CA-EDRS Version 2.4. Medical Examiner/Coroner Users Guide

CA-EDRS Version 2.4 Medical Examiner/Coroner Users Guide

Copyright Copyright 2005 Regents of University of California and California Department of Public Health. All rights reserved. This publication is protected by copyright and international treaty. No part of this publication may be reproduced in any form by any means without prior written authorization from Regents of University of California or the California Office of the State Registrar, Office of Vital Records, California Department of Public Health. TRADEMARKS: All products, services, and company names mentioned herein are trademarks of their respective companies. THIS PUBLICATION (AND ANY RELATED SOFTWARE) IS PROVIDED AS IS WITHOUT WARRANTY OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR NON-INFRINGEMENT. THIS PUBLICATION COULD INCLUDE TECHNICAL INACCURACIES OR TYPOGRAPHICAL ERRORS. CHANGES ARE PERIODICALLY ADDED TO THE INFORMATION HEREIN, THESE CHANGES WILL BE INCORPORATED IN NEW EDITIONS OF THE PUBLICATION. REGENTS OF UNIVERSITY OF CALIFORNIA AND THE CALIFORNIA DEPARTMENT OF HEALTH SERVICES MAY MAKE IMPROVEMENTS AND/OR CHANGES IN THE PRODUCTS AND/OR THE PROGRAMS DESCRIBED IN THIS PUBLICATION AT ANY TIME. All persons named in this document are fictitious. Any resemblance to actual persons, living or dead, is coincidental. For policy concerns regarding information that appears on Certificate of Death, Disposition Permit, or an amendment form, please refer to the California Birth and Death Registration Handbook, Office of Vital Records 1999, and updates. 5/8/2008 CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 2

Table of Contents Getting Started with CA-EDRS 5 About CA-EDRS 5 Technical Requirements 6 Configuring Your Web Browser 6 Security 7 Death Certificate Workflow Overview 8 Funeral Home Activities 8 Medical Facility Activities 8 Physician Activities 8 ME/Coroner Activities 9 Local Registrar Activities 9 State Registrar Activities 9 Navigating CA-EDRS 10 Logging in to CA-EDRS 10 About the Death Certificate Browser 11 Edit User Profile 12 Magnifying Glass 13 Calendars 14 Embalmer s Signature 15 Medical Certifier s Signature 15 ME/Coroner s Signature 15 Blanks 15 Getting Help 15 Backspace 16 Cautions when Printing Official Documents 16 Personal Search Filters 18 Death Certificate Records 19 Create a New Death Certificate Record 19 Find an Existing Record 20 Duplicate Records 24 Complete the Death Certificate 25 Unlocking Records 25 Submitting for Registration 26 Abandon a Death Certificate 26 Record Options 27 Decedent Folder 27 Save 27 Accept Record 28 CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 3

Attest Medical Info 29 Print Working Copy 29 Transfer Record 30 View Record History 31 Export Case 31 Additional Record Options 31 Validation 32 Validate PI 34 Validate MI 34 SpellCheck MI 34 Validate CI 34 Validate PI/MI/CI 34 Validate for Submission 34 Coroner Amendment Overview 35 ME/Coroner Activities 35 Local Registrar Activities 35 State Registrar Activities 36 General Amendments 36 Coroner Amendments 37 Create a New Amendment 37 Find an Existing Amendment 37 Completing Amendments 38 Amendment Signature 38 Submitting for Registration 39 Abandon an Amendment 39 Amendment Options 40 Save 40 Print Working Copy 40 Attest 41 Submit 42 Abandon 43 Find Amendment 43 Case Export 43 Decedent Folder 43 Amendment Validations 44 Validate Amendment 44 SpellCheck MI Amendment 44 Reports and Exports 45 Reports 45 Exports 46 CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 4

Getting Started with CA-EDRS The California Electronic Death Registration System (CA-EDRS) improves the speed of creating, submitting, and processing a Certificate of Death (form VS-11e), Affidavit to Amend a Record (VS-24e), and Physician/Coroner Amendment (VS-24Ae) in the State of California. The CA-EDRS application also helps reduce errors and omissions in Death Certificate and Amendment records. About CA-EDRS The CA-EDRS system offers a Web-based application as an online alternative to the paper process of creating, typing, then processing death certificates and amendments. When you log into the CA-EDRS application, you are presented with a centralized list of all death certificates associated with your organization. From there, you can create a new Death Certificate or select an existing record to update or continue with the submission and registration process. The CA-EDRS application runs in a Web browser. It functions the way many online Web applications do, by providing fields and menus for you to enter information, then processing the data you enter. Because it is a Web application, you can use it from any computer with a modern browser and Internet connection. When you click a button on a page displayed in the browser, your browser sends the information on the page over the Internet to a Web server. The application, running on the Web server, processes the information, often consulting a database. The application then composes a new Web page, and the Web server sends it back to your browser. The process happens quickly, but just how quickly depends to some extent on the speed of your Internet connection. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 5

Technical Requirements In order to use the CA-EDRS application, you will need: Internet connection CA-EDRS is an Internet application and requires users to be connected to the Internet in order to access the application. The application has been designed to be usable even in low-bandwidth connections such as low-speed modem connections (28,800 baud), however, we recommend that you use highbandwidth connections (DSL, T1, cable modem). A Web browser Compatible browsers are described on the public CA-EDRS website, at http://edrs.ucdavis.edu/edrs/requirements.jsp. To set up your Web browser, see Configuring Your Web Browser. Adobe Reader 6.01 or later Adobe Reader software (formerly Adobe Acrobat Reader ) can be downloaded for free from http://www.adobe.com. A Laser printer A black-and-white laser printer is required for printing any official documents intended for local registration. An example is described on the public CA-EDRS website, at http://www.edrs.us/edrs/requirements.jsp. Note: Inkjet printers, impact printers, and color laser jet printers are not allowed for printing official documents. Print only with a black-and-white laser printer. Configuring Your Web Browser Pop-ups. Pop-up search/navigation browsers allow CA-EDRS users to search for medical certifiers, funeral homes, and other information. Many Web browsers today allow you to disable pop-ups. You or your computer administrator may have also installed software that disables pop-ups. If this is the case, you will need to enable pop-ups on your computer in order to optimally use CA-EDRS. Enable Javascript. CA-EDRS uses Javascript to provide for easy navigation as well as data entry validation on some fields. You must have Javascript enabled on the browser in order to use CA-EDRS CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 6

