New York City DOHMH eVital

Introducing eVital: Digital Transformation at the NYC Bureau of Vital Statistics

Background: Context, Challenges, and Opportunities

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From its two centralized registration offices in Manhattan and Brooklyn, New York City’s Bureau of Vital Statistics (BVS) registers around 120,000 births, more than 50,000 deaths, and more than 9,000 fetal deaths per year; amends 50,000 records, and issues nearly one million certified copies of birth and death certificates.

From 2007-2010, BVS transitioned from its prior paper-based legacy system to an electronic reporting system, however, the system lacked important features that BVS needed to operate effectively and efficiently. BVS saw the need for operating efficiencies and modernizations, so, in 2014, BVS partnered with GCOM, the leading provider of tailored technology solutions for state and local governments nationwide, to transform its existing electronic reporting system. In October 2018, BVS and GCOM launched the Bureau’s next-generation system, eVital, to provide seamless access to legacy vital records, and for registering, processing, and storing birth and death certificates, acknowledgements of parentage (AOPs), and disposition permits.

eVital integrated multiple parallel systems, included a mobile friendly platform for external users, a facial recognition-enabled case certification solution, and a new component that improved the AOP registration process. Naturally, the implementation of eVital brought considerable change to both BVS’ internal operations as well as the processes for external (healthcare and funeral director) users. In order to successfully implement eVital, BVS instituted a robust change management plan that was executed methodically and efficiently, ensuring BVS employees and partners were fully prepared to leverage the new technology to the benefit of both the Bureau and its many stakeholders.

“BVS and GCOM’s partnership has led to improvements to how we operate and serve the City of New York,” said Gretchen Van Wye, Assistant Commissioner, Bureau of Vital Statistics at the New York City Department of Health and Mental Hygiene. “With eVital, stakeholders who engage with BVS technology—hospital workers, funeral directors, BVS employees—have benefitted from a more efficient, more user-friendly system that is enabling us to provide seamless service to New Yorkers.”

In this customer story, we elaborate on some of the eVital solution’s capabilities, how they have improved the way BVS operates, their impact on how stakeholders—including everyday constituents and facilities like hospitals and funeral homes—engage with BVS, and the extensive change management process BVS implemented to ensure successful technology adoption.

What is eVital?

The eVital solution is a comprehensive vital records workflow enablement system developed upon GCOM’s proprietary technology and tailored to meet BVS’s unique needs. It was adopted to enable BVS to optimize electronic workflows and business processes and is used for a number of key Bureau functions, including case reporting and registration, certificate issuance, amendments, and order processing.

The benefits of the new solution extend directly to the users of the system, stakeholders both internal—BVS staff—and—external facilities such as hospitals, nursing homes, and funeral homes. The impact of the solution touches the lives of everyday New Yorkers—the constituents who depend on access to their vital records on a timely basis.

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Background: Context, Challenges, and Opportunities

Birth and Death Case Certification

In NYC, reports of new births and deaths require electronic authentication by an authorized individual. The birth and cause of death information is certified by a clinician and the personal information for deceased individuals is signed off by funeral directors. BVS and GCOM partnered to integrate a new case certification mobile app as part of the overall eVital solution to enable the Bureau to handle birth and death cases more securely and efficiently.

The previous electronic reporting system had various shortcomings. For instance, its biometric system required hardware, a fingerprint scanning device, to be connected to a computer. Authorized users had to enroll a 5-point representation of their fingerprint in the system as part of their user profiles and provide fingerprint signoff to affirm the authenticity of each new case; successful sign-off occurred when the fingerprint at signoff matched with the baseline a 5-point representation of the fingerprint on file. This authentication process was difficult to audit and therefore was susceptible to fraud, as it could be difficult to prove that the digital representation of the fingerprint submitted with the case belonged to the certifier. The most hindering aspect was that it was not a mobile solution, meaning users were limited to signing off on cases while at the specific computer that had the fingerprint device connected.

Working closely with BVS, GCOM developed a new mobile case certification solution: the NYC eVital Certify Mobile App. The app, available on both iOS and Android, is based on a facial recognition-enabled system of electronic photo capture. With the app, an authorized user enrolls ten baseline photos of themselves as part of their user profile and submits a photo along with every new case. The app’s facial recognition capability, which matches the individual certification to the baseline photos, improves auditability, making it easy to prove the certifier’s identity. Providing users with a mobile solution has improved their ability to certify cases remotely and timely.

