Vital Records Death Reporting (VRDR) FHIR Implementation Guide
2.2.0 - STU 2.2 United States of America flag

This page is part of the Vital Records Death Reporting FHIR Implementation Guide (v2.2.0: STU 2) based on FHIR 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

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

A. Decedent Demographics

Demographic data includes information about related persons (Mother, Father, and Spouse) and social determinants such as education level and usual occupation. The information in this profile group are provided by a decedent informant.

Birth Record Identifier

Birth Record Identifier (Observation). This includes the record identifier, the jurisdiction, and the birth year.

Decedent

Decedent (USCorePatient)

Decedent Age

The decedent’s chronological age at the time of death (Observation).

Decedent Education Level

Decedent Education Level (Observation)

Decedent Father

Decedent Father (USCoreRelatedPerson)

Decedent Military Service

Decedent Military Service (Observation)

Decedent Mother

Decedent Mother (USCoreRelatedPerson)

Decedent Spouse

Decedent Spouse (USCoreRelatedPerson)

Decedent Usual Work

Decedent Usual Work (UsualWork)

Emerging Issues

Emerging Issues (Observation)

Input Race and Ethnicity

Input (from EDRS) Race and Ethnicity (Observation). This is information collected by jurisdictions and submitted to NCHS.

This profile is only for use in a Vital Records Exchange. Systems looking to exchange this observation more broadly should reference US Core.

B. Death Investigation

Data obtained during the course of investigating a death. Many of these items are conditionally present in a death certification transaction depending on whether or not an autopsy was performed, an injury incident occurred, or a transportation event was involved. The details on the pronouncement performer can be provided using USCore Practitioner profile.

Autopsy Performed Indicator

Autopsy Performed Indicator (Observation)

Death Date

Date of death (Observation). The PartialDatePartAbsent extension supports partial dates.

Death Location

Death Location (USCoreLocation)

Decedent Pregnancy Status

Decedent Pregnancy Status (Observation)

Examiner Contacted

Examiner Contacted (Observation)

Injury Incident

Injury Incident (Observation)

Injury Location

Injury Location (USCoreLocation)

Surgery Date

Date of Surgery (Observation). The PartialDate extension supports partial dates.

Tobacco Use Contributed To Death

Tobacco Use Contributed To Death (Observation)

C. Death Certification

Data related to the primary concern of the VRDR IG, Death Certification. In this group, the causes of death and the causal pathway are documented and attested to by a death certifier (coroner or medical examiner).

Cause Of Death Part 1

Cause of death Part 1 (Observation). Cause of death prior to submission of the completed death report. Line number can be 1-4.

Cause of Death Part 2

Cause of death Part 2 (Observation). Identifies factors contributing to the cause of death as asserted by the death certifier (Observation)

Certifier

Certifier (USCorePractitioner)

Death Certification Procedure

Death Certification Procedure (USCoreProcedure). The procedure where the certification of death was performed by the certifier (USCoreProcedure).

Manner of Death

Manner of Death (Observation)

D. Decedent Disposition

Data related to the disposition of the decedents remains. The data in this profile group is typically provided by the funeral home performing the disposition services. The content of this profile group is authenticated by the funeral home director. Additional content can be included using standard USCore profiles, and can be included to specify the Funeral Home Director, the Licensee, and the Mortician.

Decedent Disposition Method

Decedent Disposition Method (Observation)

Disposition Location

Disposition Location (USCoreLocation)

Funeral Home

Funeral Home (USCoreOrganization)

E. Coded Observations

Coded Observations based on the submitted death record.

Activity at Time of Death

Activity at Time of Death (Observation)

Automated Underlying Cause Of Death

Automated Underlying Cause Of Death (Observation)

Coded Race and Ethnicity

Coded (from NCHS) Race and Ethnicity (Observation). This is information that is coded by NCHS and sent back to jurisdictions, and will not be processed if submitted to NCHS by jurisdictions.

This profile is only for use in a Vital Records Exchange. Systems looking to exchange this observation more broadly should reference US Core.

Note: NCHS stopped providing RaceRecode40 data in 2022.

Coding Status Values

Coding Status Values contains various status flags that result from the coding process

Entity Axis Cause Of Death

Entity Axis Cause Of Death (Observation): Up to 20 of instances of this profile may be included in a coding bundle. Each instance is labeled with its lineNumber, Position and e-code indicator.