Security The CA-EDRS application has been designed as part of a secure system. Only users with registered usernames and passwords can log in to the system. Moreover, the system will prompt you every 60 days to change your password if you do not change it more often. When you log in, the system issues a Secure Socket Layer (SSL) certificate to your computer to be used for the duration of the session. Using SSL, the system encrypts all communication between your computer and the server to prevent eavesdropping. You can see that the system is communicating in secure mode by observing your browser s interface: check for the https (rather than http ) prefix in the URL, and look for the padlock symbol ( ) displayed on your browser window (the exact location varies between browsers). Finally, each user must share responsibility for security when using the CA-EDRS application. The application automatically logs you off after a period of inactivity, but you should still log off of the system when you leave your workstation to prevent access by unauthorized users. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 7

Funeral Home Activities Death Certificate Workflow Overview The workflow typically begins when a Funeral Home creates a new Death Certificate record. A Funeral Home staff member completes form VS-11e with as much Personal Information (PI) as is known, and saves it to the database. Funeral Home staff must attempt to request Social Security Number Verification (SSNV) at least once. The Embalmer (or other Funeral Home user with power of attorney) signs the VS-11e form electronically. When all PI has been completed, Funeral Home staff authenticates the PI, and the PI is locked against further changes. When authenticating the PI, the user confirms the personal information is correct and accurate to the best of their knowledge. Frequently, the Funeral Home user will enter the Medical Information (MI) provided by the Physician. When the MI is ready for the physician s signature, the Funeral Home or Medical facility user will request Remote Attestation. The system will send a fax to the physician s fax number provided by the requestor. Alternatively the Funeral Home may transfer the record to a medical facility to complete the Medical Information and request Remote Attestation. When appropriate, the Funeral Home or Medical Facility user will refer the record to the ME/Coroner for a coroner referral number and/or electronic signature (attestation). They may enter Coroner Information (CI) as appropriate. As soon as the death certificate is created, the Funeral Home may create Disposition Permits. Medical Facility Activities Alternatively, a Medical Facility Decedent Affairs may also create the new Death Certificate record, enter the MI, refer to the ME/Coroner when appropriate, request Remote Attestation, and then transfer the Death certificate to a Funeral Home Organization for completion of the PI, Disposition Permits, and completing the registration process. Physician Activities When MI has been completed and Remote Attestation has been requested, the Physician who is responsible for attesting to the accuracy of the MI receives a fax. If CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 8

the MI is correct, then the Physician signs the Physician Attestation Copy (PAC) and faxes the signed PAC to the CA-EDRS Fax Server. Alternatively, the physician can call the CA-EDRS Voice Server, an interactive voice response system, to attest by VOICE. When the attestation has been successfully requested, then the MI is locked by the CA- EDRS system, and no further changes can be made. After the PI has been authenticated and the MI has been attested, the record becomes complete as noted by its COMP record status. The Funeral Home then submits the completed death certificate, along with disposition permit(s), to the Local Registrar for electronic registration. ME/Coroner Activities If the record has been referred to the ME/Coroner, the ME/Coroner user reviews the record and determines if the record is an acceptable coroner case requiring a coroner referral number and attestation of the MI, or simply a reportable case requiring only a number, or declined for further action (no number required). The ME/Coroner may complete the MI and CI, then attest (electronically sign). Alternatively, a ME/Coroner office may also create the new Death Certificate record, enter the MI, attest (electronically sign), and then transfer the Death certificate to a Funeral Home Organization for completion of the PI, Disposition Permits, and completing the registration process. Typically, after the ME/Coroner has completed their activities and the record is complete (both the PI is authenticated and the MI and CI are attested) as noted by its COMP status, the Funeral Home submits the record with disposition permit(s) to the Local Registrar for registration. Local Registrar Activities The Local Registrar identifies a record submitted for registration by its SUBM LR record status. The Local Registration Office reviews it, and either accepts for registration or rejects the record. After local registration, the LRN, Local Registrar s name and electronic signature, and the registration date are assigned to the record. The record status changes to SUBM SR, making it available for State registration. The Local Registrar can then print the official Death Certificate document and issue the Disposition Permits that were created by the Funeral Home. After the Disposition Permits have been issued, Funeral Home staff can print the official copies. State Registrar Activities The State Registrar identifies a record submitted for State registration by its SUBM SR status. The State Office of Vital Records reviews it, and registers it. At this time, the State File Number is assigned to the record, and its status changes to REG SR. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 9

Navigating CA-EDRS CA-EDRS is a web-based application with features that make navigating through the electronic version of the Death Certificate (DC) or Amendment better, faster, and more reliable. One can move conveniently from field to field on the form by pressing the TAB key, (to move backwards, press Shift-TAB) or move the cursor to each field on the form using a mouse click. Whether the user is more comfortable tabbing or using the mouse to move the cursor through the form, the field containing the cursor will be highlighted with a light blue background. Logging in to CA-EDRS To get started with the application, open your Internet browser and navigate to the following URL: https://ca.edrs.us At the login page (Figure 1), enter the username and password approved for you by your CA-EDRS system administrator. The password is between 8 and 12 characters long and is case sensitive; enter it exactly as provided. The following rules apply to passwords: If you enter the wrong username-password combination five times, you will be locked out of CA-EDRS as a security measure. If this happens, please contact the CA-EDRS Help Desk to have your login information reset. Your password will expire after 60 days, and will need to be changed. The CA-EDRS application will prompt you to change your password before it expires. You can reset your password by editing your user profile (see Figure 2 for the location of the link). Passwords must be at least 8 characters long. Enter your username and password, then click the button. (Figure 1) CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 10

