Immunization Bidirectional Data Exchange



On June 26th, 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.

Refer to the information below to identify organizations being prioritized, eligibility, how to prepare and the next steps.

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.


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:

  1. Register as an authorized organization with the registry (e.g. gain access to ImmTrac2), and
  2. 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 DSHS ImmTrac2 website 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.


All questions should be directed to the Texas Immunization Registry’s Interoperability Team at