Manual Underlying Cause Of Death

Manual Underlying Cause Of Death (Observation)

Place Of Injury

Place Of Injury (Observation)

Record Axis Cause Of Death

Record Axis Cause Of Death (Observation): Up to 20 of instances of this profile may be included in a coding bundle. Each instance is labeled with its position (1-20).

F. Documents and Bundles

Documents and Bundles used to transmit death record content.

Cause of Death Coded Content Bundle

Cause of Death Coded Content Bundle (Bundle): A bundle containing instances of the resources comprising cause of death coded content. This bundle is information-content equivalent to the traditional NCHS TRX format.

Death Certificate

The body of the death certificate document (Composition).

Death Certificate Document

The resources comprising the death certificate composition (Bundle/Document).

Demographic Coded Content Bundle

Demographic Coded Content Bundle (Bundle): A bundle containing instances of the resources comprising demographic (race and ethnicity) coded content. This bundle is information-content equivalent to the traditional NCHS MRE format.

Mortality Roster Bundle

Mortality Roster Bundle (Bundle): A bundle containing instances of the resources comprising mortality roster content. This bundle is information-content equivalent to the traditional Mortality Roster. The mortality roster is a supplemental report of death for the purpose of notifying the decedent’s jurisdiction of birth that the death has occurred. The roster data points are sufficient to locate the birth certificate of the decedent but do not otherwise contain the full death record. Once received, the jurisdiction of birth uses the mortality roster data to locate the record of birth and marks it as deceased.

Example Bundles

Example Death Certificate, Coded Content, and Mortality Roster Bundles

CauseOfDeathCodedContentBundle-Example1

CauseofDeathCodedContentBundle-Example1

DeathCertificateDocument-Example1

DeathCertificateDocument-Example1

DeathCertificateDocument-Example2

DeathCertificateDocument-Example2 (with coded content)

DeathCertificateDocument-ID-1

Example Record from ID

DeathCertificateDocument-ID-5

Example Record from ID

DeathCertificateDocument-NJ-1

Example Record from NJ

DeathCertificateDocument-UT-1

Example Record from UT

DemographicCodedContentBundle-Example1

DemographicCodedContentBundle-Example1

MortalityRosterBundle-Example1

MortalityRosterBundle-Example1

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

Alias Status of a Death Roster

Alias Status of a Death Roster. If true, is an alias record.

Auxiliary State Identifier1

An identifier associated by the submitting jurisdiction with a specific death certificate number. Twelve digit number.

Auxiliary State Identifier2

An identifier associated by the submitting jurisdiction with a specific death certificate number. Twelve digit number.

BypassEditFlag

Extension to hold a codeable concept from one of several valuesets.

Certificate Number

Death certificate number. Six digit number. Leading zeroes are optional.

City Code

City expressed as a numeric value. As of the date of publication, in accordance with the NCHS Instruction Manual Part 8, Vital Records Geographic Classification, 2014. (Extension)

Date Day

The day portion (DD) of the partial date. (Extension)

Date Month

The month portion (MM) of the partial date. (Extension)

Date Time

The time portion (DD) of the partial date. (Extension)

Date Year

The year portion (YYYY) of the partial date. (Extension)

District Code

District expressed as a numeric value. As of the date of publication, in accordance with the NCHS Instruction Manual Part 8, Vital Records Geographic Classification, 2014. (Extension)

Filing Format

Filing Format Extension.

Location Jurisdiction Id

Location Jurisdiction Id (Extension)

NVSS SexAtDeath

Sex on visual inspection at the time of death by the funeral home

Partial Date

Provides values of a partial date (Extension)

Partial Date Time

Provides values of a partial dateTime (Extension)

PostDirectional

PostDirectional

PreDirectional

PreDirectional

Replacement Status of a Death Record (deprecated)

Replacement Status of a Death Record. The use of this extension has been deprecated and wil be ignored for NCHS submissions. See the NCHS Vital Records Messaging IG for a description of how to specify replace status at the message level.

Spouse Is Alive

Spouse is Alive.

State Specific Field

An arbitratry string included by a submitting jurisdiction

StreetDesignator

StreetDesignator

StreetName

StreetName

StreetNumber

StreetNumber

UnitOrAptNumber

UnitOrAptNumber

Within City Limits Indicator

Within City Limits Indicator (Extension)

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

Activity at Time of Death VS

Activity at Time of Death.

Mapping to IJE codes here.

Administrative Gender PHVS_Sex_MFU

The gender of a person used for administrative purposes.

Mapping to IJE codes here.

