How Can Medicolegal Death Investigation Become More Efficient?

The Future is a Platform-Based Approach to Data Modernization

Medical Examiner and Coroner (M.E./C.) offices across the country are at a critical juncture: caseload complexity is rising, public health demands timely data, and the national push for data modernization, championed by organizations like the CDC, is calling for connected, real-time systems.

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The core challenge is clear: the data systems meant to support death investigations often hinder them, creating administrative burdens that take investigators away from their essential work.

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Why Do Current Death Investigation Systems Create Problems?

A common challenge in medicolegal death investigation is the manual,  repetitive data entry between disconnected systems. Legacy systems require extensive, specialized training for routine tasks, creating a reliance on workarounds and shortcuts to produce accurate reports. These outdated workflows result in:  

• Frequent data errors

• Data silos that prevent a holistic view of a case

• Time-consuming training on overly complex interfaces

• Reliance on workarounds instead of streamlined processes

• Inflexible systems that struggle to adapt to changing reporting standards or protocols

The path forward requires a new approach—one that is built from the ground up to solve these specific challenges.

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What Features Must a Modern Death Investigation System Have?

An Architectural Blueprint for Next-Generation EDICMS

A modern Electronic Death Investigation Case Management System (EDICMS) must be more than just a digital filing cabinet. It must be an extensible platform built on four key architectural principles:

1. Configurability: The system must adapt to the office's workflow. A modern platform allows administrators to configure case stages, data fields, and business rules, ensuring the software supports their specific processes for field investigation, autopsy, toxicology, and certification.

2. Interoperability: The platform must be built with an API-first design. This is the cornerstone of breaking down data silos, enabling seamless, automated data exchange with toxicology labs, state Electronic Death Registration Systems (EDRS), and other critical partners.

3. Accessibility: In the world of mobile work, a modern platform must provide secure access to authorized users from any device. This includes providing field investigators with a mobile-optimized interface to capture scene data accurately and efficiently, eliminating the need for pen-and-paper notes and duplicative data entry.

4. AI Powered Insight: A modern platform does more than just manage data; it helps users understand it. The next evolution of death investigation systems will leverage Artificial Intelligence (AI) and Large Language Models (LLMs) to turn vast amounts of case information into actionable insight. This includes capabilities like natural language search to instantly find cases, automated summarization of complex files to speed up reviews, and emerging trend detection to provide real-time public health intelligence.

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From Theory to Practice: A Case Study in Solving Complex Fatality Review

At Leap Orbit, our philosophy is to run towards healthcare's biggest challenges. Since 2017, in partnership with the Maryland Department of Health (MDH) and Chesapeake Regional Information System for our Patients (CRISP), Maryland’s statewide health information exchange, we have iteratively developed and operated the Overdose Fatality Review (OFR) platform—a secure, cloud-native EDICMS solution built on Microsoft Azure to support multi-disciplinary, county-based teams in examining the circumstances of overdose fatalities.

This experience provided the blueprint for a modern MDI platform. It proved the value of a flexible data model capable of handling complex case information, a secure system for multi-jurisdiction collaboration, and a template-driven engine for user forms. The OFR platform is a tangible representation of the kind of secure, interoperable, and user-centric systems that M.E./C. offices need today.

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What Essential Capabilities Should a Future-Proof EDICMS Have?

Leveraging this platform-based approach, Leap Orbit delivers tailored EDICMS solutions that solve the specific needs of M.E. and Coroner offices. The essential capabilities of such a future-proof system include:

• Seamless Lab & EDRS Integration: Direct, automated interfaces with national toxicology labs and state vital records systems, potentially leveraging emerging standards like the HL7 MDI FHIR Implementation Guide or HL7 VRDR FHIR Implementation Guide.

• Mobile Capabilities for Field Investigators: A secure, intuitive mobile UI that allows investigators to capture notes, photos, and scene data on-site.

• Robust Reporting for Accreditation & Compliance: The system’s data model should be flexible enough to capture the data required for NAME accreditation as well as the common core data elements for medicolegal death investigation.

• Secure, Role-Based Collaboration: A permissions model that allows internal staff, forensic consultants, and other authorized professionals to access the case information they need, and nothing more.

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How Should M.E./C. Offices Choose a Product Partner?

M.E./C. offices no longer need to choose between a rigid, off-the-shelf product that doesn't fit their process or a costly, one-off custom build that is difficult to maintain. The future lies in partnering with experts to implement a flexible, modern platform that can be tailored to their needs and evolve to meet the challenges of tomorrow.