Figure 1 CA-EDRS Login Page About the Death Certificate Browser The Death Certificate Browser is shown in Figure 2. Among the things you can do from this page are: Edit your user profile. View a list of Death Certificate records. The records shown are those created by or transferred to your organization, records within your county or organization, not necessarily all records in the system. Abandoned records are not shown. Search for a Death Certificate record in the list. Create a new Death Certificate record. The records shown in the list are only those you are authorized to see; for example, records that you or someone in your organization has created. Local Registrars will be able to see all of the records in their registration district; Coroners will see all the records in their county. Each record represents a Death Certificate that has been created, but not necessarily completed. Some incomplete records may only include a first name, last name, and date of death. The CA-EDRS application assigns a record number and status to each record. The record number, shown in the Record Number column in Figure 2, is used only in the CA-EDRS system; it should not be confused with the Local Registration Number (LRN) or State File Number (SFN) that is assigned when the Death Certificate is registered. The CA-EDRS system also assigns an Office of Vital Records document CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 11

tracking number (DTN) to each record when it is printed as an official document. The DTN appears as a barcode at the bottom of the official document. Edit User Profile Create New DC Search for existing DC Records View DC Records Edit User Profile Figure 2 Death Certificate Browser Page You my edit your personal contact information or change your password at any time in the Update Personal Profile screen (Figure 4) by selecting Profile (Figure 3) in the blue banner of your EDRS Browser. Figure 3 Edit User Profile CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 12

Magnifying Glass Figure 4 Edit your personal profile Fields with a limited number of possible entries let you fill them in by selecting from a dropdown menu or by clicking a search icon ( ) to open a search browser. The search browser lets you select from a list of valid entries. If the list is very long, you can search for an entry of interest. For example, if you click the icon in VS-11e, field 9 (Birth State/Foreign Country), you will see the search browser shown in Figure 5. Figure 5 Search Browser CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 13

To search for the country of Bulgaria in the search browser, enter the first few letters of the name in the Country/Province search field and click. If you need to narrow your search, enter additional letters and click. again. The search browser will find Bulgaria, as shown in Figure 6. Figure 6 Search and select County or Province To enter the result of the search into the form, click on the link in the Country/Province column in Figure 6. The correct abbreviation for Bulgaria will be entered into field 9 as shown in Figure 7. Calendars Figure 7 County/Province selected For fields that require dates, a similar feature lets you pick a date from a calendar rather than entering it by hand. To use the calendar feature, click on the calendar icon ( ) and choose the date from the calendar browser (Figure 8). When you choose a date, the calendar will automatically populate the field using the correct format. This feature may not be convenient for the decedent date of birth. Figure 8 Calendar Icon Note: Using the pop-up search browsers and calendars eliminates mistyping information. These features are the recommended way to fill out fields wherever they are available. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 14

Embalmer s Signature The Embalmer s electronic signature is the Embalmer s name with the esignature symbol. (Figure 9) Figure 9 Embalmer esignature Medical Certifier s Signature The Medical Certifier s attestation is the Physician s name with the FAX Signature symbol, if attestation is by the fax method (Figure 10), or the VOICE Signature symbol, if attested by the voice method (Figure 11). Click on the blue icon next to the symbol to view the physician s signature or hear the voice attestation. Figure 10 FAX attested Figure 11 VOICE attested ME/Coroner s Signature The ME/Coroner s attestation is the ME/Coroner s name with the esignature symbol (Figure 12). Blanks Figure 12 ME/Coroner esignature In most cases, a field that is left entirely blank is not acceptable. If you want to leave a field blank, enter a hyphen in it (if allowed), as stipulated in the California Birth and Death Registration Handbook. For example, even if the decedent is identified as never married (field 12), you must enter hyphens in the surviving spouse fields (fields 28-30). Getting Help If you need help in filling out the Certificate of Death, the CA-EDRS application provides quick access to an electronic copy of the California Birth and Death Registration Handbook. To view the handbook for a specific topic, click the help symbol ( ) in the CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 15

field where you need help. For example, to learn about the Social Security Number entry in field 10, click the help symbol (Figure 13). A window will pop up showing the relevant page from the California Birth and Death Registration Handbook (Figure 14). Figure 13 Getting Help Figure 14 California Birth and Death Registration handbook reference In addition, you can view a complete section of the handbook by selecting the link at the bottom of the page for the Death Certificate section, the Disposition Permit section, the Amendment section, Appendix B, Appendix C and CoD Guidelines. (Figure 15). Backspace Figure 15 Links to California Birth and Death Registration handbook sections Caution: Do not use your keyboard backspace key or Internet browser backspace arrow while using the CA-EDRS application. Most Internet browsers use the backspace key to return to the previous page. If you return to the previous page while filling out the VS-11e form, you will lose all your unsaved data. Cautions when Printing Official Documents When printing any official document from CA-EDRS there are specific requirements. Failure to adhere to all requirements may result in rejection of the document by Local Registrar and/or State Office of Vital Records. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 16

Print at 100% size ( ) (see Figure 16) Print in black and white only (no color) Print using a Laser printer only Print in the proper orientation Death Certificates and Amendments must be printed on the official paper provided by the State and distributed by the Local Registrar offices. Disposition permits may be printed on plain white paper. Figure 16 Confirm Page Scaling is NONE before printing any official document. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 17

