part1 Cause of Death Line c CauseOfDeathPart1 value.text, component[lineNumber] = 3
32Part1 Cause of Death Line d CauseOfDeathPart1 value.text, component[lineNumber] = 4
32Part2 Other Cause of Death CauseOfDeathPart2 value.text
33 Was an Autopsy Performed? AutopsyPerformedIndicator value
34 Were Autopsy Findings Available to Complete the Cause of Death? AutopsyPerformedIndicator component[autopsyResultsAvailable].value
35 Did Tobacco Use Contribute to Death? TobaccoUseContributedToDeath value
36 Pregnancy Status DecedentPregnancyStatus value
37 Manner of Death MannerOfDeath value
38 Date of Injury InjuryIncident effective
39 Time of Injury InjuryIncident effective
40 Place of Injury InjuryIncident component[placeOfInjury].value.text
41 Injury at Work? InjuryIncident component[workInjuryIndicator].value
42 Location of Injury InjuryLocation address
43 Describe How Injury Occurred InjuryIncident value.text
44 If Transportation Injury, Specify InjuryIncident component[transportationRole].value
45 Certifier DeathCertification performer.function
46 Name, Address, and Zip Code of Person Completing Cause of Death Certifier name, address
47 Title of Certifier Certifier qualification
48 License Number Certifier identifier:NPI
49 Date Certified DeathCertification performed
50 For Registrar Only-Date Filed DeathCertificate date
51 Decedent's Education DecedentEducationLevel value
52 Decedent of Hispanic Origin? ObservationInputRaceAndEthnicityVitalRecords component.value, subject is Decedent
53 Decedent's Race ObservationInputRaceAndEthnicityVitalRecords component.value, subject is Decedent
54 Decedent's Usual Occupation DecedentUsualWork value.text
55 Kind of Business/Industry DecedentUsualWork component [odh-UsualIndustry].value.text