Since 1970, advocates for the Emergency Medicine specialty.
Virginia’s e-death certificate system:
The Virginia Electronic Death Registration System (EDRS) enables physicians, funeral directors, and others in the death-registration process to file death records online with the Virginia Department of Health’s Division of Vital Records (DVR). This helps usher in an era of a paperless system.
Virginia lawmakers passed legislation in the 2019 General Assembly to mandate all emergency room physicians, physician assistants, and nurse practitioners register to use the EDRS system on or before July 1, 2019. Other providers by specialty have rolling registration dates in the fall of 2019. All providers are required to use the EDRS as of January 1, 2020.
With the help of the Medical Society of Virginia, we’ve pulled together some answers you may have to questions on the new system.
What is the Electronic Death Registration System (EDRS)?
It is a system intended to enable physicians register to use in order to complete death certificates electronically as opposed to by paper copies.
The office of Vital Statistics at the Virginia Department of Health maintains and administers the system. There is no fee or cost to a physician or anyone to register to use it. In order to register, visit the VDH website. There is also a toll-free number to call for assistance ((804) 864-7200, press option 2), along with EDRS trainers who can come meet with your group or provide education at no cost.
What if I practice in a emergency physician group that covers multiple hospitals?
Today the EDRS system is designed such that you can enter only one hospital when you register. In order to enter additional hospitals, the names of those additional hospitals must be submitted in writing to VDH and added manually.
The EDRS is being updated and this fall it is expected that all hospitals can be listed electronically.
What is the role of funeral directors under EDRS?
Today, funeral directors begin the paper copy of death certificates. Under EDRS, they will do the same. Funeral directors will enter identification information of the decedent, and the EDRS will notify you by email that you have a pending certificate to sign electronically. You can complete your part at any computer, tablet, or smartphone.
As it is today, your role is to enter the cause or causes of death. Once entered, just click send, and the EDRS will send the death certificate back to the funeral director so he or she can file it.
Current law remains unchanged in that death certificates are to be completed within 24 hours of death. A decedent may not be cremated without a completed certificate and with more persons electing cremation, the push to have death certificates done timely is intensified.
What is my liability for signing a death certificate or my risk for refusing to do so?
For several years, Virginia law provides that absent willful misconduct on your part, the signature of a death certificate does not give rise to liability. In other words, you are immune from acts of simple negligence.
There may be a number of providers who can sign a death certificate, but the code refers to the physician in charge of the patient. This has been interpreted to mean anyone from the emergency physician to a physician who has prescribed or seen the patient within a year prior to death. If a patient presents to the emergency department with little to no history and is pronounced dead, the emergency room physician can consult the local medical examiner for advice on what to list as the cause of death.
The 2019 legislation added another factor in that failure of a provider to sign a death certificate (physician, nurse practitioner or physician assistant) can be grounds for a finding of unprofessional conduct by the Virginia Board of Medicine.
How do I make a correction on a certificate in EDRS?
Providers are able to make revisions or corrections to the cause of death section of a certificate by submitting to VDH on your letterhead the patient’s name, DOB, DOD, address and what information you want to change. For example, if you listed the cause of death as “abdominal aortic aneurism” and it was really a “pulmonary embolism,” then you would provide that information.
What is a “designee” under the EDRS?
Physicians can appoint and have register with the EDRS a designee. A designee is anyone who has access to the patient’s chart and who can complete the provider portion of a certificate sent to you under the EDRS system. For example, my nurse “Mary” or my PA, “Joe” could be appointed by a physician as a designee and can complete the cause of death portions of the certificate in place of having the physician do so. Just remember, the designee has to register with the EDRS system to be a user just like the physician does. You are not mandated to use or have a designee.
What is a “facility use administrator (FAU)” under the EDRS?
Groups of physicians, generally greater than five, are encouraged to appoint a FAU. The primary role of the FAU is to help physicians with the administrative duties of the EDRS such as changing or appointing designees. It is common for a hospital to have a FAU, for the hospitalist group covering to have one, and the emergency physician group to have one. Use of a FAU is not mandatory, but is designed for ease of use. The same person may serve both as a designee and FAU at the same time.
What if I get sent a certificate to sign in the EDRS system and the decedent was not seen by me or my group?
The EDRS will send via email the certificate to the physician the funeral director enters into the field when requested. With commonality of names, it can be that you get a certificate sent to “Scott Johnson” when it should have been sent to “Steve Johnson.” The EDRS enables to reject the certificate. A telephone call to the funeral director is recommended in order to keep good lines of communication.
If you have further questions on the EDRS, email Bob Ramsey, VACEP’s executive director.