Personal Search Filters CA-EDRS provides the ability to save any combination of search criteria as Saved Filters. This feature is useful when you frequently use the same search criteria. To create, edit, or delete a saved filter, select Manage Search Filters (Figure 17) to display the Manage Personal Search Filters page (Figure 18). Figure 17 Manage Search Filters Enter the desired combination of search criteria, enter a filter name, then click. to save a new filter. To edit an existing filter, select the Filter Name from the list, make the changes to the criteria, then click to save the updated filter. You may identify one filter to be the default filter each time you log in. To delete an existing filter, select the trash can ( ) icon. (Figure 18) Figure 18 Manage Personal Search Filters page From the Certificate Browser, you may select any one of your Saved Filters from your list (Figure 19 Saved Filters list). For example, if you want to search for INC records REF to the Coroner, select that Saved Filter from the list and those records will be displayed in one action. Figure 19 Saved Filters list CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 18

Death Certificate Records The Certificate of Death, State of California form VS-11e requires the same information as the paper form, VS-11. Fields 2, 4, 5, and 9 38 on the form are considered personal information (PI) about the decedent. Fields 1, 3, 6 8, and 101 118 are considered medical information (MI), including the physician s attestation. Fields 119-128 are considered coroner information (CI), if required. In general, refer to the most recent version of the California Birth and Death Registration Handbook for instructions when completing the VS-11e form. Note: In some circumstances, fields 1, 3, and 6 (first name, last name, sex) are linked to both PI and MI; thus, may be locked when PI is locked or locked when MI is locked. Create a New Death Certificate Record To create a new Death Certificate (DC) record, you begin by providing four required pieces of information about the decedent (first name, middle name, last name, and date of death). Coroners and Local Registrar s who use CREATE will not be shown the Registration District field; its value will be defaulted to their jurisdiction. You then continue to complete form VS-11e, an electronic version of the California VS-11 Certificate of Death form. From the Death Certificate Browser page (Figure 20), go to Record Options, then Click Create Record button near the top of the Death Certificate Browser window. In the Create New Record page, (Figure 21) enter the required Decedent Information: First Name: Enter the first name of the decedent. Middle Name: Enter the middle name of the decedent (if none, use a dash (-)). Last Name: Enter the last name of the decedent. Date of Death: Click the calendar icon ( ) and select the date of death from the calendar pop-up; or enter the date of death, in mm/dd/yyyy format (for example, 10/30/2007). Then click the button. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 19

Figure 20 Record Options Create Record Figure 21 Create New Record page Note: When a Coroner staff member initiates a record, by default the Local Registration District and county of death are identified and the Coroner referral status is set at Accepted. Find an Existing Record Using the Certificate Browser page ( Figure 22), you can search for decedent records by First Name, Last Name, and Record Number. You can also search by Date of Death and Record Status. You can enter multiple search criteria in order to refine the search. After entering your search criteria, click the button as shown in Figure 22. Then click on the name of the record you wish to view. Click to clear search criteria. Figure 22 Searching for an existing record CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 20

To search for a decedent by name: Enter the decedent s first and/or last name or first few letters of the name. You can also search for groups of decedents. For example, to find all decedents with a given last name, enter the last name and leave the first name field blank. Click the button. To search for a decedent by EDRS number: Enter the CA-EDRS record number Click the button. To search for decedents by date of death: Enter your estimates of the earliest and latest dates of death. The search will be confined to records whose dates lie between the two selected dates. Click the button. To search for records by Record Status: Choose one of the following from the dropdown menu: ABAND (Abandoned) The record has been abandoned because it was not completed within 60 days, or a Registrar abandoned it manually. COMP (Complete) The Death Certificate is completed and ready to submit. DUP (Duplicate) The Death Certificate is a duplicate of another record in the system. INC (Incomplete) The Death Certificate requires more information before it can be submitted. REG SR (Registered SR) The Death Certificate has been registered by the State of California, and a State File Number (SFN) has been assigned. REJECT The Death Certificate has been rejected by the Local Registrar or the State of California. SUBM LR (Submitted LR) The Death Certificate has been submitted for local registration but has not yet been registered. SUBM SR (Submitted SR) The Death Certificate has been registered locally and submitted for State registration. Records with this status have a Local Registration Number (LRN), and the Application and Permit for Disposition of Human Remains can now be approved and issued. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 21

VOID (Voided) The record has been registered and subsequently voided by the State Registrar. Click the button. To search for records by Attestation Status: Choose one of the following from the dropdown menu: MC ATT (Medical Certifier-Attested) The record has been attested (electronically signed) by a physician in Field 115 on the Death Certificate. ME/C ATT (Medical Examiner/Coroner-Attested) The record has been attested (electronically) signed by a Medical Examiner/Coroner in Field 126 on the Death Certificate. ME/C-MC ATT (Medical Certifier and Medical Examiner/Coroner -Attested) The record has been attested (electronically signed) by both a physician in Field 115 and a Medical Examiner/Coroner in Field 126 on the Death Certificate. UN ATT (Un-Attested) The record has not yet been attested (electronically signed) by a physician and/or ME/Coroner. Click the button. To search for records by Coroner Status: Choose one of the following from the dropdown menu: NOT REF (Not Referred) The record has not been referred to the ME/Coroner. REF (Referred) The record has been referred to the ME/Coroner. ACC (Acceptable Coroner Case) The record has been identified by the ME/Coroner office as a full Coroner Case requiring both a coroner referral number and ME/Coroner attestation. REV (Reviewed Reportable Death) The record has been reviewed by the ME/Coroner office and identified as a reportable death requiring only a coroner referral number. A ME/Coroner attestation is not required DECL (Decline further action) The record has been reviewed by the ME/Coroner office and identified as requiring no further action. Neither a coroner number nor a ME/Coroner attestation is required. Click the button. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 22

