Vital statistics offers a case study in the potential of new information technology and reengineering to achieve better public sector performance.
New technology--notably the shift from a paper-based to an electronic process for recording vital events and transmitting the data to public agencies--is creating opportunities to produce more timely, accurate, and useful information. The furthest advanced innovation is the electronic birth certificate (EBC).
At the same time, changes in welfare policy and health care--including efforts to establish paternity at the time of birth and to improve health care outcomes--are creating pressures for more policy-relevant data about vital events. In addition, the rise of integrated health plans and health information networks is radically altering the organizational context of vital statistics.
On the basis of a State-by-State survey of vital statistics officials, the authors estimate that at the end of 1994 58 percent of all births in the U.S. were being recorded on an EBC and communicated to a public agency electronically. Nearly all respondents reported that the electronic birth certificate brought improvements in both timeliness and accuracy of data. Achieving the full promise of the new technology, however, will require more fundamental changes in institutions and policies and a reconceptualization of the birth certificate as part of a broader perinatal information system.
Sandra Starr is director of the Office of Information and Technology Development at the Health Research and Education Trust (HRET) of New Jersey.
Support for this research was provided by HRET and by the National Institute of Child Health and Human Development under a grant to Sara McLanahan, NICHD Grant No. RO1 HD19375-10. Rona Remstein of HRET conducted the survey for this article.