Data Exchange Practices of Medicolegal Death Investigation

Data Exchange Practices of Medicolegal Death Investigation


December 2022


The National Institute of Justice (NIJ)—in partnership with its Forensic Technology Center of Excellence (FTCOE) at RTI International and the National Center for Health Statistics, Centers for Disease Control and Prevention (CDC)—convened a virtual Medicolegal Death Investigation Data Exchange Working Group (MDI-Data-WG) over a 12-month period, beginning in September 2020. This working group was formed to:

  • Document the types of data that are commonly exchanged with public health and public safety partners
    and determine collective usage points for medicolegal death investigations (MDIs);
  • Provide recommendations on how to improve the naming process for emerging drugs;
  • Guide the drug mapping/classification process; and
  • Recommend needed enhancements to the operation of exchanging forensic data with other

This document summarizes the opportunities for and challenges of increasing standardization and automation in approaches to collecting and exchanging data among MECs, investigators, forensic scientists, and other MDI collaborators identified by the MDI-Data-WG. It also identifies high-priority needs that, if fulfilled, will build a foundation toward implementing best practices and standards, promoting improved data collection and surveillance, and supporting data exchange for MDI.

The information collected in this document will impact MDI and forensic science communities in the United States by (1) defining, updating, and establishing the most frequently exchanged data elements that are necessary components of a comprehensive and modernized data exchange in MDI; (2) laying the framework for how drugs are named and how these names are communicated to others; and (3) documenting workflow processes, data exchange needs and processes, data standardization methods, and common language for the MDI systems and its stakeholders.


Medicolegal Death Investigation Frequently Used Data Elements and Descriptions

Appendix A shows the final list of data elements that should be collected for every case. This graphic also links these frequently used elements to overarching categories of death investigation and indicates how these elements are integrated into the death investigation process. Italicized items are examples of information that could be provided during an investigation, and standard information is represented in normal text. This graphic can be downloaded and used in agency training to ensure all data are collected. Additionally, the graphic can be used to develop checklists for death investigators, develop programming requirements for data developers to code MDI information, or assist with standardization and consistency among data exchange as part of other resources.

Appendix B includes a final description about frequently used data elements that should be collected for every case. This table includes suggested data element titles and descriptions. The potential solutions summarize considerations and issues surrounding a specific data element. For example, this focus area discussed and considered process changes, legal and jurisdictional distinctions, data origin, technology advancements, family, and religious considerations. Many issues stemmed from the variance between MDI jurisdictions. For example, some offices currently depend on the mortuary to complete selected items on a death certificate, like ethnicity, and therefore do not currently capture that information in their files. Their case management system may not currently have fields for those elements. These offices would either need to begin collecting the data themselves or obtain the data from the mortuary or via an electronic death registration system and would also need to update their case management system to capture the data.

Drug Taxonomy: Framework for Subclassification and Naming of Novel Psychoactive Substances

This framework tool can assist forensic scientists seeking to better understand how drugs are classified by structural components. It is broken down by NPS classes (e.g., opioids) and then further subdivided by subclassifications of each NPS class (e.g., fentanyl analogs). This framework provides potential names for a substance, a figure with a drug structure from the subclass (with core components highlighted), and an example substance that fits within this subclassification. Users of this framework can easily follow this layout to understand how NPS are subclassified and how those drug molecules could be named. The framework was created to be a standalone poster to use as a reference. This alleviates scientists of the need to check multiple sources and allows for quicker association with naming convention and nomenclature. Although this framework tool helps users understand the drug-naming process, it does not provide a means to predict and name future unknown substances by simply following this subclassification scheme and framework.

Ideal State Required for Successful Medicolegal Death Investigation Data Exchange Across Data Exchange Entities

This graphic shows the ideal state of medicolegal death investigation data exchange among data entities (i.e., data users and data producers). Data users and data producers are all data entities located in the outermost ring. Each data entity segment indicates specifically named data types or data exchanged systems within it. Arrows in the background indicate the primary (larger arrow), secondary (smaller arrow) or equivalent (equal arrow size) direction of data workflow either coming from the medicolegal death investigation system (i.e., medical examiner and coroner offices within the United States) or being provided to the medicolegal death investigation system indicated by the innermost ring. A middle ring indicates the "System of data programmers and technology developers" that play a professional role by assisting with modernization and digitization of data for the medicolegal death investigation system.

Funding for this Forensic Technology Center of Excellence report was provided by the National Institute of Justice, Office of Justice Programs, U.S. Department of Justice. This work was also supported by the Centers for Disease Control and Prevention (Contract Number HHSM500201200008I, Task Order Number 200-2016-F-91567).

The opinions, findings, and conclusions or recommendations expressed in this report are those of the author(s) and do not necessarily reflect those of the U.S. Department of Justice or the Centers for Disease Control and Prevention.

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