HISTORY

Beginning in 1980, the Automated Vital Statistics System (AVSS) was envisioned to be an integrated computer system for the collection, management, and reporting of public health paper forms, with special emphasis on vital records. The primary goal of AVSS has been the improvement of timeliness and accuracy of vital records by means of computer automation. AVSS used an innovative approach that was both revolutionary and evolutionary. It was revolutionary since it was the first operational electronic birth certificate system that interactively produced a computerized legal copy of a paper birth certificate that passed state-mandated quality assurance edits. Information was collected as close as possible to the source of data. Electronic data resulting from birth registration in hospitals was automatically transmitted to public agencies thus eliminating many of the time-consuming, redundant, and error-prone manual processes. But AVSS was also evolutionary since it adapted to the existing system of vital event registration that has been in place in most states for nearly a century. This gave rise to the world's first electronic birth certificate in 1981 at Santa Barbara's Cottage Hospital.

Thus the goal of AVSS, as announced nationally in 1983, was to create an interactive vital records computer system that would:

• Improve timeliness
• Emphasize accuracy
• Minimize redundant data entry
• Feedback data to providers

Accuracy was achieved by developing and implementing in four states (California in 1981, Massachusetts and Rhode Island in 1986, and Connecticut in 1987 --- see Chronology) a system of direct data entry into a central computer with quality edits performed before the birth certificate was printed. This interactive system used automated telecommunications with modems and ordinary telephone lines to achieve the goal of timeliness. This was made possible by building a hierarchical standardized system with data flowing automatically from the hospital to the county health department to the state registrar, then eventually to the National Center for Health Statistics. A report generator was incorporated to achieve the goal of data feedback. Import-export functions were built in to allow for data sharing.

AVSS is now statewide in California and Connecticut where all birthing hospitals are using the software to produce paper and electronic birth certificates. In California it is also used to report communicable diseases statewide, and more than half of all the state's death certificates are entered into the AVSS data base. AVSS was used by most hospitals and the State of Massachusetts during the decade from 1986 to 1995, and automates nearly all the birth certificates in Rhode Island. Professor Paul Starr has cited AVSS as an example of "reinventing vital statistics" wherein technology can be effectively applied to community problems.

Updated September 18, 1996 by RL Williams
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