1. Introduction By Attendees.
2. Opening Statements.
Review of minutes from December 7, 1998 TAG meeting.
Main purpose of this meeting is to discuss AMRs with approximately
200 received and acted on annually.
Explanation of AMR factors: need for consistency and standardization.
Version 4.8 and 4.9 Update Procedure/Schedule
Version 4.8 update procedure was automated, resulting in easier,
faster, and more reliable updates. AVSS Project thanks those LRD
staff members who helped; San Bernardino, Riverside, Los Angeles,
San Diego, and Santa Clara.
Los Angeles County had problems with some hospitals having extra
variables like Apgars; this will require an AMR.
Version 4.9 must be installed at all sites before 1/1/2000 due
to race/ethnicity changes and new birth certificate form.
4. Site Interdependency and DHS Use of AVSS (Alan Oppenheim).
A primary goal is a consistent database at LRDs and OVR with
identical number of events (births, deaths, CMRs).
The DHS Birth System Redesign project was described with the outcome
that DHS will apply amendments via AVSS.
5. AVSS Modification Request (AMR) Review and Discussion.
99-007: This has already been programmed and implemented,
but has created some complaints from LRDs since they can no longer
edit AVSS birth certificates (LCAs), so it was revisited. Three
possibilities were discussed: 1. Leave as is; 2. Rescind the AMR
and allow LRDs to edit LCA; 3. Allow LRDs to edit LCAs up to the
date that they are sent to OVR. No consensus could be reached
on the three alternatives, so it will be left as is for the time
being.
98-141: OK to reallocate state applied AVSS electronic amendments
resulting from Birth System Redesign to the LRDs.
98-142: OK to disallow amending SSA1, SSA2, and LFN on the LCA.
98-088: Would have to be standard statewide and most LRDs do not
want the additional prompt. Other complications related to parental
notification and legal issues. San Diego to work with OVR regarding
wording, reporting, and possible legislation.
99-001: Withdrawn.
99-002: OK to delete DMRs at the state when the corresponding
CMRs are electronically received.
99-003: Withdrawn.
99-004: Mark Starr and Peaches Grant will investigate further.
Los Angeles has a custom report that could be the solution.
99-007: OK to allow OVR to edit LCAs using a special edit menu
choice only available at OVR.
99-008: OK to allow reallocated OVR-edited or amended LCAs back
to the LRD and LRD of residence.
99-023: Suggest entering Underlying Cause Of Death (UCOD).
99-024: OK to correct #CDCLST4 report as suggested.
99-026: Presentation by Anthony Oreglia regarding Year 2000 race/ethnicity
specifications from OMB, Census Bureau, FHOP, and DHS. Follow
up by Alan Oppenheim on OVR perspective including an extensive
standardized race list to be included in revised CBC specifications,
then by Ron Williams on the AVSS approach for satisfying OVR objectives
of multiple race reporting. In order to satisfy the many constraints,
users will be limited to the choices available on the CBC race
list. There will be considerable work involved including adding
the multiple race variables to the 1400 byte CBC record and incorporating
them into the foreign import process. The birth certificate must
be redesigned to accommodate the multiple races and the changes
in the software must take place throughout the state on January
1, 2000. The death certificate will also allow multiple races
after that date. A separate AMR would be required to add multiple
races to the current CDC form or to AVSS/EDR, otherwise the first
race listed should be entered into AVSS quick registration for
deaths.
99-030: Consensus was that we don't want to discourage reporting
of Haemophilus Influenzae, so it was not approved.
99-032: All County Letter #99-002 has only CR/SCAT, not CR/PR
and CR/PB as suggested by AMR, so more information is needed.
OVR will investigate further.
6. Confidential Morbidity Report (Discussion Led By Mark Starr).
AVSS changes for CMR, WMPR, Case Hx forms have been incorporated
into Version 4.8, and DMR is ready to use.
Users should enter all Hepatitis C cases.
Electronic Laboratory-based Reporting (ELR) activities are proceeding
by means of a Task Force.
Outstanding issues: revised ASCII output file layout, revised
disease list, expanded and updated Serotype/Subtype list.
Need for CMR Users Group, updated documentation, user training,
and volunteers to help with AVSS/CMR.
7. Electronic Death Registration System.
AVSS/EDR pilot is continuing in Santa Barbara County, but
with not much enthusiasm from funeral directors mainly due to
the problem of obtaining certifier signatures. Several possible
solutions were proposed by the AVSS Project. The one chosen was
the 'second pass' whereby only the medical portion and the official
form would first be printed on blank paper, then the certifier's
signature would be obtained. Later, after the personal data were
available and entered into AVSS/EDR, the certificate would be
placed in the laser printer for the second time and the personal
data fields would be overprinted. This was implemented on in April
1999 and increased the participation rate from 35% to 70%.
The funeral directors are still interested in an electronic signature,
allowing for security, validity, and non-repudiation.
There will be no implementation of AVSS/EDR in other LRDs for
some time to come.
8. AVSS Automated Birth-Death Matching.
Beginning in January 1999, AVSS electronic death certificates
(CDCs) were automatically transmitted from LRD computers to the
AVSS/OVR computer in Sacramento..
The automatic birth-death matching rate increased from 72% as
received from the LRD to 90% at OVR.
Follow up interactive matching increased the match rate to nearly
95%. The remaining non-matches were frequently cases that need
further investigation due to unusual circumstances surrounding
the death.
There were more false matches at the state level, but it should
be possible to nearly eliminate them with minor modifications
to the matching algorithm.
The AVSS Project will investigate the possibility of back-transferring
OVR-matched records to the LRDs.
Ideally, all LRDs would enter deaths by means of the CDC quick
registration. Advantages to the LRD are: indexing, reallocation
from other LRDs, birth/death matching, and reports to the registrar
of voters.
9. AVSS Census Tracting.
Work continuing by Scott Shepard of DM Information to improve
AVSS census tracting routines.
Current match rate is 80-85%, which can be improved by 5-10% by
relaxing the assumptions defining a match. However, the program
needs to be made more reliable before implementation.
Some LRDs are entering false census tracts for non-residents.
This causes a problem when reallocation later occurs. An AMR is
probably needed here.
10. BirthNet.
BirthNet has been phased out. AVSS data will be transmitted
to local MCH programs by means of Zip drives.
11. Equipment/Operating System Recommendations.
AVSS is still a DOS-based program and it is preferred to have
a low-cost dedicated computer running DOS 6. If it is absolutely
necessary to run on Win 9x, then the procedure posted on the AVSS
web page must be followed.
12. AVSS Technical Assistance.
Most LRDs have paid their FY98-99 contributions of $1,500
plus $500 per added AVSS site.
13. Year 2000.
Bette Ingle of Santa Clara County found a problem with AVSS
Field 27F on the birth certificate during her Y2K testing due
to the MM/YY format. It is minor problem that has an easy fix.
Alan Oppenheim recommended that everyone check their computer
BIOS for Y2K compliance.
Updated March 28, 2000 by RL Williams
