Texas Immunization Registry – Electronic Data
Exchange
Organizations that administer immunizations
may participate in electronic data exchange with the Texas Immunization
Registry. Electronic data exchange with
the registry allows organizations to electronically import patient and
immunization data into ImmTrac2 without the burden of manual data entry into
both an electronic health records (EHR) system and ImmTrac2.
What is Electronic Data Exchange?
Electronic
data exchange is a connection between systems exchanging data with one another. For the Texas Immunization Registry,
electronic data exchange occurs between organizations, such as physician’s
offices, hospitals, and local health departments, utilizing their EHR systems
to exchange patient and immunization information with the registry.
Information for Schools
Schools may
report student information to the Texas Immunization Registry if they adhere to
Family Educational Rights and Privacy Act, FERPA (if subject to it) and the registry’s
consent requirements.
Visit the U.S. Department of Education website for
more information on FERPA.
Information for Health Plans
Health plans that must meet Health Care
Effective Data and Information Set (HEDIS) requirements currently query the
registry for member data through a process known as immunization history query
(IHQ) and immunization history response (IHR) files.
Once the registry declares public readiness
for bi-directional data exchange, health plans are required to transition over
to bi-directional data exchange, as the IHQ and IHR files will no longer be
accepted.
Is Your Organization Ready for Data Exchange?
To determine
if your organization is ready to establish a data exchange connection with the
registry, review the qualifications below. Organizations should review and complete each
qualification before contacting the Texas Immunization Registry for
establishing a data exchange connection.
Registry Status Qualifications
Ensure that your organization’s information is
up to date with the registry as follows:
1. Your main headquarters or stand-alone
facility is:
a.
Registered with the Texas Immunization
Registry and the site agreement is not expired; or
b.
Renewed (i.e. site agreement) with the
registry.
2. All your associated facilities are registered
as sub-sites of the main organization (i.e. not as separate or stand-alone
facilities) with the registry.
3. Your organization staff have active ImmTrac2
user accounts to log into the registry.
Identify staff at your organization who will
be the lead contacts and/or team for establishing and overseeing the data
exchange connection with the registry. These staff will collaborate with the registry throughout the data
exchange process.
Suggested staff members include, but are not
limited to, staff who oversee other types of data exchange for the
organization, senior or lead clinical staff, subject matter experts, trainers,
or IT support staff.
For
assistance with ImmTrac2 registrations, renewals or user accounts, contact the
Texas Immunization Registry’s Customer Service at 800-348-9158. Also available for detailed information on site
renewals is the publication stock #11-15252 ImmTrac Site Renewal Guide
on the Forms & Documents webpage.
Data
Exchange Qualifications
To
engage in electronic data exchange, your organization must have an EHR system
that meets the Texas Immunization Registry standards and requirements as
follows:
- Your
organization, through their EHR system, must submit patient and
immunization information in Health Level Seven (HL7) 2.5.1 Release 1.5
files to the registry.
Speak with your EHR vendor to confirm that your organization’s systems are
upgraded to send data in this format.
- Your
organization, through your EHR system, must be able to submit immunization
data to the registry according to the uni or bi-directional requirements.
- Uni-directional:
Batch files means data is combined into one file that is submitted via File
Transfer Protocol (FTP) on a weekly, bi-weekly, monthly, or yearly basis.
- Bi-directional:
Real-time means data is submitted via web services (SOAP) as they are
administered.
Speak with your EHR vendor to confirm whether
uni or bi-directional requirements can be configured.
- Your
organization’s patient and immunization data does not have data quality
issues or errors. Your organization
must take and own responsibility of the patient and immunization data it
submits as part of establishing a data exchange connection with the
registry. To ensure your
organization is submitting great data quality it must identify any data
quality errors and correct them in a timely fashion.
Speak with your EHR vendor to confirm your organization’s systems are
configured to federal and state requirements for data exchange to decrease
the likelihood of data quality errors.
Note: The
registry verifies that the above qualifications have been completed before
establishing a data exchange connection with an organization.
Establishing A Data Exchange Connection
The
following steps must be completed to establish a data exchange connection with
the registry. More information about
each step is found in the publication stock #11-15231 Electronic Data Exchange Resource Guide
on the Forms & Documents webpage.
Step 1:
ImmTrac2 Registration/Renewal Information
Your
organization must have an up to date ImmTrac2 Site Agreement for all your
sites.
Step 2:
Registration of Intent
Organizations
must fill out a Registration of Intent (ROI). These are processed within 2-5 business days after submission.
Step 3:
Gaining Access to Registry Data Exchange Methods
The
steps to gain data exchange access with the registry are:
1. Your
organization receives login credentials to a data exchange account from the
registry.
2. The
account allows your organization to send data to the registry.
3. The
registry sends data quality information back to your organization.
Step 4:
Testing
The
organization follows a test plan provided by the registry to ensure it can:
1. Connect
to the registry,
2. Send
data in the correct formats,
3. Receive
data quality reports, such as error and consent notification files,
4. Correct
data quality issues, and
5. Regularly
check the data reported.
Step 5:
Production
After
successful testing, your organization is promoted to production.
Step
6: Ongoing Submission of Data
Once
your organization has been promoted to production, further actions by your organization
and EHR vendor may be necessary when data errors are identified. Organizations should continue to monitor for
data errors.
