Laserfiche WebLink
Attachment 1 <br />HIPAA Required Elements to De -identify Case Data* <br />These data elements will be removed for all persons accessing de -identified case data, per <br />the Data Use Agreement. The source of these data elements is the National Center for <br />Child Death Review Case Reporting System: Case Report Tool. <br />Inlracluv rm Cose Dee lrririw: <br />Case number <br />County of review <br />Review team number <br />Sequence of review <br />Death certificate number <br />Birth certificate number <br />ME/Coroner number <br />Lection.4: C hrlel Inornuaim� <br />Child first name <br />Child middle name <br />Child last name <br />Child name: unknown <br />Date of birth: month, day, year <br />Date of birth: unknown <br />Date of death: month and day <br />Date of death: unknown <br />Residential address: unknown <br />Residential address: street <br />Residential address: apartment <br />Residential address: city <br />Residential address: county <br />Residential address: zip <br />Sesyiurr U_ I ICLelerrl Inlnr mcr[inn <br />Date of incident <br />Date of incident: same <br />Date of incident: unknown <br />Time of incident <br />Time of incident: am or pm <br />Time of incident: unknown <br />Incident County <br />Death County <br />i5edion ;V: Form C'rarrrpleled B <br />The names and contact information will be removed. <br />". Source: liltgx,vww.lihs.Mvis±cr/cLmlhinedregtext.ell', Section 164.514(b)(2)(i) of the rules. <br />29 <br />