An Evaluation of the Timeliness, Acceptability, and Utility of the Wisconsin Violent Death Reporting System

BACKGROUND: The Wisconsin Violent Death Reporting System (WVDRS) is a statewide, active surveillance system that compiles information from death certificates, coroner and medical examiner (C/ME) records, law enforcement (LE) reports, and crime lab data to construct a unique and thorough picture of the characteristics and circumstances of violent death incidents. The Wisconsin Department of Health Services first received National Violent Death Reporting System (NVDRS) funding from the Centers for Disease Control and Prevention (CDC) in 2003 and data collection began in 2004. As the system nears its 10^th year of operation, it is necessary to formally evaluate WVDRS according to the CDC guidelines in order to identify and address system limitations.

METHODS:   An evaluation of WVDRS processes and attributes was conducted according to the CDC’s “Updated Guidelines for Evaluating Public Health Surveillance Systems.” Quantitative measures of system timeliness and data provider participation were obtained from CDC-generated reports and through analysis of the 2008 WVDRS database and research file. WVDRS acceptability and utility were assessed qualitatively through key informant interviews with WVDRS staff, data providers, and data users.

RESULTS: Timeliness of case initiation in NVDRS decreased from 92.7% initiation within 180 days of death in 2008 to 21.8% in 2009 and 0.0% in 2010. Changes in the case ascertainment process in 2011 led to substantial improvements in timeliness in more recent data years. The decentralized structure of C/ME and LE systems in Wisconsin, understaffing in local C/ME offices, and limited outreach to data providers have resulted in diminished acceptability of and participation in WVDRS since 2008. The potential utility of WVDRS is widely recognized by data providers and users but has been limited in the past few years by insufficient epidemiologic and technical support and consequent delays in data dissemination. Additions to staff and increased support from Wisconsin’s Office of Health Informatics are expected to rapidly improve the utility of WVDRS as the system moves forward. 

CONCLUSIONS: The evaluation identified many strengths and weaknesses to WVDRS processes.  In recent years, WVDRS has struggled to restore and maintain timeliness, acceptability, and utility while faced with losses in personnel and changes in data provider operations. The evaluation resulted in recommendations for internal process changes that will be implemented to improve the acceptability, utility, and timeliness of the surveillance system.