Citywide Immunization Registry: Meaningful Use FAQ

Does the CIR support meaningful use testing?

Yes, the CIR support eligible EH and EPs who administer immunization within the five boroughs of New York City and want to exchange immunization data to fulfill the Immunization Registry Reporting measure in NYC. For more information on the CIR MU data element review the CIR MU Checklist (PDF) and the Information for NYC Providers section.

What is the difference between MU Stage 1 and MU Stage 2?

Meaningful Use Stage 1 could be satisfied by a provider submitting one HL7 test message via their EHR system. However, 2015 was the last year that an Eligible Provider (EP) could attest for Meaningful Use Stage 1. As of 2016, EPs can only attest for Modified Stage 2, meaning that all EPs located in NYC that choose the Immunization Registry Reporting Measure must actively engage with the CIR to comply. Active engagement requires more effort on the part of the EP to ensure compliance, as the provider must actively work towards connecting their EHR system to the CIR’s HL7 Web Service and continue to submit immunization data on an ongoing basis throughout their EHR Reporting Period.

In 2016, the EHR Reporting Period for EPs demonstrating Meaningful Use for the first time will be any continuous 90-day period within the calendar year. For EPs who have previously demonstrated Meaningful Use, the EHR Reporting Period in 2016 will be the full calendar year.

What is active engagement?

To achieve Active Engagement Option 3: Ongoing Submission EH/EP must provide the following HL7 data elements:

  • Adult Patient Consent: If your practice administers vaccines to patients 19 and older, consent to report their immunization data should be documented in your EHR.
  • Next of Kin: For pediatric patients 18 and under, please document Mother and/or Father information.
  • Patient Phone Numbers
  • VFC Participants: For VFC Participants there are (2) data elements that should be reported for every pediatric patient.
  • VFC Program Eligibility: The patient’s Vaccine for Children Eligibility Status.
  • Vaccine Funding Source: The Funding Source, whether public or private funds, used for the vaccine being administered.
  • NDC Codes: For new immunization administrations the National Drug Code (NDC), located on the immunization box or vile, must be included.
  • Query CIR for Patient’s Immunization History and Forecasting.
  • For more information about CIR MU visit the CIR MU site

    If I use the Online Registry to exchange immunization data do I quality for EHR incentive programs?

    No. All EHR incentivized programs require the use of an CEHRT 2015 EHR product to exchange data for the Immunization Registry Reporting measure.

    I already report to the CIR electronically through my Electronic Health Record (EHR). Does this mean I have fulfilled the Meaningful Use measure to send data to the immunization registry?

    This depends on the HL7 format that you are using to exchange immunization data with the CIR. To achieve Active Engagement Option 3: Ongoing Submission EH/EP must provide the following HL7 data elements:

    • Adult Patient Consent: If your practice administers vaccines to patients 19 and older, consent to report their immunization data should be documented in your EHR.
    • Next of Kin: For pediatric patients 18 and under, please document Mother and/or Father information.
    • Patient Phone Numbers
    • VFC Participants: For VFC Participants there are (2) data elements that should be reported for every pediatric patient.
    • VFC Program Eligibility: The patient’s Vaccine for Children Eligibility Status
    • Vaccine Funding Source: The Funding Source, whether public or private funds, used for the vaccine being administered.
    • NDC Codes: For new immunization administrations the National Drug Code (NDC), located on the immunization box or vile, must be included.
    • Query CIR for Patient’s Immunization History and Forecasting.

    I already exchange data with the CIR through my Electronic Health Record (EHR) with a bidirectional interface. Does this mean I have fulfilled the Meaningful Use Immunization Registry Reporting measure?

    This depends on the HL7 format that you are using to exchange immunization data with the CIR. To achieve Active Engagement Option 3: Ongoing Submission EH/EP must provide the following HL7 data elements:

    • Adult Patient Consent: If your practice administers vaccines to patients 19 and older, consent to report their immunization data should be documented in your EHR.
    • Next of Kin: For pediatric patients 18 and under, please document Mother and/or Father information.
    • Patient Phone Numbers
    • VFC Participants: For VFC Participants there are (2) data elements that should be reported for every pediatric patient.
    • VFC Program Eligibility: The patient’s Vaccine for Children Eligibility Status
    • Vaccine Funding Source: The Funding Source, whether public or private funds, used for the vaccine being administered.
    • NDC Codes: For new immunization administrations the National Drug Code (NDC), located on the immunization box or vile, must be included.
    • Query CIR for Patient’s Immunization History and Forecasting.

