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

Vital Records Death Reporting (VRDR) FHIR Implementation Guide, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 3.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/vrdr/ and changes regularly. See the Directory of published versions

Artifacts Summary

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

Decedent Demographics

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

Decedent

Decedent (PatientVitalRecords)

Decedent Age

The Decedent Age (Observation) profile provides the decedent’s chronological age at the time of death.

Decedent Education Level

Decedent Education Level (ObservationEducationLevelVitalRecords)

Decedent Father

Decedent Father (RelatedPersonParentVitalRecords)

Decedent Military Service

Decedent Military Service (Observation)

Decedent Mother

Decedent Mother (RelatedPersonParentVitalRecords)

Decedent Spouse

Decedent Spouse (USCoreRelatedPerson)

Record Linkages

Record Linkages enable deaths to be linked to associated vital records reports

Birth Record Identifier Child

Birth Record Identifier (Observation). For use in Maternal Death. This includes the record identifier, the jurisdiction, and the birth year. The focus is a Decedent (mother), whose death was related to the birth of the Subject (child).

Birth Record Identifier Infant

Birth Record Identifier Infant (Observation). This includes the record identifier, the jurisdiction, and the birth year. Subject is constrained to Decedent (infant) to allow decedent linkage to birth record. For maternal death cases, see BirthRecordIdentifierChild and FetalDeathRecordIdentifier.

Fetal Death Record Identifier

Fetal Death Record Identifier (Observation). For use in Maternal Death. This includes the record identifier, the jurisdiction, and the birth year. The focus is the Decedent (mother), whose death was related to the birth of the Subject (fetus).

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 Location

Death Location (LocationVitalRecords)

Examiner Contacted

Examiner Contacted (Observation)

Injury Location

Injury Location (LocationVitalRecords)

Observation - Death Date

The Death Date profile (Observation) provides the death date, death pronouncer, and date pronounced dead. If the actual date of death is known, set value to type dateTime. If the date of death is not known, and a range is known, set value to type Period. This profile is designed to supplant the similar profiles in VRDR and MDI.

Observation - Decedent Pregnancy

The Decedent Pregnancy Status profile (Observation) provides an indication of the pregnancy status of the decedent. This profile is designed to support VRDR and MDI

Observation - Injury Incident

This Observation provides the certified explanation of how the injury leading to death occurred.

Surgery Date

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

Tobacco Use Contributed To Death

Tobacco Use Contributed To Death (Observation)

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

The Cause of Death Part 1 (Observation) profile reflects the ordered causes of death asserted by the death certifier. The cause of death is initially specified with text. Line number can be 1-4

Cause of Death Part 2

The Contributing Cause of Death Part 2 (Observation) profile is used to identify factors contributing to the cause of death as asserted by the death certifier.

Death Certification Procedure

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

Death Certifier

The Death Certification Practitioner

Manner of Death

Manner of Death (Observation)

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)

Mortician

Mortician.

Note This profile is not needed for submission of records to NCHS but may be relevant for other use cases.

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)

Coding Status Values

Coding Status Values (Parameters) 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).

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.

Industry Occupation Coded Content Bundle

Industry and Occupation Coded Content Bundle (Bundle): A bundle containing coded industry and occupation data for a decedent. This bundle is information-content equivalent to the tranditional MIO files.

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

Death Certificate for Davis Lineberry Jr

DeathCertificateUT-Example1

DeathCertificateDocument-UT-1

Example Record from UT

DeathCertification-Example1

DeathCertification-Example1

DeathCertification-Example2

DeathCertification-Example1

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.

Filing Format

Filing Format Extension.

NVSS SexAtDeath

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

Practitioner Role

Used to indicate the role played by a practitioner to facilitate simple FHIRPath-based queries.

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

Terminology: Value Sets

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

Activity at Time of Death ValueSet

Activity at Time of Death.

Mapping to IJE codes here.

Administrative Gender ValueSet

The gender of a person used for administrative purposes. This uses codes that are aligned with USCore and VRCL.

Mapping to IJE codes here.

Administrative Gender ValueSet - Max

This valueset contains codes to represent gender. It expands on the [AdministrativeGenderVS] by including the gender codes used in STU2.2([AdministrativeGenderOldVS])for backward compatibility.