Birthplace Country Value Set

2 Letter Birthplace Country Codes from GEC and ISO 3166-1. Includes historic countries that no longer exist.

Canadian Provinces Value Set

2 Letter Canadian Provinces Value Set

Certifier Types VS

Certifier Types Value Set

Mapping to IJE codes here.

Contributory Tobacco Use VS

Did Tobacco Use Contribute to Death

Mapping to IJE codes here.

Date of Death Determination Methods Value Set

Date of Death Determination Methods Value Set. The method of date of death determination is not used for the Death Record submission process. The binding to this value set is included for compatibility with the Medicolegal Death Investigation (MDI) Implementation Guide. The valueset only includes the values used by MDI, but is bound extensibly. If a jurisdiction chooses to use this field, and requires additional values (e.g., ‘presumed’), these values can be used while remaining in full conformance with the VRDR IG.

Edit Bypass 01

A subset of code values (0 and 1) use to indicate the outcome of data validation assessment for unusual data values.

Edit Bypass 012

A subset of code values (0, 1, and 2) use to indicate the outcome of data validation assessment for unusual data values.

Edit Bypass 01234

A subset of code values (0, 1, 2, 3, and 4) use to indicate the outcome of data validation assessment for unusual data values.

Edit Bypass 0124

A subset of code values (0, 1, 2, and 4) use to indicate the outcome of data validation assessment for unusual data values.

Education Level

Highest educational level achieved.

Mapping to IJE codes here.

Filing Format ValueSet

Filing Format

Mapping to IJE codes here.

Hispanic(Yes) No Unknown

Value set with Hispanic(Yes), No and Unknown.

Mapping to IJE codes here.

HispanicOrigin Value Set

NCHS HispanicOrigin Value Set.

Mapping to IJE codes here.

ICD10 Causes of Death VS

ICD10 Causes of Death VS

Intentional Reject ValueSet

Intentional Reject ValueSet.

Mapping to IJE codes here.

Jurisdictions Value Set

2 Letter Codes for all 57 Jurisdictions Reporting Deaths to NCHS

Jurisdictions and Provinces Value Set

2 Letter Jurisdictions and Provinces Value Set

Manner of Death VS

A set of code used to indicate a classification of the manner of death.

Mapping to IJE codes here.

Marital Status Value Set

The set of codes used to indicate the marital status of the decedent

Mapping to IJE codes here.

Method of Disposition VS

The set of codes used to indicate the method used to dispose of the decedents remains.

Mapping to IJE codes here.

Place of Death VS -- PHVS_PlaceOfDeath_NCHS

Code values reflecting the death location of the decedent (e.g., hospital, home, hospice).

Mapping to IJE codes here.

Place of Injury VS

Place of Injury from NCHS TRX Format. This contains all of the codes from https://loinc.org/LL1051-3/ except for LA14087-3 (Public Institution).

Mapping to IJE codes here.

Pregnancy Status

Pregnancy Status based on PHVS_PregnancyStatus_NCHS

Mapping to IJE codes here.

Race Code Value Set

NCHS Race Codes.

Mapping to IJE codes here.

Race Missing Value Reason

A set of code values used to indicate the reason decedent race data is absent.

Mapping to IJE codes here.

Race Recode 40 Value Set

NCHS Race Recode 40 Valueset.

NCHS will stop delivering this coded data in this representation in 2022.

Mapping to IJE codes here.

Replacement Status VS

Replacement Status Value Set. NCHS will not process original or update submissions flagged ‘updated_notforNCHS’.

Mapping to IJE codes here.

Residence Country Value Set

2 Letter Residence Country Codes from GEC and ISO 3166-1. Excludes historic countries that no longer exist

Spouse Alive Value Set

The set of codes used to indicate whether the decedent’s spouse is alive.

Mapping to IJE codes here.

States, Territories and Provinces Value Set

2 Letter States and Provinces Value Set

System Reject ValueSet

System Reject ValueSet.

Mapping to IJE codes here.

Transax Conversion ValueSet

Transax Conversion ValueSet.

Mapping to IJE codes here.

Transportation Incident Role

Role of the decedent in a transportation incident resulting in a death-related injury.

Mapping to IJE codes here.

US States, Territories Value Set

2 Letter States and Territories Value Set

Units of Age

Units of Age.

Mapping to IJE codes here.

Yes No Unknown

Value set with Yes, No and Unknown.

Mapping to IJE codes here.

Yes No Unknown NotApplicable

Valueset with Yes, No, Unknown, and Not Applicable.

Mapping to IJE codes here.

