1198: Modernizing the Data Behind Death Investigations

JOHN SHEEHAN: 

This is Public Health Review Morning Edition for Thursday, September 3, 2026. I'm John Sheehan with news from the Association of State and Territorial Health Officials.

 

Medical examiners and coroners sit at a critical intersection of public health, health care, law enforcement, and vital statistics, generating data that can provide important insight into why people die. Dan Tauriello, senior analyst for Public Health Data Modernization and Informatics at ASTHO, explains how modernizing data systems in medical examiner and coroner offices can improve efficiency, strengthen connections with public health, and create better access to timely information.

 

DAN TAURIELLO: 

Think of data modernization as existing along a long continuum. So you have some offices that are just making the jump to paperless record-keeping and digitizing a lot of the things that they've been hanging on to for years, and in some cases decades, and then others are really moving ahead and looking at interoperability between systems and what, you know, a responsible AI implementation looks like. Undertaking data modernization realizes an opportunity to kind of reshape how an MEC office, so a medical examiner and coroner office, functions. It's a lot of process improvement, and also it's a lot of making things interconnected that really weren't necessarily before. So exposing different parts of an office to a data system at the state or CDC that is tracking a lot of death data and things like that.

 

SHEEHAN: 

So it sounds like this is sort of a corner of public health that maybe hadn't really been considered in a lot of processes?

 

TAURIELLO: 

A little bit. The medical examiner/corner space is really at the intersection of a lot of different spaces. So in in some ways, it it is a Venn diagram between vital statistics and public health, but also it's you know medical examiners and coroners working with law enforcement and the and the and the justice system because there's a lot going on there, and also just raw healthcare. You know, sometimes there are reasons why folks can pass away in, like, a hospital and then they wind up in a medical examiner or coroner's office, and then also obviously a lot of these offices deal with otherwise unattended deaths. So there's a lot of data that's generated at these offices that are of interest to public health, and vice versa. Public health is obviously very interested in, you know, why folks might be passing away, but also, you know it's it's working with a lot of other spaces in government itself, so it's a really interesting space that covers a lot of other spaces as well, while being on its own; in it has the MEC space and very much has its own identity.

 

SHEEHAN: 

For sure, and that actually makes a lot of sense. And you can imagine how a lot of that data that they generate and that they have access to that, you know, making that available in systems that can talk to public health, and you know, especially reducing that friction of having everything as being done by paper, advancing those systems, makes a lot of sense.

 

TAURIELLO: 

Yes. Yeah. And you know, a lot of challenges that I think public health has seen over time, perhaps not enough attention paid on a policy level, or not enough funding, or stuff like that. That is very often replicated in the MEC space. So there's a lot of advocacy work that could be done to, you know, increase funding, or, you know, really just make these issues more front of mind to folks in charge, because, you know, a lot of this stuff is critical to how a society functions. So there's a lot of challenge there with resourcing these offices appropriately so that they can make, you know, some of these jumps to, say, interoperable systems or start implementing AI to increase or make more efficient their workloads

 

SHEEHAN: 

And so you know the potential is there; there's the potential for not just streamlining their own work processes, but now you know looping in public health in a more engaged way. What would that look like for both entities?

 

TAURIELLO: 

A lot of it is, especially in data modernization. A lot of it comes down to communication. There's a lot of challenge in data modernization to be speaking the same language in both public health and the MEC space; folks have big-time jobs to do that are not necessarily data monetization. So, getting a lot of this looks like getting on the same page to begin with. You know, learning some of the acronyms and how some of these systems function, and that you know isn't necessarily always something that you know a public health professional or a medical examiner, a coroner, really has front of mind. So a lot of this is going through the basics of, like, here's how your system works. Here's, you know, maybe what the acronym FHIR Fast Health Interoperability Resources, stands for, and then going from there and building relationships around this common language and, you know, working towards a common goal with both partners and software vendors. So a big part of a medical examiner/coroner office is very often its case management system, and this is, you know, bespoke software that is essentially how an MEC office manages its digital records. So, like, if there's law enforcement involvement, very often. There's you know, investigation photos, autopsy reports, you know, lab test results, things of that nature that all get managed in this CMS case management system. Getting common language and terminology around that, and scoping things out with partners to say, hey, you know, X state system, we want to, you know, exchange data with you. We're bringing in our software vendor or other data exchange partner. We need to figure out, you know, common terminology and also meet frequently enough so that there isn't, you know, issues of scope drift or, you know, issues with software incompatibilities and stuff like that. Because a lot of this stuff, it doesn't necessarily happen in a vacuum. It can sometimes happen in many different vacuums at once. So as one system gets very far ahead, sometimes it will not be compatible with older systems, and vice versa. So, like if a if an older system is kind of isolated for too long, then it's not compatible with newer software. So there's really a need to have, you know, the phrase "a rising tide lifts all boats. There's a need to have sort of a rising tide beneath data modernization efforts, both in MEC offices and in, you know, counterparts in public health, or counterparts in law enforcement, or counterparts elsewhere in a government. Sometimes that's vital records, for instance, or laboratories. It's a lot of communication, and the technical piece very often is, in some ways, the easiest part to solve.

