ABSTRACT
The certification of causes of death by physicians as well as further processing by local health offices, registrar's offices, statistical offices, and other public authorities are conducted in a paper-based way and regulated individually by the laws of the different states of Germany.The concept of a nationally standardized electronic death certificate (eTB), enabling a digitalized processing chain and timely and improved mortality statistic, is presented.Starting with a nationally agreed upon data set, aligned with WHO requirements, an electronic death certificate pilot will be developed and tested in different regions. Synergies resulting from digitalization of the public administration and of the health system will be harnessed.Data collected electronically in the testing phase will be processed with the electronic coding system Iris. Effects on data quality of national mortality statistics will be investigated through multicausal analysis, which will be compared to results from other countries, and through comparisons with data from the existing paper-based process. For the first time, a national multicausal analysis of causes of death will be conceptualized in order to visualize effects of the aging and multimorbid population in national mortality statistics for consideration by healthcare politics and research.Results and lessons learned from the pilot can serve as the basis for national implementation of an electronic death certificate in Germany.