To search for records by MI Review Status: Choose one of the following from the dropdown menu: NOT SUBM (Not Submitted) The record has not been submitted to the Local Registrar for review of the medical information. SUBM (Submitted) The record has been submitted to the Local Registrar for review of the medical information. ACC (Accepted) The medical information has been reviewed and accepted by the Local Registrar NOT ACC (Not Accepted) The medical information is not acceptable to the Local Registrar and needs correction. Click the button. To search for records by Amendment Status: Choose one of the following from the dropdown menu: ABAND (Abandoned) The amendment has been abandoned manually by a Registrar or ME/Coroner. COMP (Complete) The Amendment is completed and ready to submit. INC (Incomplete) The Amendment requires more information before it can be submitted. REG (Registered) The Amendment has been registered by the Local or State Registrar, and Local Registration Number (LRN) and/or State File Number (SFN) have been assigned. REG W/EX (Registered with Exception) Over time, new or additional validations are added to the system which may result in an error message for a Death Certificate that was registered before the new validation was implemented. The Amendment was registered by the Local or State Registrar with knowledge of this exception, and Local Registration Number (LRN) and State File Number (SFN) were assigned. SUBM (Submitted) The Amendment has been submitted for registration. Amendments for death certificate records registered by the State, must be registered by the State. Amendments for death certificate records not yet registered by the State, may be registered by the Local Registrar or the State. VOID (Voided) The Amendment has been registered and subsequently voided by the State Registrar. Click the button. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 23

To search for records by Custom Column: First, click the Column to None. to clear all search filter criteria fields and reset the Custom Second, select the values for your appropriate SEARCH FILTER(S) or one of your SAVED FILTERS. This determines the records that will be displayed. Third, select the appropriate CUSTOM COLUMN Date/Time radio button. This will display a new Column showing the Date/Time of the selected action. Fourth, select the SEARCH button to display the records. Fifth, click the Custom Column Date Header Label to further order the Records found ascending or descending as indicated by the red arrow. Note: search criteria remains selected, click to clear. NONE No Custom Date column displayed SUBM MI Date Display Date/Time Submitted for MI Review CORONER REF Date Display Date/Time Referred to Coroner SUBM LR Date Display Date/Time Referred to Coroner SUBM SR Date Display Date/Time Submitted for State Registration SUBM AMND Date Display Date/Time Amendment Submitted for Registration AMND REG Date Display Date/Time Amendment Registered DISP Date Display Date/Time of Disposition SR Date Display Date/Time Registered by State Registrar Click the button. Click the button to reset or clear all search filter criteria and reset the Custom Column to None Duplicate Records When you create a new record, the system searches for existing records with the same or very similar first and last names in the set of records you are authorized to view. If the system finds any, the potential duplicate(s) will be displayed in the Potential Duplicate Browser. (Figure 23) View an existing record by clicking on the decedents names. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 24

The system will ask you if you want to continue with the existing record displayed in the Potential Duplicate Browser, or use the one you have created. If you choose to use the existing record, a duplicate new record is NOT created. If you choose to continue to create a new record, a new record is created and you are presented with the Web data entry page for the Death Certificate. Figure 23 - Potential Duplicate Browser Complete the Death Certificate The PI may be completed first, the MI may be completed first, or they may be completed simultaneously. The CI can be completed only after the record has been referred to the ME/Coroner. The Death Certificate may be completed by one or any combination of the following: funeral home user, medical facility user, and/or ME/Coroner user. Unlocking Records Once a section of the Death Certificate is locked, it is no longer editable. If the Death Certificate is not yet registered, the Local Registrar s office can unlock PI, MI, and/or CI allowing you to make corrections. When a section is unlocked, any electronic signature associated with that section will be deleted. If PI is unlocked, the embalmer will need to re-sign as Embalmer and PI will need to be re-authenticated. If MI is unlocked, the Physician must re-attest and/or the ME/Coroner must re-attest. If CI is unlocked, the ME/Coroner must re-attest. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 25

Submitting for Registration When the PI is AUTH (authenticated) and the MI is ATT (attested) either by a physician or the ME/Coroner, the record status becomes COMP (complete). The Record Option menu now displays an additional option - Submit to Local Registrar. Before submitting for Local Registration, confirm your permit(s) are created online. Contact the jurisdiction of death for county specific requirements. (E.g., attestation by both the physician and ME/Coroner) If the Local Registrar determines that the record and permit(s) are acceptable, then he/she will register the death certificate and issue the permit(s). If the Local Registrar determines the record and/or permit(s) are not acceptable, then he/she will reject the record and unlock PI, MI and/or CI allowing you to make corrections. Abandon a Death Certificate Occasionally an unregistered Death Certificate must be abandoned in order to remove it from your Certificate Browser. For example, a duplicate record was created or some other extenuating circumstance prevented the record from being completed and registered. Only a registrar can abandon a record. Contact your Local Registrar s office to request a record be abandoned. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 26

Record Options Record Options let you process a Death Certificate record through the various stages from creation to registration. The menu of available options will change depending on the record s statuses and whether the record is fully electronic or has been printed from CA-EDRS. Decedent Folder The decedent folder shows the various statuses of the record and messages/reasons for a registrar declining to approve or register the Death Certificate. (Figure 24) Save Figure 24 Decedent Folder page Save your work in the CA-EDRS database at any time, without validations. To avoid losing unsaved data, SAVE OFTEN. Note the confirmation message Record has been updated and saved successfully outlined in yellow at the top of the data entry form. (Figure 25) CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 27

Figure 25 Save without validations Accept Record This option allows you to update the coroner status from REF (referred) to one of three statuses. You may update the coroner status anytime before the record is submitted for registration (coroner status cannot be updated when record status is SUBM LR, SUBM SR, or REG SR or attestation status is ME/C ATT). ACC (accepted) you have determined this is a coroner case requiring both a coroner referral number and a ME/Coroner Signature. REV (reviewed) you have reviewed this death and have determined this is a reportable death requiring a coroner referral number. No ME/Coroner signature is required. DECL (declined) you have reviewed this death and determine no further action is required. Neither a coroner referral number nor a ME/Coroner signature is required. The system will enter NONE in the coroner referral field on the Death Certificate form. Select the appropriate check box, then enter the coroner referral number if applicable, then click the button (Figure 26). The coroner status for this record is now updated to ACC, REV, or DECL. Figure 26 Accept Record CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 28

