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Know your legal obligation to promptly complete death certificates
e-Reports, April 6, 2015
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Indiana became the first state in the nation to implement the mandatory electronic death registry system (IDRS) on Jan. 1, 2011. As with most new things, the IDRS has exposed some challenges, and you may have struggled with how to certify cause of death in some cases with limited information.

The ISMA is helping identify challenges for physicians using the system and working with stakeholders to implement solutions. In the meantime, you should take note of your obligation to comply.

Current concerns
Some funeral home operators and coroners have put up a recent public outcry, prompting Indianapolis news media to highlight concerns about physicians not filing death certificates. Delays can interfere with a family’s ability to promptly and respectfully bury a loved one and file for life insurance benefits. For those reasons, filing delays may prompt complaints against physicians with the Indiana State Department of Health (ISDH) and the Medical Licensing Board of Indiana.

Compliance with the law
Indiana law requires the physician “last in attendance upon the deceased” to submit the death record using the IDRS within five days of initiating the documentation process or receiving notification from someone in charge of interment. Failure to comply can lead to fines of up to $1,000.

The electronic death record process can be initiated by the doctor, but more typically it’s done by the funeral director. The director enters some information and then sends an email to the physician who last attended the deceased, indicating a death record awaits completion. Physicians cannot receive such emails unless they are already registered to use the IDRS.

Medical office staff can assist physicians with gathering information and completing some of the data fields, but physicians must ultimately review, approve and sign the record using their four-digit pin number assigned at registration. Physicians have five days to complete this step; the record then goes electronically to the local health department for review. Next, the record is sent to the ISDH for final approval and release.

Registering for IDRS
To complete a death certificate, physicians must first register to use the IDRS. Because of the time needed to process registrations, it is prudent to proactively register before needing to use the system.

Start by completing a Confidentiality and User Agreement on the IDRS website. If your staff will assist you in completing the electronic documents for your review, those staff members must also complete a user agreement.

For more information, including training tutorials, visit here.

Find a Tip Sheet on the ISMA website.

Special situations
When a death occurs without medical attendance or the physician last in attendance is physically or mentally unable to sign the death certificate, the law directs the local health officer to make inquiries of anyone with knowledge about the cause of death. The health officer may issue a subpoena for information and request an autopsy when necessary to certify cause of death. If circumstances suggest the death was from other than natural causes, the attending physician or, if none, the local health office is required to refer the case to the coroner.

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