 

SHEEHAN: 

And what opportunities does that present for public health agencies, if and once you know MAC offices can get themselves in a position of, you know, having this, like, a clearer line of communication?

 

TAURIELLO: 

Really a gigantic benefit to a lot of this stuff is that it makes any given case more efficient. So if your systems are interoperable at an MEC office with suitors at the state level, the state unintentional drug overdose reporting system. You know, if you're saving five minutes per case, then you know that's five minutes on one case. But if you have 1000 cases a year, that's many, many minutes. So, like, let's do some more back-of-the-napkin math. If you're saving 10 minutes on one case, and you know you have 1000 cases per year, that's 10,000 minutes, which translates to I think it's like 167 hours of someone's effort, and that's you know if you break that down even further, that's a little less than 1/10 of a full time employee per year, and that's just 10 minutes. You know, some of this stuff, if you're saving, you know, if you do a massive upgrade, if you go paperless, or you know, you completely redo your case management system to work much better for you. That could be an hour per case in some instances. So if you have, you know, 1,000 cases per year, that's 1,000 hours saved. That's half of a full-time employee. So really, a lot of the effects of data modernization knock on very quickly, depending on how much time is saved on any particular case, and then of course that's, you know, just the very tactile, you know, feeling for an MEC office. A lot of it also just comes from the raw relationship building. You know, if you have a system at an MEC office that exchanges data effectively with state partners, and you're in close contact with them, you have those relationships already in place, and you can then make the ask of what your office needs. You know, a lot of MEC offices feel like they share data with public health, but don't necessarily know how to make requests in return for the kinds of things that they need. So, having those close relationships, you can more easily ask something of someone who's down the hall or on the other end of the phone every week than someone where it's like, oh, we did this project and phoned each other up once a month or something like that. So it's really on the directional benefit from getting these projects done, or even just getting the project started in the first place. You know, sometimes you might start a project and try to start iterating on it, and it doesn't quite work out, or the funding paradigm changes, or something, and you have to let it go, or you know, leave it partially finished, or something like that. Even just going through the motions of starting and moving through a data modernization project can bring benefits, you know, in its in its own right.

 

SHEEHAN: 

Which is itself a good lesson. That said, are there emerging technological solutions or standards, data standards, that are coming out that will really help public health reporting in the future?

 

TAURIELLO: 

Yeah, I mean there's a couple of them, like way out on, perhaps you know, you could think of it as the right side of the continuum, you know, where the left side is paperless, and then you have case management system upgrades towards the middle, and then out. You know, on the right side of it, you have, you know, interoperability standards we'll call them. So it's ways for machines to talk to each other in a way where both sides of the exchange understand what's being sent, and it's consistent. And you know, the data being sent is quality and time. And things of that nature, and then way out on the very far right end of the spectrum is, as you can probably guess, responsible AI implementations. A lot of the work that ASTHO has focused on in the MEC space over the last couple of years has been on fire implementations. So a lot of public health is picking up on fire implementations. This might be, you know, familiar to some listeners, but it's also starting to take root in some of the medium- to large-sized offices in the medical examiner and coroner space. Those are, you know, your medium- to large cities typically, or some regional or state forensic examination offices, and that is, you know, it's a big lift to get your first fire implementation done. But what we've heard from some of the offices that we've worked with is that the second and third and, you know, subsequent FHIR implementations take less effort because they already know what they're doing; they know where to find the resources and things of that nature. So that is very helpful for exchanging data between systems in a really consistent manner. And because, you know, FHIR is a is an interoperability standard, all of these systems that are FHIR-enabled, they are all speaking the same language to each other, so it's easier to develop for and troubleshoot and things of that nature.

 

SHEEHAN: 

Moving back a little bit to some more of those foundational steps to really improve that digital infrastructure now, and maybe set yourself up for a better relationship with your MAC office. What would you suggest?

 

TAURIELLO: 

You know, you might be surprised by what you find just by starting. That is the advice that I would have: is if you are thinking about data modernization, put the pieces on the board and see if a game starts with your partners.

 

SHEEHAN: 

Always good advice. Dan Tauriello, thanks so much.

 

TAURIELLO: 

John, thank you.

 

SHEEHAN: 

Dan Tauriello is a senior analyst for Public Health Data Modernization and Informatics at ASTHO.

 

Public health data modernization is a collective effort by federal, state, local, and tribal organizations to strengthen public health data and surveillance systems. The ultimate goal is to move from siloed public health data systems to a connected, resilient, adaptable, and sustainable response-ready data ecosystem. ASTHO's data modernization primer and tactical guides provide state and territorial health officials with a high-level understanding of the objective and significance of data modernization, as well as the roles that they play in a successful data modernization initiative. Find more at the links in the show notes.

 

Join us for ASTHO's Leading Change Workshop, October 6 and 7, which is designed specifically for professionals in clinical and non-clinical public health roles. This two-day in-person opportunity equips participants with strategies and skills to navigate change and uncertainty as individuals, team members, and organization-wide leaders, emphasizing actionable instruction and resources, it enables leaders to create and implement real-world initiatives at their agencies for 2026 and beyond. Participants will gain tools to design targeted initiatives and foster tangible organizational change. Register at the link in the show notes.

 

This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of State and Territorial Health Officials.