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California immunization registry

 Test Plan for HL7 VXU Submission       CAIRlogo-new-197x42

To CAIR2

Version 3.2 October 25, 2021


Revision History

Editor

Edit Date

Version

Changes

E. Dansby

July 28, 2016

1.0

 -

E. Dansby / S. Nickell

August 24, 2016

1.1

 -

S. Nickell

November 15, 2016

1.2

 -

E. Dansby

March 1, 2017

1.3

(Updated Table 1)

E. Dansby

October 21, 2019

2.0

Updated Table 1, links, and refined some text

I. Cheever / E. Dansby

February 25, 2020

3.0

Added test patients, updated Table 1, links, and refined text

I. Cheever / E. Dansby

August 3, 2020

3.1

Updated test patients

I. Cheever / E. Dansby

October 25, 2021

3.2

Updated staging WSDL, patient data elements required for testing, and test patients


CAIR Data Exchange Contact Information

For data exchange questions and support, please email CAIRDataExchange@cdph.ca.gov.

To get the latest information regarding data exchange with CAIR2, please visit the Data Exchange page

 

Overview

This document is intended for data exchange (DX) submitters that have registered at the CAIR Immunization Portal, have received their credentials for submitting data to CAIR2, and are ready to move forward with the testing process.

If your Site has not registered, please go to at the CAIR Immunization Portal yet, please go to the CAIR2 IZ Portal Registration/Login Page.  

 

Message Content

Prior to submitting test messages, please review the CAIR2 HL7 2.5.1 v1.5 Data Exchange Specifications (PDF) document for a complete and detailed overview of HL7 message requirements.

 

Pre-testing Steps 

CAIR2 Staging WSDL (Direct Submitters and Data Aggregators only)

To send test messages to the CAIR2 staging environment, submitters will need to download and install the CAIR2 STAGING WSDL to the server/interface engine that will be submitting the HL7 messages. This ensures that HL7 messages can be sent to CAIR2.

 

Testing HL7 Messages in CAIR2

Real Time HL7 Message Submission

The submitSingleMessage operation is used to submit a HL7 message. In the submitSingleMessage SOAP operation, the hl7Message parameter must contain the properly formatted HL7 VXU message. HL7 messages need to be wrapped in a SOAP envelope using the credentials emailed to you after registration at the CAIR Immunization Portal. Fake patient data should be used when submitting test messages to CAIR2.

Example SOAP message:

<soap:Envelope xmlns:soap="http://www.w3.org/2003/05/soap‐envelope"

xmlns:urn="urn:cdc:iisb:2011">

<soap:Header/>

<soap:Body>

<urn:submitSingleMessage>

<urn:username>Portal Username</urn:username>

<urn:password>Portal Password</urn:password>

<urn:facilityID>Portal Facility ID</urn:facilityID>

<urn:hl7Message><![CDATA[

MSH|^~\&|MyEMR|DE-000001|…

……

]]>

</urn:hl7Message>

</urn:submitSingleMessage>

</soap:Body>

</soap:Envelope>


Note: As shown in the example SOAP message, in the SOAP UI application you will need to add ‘<![CDATA[‘ before ‘MSH’ in the HL7 message and use closing brackets ‘]]>’ at the end of the HL7 message.

If the submitSingleMessage is unsuccessful, make sure:

  • The correct SOAP Username and SOAP Password assigned through the online registration Portal are being used.

  • The correct WSDL is being used.

If still unsuccessful, please send an email to CAIRdataexchange@cdph.ca.gov

 

HL7 ACK/NAK Process

As each submitted HL7 VXU message is received by CAIR2, an HL7 ACK (message accepted) or NAK (message has errors/warnings) is returned back to the submitter. The returned ACK/NAKs will help to guide your Site in making changes to your data formatting until you can submit a message without errors. These ACK/NAKs follow the format laid out in the CDC HL7 Version 2.5.1: Implementation Guide for Immunization messaging, Release 1.5 and will provide details as to any segments/fields that contain errors. The NAK will also inform as to whether the error constituted a message failure or simply an informational error/warning. See page 40 of the CAIR2 HL7 2.5.1 v1.5 Data Exchange Specifications (PDF) for details on the ACK/NAK format.