Administrative Gender ValueSet - Old

The gender of a person used for administrative purposes. This valueset was used in STU2.2.

Mapping to IJE codes here.

Certifier Types Value Set

Certifier Types Value Set

Mapping to IJE codes here.

Contributory Tobacco Use ValueSet

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.

Death Pregnancy Status ValueSet

A set of codes that reflect whether the decedent was pregnant at or around the time of death. Based on Pregnancy Status (NCHS)[2.16.840.1.114222.4.11.6003].

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 0124

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

Event Code for Death Certificate Composition

The code used for Event.code for the Death Certificate Composition

Event Code for Death Certificate Composition - Max

The maximum valueset for Event.code for Death Certificate Composition. Includes an inactive but valid code used in STU2

Filing Format ValueSet

Filing Format ValueSet

Mapping to IJE codes here.

ICD10 Causes of Death ValueSet

ICD10 Causes of Death ValueSet

Intentional Reject ValueSet

Intentional Reject ValueSet.

Mapping to IJE codes here.

Manner of Death ValueSet

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

Mapping to IJE codes here.

Method of Disposition ValueSet

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

Mapping to IJE codes here.

Place of Death ValueSet

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

Mapping to IJE codes here.

Place of Injury ValueSet

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.

Replacement Status ValueSet

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

Mapping to IJE codes here.

Spouse Alive ValueSet

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

Mapping to IJE codes here.

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 ValueSet

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

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

Date of Death Determination Methods

Date of Death Determination Methods CodeSystem

Death Pregnancy Status Codesystem

Codes that reflect whether the decedent was pregnant at or around the time of death.

Document Section

Document Section Code System

Filing Formats

Death Certificate Filing Formats CodeSystem

Intentional Reject

Intentional Reject CodeSystem

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

Location Type Code System

Replacement Status of Death Record Submission CodeSystem

Replacement Status of Death Record Submission CodeSystem

System Reject Code System

System Reject Code System

Transax Conversion CodeSystem

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

AdministrativeGenderOld Concept Map

A mapping between NCHS IJE and FHIR AdministrativeGenderOld 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

EditBypass0124 Concept Map

A mapping between NCHS IJE and FHIR EditBypass0124 Value Sets

FilingFormat Concept Map

A mapping between NCHS IJE and FHIR FilingFormat Value Sets

IntentionalReject Concept Map

A mapping between NCHS IJE and FHIR IntentionalReject Value Sets

MannerOfDeath Concept Map

A mapping between NCHS IJE and FHIR MannerOfDeath 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 IJE and FHIR PlaceOfInjury Value Sets

PregnancyStatus Concept Map

A mapping between NCHS IJE and FHIR PregnancyStatus 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 IJE and FHIR SystemReject Value Sets

TransaxConversion Concept Map

A mapping between NCHS IJE and FHIR TransaxConversion Value Sets

TransportationIncidentRole Concept Map

A mapping between NCHS IJE and FHIR TransportationIncidentRole 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

AgeUT-Example1

AgeUT-Example1

Atlanta GA Death Location - Freeman

Example

Atlanta GA Injury Location - Freeman

Example

AutomatedUnderlyingCauseOfDeath-Example1

AutomatedUnderlyingCauseOfDeath-Example1

AutopsyPerformedIndicator-Example1

AutopsyPerformedIndicator-Example1

AutopsyPerformedIndicatorUT-Example1

AutopsyPerformedIndicatorUT-Example1

BirthRecordIdentifier-Example1

BirthRecordIdentifier-Example1 - identifier of the decedent’s birth certificate

BirthRecordIdentifierChild-Example1

BirthRecordIdentifierChild-Example1 - identifier of the decedent’s child’s birth certificate number

BirthRecordIdentifierUT-Example1

BirthRecordIdentifierUT-Example1

CauseOfDeathPart1-Example1

CauseOfDeathPart1New-Example1

CauseOfDeathPart1-Example2

CauseOfDeathPart1New-Example2

CauseOfDeathPart1UT-Example1

CauseOfDeathPart1UT-Example1

CauseOfDeathPart2-Example1

CauseOfDeathPart2New-Example1

Certifier-Example1

Certifier-Example1

CodedRaceAndEthnicity-Example1

CodedRaceAndEthnicity-Example1

CodingStatusValues-Example1

CodingStatusValues-Example1

DeathCertificate Example1

DeathCertificate-Example1

DeathCertificate Example2

DeathCertificate-Example2 (with coded content)