Attest Medical Info This option allows you to attest (electronically sign) the Medical Information in the MI and CI sections of the Death Certificate. You confirm that you have legal authorization to sign/attest the death certificate and to the best of your knowledge, the death did occur at the hour, date, and place, and from the causes stated. Select the YES check box, then click the button (Figure 27). Your name and title are automatically entered as they appear in your user profile. Your electronic signature is your name and the esignature icon ( ). Figure 27 Attest Medical Information Note MI and CI sections on the death certificate screen are now locked (not editable). The esignature icon can be viewed on the death certificate screen and will be displayed on official documents. The esignature icon is redacted and not displayed on the Working Copy. Note: If your name is incorrect in your user profile, submit an account maintenance form available on the CA-EDRS web site at https://www.edrs.us (Obtaining an Account page). Only a system administrator can update your name. Print Working Copy This option creates a PDF file of the Death Certificate displaying the information saved in the data base at that moment in time. Typically, the Working Copy is visually reviewed on the screen when proofing for errors. However, this copy can also be printed at any time. WORKING COPY is printed across the form and the username and date/time stamp are included at the bottom of the form. Do not distribute a Working Copy. It is an unofficial copy and has no legal validity. Local Registration Numbers, State File Numbers, esignature icons, Fax signature icons, and Voice signature icons are redacted information and will not be printed on a Working Copy. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 29

Figure 28 View a Working Copy Transfer Record This option share-transfers the record to a funeral home organization allowing them access to the record. You may also share-transfer the record to medical facility organization allowing them access the record. In addition, if you want to give access to a second ME/Coroner office, you may do so using this option. Select the new funeral home organization, medical facility organization, or another ME/Coroner office from the dropdown lists, then click the button. (Figure 29) Figure 29 Transfer a Record CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 30

View Record History This option allows you to view the activities or functions performed by any user for a given record. You can search by activity, username, and/or date/time. Export Case Figure 30 View Record History Cased-based data export allows for a single case export in real-time as the user is accessing the record online. The file produced by CA-EDRS is in Tab Separated Value format, which can be imported by several available desktop programs or other applications. Figure 31 Export Case file Additional Record Options Occasionally, no Funeral Home will be involved, therefore a ME/Coroner office needs the ability to complete the entire Death Certificate and Disposition Permit, and then complete the registration process. Additional Record Options are available to you which are typically Funeral Home functions. Refer to the Funeral Home User s Guide (http://www.edrs.us User Documentation) for detailed instructions when you need to act in lieu of a Funeral Home (e.g., an indigent decedent). CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 31

Validation Validation is a valuable feature designed to detect common errors. Validation not only reduces the number of rejected Death Certificate records but also the need for Amendments at a future date. The values saved for each field must pass State data quality criteria. Validating provides multiple checks and cross-checks and provides quality control of the Death Certificate information. Validation alerts the user to obvious mistakes, missing values, formatting errors, disallowed entries, incorrect date sequences, and inappropriate cross field edits. An example of a cross field edit: If sex is female, then the pregnancy question must be answered. Validations include a check for Hispanic and Race field entries. If the values in these fields are not found in the reference lists, a warning message will be displayed to alert you to possible misspelling or inappropriate entry. Validations also include a medical spell check for causes, other significant conditions, and surgeries (fields 107A, 107B, 107C, 107D, 112, and 113). If the individual words in these fields are not found in the reference list provided by the National Center for Health Statistics (NCHS), a warning message will be displayed to alert you to possible misspellings. Note, a few correctly spelled medical words are not included in the reference list and will be overlooked and some foreign spellings are included that may be considered incorrect in California. Despite these limitations, it is a very valuable tool for data quality. Validation will result in three types of responses: If validation is successful, the message indicating data has been successfully validated is displayed outlined in yellow at the top of the death certificate screen. Error messages will be displayed outlined in red at the top of the death certificate screen and a red arrow is displayed in the field(s) containing the error(s). Errors must be corrected before proceeding. Warning messages will be displayed outlined in yellow at the top of the death certificate screen indicating a possible error or misspelling. Warnings should be reviewed to confirm that the information is indeed correct. Validation does not catch all typographical errors, therefore it is very important that you use all validations and carefully review the information before authenticating PI, submitting MI for LR review, or requesting remote attestation. View the Print Working Copy. Proof read for errors. Does the text for each value fit in the box? CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 32

Validation does not check the accuracy or the medical logic of causes. Utilize the Submit MI for LR Review option if you are uncertain whether or not the causes are acceptable. The following is an example of a cross field edit between the decedent s age and the years in occupation: If the decedent s age (field 5) is 40 years old and the years in occupation (field 19) is 40 years, a warning message outlined in yellow will be displayed asking you to confirm that this information is correct. (Figure 32) If the decedent s age (field 5) is 40 year old and the years in occupation (field 19) is 41 years, a red error message outlined in red will be displayed and a red arrow in field 19. (Figure 33) Figure 32 - Warning message outlined in yellow Figure 33 Error message outlined in red must be corrected. Red arrow in field with error. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 33