Acknowledgement of Parentage (AOP)

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When children are born to unmarried parents in NYC, the second parent (not birth parent) has the option to voluntarily submit an acknowledgment of parentage (AOP) to authenticate themself as the child’s other legal parent. The AOP, submitted to BVS’s Birth Registration Unit upon a child’s birth, thus serves to connect children with essential information about their second parent. BVS reviews the submitted AOP and, if successfully completed, registers the birth case, and also submits the AOP to the New York State Putative Father Registry.

Prior to the eVital implementation, BVS used paper-based systems that required multiple procedures and systems to complete the AOP submission process. Typically, facilities would have to collect and fax completed AOPs to BVS, and manually write the birth case ID at the top of the AOP. The faxed documents were then converted to electronic formats and saved to an electronic folder at BVS. BVS’s Birth Registration Unit used a separate electronic system to review faxed AOPs and match them with electronic birth cases.

Today, with eVital, facilities can opt to easily create AOPs in the eVital system, print and obtain signatures, scan and save the signed copy in the system, or to scan the paper copy of the AOP and attach it to the electronic birth case before submitting it to BVS. These enhanced workflow options both streamline the process for facilities and improve workflow for BVS.

Implementing Change Management

Taking on a digital transformation process of this significance called for a comprehensive change management plan that would equip all users with the know-how to use eVital while minimizing disturbances during the transitional period. BVS used a multi-pronged approach to implement its change management strategy. The Bureau conducted in-person trainings and engaged in various types of communication including emails, phone calls, robocalls, and website updates. BVS also partnered with professional organizations who helped to amplify and support messages, and held frequent conference calls with users such as funeral directors and clinicians to address issues, answer questions, and identify improvements. Additionally, recognition and engagement from City Hall and agency leadership was instrumental in providing BVS the support they needed to effectively engage all stakeholders through the change management process. Though BVS is a full-time operation, it successfully managed a complex change management process while ensuring the continuity of day-to-day services.

Background: Context, Challenges, and Opportunities

BVS regularly and methodically measured progress of implementation using several key performance indicators to ensure successful adoption by stakeholders both internal and external. For example, prior to full implementation of eVital, BVS measured the number of users who were trained at each facility and the number of users that successfully enrolled in the new system both by facility and by user role. Once the users transitioned to fully use eVital for registration and issuance, they monitored the progress of case completion including successful certification and ability to attach. Subsequently, BVS ensured that their own employees were able to successfully register cases, process orders, print certificates, and ensure certificate security. BVS focused additional attention on monitored response times for specific software modules to ensure that internal and external modules worked under challenging conditions and endeavored to discover and resolve bugs rapidly and efficiently.

Key Results

The transition from the previous electronic reporting system to the current eVital solution has been transformative for BVS, end-users, and the constituents of NYC who depend on seamless access to vital records.

Service During COVID-19 Crisis

During the early months of the COVID-19 pandemic in NYC, the eVital system—which faced pressures due to the unprecedented increase in the number of death certifications that needed processing, continued to operate effectively, allowing the Bureau to continue to fulfill its obligations to NYC constituents.

As the death rate in New York City escalated, the City needed to be able to identify and track the deceased individuals rapidly and efficiently. BVS rose to the occasion, quickly enhancing their interface with the Office of the Chief Medical Examiner to assist the City in identifying and tracking the location of the deceased whether with a funeral home or facility. Furthermore, in order to help field hospitals process the increasing number of deaths, BVS enrolled and trained death certifiers to properly create and issue death certificates.

“In the early days of the pandemic in New York, the challenges facing the City were immense, as the government need- ed to quickly respond to the unprecedented death toll,” said Program Manager at DOHMH. “As we continued to lose our fellow New Yorkers to the pandemic at a rapid rate, we needed to do our part to help the City account for the deceased. The solution BVS developed was a testament to the value the agency provides constituents, the power of collaborative innovation, and the resolve of New Yorkers in the face of difficult circumstances.”

Serving a Critical Role

BVS serves a critical function for New Yorkers. Though the importance of vital records accessibility may go unnoticed when things go right, their important role in New Yorker’s daily lives is readily apparent if things do not. With GCOM’s eVital solution, BVS is fully equipped with the innovative, leading-edge technology it needs to ensure continuity of operations, even amid the most challenging circumstances.

Why GCOM?

GCOM has established an outstanding reputation of delivering innovative, tailored technology solutions with a focus on modernizing legacy IT systems. We combine the scale to support large complex projects with the agility and accessibility of a smaller company giving state and local leaders a third option when looking for a partner to their technology challenges. Our reputation for innovation and reliability has been earned by helping clients leverage cutting edge technology while mitigating risk. Our team collectively brings decades of successful government experience to the table. GCOM combines its experience and domain expertise with user-centric design for solutions that improve agency performance, accessibility and transparency.

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