Mortality Information System in Portugal: transition to e-death certification

Inability to invest in and develop mortality information systems has been considered the single most critical failure in health information systems and there is a recognized urgent need to improve mortality statistics and cause of death information. Although there have been major developments in information technology with the potential to improve public health information systems, mortality data collection has largely remained unchanged in most countries, mainly due to legal and operational barriers. Electronic registration and certification of death certificates has the potential to improve the quality and timeliness of mortality statistics. The Mortality Information System in Portugal has, since 1950, been a paper-form death certification model. The Portuguese Directorate-General of Health recently implemented electronic death certification as the basis of a new mortality information system. A strategic multistep approach, defined by geographic areas of the country, was planned for implementation of the system. National implementation was completed in December of 2013 and 100% e-death certification was achieved beginning January 2014. This article reports the implementation process and describes the newly established mortality information system.