    If you are not sure which format you are exchanging reach out to the CIR MU Tracking team at MUTracking@health.nyc.gov requesting a Gap Analysis to understand what is still missing to fulfill Meaningful Use Stage 3.

    What if my practice is not exchanging data yet with the CIR but I have opened a request to connect, does this mean I have fulfilled the Meaningful Use Immunization Registry Reporting measure?

    If you have communicated to the CIR MU Tracking team at MUTracking@health.nyc.gov that your practice has opened a ticket for a Meaningful Use Stage 3 HL7 Interface, your practice will be eligible for Active Engagement Option 1: Active Engagement Option 1 (Completed Registration to Submit Data)

    What are the requirements for an HL7 interface with the CIR?

    What is a CIR facility code and Why do I need one?

    CIR Facility Codes are created through the CIR registration process. It is an address based unique identifier required to exchange immunization data for any location administering vaccines in the five boroughs of NYC. The CIR facility code is used to verify compliance for programs like VFC, Meaningful Use, MIPPS and QPP. In addition, the CIR facility code associated the immunization data to the correct administer

    My EHR vendor does not currently have an HL7 interface with the CIR. How can I get one?

    Open a ticket with EHR vendor requesting an MU HL7 interface with the CIR. The vendor will work with the CIR Interoperability Team to complete testing and implement a connection with the CIR’s HL7 Web Service to meet the requirements listed in the CIR MU Checklist and the CIR HL7 Implementation Guide.

    You send an email to cir_interop@health.nyc.gov, indicating that you have put in a request with your vendor. Please include your vendor contact information. The CIR will follow up with the vendor and provide them with all the necessary information to develop the interface.

    I am a provider that serves adults. Can I send data to the CIR?

    The CIR supports the exchange of adult immunization data, but consent (verbal or written) for any patient ages 19 or older is required to share their immunization data with the CIR. In addition, this consent must be documented in your EHR system and reported to the CIR.

    View CIR Fact Sheet for Health Care Providers for Adults (PDF) and a sample consent form for adults (PDF).

    Is patient consent required when using my EHR to query their immunization history in the CIR?

    No, there are no consent requirements to query your patients’ immunization history in the CIR from your EHR.

    Can I import CIR data into my EHR?

    Yes, to meet MU 3 requirements your EHR must supports bidirectional data exchange. Bidirectional data exchange entails both reporting immunization data via your EHR and querying for your patients’ immunization histories in the CIR. When your EHR vendor has successfully connected a bidirectional interface, you can send a query for a specific patient to the CIR from your EHR. If that patient is found, the CIR will return the patient’s entire immunization history along with clinical decision support that indicates which immunizations are past due or next due. This process is usually instantaneous but can vary from EHR to EHR. This information can be stored within the patient’s record in the EHR.

    Which EHR vendors have implemented an HL7 interface with the CIR?

    Visit the list of vendors (PDF) that have implemented a MU3 certified interface with the CIR.

    How can I request an Audit or Status Letter for the Immunization Registry Reporting measure in NYC?

    All MURPH registrants have access to the MURPH Audit Report Card. Starting January 1st, 2019, there is a self-service option within MURPH to generate an Audit Report Card of Active Engagement statuses, by EPs. The Audit Report Card is a new feature of the Meaningful Use Registration for Public Health (MURPH) System. This new feature allows EPs and their representatives quick and easy access to a report of their public health status history for all of the Public Health registries with which they have registered intent to submit data. For more information about MURPH Audit Reporting Card and user guidance please reference the following resources:

    For MURPH questions feel free to reach out to the MU Public Health Reporting Objective Support Team at: 1-877-646-5410, Option 3 (Mon-Fri, 8:30am - 5:00pm) or via e-mail at: MUPublicHealthHELP@health.ny.gov

    If your practice is not registered in MURPH, please email mutracking@health.nyc.gov with the following:

    • Practice Name and Address
    • CIR facility code
    • Audit Year/EHR Reporting Period
    • Primary contact name, e-mail and phone number
    • EHR software name and version number

    What is HL7?

    HL7 stands for Health Level 7. It is an international organization that develops standard formats for the electronic exchange of health information. Meaningful Use requires the exchange of immunization information in HL7 2.5.1 format. For more information about HL7, please visit the HL7 Web site.

    What version of HL7 does the CIR support?

    The CIR is only connecting new sites in HL7 version 2.5.1.

    Does the CIR support HL7 batch file transmissions?

    No.