If your Site is submitting data to CAIR2 through an intermediary Sending Facility (e.g. HIE, cloud-based EHR, data warehouse, etc.), you should contact the Sending Facility and your EHR vendor to determine whether ACK/NAKs returned to the Sending Facility by CAIR2 can be returned and displayed in your EHR. As noted previously, Sites must monitor returned ACK/NAK messages and make corrections to their submissions as needed. Test messaging will also be will be monitored by DX staff who can be consulted at any time if a Site has questions, at CAIRDataExchange@cdph.ca.gov. Also, if your Site would like to engage in more extensive end-to-end message testing, contact CAIRDataExchange@cdph.ca.gov for a CAIR2 User Interface test account.

 

Data Validation 

The following table and HL7 example will be primarily beneficial to non-technical staff, as the required data elements for the test patients listed below contains only a partial list of segments/fields required for a successful HL7 message. Please ensure IT/EMR staff have reviewed the CAIR2 HL7 2.5.1 v1.5 Data Exchange Specifications (PDF) document for complete and detailed HL7 message requirements. 


At minimum, all test patients must contain:

Table 1: Data Elements and Segments/Fields that shall be validated during the testing process

 Below is the Patient Data Required for Testings and IT / Vendor Use Information:

Patient Information
 Required
HL7 Segment / Field
 Usage
 HL7
 Code
Table
 Comment
Patient ID YES PID-3 R  -
This is the patient ID from the provider's system, commonly referred to as medical record number. CAIR2 only accepts type codes, 'MR', 'PI', 'PN', 'PRN', or 'PT'
Patient Name YES PID-5 R  -
Each name field has a 50 character length limit in CAIR2
Mother's Maiden Name YES, if available: needed for patient matching PID-6 RE  -
 -
Date of Birth YES PID-7 R  -
 YYYYMMDD
Sex YES PID-8 R HL70001  'M', 'F', 'X' or 'U' only
Race YES PID-10 RE HL70005  -
Patient
Address
YES PID-11 RE  -
 -
Phone YES PID-13 RE  -

Example:

Home Phone
|^PRN^PH^^^555^5555555|

Cell Phone
|^PRN^CP^^^555^5551234|

Email YES PID-13 RE  -
Example:
|^NET^X.400^CAIR@
CAIR.COM|
Ethnicity YES PID-22 RE HL70189 Used to further identify race as Hispanic or non-Hispanic
Protection Indicator YES PD1-12 R  -
'Y', 'N'. Indicates whether patient data should be 'locked' so other CAIR providers can't view.
Next of Kin Name YES NK1-2 R  -
Name of next of kin or associated party
Relationship YES NK1-3 R HL70063 Personal relationship that the next of kin or associated party has to the patient
Ordering Provider YES, if given dose ORC-12 RE  -
NPI, provider name, assigning authority, identifier type code, and professional suffix are required

Date/Start of Administration

YES
RXA-3 R  -
YYYYMMDD
Administration Code YES RXA-5 R  -
CVX or NDC codes accepted
Administered Amount YES RXA-6 R  -
Required for all doses
Administered Notes YES RXA-9 R NIP001 Indicates historical or given shot
Administering Provider YES RXA-10 C(RE/O)  -
The person who administered the shot.
If RXA-9.1 = '00' and RXA-20 is valued at 'CP' or 'PA'.
Administered-at Location YES RXA-11 C(R/O)  -
CAIR2 org code of the location where the shot was administered
Substance Lot Number YES, if given dose RXA-15 C(R/O)  -
If RXA-9.1 = '00' and RXA-20 is valued at 'CP' or 'PA', substance lot number must be supplied
Substance Lot Manufacturer YES, if given dose RXA-17 C(R/O) HL70227 If RXA-9.1 = '00' and RXA-20 is valued at 'CP' or 'PA'
MVX code only
Route YES, if given dose RXR-1 RE HL70162 Route of the administration
Administration Site YES, if given dose RXR-2 RE HL70163 Body site of the administration route
Observation Identifier YES OBX-3 R NIP003 Only "64994-7" Vaccine funding program eligibility category accepted
All other OBX segments will be ignored
Observation Value YES OBX-5 R HL70064 This is where the code for VFC eligibility will be recorded at the vaccine level

 

For detailed information on segments and fields, please review the CAIR2 HL7 2.5.1 v1.5 Data Exchange Specifications (PDF) document.

 

Highlighted Patient Data Required for Testing

While only data elements from Table 1 have been highlighted below, all HL7 messages sent to CAIR2 should be as complete and accurate as possible. Throughout the testing process, CAIR Data Exchange Specialists will provide feedback on various segments/fields that may or may not be highlighted below.

Note that indentation has been added to each segment for readability.