Validate PI Validate MI SpellCheck MI Validate CI Validate PI only checks for errors in the PI section. This process also confirms that the Embalmer has signed, unless NOT EMBALMED in entered in field 42, and it compares the entries in the Hispanic and Race fields to State reference lists. Validate MI only checks for errors in the MI section. This validation should be run prior to Submitting MI for LR review, before requesting remote attestation, or before ME/Coroner attestation. Since this validation is used before attestation, it does not check the dates attested. SpellCheck MI compares the words currently saved in fields 107A, 107B, 107C, 107D, 112, and 113 to the reference lists provided by the NCHS. It does not check MI for accuracy or logic. Note: some correctly spelled terms are not in the list and some foreign spellings (considered incorrect in California) are included in the list. Validate CI only checks for errors in the CI section. Since this validation is used before attestation, it does not check the dates attested. Validate PI/MI/CI Validate PI/MI/CI checks all sections of the Death Certificate for errors. Since this validation is used before attestation, it does not check the dates attested. Validate for Submission Validate for Submission checks all sections of the Death Certificate for errors, including dates attested. Since this validation is used after attestation, it also checks the dates attested. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 34

Coroner Amendment Overview The Physician/Coroner Amendment, form VS-24Ae, is referred to as the Coroner Amendment (CA) in CA-EDRS. A Coroner Amendment corrects information on a Death Certificate record that has already been registered either at the local or State level. Medical Examiners, Coroner, Deputy Coroners, and designated Staff Level 1 can create a Coroner Amendment. Only one incomplete amendment (Coroner or General Amendment) can exist at any point in time. Only after the amendment is completed and registered (status REG ) or deleted (status ABAND or VOID ) can another amendment be created. For ease of use, the CA-EDRS application enables you to create and edit an amendment on a page that looks like the Death Certificate form, but is labeled as the Coroner Amendment to the Death Certificate. However, when you view or print the PDF file, the application produces the required State of California form VS-24Ae (Physician/Coroner Amendment). Amendments in CA-EDRS may span multiple pages if the amended information exceeds the space available on a single amendment form page. ME/Coroner Activities A ME/Coroner office typically creates a Coroner Amendment to complete a pending case. You also have the ability to correct or complete information in any section of the registered Death Certificate. The Medical Examiner, Coroner, or Deputy Coroner electronically signs the amendment. Since the signature is electronic, the Amendment can be submitted for registration electronically. Local Registrar Activities In the case where a Death Certificate has been registered locally, not yet at the State level, the Local Registrar can register an amendment to the Death Certificate. The Local Registrar can then issue certified copies of the Death Certificate and the amendments. After the amendment has been registered, the official document is sent to the State Registrar. Since the amendment was submitted electronically, the Local Registrar can register the amendment electronically then print official copies with the Local Registrar s esignature, CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 35

date registered, and LRN. This printed official document is used to issue certified copies and then forwarded to the State Registrar. The Local Registrar cannot register an amendment if the associated Death Certificate has been registered with the State Registrar. State Registrar Activities If the amendment was registered by the Local Registrar, the State Registrar s office completes the registration process by printing the SFN on the official document. If the amendment was not previously registered by the Local Registrar and since the amendment was submitted electronically, the State Registrar s office registers the amendment electronically then prints official copies with the State Registrar s esignature, date registered, LRN, and SFN. This official paper document is used to issue certified copies by either the State Registrar or the Local Registrar. General Amendments The Affidavit To Amend a Record, form VS-24e, is called the General Amendment (GA) in CA-EDRS. A General Amendment corrects information on a Death Certificate record that has already been registered either at the local or State level. A Funeral Home typically creates a General Amendment to correct misinformation in the PI section or coroner referral field of the registered Death Certificate. The signatures of two people who have knowledge of the facts are required, and are designated First Person and Second Person on the form. ME/Coroner users have the ability to create, electronically sign and submit a General Amendment. Refer to the Funeral Home User s Guide (http://www.edrs.us User Documentation) for detailed instructions should you wish to create or sign a General Amendment. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 36

Coroner Amendments You can only create a new amendment if the associated Death Certificate is registered (record status SUBM SR or REG SR) and all previous amendments are registered (amendment status REG) or deleted (amendment status ABAND or VOID). Create a New Amendment The Amendment Options menu will only appear after a Death Certificate has been registered. Select the Create Coroner Amendment option from the Amendment Options menu. You will be presented with the Coroner Amendment screen (Figure 34). Refer to the Funeral Home User s Guide (http://www.edrs.us User Documentation) for detailed instructions should you wish to create a new General Amendment. Figure 34 Create a New Coroner Amendment Find an Existing Amendment The Amendment Browser displays a list of the existing amendment(s) associated with the Death Certificate. The Amendment Browser also displays useful information such as type of amendment (General Amendment or Coroner Amendment) and Amendment Status. To find the Amendment Browser, you may either click on the value in the amendment status column of the Death Certificate Browser (Figure 35) or select the Find Amendment option from the Amendment Options menu (Figure 36). Figure 35 Click to find the Amendment Browser from the Certificate Browser page To view a specific amendment, click on the name (Figure 36). CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 37

Figure 36 Find the Amendment Browser using the Amendment Options menu Completing Amendments The web page screen to complete the amendment looks like the Death Certificate screen (Figure 37). Fields that may be amended are editable and display the current values in the data base. Fields 112 & 113 have been changed to allow the ME/Coroner to enter up to 4000 characters in each field. Edit the field(s) as necessary to correct the information, run validations and review the Working Copy before obtaining signatures. Figure 37 Coroner Amendment web page before esignature Amendment Signature When electronically signing a Coroner Amendment, the user must log in using their own user name and password. It is a violation of security to use another person s login. Your name, title, and address are automatically entered as it appears in your user profile. The esignature will appear on the official copy of the amendment with the esignature ( ) icon. After the first esignature, the amendment fields are locked (not editable). Note: If your name is incorrect in your user profile, submit an account maintenance form available on the CA-EDRS web site at https://www.edrs.us (Obtaining an Account page). Only a system administrator can update your name. Note: If an amendment has multiple pages, the esignature and signatory s information is affixed to all pages. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 38

