Vital Records: FHIR Implementation Drives Faster, Standardized Data Exchange

Overview

Most states still rely on legacy systems to exchange vital records (e.g., death and birth data). These systems are slow, inconsistent, and largely manual. Each state’s approach was different, leading to inefficiency and delays in critical processes such as receiving benefits, family notifications, and epidemic response.

Now, federal mandates require states to standardize and accelerate data exchange to support interoperability. CMS and ASTP guidance heading into 2026 reinforces expectations for interoperable, real-time data exchange, highlighting API-based standards such as Fast Healthcare Interoperability Resources (FHIR) to reduce administrative burden and improve program integrity and public health outcomes. Federal funding incentives and CDC deadlines are accelerating action—and Altarum is helping states meet the challenge.

Soultion: Impliment FHIR Standards

Altarum partnered with states to implement FHIR standards for vital records reporting. FHIR enables both broad and highly specific data exchange, allowing for flexibility and precision.

We collaborated closely with state technical teams to accommodate their vital records system’s current level of readiness, whether it was supporting a legacy system’s current flat file batch process, moving to a single flat file message exchange, or integrating with a modern system to support FHIR messages.

Altarum has helped five states (57 total jurisdictions) navigate the complexities of FHIR implementation and compliance:

  • Washington, Colorado, North Dakota, and Michigan are in production for death reporting.
  • Wisconsin has begun work on all three: birth, death, and fetal death reporting.
  • Michigan is also piloting birth certification reporting directly from hospital EHR to the state birth registry.

Focus Areas

Public Health Information Technology

Outcomes: Better Data Exchange, Better Public Health

These efforts deliver measurable benefits for agencies, providers, and families:

  • Faster, more consistent, and higher quality data exchange: This is essential for timely benefits, notifications, and public health response.
  • Measurable improvements in quality and timeliness: Ongoing feedback will drive future enhancements.
  • Cost effectiveness, and public health and patient benefit: Faster, more accurate data improves care coordination for patients, supports better infant health outcomes, reduces administrative burden, and streamlines family notification and related services.

Focus Areas

Public Health Information Technology