Mortality Digitalization – From Medical Certificates to Trusted Health Data

From certificates to trusted mortality intelligence

Digitizing mortality is more than building tools. It is an end-to-end, interoperable infrastructure that supports digital medical certification, ICD-11 coding, automated underlying-cause of death selection, quality assurance, data analysis, and open participation so countries can produce comparable, timely mortality data for policy and action.

Simple to adopt Transparent & reproducible Secure & privacy-conscious Scalable for country capacity Interoperable standards-first

 

Why digitize?

To reduce delays, improve comparability, and make cause-of-death processing auditable and explainable.

WHO’s role

Standards, rules, and digital public goods co-developed with countries and partners. For the people by the people.

Not just IT

Governance, capacity building, integration, and sustainability enable scale.

End-to-end mortality pipeline

A single, coherent flow: capture → code → select → analyse → improve. Each component is designed to be transparent, reproducible, and interoperable.

1) Capture

Medical certification of cause of death (eMCCD data fields) and verbal autopsy structured capture.

2) Code

Convert text to standardized ICD-11 codes (multilingual, smart search, postcoordination where relevant).

3) Select (UCOD)

DORIS applies ICD mortality rules transparently and reproducibly for underlying cause of death selection.

4) Analyse data

ANACoD analyses mortality data, identifies ill-defined causes, unusual patterns, and data quality gaps for routine improvement.

5) Improve

Open proposals, value sets, rule editing/testing, and guidance updates, evidence-based participation.

Transparency matters: outputs should be explainable to ministries, statisticians, implementers, and clinicians supporting trust and accountability in mortality statistics.

Tools and platforms

Practical components that implement standards and rules. Countries can adopt parts and scale progressively, while keeping interoperability through shared specifications.

ICD-11 Coding & classification

ICD-11 coding tool & browser

Multilingual smart coding with support for retaining clinical detail (including postcoordination where relevant), enabling consistent downstream processing.

  • Standardized ICD-11 output for interoperability
  • Supports multilingual medical certification contexts
  • Designed for consistent coding and analysis
DORIS Underlying cause of death selection

DORIS: automated UCOD selection

Applies ICD mortality rules transparently and reproducibly, with detailed steps applied so users can explain how the selection was made.

  • Rule-based, explainable selection outputs
  • Reproducible processing across datasets and time
  • Supports training and trust-building
ANACoD Data quality analysis

ANACoD: routine mortality data analysis

Provides a systematic, automated analysis of mortality and cause-of-death data to identify quality gaps, support routine review, and guide evidence-based improvement

  • Estimates completeness of death reporting
  • Produces comparable mortality indicators and trends
  • Flags ill-defined causes and inconsistencies
CodEdit Coding quality assessment

CodEdit: assess and improve coding quality

Supports coding quality evaluation and provides warnings, helping strengthen consistency and training outcomes.

  • Quality assessment and feedback for coders
  • Supports capacity building and training
Open platforms Participation & transparency

Proposals, rules, value sets, and testing platforms

Maintain standards and rules openly. Participation is evidence-based: contributors propose improvements, test cases, and help maintain shared value sets and mappings.

Key platforms

  • Proposal platform: propose updates to classification, rules and guidance
  • Rule editing platform: maintain and refine selection logic
  • Value set platform: shared ICD-11 groupings and categories (e.g., tabulation lists)
  • Rule testing platform (e.g., MIROR): validate changes transparently
  • Download platform: access digital public goods

Participation principles

  • Evidence-based proposals with rationale and references
  • Transparent review and reproducible outcomes
  • Shared maintenance for sustainability

 

Guidance, standards, and structured capture

Data quality starts before the first code. Standardized capture and training reduce “garbage in, garbage out” and enable reliable analysis.

Before the data Capacity building

Examination of the deceased & medical certification training

Guidance and learning resources to support accurate medical certification practices and strengthen the quality of input data.

eMCCD specs Structured capture

Electronic MCCD specifications

Defines data fields and encoding so medical certificates of cause of death can be processed consistently across national systems and tools.

Verbal autopsy Community deaths

Standardized verbal autopsy capture

Structured data capture for deaths outside facilities, aligned to enable consistent processing and analysis.

Implementation note: WHO provides specifications and digital public goods. Countries can implement in different ways, but shared standards keep data interoperable and workflows reproducible.

Open participation and transparency

Rule clarifications, value sets updates, and guidance improvements are maintained openly with countries and partners. Outputs remain explainable and auditable over time.

How to contribute Evidence-based

Contribute improvements

Propose updates to selection rules, value sets, and guidance using evidence and clear rationale. Test changes and support shared maintenance.

  • Submit a proposal with references and examples
  • Participate in rule/value-set updates discussions
  • Support testing and validation workflows
Transparency Trust & accountability

Explainable outputs

Ensure stakeholders can trace how text becomes codes, and how codes become an underlying cause of death critical for trust in mortality statistics.

  • Auditable steps in cause of death selection (DORIS)
  • Routine analysis (ANACoD)
  • Reproducibility over time and across systems

Implementation and sustainability

Digitization succeeds when governance, integration, and capacity building are planned alongside tooling. Partners can support deployment and scale.

Beyond tools Enable scale

What countries need to plan for

  • Governance: roles, processes, accountability
  • Capacity building: medical certification of cause of death and coding training
  • Integration: linkage to health information systems
  • Sustainability: maintenance, budgets, and local ownership
  • Privacy & security: confidence in handling mortality data
Outcome: comparable, timely mortality intelligence for policy and action supported by standards, rules, tools, and open collaboration.
Mortality Digitalization

This page reflects an end-to-end approach: standardized capture (eMCCD/VA), ICD-11 coding, automated UCOD selection (DORIS), routine data quality checks (CoDEdit), routine data quality analysis (ANACoD), and open participation (proposals, value sets, rule editing/testing).