Submitting for Registration After the amendment is signed electronically, the amendment status becomes COMP (complete). The amendment can now be submitted electronically. If manual signatures were required, the printed official amendment must be submitted for registration. Abandon an Amendment Occasionally an unregistered amendment must be abandoned in order to allow another amendment to be created. Only a Registrar or ME/Coroner can abandon an amendment. Coroner Amendments to amend pending causes of death have priority over General Amendments which are used to amend only PI. The Coroner may abandon a General Amendment in order to expedite the completion and registration of a Coroner Amendment. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 39

Amendment Options Amendment Options let you process an amendment through various stages from creation to registration. Save Save your amendment in the CA-EDRS database at any time, without validations. To avoid losing unsaved data, SAVE OFTEN. Note the confirmation message The Amendment has been updated and saved successfully outlined in yellow at the top of the data entry form. (Figure 38) Print Working Copy Figure 38 Save an Amendment This option creates a PDF file of the Amendment displaying the information saved in the data base at that moment in time on the VS-24e or VS-24Ae form. Typically, the Working Copy is visually reviewed on the screen when proofing for errors. However, this copy can also be printed at any time. WORKING COPY is printed across the form and the username and date/time stamp are included at the bottom of the form. (Figure 39) Do not distribute a Working Copy. It is an unofficial copy and has no legal validity. LRNs, SFNs, and esignature icons are redacted information and will not be printed on a Working Copy. CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 40

Figure 39 Print or View a Working Copy Attest Select the Attest option from the Amendment Options menu. Your name is automatically entered as it appears in your user profile. Click the Attest Amendment checkbox to confirm that you are legally authorized to sign/attest the Coroner Amendment to a death certificate, and to the best of your knowledge, the Death did occur at the hour, date, and place, and from the causes stated and, then click the button. (Figure 40) Figure 40 Attest CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 41

Over time, new or additional validations are added to the system which may result in an error message for a Death Certificate that was registered before the new validation was implemented. For example, early versions of CA-EDRS did not check for the embalmer s esignature and a death certificate could be registered without the esignature. Validations would now show this error; however, you are not amending the embalmer s signature. After reviewing the error message, you have the option to Attest amendment with exception. You acknowledge the error message and proceed to attest so you can then submit the amendment for registration. (Figure 41) Figure 41 - Attest with exception Select to return to the amendment screen. Note all fields are now locked (not editable). The signatory s information can be viewed on a Working Copy (Figure 39). If the amendment is more than one page, the esignature and first person s information is shown on all pages. The esignature icon is redacted and not displayed on the Working Copy. Submit This option only appears after the amendment is complete (Figure 42). An amendment is complete only after the two persons have signed electronically. (Amendment status is COMP) The ME/Coroner/Deputy Coroner or designated Staff Level 1 can submit the amendment for registration. Click the YES checkbox to confirm that you wish to submit this amendment, then click the button. (Figure 42) Figure 42 Submit for Registration CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 42

Abandon This option allows you to abandon another amendment already in process so that you can create a Coroner Amendment. Only a Registrar or ME/Coroner can abandon an amendment. Coroner Amendments to amend pending causes of death have priority over General Amendments, which are used to amend only PI, due to the importance of resolving pending cases. Click the YES checkbox to confirm that you wish to submit this amendment, then click the button. (Figure 43) Find Amendment Figure 43 Abandon an Amendment To return to the Amendment Browser page (Figure 36), select the Find Amendment menu option. (Figure 46) Case Export To generate a case export with the amended information, (Figure 45) select the Case Export menu option Decedent Folder To return to the decedent folder page (Figure 24), select the Decedent Folder menu option. (Figure 46) Figure 44 Return to Amendment Browser Figure 45 Amended Case Export Figure 46 Return to Decedent Folder CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 43

Amendment Validation There are two Validation menu option for Coroner Amendments. Validate Amendment This option runs all the validations of the original Death Certificate to prevent errors from being introduced. Amendment validation checks all the new amended field values and all previously entered values from the Death Certificate and any prior amendments for errors. Successful validation messages, error messages, and warning messages are displayed (Figure 47) on the amendment screen as they are on the Death Certificate screen. Figure 47 Validate an Amendment SpellCheck MI Amendment This option compares the words currently saved in fields 107A, 107B, 107C, 107D, 112, and 113 to the reference lists provided by the NCHS. (Figure 48) It does not check MI for accuracy or logic. Note: some correctly spelled terms are not in the list and some foreign spellings (considered incorrect in California) are included in the list. Figure 48 Medical Spell Check CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 44

Reports and Exports ME/Coroner/Deputy Coroners have access to the CA-EDRS Report and Export Function. Reports and Export functions are found by selecting the Reporting tab. Of particular interest is the Pending DC Aging Report which returns the records where Manner of Death (field 119) is Pending Investigation and it has not yet been amended to another value. The Pending DC Aging Report lists the records and the number of days between Date of Death and the date the report was generated. Reports The data manager enters a date range, selects the report from the list, then clicks the button. (Figure 49) A report will be displayed in PDF format. Figure 49 - Reports To view the MWR Report, the data manager enters a LRN range or Date of Registration range, selects the report checkbox, then clicks the button. (Figure 50) The report will be displayed in PDF format. Figure 50 WMR Report CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 45

Exports The data manager enters a date range, selects the export from the list, then clicks the button. (Figure 51) The web browser will ask whether you want to save or open the file. Click save and store the file on your computer. The file is saved as an.edrs file in CSV format, with each field separated by a comma. After the file is saved the file.edrs extension must be changed to.csv. This is a common import/export format and is supported by the vast majority of desktop programs including Microsoft Access and Excel. To facilitate importing this data, we have produced a Microsoft Access template which is available on the EDRS web site (http://www.edrs.us ). Figure 51 LRD Exports For additional information is available, refer to the EDRS Data Export Specifications: LRD Data Manager Version document at http://www.edrs.us (User Documentation). CA-EDRS Medical Examiner/Coroner User Guide Version 2.4 46