Responding to the initiative of coroners in Australia, the National Injury Surveillance Unit agreed to undertake a feasibility study for a national coronial information system. This paper contains the results of this investigation.

• Executive Summary
  • Major findings
  • Technical Recommendations
  • Recommendations of coroners and users
• List of Acronynyms Used in the Report
• Introduction
  • History
  • Purpose of the paper
  • The coronial system
    • The coroner
    • Forensic pathologist
    • The nature of coronial investigations
    • The nature of coronial findings
    • The role of an information system
  • The research paradigms of major users
    • Coroners
    • Forensic scientists
    • Preventers and policy makers
• Coronial system needs
  • Case management
  • Identifying common issues
  • Preventive activities
• External User needs
  • Australian Bureau of Statistics
  • Health
  • Consumer affairs
  • Road
  • Occupational health and safety
  • Deaths in Custody
  • Other users
• Information flow
  • Case initiation
  • Investigation
  • Decisions on the depth of investigation
  • Final reporting
• Data quality
  • Coverage of cases
    • Types of cases
    • Region of investigation
  • Reliability and validity
    • Obtaining uniform information standards
  • Coverage of relevant information
    • Differences in information: case investigation and population study
• Existing coronial information systems
• Coding systems available for death and injury event coding
  • Coroners' classification systems
  • International Classification of Diseases
  • ISIS
  • NMDS(IS)
  • Road fatalities
  • Occupational health and safety
• Factors affecting information release
  • Privacy and confidentiality
    • Privileged users
    • Statistical information
    • Ethics clearance
• Assessment of existing systems
• Information systems needed
  • Administrative system
  • Research system
• Technical possibilities
• Development required
  • Administrative systems
  • Research systems
    • Data quality
    • Coding and indexing
    • Detailed text and documents
  • Information access systems
    • Coroner access
    • Early access subscribers
    • Release of completed case information
    • International network release
• Implementation plan
  • Options considered
  • Preferred solution
  • System development
    • Stage 1
    • Stage 2
    • Stage 3

• Funding
  • Establishment costs
  • Running costs
• Conclusions of the feasibility study
• Consultation with coroners and major users
• References
• Appendix 1 Part A Core data items all cases
• Appendix1 Part B Additional items for external cause deaths
• Appendix 1 Part C Additional items for specific users

List of Acronynyms Used in the Report

ABS Australian Bureau of Statistics
ACS Australian Coroners' Society
AIC Australian Institute of Criminology
AIDS Acquired Immune Deficiency Syndrome
ANZCO Australian New Zealand Classification of Occupations
ANZSIC Australian new Zealand Standard Industry Classification
ASGC Australian Standard Geographic Classification
BAC Blood Alcohol Concentration
DCA Defined Classification of Accidents
FORS Federal Office of Road Safety
HIV Human Immuno-Deficiency Virus
ICD International Classification of Diseases
ICD9 International Classification of Diseases 9th Revision
ICD9CM International Calssification of Diseases 9th Revision (Clinical Modification)
ISIS Injury Surveillance Information System
NCIS National Coronial Information System
NISU National Injury Surveillance Unit
NMDS(IS) National Minimum Data Set (Injury Surveillance)
PM Post Mortem
RUM Road User Movement
SIDS Sudden Infant Death Syndrome
SLA Statistical Local Area
US CPSC United States Consumer Product Safety Commission

Introduction

History

The role of the coroner has developed throughout history. A conservative view of the coroner as the one who investigates a suspicious death and establishes its cause, has been tempered with more activist views which see the coroner as "allowing the community to view the circumstances surrounding death"(1) and, most recently, as an active identifier of preventable injuries and deaths.(2) In Australia, coroners have actively debated their role and, in particular, the information needs associated with an active preventive stance.

There have been a number of instances in recent years where coroners have identified possibilities for prevention through the thorough investigation of a single death or the patterns seen in a series of deaths. Perhaps the most publicly acknowledged activity of this type, was the identification of problems associated with a particular model of Mistral fan, which had been involved in a number of fires. The fans were subsequently recalled. The ability to undertake this role is limited by the fragmentation of data between jurisdictions and by the difficulty of identifying common factors in an information system based on paper documents.

In 1993 a national meeting of coroners canvassed the need for an expanded national coronial information system with a number of interested parties including the National Injury Surveillance Unit (NISU). The Australian Coroners' Society (ACS) supported the cooperation between coroners of each State and Territory and published a statement that among other things contained the following;

"The Australian Coroners' Society

(a) regards as essential to efficient coronership, a computerised process with database, to enable the results of coroners' investigations to be nationally accessible,

(b) recognises that a needs analysis and feasibility study is required to effect the above objective; and

(c) resolves that endorsement be sought from each State and Territory government."

As a result of this initiative, NISU agreed to undertake a feasibility study into the development of such an information system. NISU and Worksafe Australia jointly funded the project.

Purpose of the paper

This paper presents the results of the feasibility study. It analyses the state of information systems in coronial jurisdictions across Australia, the views of coroners about what is required, and the needs of other major users of coronial information.

The paper sets out to :

• describe what is possible using current information and systems;
• detail the processes involved in the collection and dissemination of information;
• define what is needed;
• consider what changes are possible and the time frame required;
• make recommendations on ways of proceeding.

(1) Bennet R C, The changing role of the coroner, Canadian Medical Association Journal, May 1978, p1138.
(2) Johnstone G, An avenue for death and injury prevention, in Selby H (Ed.), The Aftermath of Death, Leichhardt Federation Press, 1992, Chapter 10.