Citywide Immunization Registry: Meaningful Use FAQs

Does the CIR support meaningful use testing? +

Yes, the CIR is supporting providers who want to report immunizations to the CIR using HL7 standards to fulfill their Meaningful Use requirement. The CIR has been accepting HL7 data since 2009. Details on the CIR’s processes are described in the Information for NYC Providers section.

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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.

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What is active engagement? +

In order to comply with the Meaningful Use Modified Stage 2 Immunization Registry Reporting Measure, a provider must actively engage with the CIR during their EHR reporting period.

After registering intent to submit immunization data via the Meaningful Use Registration for Public Health on the Health Commerce System  website, CIR staff will receive the registration data and reach out to providers with one of these requests:

  • Invitation to Test: If a provider does not have an interface with the CIR’s HL7 Web Service, their EHR vendor will need to connect them.
  • Request for Action: There are several scenarios associated with this request.
    • Providers who do not have CIR facility codes will be asked to register and obtain a CIR facility code.
    • If a provider’s EHR vendor does not currently have an interface with the CIR, they will be asked to implement that connection.
    • Providers may also receive requests for action if they are connected and reporting via the CIR’s HL7 Web Service, but there is an issue related to the quality or quantity of data that they are submitting.
  • Acknowledgement of Submission of Production Data: If a provider has already connected to the CIR’s HL7 Web Service and established submission of production data, they will be asked to continue submitting immunization data on an ongoing basis.
  • Providers must respond to all CIR requests in a timely manner in order to be considered in active engagement.

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    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 format that you are using to send data to the CIR. Many providers have been reporting from their EHR for several years using an automatic file upload in a CIR-designed format called UPIF (Universal Provider Interface Format). Providers reporting via a UPIF file do not qualify for Meaningful Use. Meaningful Use requires immunizations to be reported in HL7 format. If you are not sure which format you are currently using to report, you can contact your EHR vendor or contact the CIR at MUTracking@health.nyc.gov.

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    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.

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    What version(s) of HL7 does the CIR support? +

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

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    What options does the CIR support for HL7 message transport? +

    The CIR has a SOAP Web Service that allows for real-time bidirectional exchange of immunization data.

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    Does the CIR support HL7 batch file transmissions? +

    No, the CIR does not accept HL7 batch files.

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

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    Can I import CIR data into my EHR? +

    Yes, if your EHR supports bidirectional data exchange. The CIR’s HL7 Web Service supports bidirectional interfaces with EHRs, including real-time queries for patient immunization histories. The EHR will send a query for a specific patient to the CIR. 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 takes approximately 1-2 seconds. This information can be stored within the patient’s record in the EHR.

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

    The CIR encourages the reporting of adult immunizations, but consent (verbal or written) from the patient is required (consent is not required for patients under 19). View CIR Fact Sheet for Health Care Providers for Adults (PDF) and a sample consent form for adults (PDF).

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

    Please visit the list of vendors that have implemented unidirectional and bidirectional interfaces with the CIR

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

    You will need to put in a request to your EHR vendor for an HL7 interface with the CIR. The vendor will need to work with the CIR to implement a connection with the CIR’s HL7 Web Service. You can also contact the CIR (MUTracking@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.

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    I do not currently use an EHR but I am interested in using one. Where can I get more information? +

    NYC REACH is the regional extension center for New York City. Their objective is to help NYC providers through the process of adopting and implementing an EHR and to help providers achieve Meaningful Use. For more information please visit NYC REACH or contact them via e-mail at pcip@health.nyc.gov

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