Vital Records Death Reporting (VRDR) FHIR Implementation Guide
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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-cibuild 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

Usage

Miscellaneous Comments

  • Guidance on missing data is missing from the IG
  • Guidance on Must Support (and flag data elements as MS)
  • Some IJE Fields intentionally not mapped
    • SEX_BYPASS – deprecated

Alias, Replace, Void Actions

The ALIAS and VOID IJE fields are used to direct an action be performed on a death record. These actions are now specified through message types in the accompanying Vital Records Messaging Implementation Guide message descriptions for Alias and Void. Sending a replacement death record is also specified through the Replace message type, but the status of the replacement is mapped to the VRDR IG (see DeathCertificate).

Local Time

All event times should be recorded as the local time and local time zone where they took place.

Partial Dates and Times

Several date/time fields (Date of Death, Date of Surgery, Date of Birth, and Date of Injury) in the IG allow components of the field to be unknown. The FHIR date and datetime fields provide the ability to leave the less significant components unspecified (e.g., 2018, 1973-06, or 1905-08-23 are valid dates). In addition to the built-in FHIR method for specifying partial dates, this IG provides extensions (ExtensionPartialDateVitalRecords and ExtensionPartialDateTimeVitalRecords) that allow the components to be specified independently. When using these extensions, a value must be specified for each component (e.g., year, month, day), or a missing value code specified. This allows dates where any component is missing to be specified. Creators of conformant content are free to choose to always use the Partial date and datetime extensions to represent their dates and times.

A value of unknown (all 9’s) in IJE is equivalent to a null value and a DataAbsentReason extension with the value of “unknown”. See this DeathDate for an example of both unknown integer values – the day of death, “99” in IJE – and unknown time value – the time of death, “9999” in IJE.

A value of blank (all ‘ ‘) in IJE is equivalent to a null value and a DataAbsentReason extension with the value of “temp-unknown”.

Note: The partial dates and times representation will be modified somewhat in the next update of VRDR. See the description in the draft Vital Records Common Library IG.

City Codes

FHIR addresses support a string value for city. The death record submission requires a 5 digit coded value, so the IG defines an extension ExtensionCityCodeVitalRecords for this purpose. The code should be selected to match the literal content of the city field. As of the date of publication, these codes should be in accordance with the NCHS Instruction Manual Part 8, Vital Records Geographic Classification, 2014.

County Codes

FHIR addresses support a string value for county (district). The death record submission requires a 3 digit coded value, so the IG defines an extension ExtensionDistrictCodeVitalRecords for this purpose. The code should be selected to match the literal content of the district field. As of the date of publication, these codes should be in accordance with the NCHS Instruction Manual Part 8, Vital Records Geographic Classification, 2014.

State Literals

States and jurisdictions are consistently represented using two letter postal codes bound to a string field. The IJE typically represents states using a 2 letter postal code and a separate literal field. Mapping from the 2 letter codes to literals must be provided outside of the VRDR IG, and can leverage the ValueSetStatesTerritoriesAndProvincesVitalRecords.

Country Literals

Countries are consistently represented using two letter postal codes bound to a string field. The IJE typically represents countries using a 2 letter postal code and a separate literal field. Mapping from the 2 letter codes to literals must be provided outside of the VRDR IG, and can leverage the CodeSystemCountryCodeVitalRecords.

Decedent Name

Profile conformance requires that either a first, last, or middle name be provided based on US Core requirements. If no name components are available, a data absent reason should be provided for at least one name component in order to conform to the profile requirements.

NCHS submission requires only a last name. Last name is required for NCHS submission. If the decedent’s legal name is unknown, name.family should be reported as ‘UNKNOWN’, or omitted. Placeholder names such as ‘John Doe’ or ‘Jane Doe’ should not be reported.

Decedent Gender

Profile conformance requires that gender be provided. A value of ‘unknown’ will satisfy this requirement. There is no IJE field that is mapped to the Decedent.gender field.

Birthplace State and Country

Recording birthplace state and country is described in Instruction Manual Part 8a (2004), Section I.

address.country address.state BPLACE_CNT BPLACE_ST Comment
US or CA Valid 2-letter state Same as FHIR Same as FHIR  
US Invalid code, Blank, or UNK US ZZ UNK is equivalent to ZZ.
CA Invalid, Blank, or UNK CA XX  
Other valid country code (except ZZ, and obviously US and CA) All values. Same as FHIR XX  
ZZ or other invalid values All values. ZZ ZZ ZZ is a valid country code in the valueset.