Important:
Organizations in production must regularly submit data, check the data
reported, and correct data quality issues.
Promoting Interoperability (PI) for Public
Health Overview
The Centers for Medicare and Medicaid
Services (CMS) launched an incentive program to encourage Eligible Providers,
Eligible Hospitals, and Critical Access Hospitals to transition to Electronic
Health Record systems.
For more information about CMS, or about Promoting
Interoperability (formerly known as “Meaningful Use”) visit the CMS website.
DSHS – Promoting
Interoperability
For information about Texas (DSHS) support of
Promoting Interoperability, including other agency initiatives on Promoting
Interoperability, visit the DSHS Promoting
Interoperability website .
Texas
Immunization Registry – Promoting Interoperability
The Texas
Immunization Registry supports Promoting Interoperability measures.To participate in Promoting Interoperability
with the registry, your organization needs to establish a data exchange
connection with the Texas Immunization Registry.
Promoting Interoperability:
Stage 2
The Texas Immunization Registry is engaged in
uni-directional (batch) data exchange with organizations. Uni-directional data
exchange requires organizations to submit a large volume of data in a single
file at a set date/time to the registry. In return, the registry sends data quality
reports back to the organization. Both
the organization and the registry use FTP to send
and retrieve data.
Promoting
Interoperability: Stage 3
On June 26, 2020, the Department of State Health Services (DSHS) announced that the Texas Immunization Registry (ImmTrac2) has the capability for bidirectional data exchange using the current data exchange standards specified in the Promoting Interoperability (PI) programs, including the Medicaid Electronic Health Record Incentive/PI Program.
DSHS is providing health care providers the required six months’ notice to prepare for bidirectional data exchange by January 1, 2021.
Bidirectional Onboarding Prioritization
Entities exchanging data with the Texas Immunization Registry will be able to access and submit patient and vaccination information in real-time with this change.
The following entities will be prioritized for onboarding for bidirectional data exchange:
- Reporting high-quality data (90% acceptance rate)
- Pharmacies
- Schools and universities
To determine reporting acceptance rate, entities registered in ImmTrac2 can access the Texas Immunization Provider Summary (TIPS) Report. This report can be accessed via the “generate reports” section of ImmTrac2 and provides an overview of all user activity, online activity, and data exchange activity from the previous month.
Eligibility
All Entities
DSHS is accepting requests to exchange data bidirectionally from all authorized entities with Certified Electronic Health Record Technology (CEHRT) and are authorized to access the registry by Texas Statute.
There are two registrations required to participate in bidirectional exchange with the Texas Immunization Registry:
- Register as an authorized organization with the registry (e.g. gain access to ImmTrac2), and
- Registration of intent (ROI) to implement bidirectional data exchange.
The ROI for bidirectional data exchange is submitted only once to the Texas Immunization Registry.
PI Program Participants
Participants must be actively engaged with the Texas Immunization Registry during their reporting period to be able to attest to meeting the PI immunization registry reporting measure. Both registrations mentioned above are required to meet PI program requirements.
To use participation with the Texas Immunization Registry to meet PI program requirements, a provider must complete their ROI no later than the 60th day of their reporting period the first year they want to report data to the registry.
How to Prepare
Prior to registering intent to participate in bidirectional data exchange with the registry, entities must:
- Review publication 11-14972, Texas Immunization Registry HL7 2.5.1 Implementation Guide, to identify how to configure HL7 data.
- Review publication 11-15235, Bidirectional Readiness Checklist, to determine steps to take to prepare for bidirectional data exchange.
- Review publication 11-15703, Texas Immunization Registry HL7 2.5.1 Error Guide, to identify all HL7 error messages and how to resolve them.
Publications referenced, and other resources are available on the Forms & Documents webpage that will be useful in entities preparation for bidirectional data exchange.
Next Steps
Once a provider or their affiliated entity has successfully completed the Bidirectional Readiness Checklist, only then should the entity contact the registry for verification of readiness and information on how to register their intent to engage in bidirectional data exchange.
Entities will be reviewed by the registry to determine their readiness for bidirectional data exchange and streamline the onboarding process.
Proof of Promoting
Interoperability Engagement and Exemption Requests
For proof of Promoting Interoperability
engagement, contact the Interoperability Team at the Texas Immunization
Registry. The document may include your
organization’s name, the date your organization registered intent, the date
your organization began testing, as well as the date your organization went
into production. Additional information
such as files submitted may be provided upon request. Refer to the Data
Exchange Support section below
for our contact information.
The Texas Immunization Registry does not
provide Exemption/Exclusion Letters. To
receive an exemption or exclusion, please contact CMS.
Resources
For
all registry related forms, publications, data exchange specifications, HL7
implementation guides and data exchange resources, refer to the Forms & Documents webpage.
For
training videos, webinars and other resources refer to the User
Training webpage.
Data
Exchange Support
For additional questions
regarding data exchange or Promoting
Interoperability with the Texas Immunization Registry, please contact the registry’s
Interoperability Team:
Phone: 800-348-9158
Email:
ImmTracMU@dshs.texas.gov
Hours of Operation: Monday – Friday 8:00 a.m.- 4:30 p.m. Central Time
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