Vital Records Death Reporting (VRDR) FHIR Implementation Guide
3.0.0 - STU3

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 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/QRPH.VRDR/ and changes regularly. 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:

- U.S. Standard Certificate Of Death (see table)

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