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

Activity at Time of Death Codesystem

Activity at Time of Death Codesystem based on PHVS_ActivityType_NCHS

Bypass Edit Flag Code System

Bypass Edit Flag Code System

Canadian Provinces

Canadian Provinces

Country Codes

2 Letter Country Codes from GEC and ISO 3166-1

Date of Death Determination Methods

Date of Death Determination Methods

Document Section Code System

Document Section Code System

Filing Formats CodeSystem

Death Certificate Filing Formats

HispanicOrigin CS

HispanicOrigin from Appendix_D_Excel_Hispanic_Origin_Code_List_Update_2011

Intentional Reject CodeSystem

Intentional Reject CodeSystem

Jurisdictions that are not US States or Territories

NVSS Jurisdictions that are not US States or Territories

Local Component Codes

Local Component Codes for observation components that lack an appropriate LOINC code

Local Observation Codes

Local Observation Codes for observations that lack an appropriate LOINC code

Local Organization Type

Local Organization Types

Location Type Code System

Location Type Code System

Missing Value Reason Codesystem

Missing Value Reason Codesystem

Pregnancy Status Codes

PHVS_PregnancyStatus_NCHS codes from PH_PHINVS_CDC

Race Code CS

RaceCode from Appendix E Excel Race Code List Update 2001

Race Recode 40 CS

Race Recode 40

Replacement Status of Death Record Submission

Replacement Status of Death Record Submission

System Reject Code System

System Reject Code System

Transax Conversion Code System

Transax Conversion Code System

Terminology: Concept Maps

These define transformations to convert between codes by systems conforming with this implementation guide.

ActivityAtTimeOfDeath Concept Map

Concept Map for ActivityAtTimeOfDeath Value Set.