DeathCertificateDocument-Example1

DeathCertificateDocument-Example1

DeathCertificateDocument-Example2

DeathCertificateDocument-Example2 (with coded content)

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

DeathDateUT-Example1

DeathDateUT-Example1

DeathLocation-Example1

DeathLocation-Example1 - State = Jurisdiction

DeathLocation-Example2

DeathLocation-Example2 - State != Jurisdiction

DeathLocation-Example3

DeathLocation-Example3 - Stripped Down for Mortality Roster

DeathLocationUT-Example1

DeathLocationUT-Example1

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

DecedentUT-Example1

DecedentUT-Example1

DecedentUsualWork-Example1

DecedentUsualWork-Example1 - without coded values

DecedentUsualWork-Example2

DecedentUsualWork-Example2 - with coded values

DispositionLocation-Example1

DispositionLocation-Example1

DispositionLocationUT-Example1

DispositionLocationUT-Example1

DispositionMethodUT-Example1

DispositionMethodUT-Example1

EducationUT-Example1

EducationUT-Example1

EmergingIssues-Example1

EmergingIssues-Example1 make sure it is example

EmergingIssuesUT-Example1

EmergingIssuesUT-Example1

EntityAxisCauseOfDeath-Example1

EntityAxisCauseOfDeath-Example1

EntityAxisCauseOfDeath-Example2

EntityAxisCauseOfDeath-Example2

EntityAxisCauseOfDeath-Example3

EntityAxisCauseOfDeath-Example3

EntityAxisCauseOfDeath-Example4

EntityAxisCauseOfDeath-Example3

ExaminerContacted-Example1

AutopsyPerformedIndicator-Example1

ExaminerContactedUT-Example1

ExaminerContactedUT-Example1

FatherUT-Example1

FatherUT-Example1

FetalDeathRecordIdentifier-Example1

FetalDeathRecordIdentifier-Example1

FuneralHome-Example1

FuneralHome-Example1

FuneralHomeUT-Example1

FuneralHomeUT-Example1

IndustryOccupationCodedContentBundle-Example1

IndustryOccupationCodedContentBundle-Example1

InjuryIncident-Example1

InjuryIncident-Example1 (with literal transportationRole)

InjuryIncident-Example2

InjuryIncident-Example2 (with coded transportationRole)

InjuryIncidentUT-Example1

InjuryIncidentUT-Example1

InjuryLocation-Example1

InjuryLocation-Example1

InputRaceAndEthnicity-Example1

InputRaceAndEthnicity-Example1

InputRaceAndEthnicityUT-Example1

InputRaceAndEthnicityUT-Example1

MannerOfDeath-Example1

MannerOfDeath-Example1

MannerOfDeathUT-Example1

MannerOfDeathUT-Example1

ManualUnderlyingCauseOfDeath-Example1

ManualUnderlyingCauseOfDeath-Example1

MilitaryServiceUT-Example1

MilitaryServiceUT-Example1

Mortician-Example1

Mortician-Example1

MotherUT-Example1

MotherUT-Example1

PlaceOfInjury-Example1

PlaceOfInjury-Example1

Practitioner - Vital Records - Janet Seito

Practitioner - Vital Records: Janet Seito example

PractitionerUT-Example1

PractitionerUT-Example1

PregnancyUT-Example1

PregnancyUT-Example1

Procedure - Death Certification Vital Records - A Freeman

Example

ProcedureDeathCertificationUT-Example1

ProcedureDeathCertificationUT-Example1

RecordAxisCauseOfDeath-Example1

RecordAxisCauseOfDeath-Example1

RecordAxisCauseOfDeath-Example2

RecordAxisCauseOfDeath-Example2

SurgeryDate-Example1

SurgeryDate-Example1

TobaccoUseContributedToDeath-Example1

TobaccoUseContributedToDeath-Example1

TobaccoUseUT-Example1

TobaccoUseUT-Example1

USCorePatient - Patient example [A Freeman]

Example of US Core Patient profile (A Freeman)

UsualWorkUT-Example1

UsualWorkUT-Example1