AdministrativeGender Concept Map

A mapping between NCHS IJE and FHIR AdministrativeGender Value Sets

CertifierTypes Concept Map

A mapping between NCHS IJE and FHIR CertifierTypes Value Sets

ContributoryTobaccoUse Concept Map

A mapping between NCHS IJE and FHIR ContributoryTobaccoUse Value Sets

EditBypass01 Concept Map

A mapping between NCHS IJE and FHIR EditBypass01 Value Sets

EditBypass012 Concept Map

A mapping between NCHS IJE and FHIR EditBypass012 Value Sets

EditBypass01234 Concept Map

A mapping between NCHS IJE and FHIR EditBypass01234 Value Sets

EditBypass0124 Concept Map

A mapping between NCHS IJE and FHIR EditBypass0124 Value Sets

EducationLevel Concept Map

A mapping between NCHS IJE and FHIR EducationLevel Value Sets

FilingFormat Concept Map

A mapping between NCHS IJE and FHIR FilingFormat Value Sets

HispanicNoUnknown Concept Map

A mapping between NCHS IJE and FHIR HispanicNoUnknown Value Sets

HispanicOrigin Concept Map

A mapping between NCHS MRE and FHIR HispanicOrigin Value Sets

IntentionalReject Concept Map

A mapping between NCHS TRX and FHIR IntentionalReject Value Sets

MannerOfDeath Concept Map

A mapping between NCHS IJE and FHIR MannerOfDeath Value Sets

MaritalStatus Concept Map

A mapping between NCHS IJE and FHIR MaritalStatus Value Sets

MethodOfDisposition Concept Map

A mapping between NCHS IJE and FHIR MethodOfDisposition Value Sets

PlaceOfDeath Concept Map

A mapping between NCHS IJE and FHIR PlaceOfDeath Value Sets

PlaceOfInjury Concept Map

A mapping between NCHS TRX and FHIR PlaceOfInjury Value Sets

PregnancyStatus Concept Map

A mapping between NCHS IJE and FHIR PregnancyStatus Value Sets

RaceCodes Concept Map

A mapping between NCHS MRE and FHIR RaceCodes Value Sets

RaceMissingValueReason Concept Map

A mapping between NCHS IJE and FHIR RaceMissingValueReason Value Sets

RaceRecode40 Concept Map

A mapping between NCHS MRE and FHIR RaceRecode40 Value Sets

ReplaceStatus Concept Map

A mapping between NCHS IJE and FHIR ReplaceStatus Value Sets

SpouseAlive Concept Map

A mapping between NCHS IJE and FHIR SpouseAlive Value Sets

SystemReject Concept Map

A mapping between NCHS TRX and FHIR SystemReject Value Sets

TransaxConversion Concept Map

A mapping between NCHS TRX and FHIR TransaxConversion Value Sets

TransportationIncidentRole Concept Map

A mapping between NCHS IJE and FHIR TransportationIncidentRole Value Sets

UnitsOfAge Concept Map

A mapping between NCHS IJE and FHIR UnitsOfAge Value Sets

YesNoUnknown Concept Map

A mapping between NCHS IJE and FHIR YesNoUnknown Value Sets

YesNoUnknownNotApplicable Concept Map

A mapping between NCHS IJE and FHIR YesNoUnknownNotApplicable Value Sets

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

ActivityAtTimeOfDeath-Example1

ActivityAtTimeOfDeath-Example1

AutomatedUnderlyingCauseOfDeath-Example1

AutomatedUnderlyingCauseOfDeath-Example1

AutopsyPerformedIndicator-Example1

AutopsyPerformedIndicator-Example1

BirthRecordIdentifier-Example1

BirthRecordIdentifier-Example1

CauseOfDeathPart1-Example1

CauseOfDeathPart1-Example1

CauseOfDeathPart1-Example2

CauseOfDeathPart1-Example2

CauseOfDeathPart2-Example1

CauseOfDeathPart2-Example1

Certifier-Example1

Certifier-Example1

CodedRaceAndEthnicity-Example1

CodedRaceAndEthnicity-Example1

CodingStatusValues-Example1

CodingStatusValues-Example1

DeathCertificate Example1

DeathCertificate-Example1

DeathCertificate Example2

DeathCertificate-Example2 (with coded content)

DeathCertification-Example1

DeathCertification Example1

DeathCertification-Example2

DeathCertification Example2

DeathDate-Example1

DeathDate-Example1

DeathDate-Example2

DeathDate-Example1

DeathDate-Example3

DeathDate-Example3 - Stripped down for Mortality Roster

DeathDate-Example4

DeathDate-Example4 - an example with only a death time

DeathLocation-Example1

DeathLocation-Example1 - State = Jurisdiction

DeathLocation-Example2

DeathLocation-Example2 - State != Jurisdiction

DeathLocation-Example3

DeathLocation-Example3 - Stripped Down for Mortality Roster

Decedent-Example1

Decedent-Example1

Decedent-Example2

Decedent-Example2 - with birth jurisdiction

Decedent-Example3

Decedent-Example3 - Stripped down for Mortality Roster

DecedentAge-Example1

DecedentAge-Example1

DecedentDispositionMethod-Example1

DecedentDispositionMethod-Example1

DecedentEducationLevel-Example1

DeathDate-Example1

DecedentFather-Example1

DecedentFather-Example1

DecedentMilitaryService-Example1

DecedentMilitaryService-Example1

DecedentMother-Example1

DecedentFather-Example1

DecedentPregnancyStatus-Example1

DecedentPregnancyStatus-Example1

DecedentSpouse-Example1

DecedentSpouse-Example1

DecedentUsualWork-Example1

DecedentUsualWork-Example1 - without coded values

DecedentUsualWork-Example2

DecedentUsualWork-Example2 - with coded values

DispositionLocation-Example1

DispositionLocation-Example1

EmergingIssues-Example1

EmergingIssues-Example1 make sure it is example

EntityAxisCauseOfDeath-Example1

EntityAxisCauseOfDeath-Example1

EntityAxisCauseOfDeath-Example2

EntityAxisCauseOfDeath-Example2

EntityAxisCauseOfDeath-Example3

EntityAxisCauseOfDeath-Example3

EntityAxisCauseOfDeath-Example4

EntityAxisCauseOfDeath-Example3

ExaminerContacted-Example1

AutopsyPerformedIndicator-Example1

FuneralHome-Example1

FuneralHome-Example1

InjuryIncident-Example1

InjuryIncident-Example1 (with literal transportationRole)

InjuryIncident-Example2

InjuryIncident-Example2 (with coded transportationRole)

InjuryLocation-Example1

InjuryLocation-Example1

InputRaceAndEthnicity-Example1

InputRaceAndEthnicity-Example1

MannerOfDeath-Example1

MannerOfDeath-Example1

ManualUnderlyingCauseOfDeath-Example1

ManualUnderlyingCauseOfDeath-Example1

Mortician-Example1

Mortician-Example1

PlaceOfInjury-Example1

PlaceOfInjury-Example1

RecordAxisCauseOfDeath-Example1

RecordAxisCauseOfDeath-Example1

RecordAxisCauseOfDeath-Example2

RecordAxisCauseOfDeath-Example2

SurgeryDate-Example1

SurgeryDate-Example1

TobaccoUseContributedToDeath-Example1

TobaccoUseContributedToDeath-Example1