MSH|^~\&|MyEMR|DE-000001||CAIR2|20200225123030||VXU^V04^VXU_V04|CA0001|P|2.5.1|||AL|AL||||||DE-000001

PID|1||PA123456^^^XYZCLINIC^MR||JONES^GEORGE^M^JR|MILLER^MARTHA^G|20140227|M||2106-

3^WHITE^HL70005|1234 W FIRST ST^^BEVERLY HILLS^CA^90210^^H^^||^PRN^PH^^^555^5555555

~^PRN^CP^^^555^5551234~^NET^X.400^cair@cair.com||ENG^English^HL70296|||||||2186-5^ not Hispanic or Latino ^HL70189||Y|2

PD1|||||||||||02^REMINDER/RECALL – ANY METHOD^HL70215|N|20140730|||A|20140730|

NK1|1|JONES^MARTHA|MTH^MOTHER^HL70063||||||||||||||

ORC|RE||197023^CMC|||||||^Clark^Dave||1245319599^Smith^Janet^^^^^^CMS_NPPES^^^^NPI^^^^^^^^MD|||||

RXA|0|1|20200225||08^HEPB-PEDIATRIC/ADOLESCENT^CVX|.5|mL^mL^UCUM||00^NEW IMMUNIZATION RECORD^NIP001|85041235^Bear^Elizabeth^^^^^^NG^^^^NP^^^^^^^^NP|^^^DE-000001||||0039F|20200531|MSD^MERCK^MVX|||CP|A

RXR|IM^INTRAMUSCULAR^HL70162|LA^LEFT ARM^HL70163

OBX|1|CE|64994-7^Vaccine funding program eligibility category^LN|1|V03^VFC eligibility – Uninsured^HL70064

||||||F|||20200225140500

 

Test Patients

Create the following patients based on the site’s clinic type. Sites are welcome and encouraged to create additional test patients or send additional CVX or NDC codes not listed below based on their testing needs. While not all test patient ages or data elements (e.g. vaccine eligibility) may be applicable to the site, testing all scenarios listed under the clinic type is important for future data completeness and accuracy.


Throughout the testing process, review the returned acknowledgments (ACKs) and make corrections as needed.

 

Pediatric Clinic

Create five (5) test patients.

 

Patient 1: age 2 months


 

Vaccine

Administered Date

Lot

MVX

Body Site

Route

Vaccine Eligibility

PT 1

DTaP-HepB-IPV

Today

- -

Medi-cal/CHDP eligible

PT 1

Hep B

Historical on DOB

-

-

-

-

N/A

PT 1

Hib

Today

-

-

Medi-cal/CHDP eligible

PT 1

PCV13

Today

-

-

Medi-cal/CHDP eligible

PT 1

Rotavirus

Today

- - -

Medi-cal/CHDP eligible

 

 

Patient 2: age 6 months

 

 

Vaccine

Administered Date

Lot

MVX

Body Site

Route

Vaccine Eligibility

PT 2

DTaP-IPV/Hib

Historical at 2 mo

-

-

-

-

N/A

PT 2

DTaP-IPV/Hib

Historical at 4 mo

-

-

-

-

N/A

PT 2

DTaP-IPV/Hib

Today


-  

-  

-  

Private

PT 2

HepB

Historical on DOB

-

-

-

-

N/A

PT 2

HepB

Historical at 2 mo

-

-

-

-

N/A

PT 2

HepB

Today

- -

Private

PT 2

Influenza (seasonal)

Today

-  

-  

-  

-  

Private

PT 2

PCV13

Historical at 2 mo

-

-

-

-

N/A

PT 2

PCV13

Historical at 4 mo

-

-

-

-

N/A

PT 2

PCV13

Today

Private

PT 2

Rotavirus

Historical at 2 mo

-

-

-

-

N/A

PT 2

Rotavirus

Historical at 4 mo

-

-

-

-

N/A

PT 2

Rotavirus

Today

-  

-  

-  

-  

Private

 

 

Patient 3: age 4 years


 

Vaccine

Administered Date

Lot

MVX

Body Site

Route

Vaccine Eligibility

PT 3

DTap

Today

-
-

Uninsured

PT 3

HepA

Historical at 12 mo

-

-

-

-

N/A

PT 3

HepA

Today

Uninsured

PT 3

HepB

Historical at 12 mo

-

-

-

-

N/A

PT 3

HepB-Hib

Today

-

Uninsured

PT 3

Hib

Historical at 12 mo

-

-

-

-

N/A

PT 3

Influenza (seasonal)

Historical at 12 mo

-

-

-

-

N/A

PT 3

Influenza (seasonal)

Today

State General Fund

PT 3

MMRV

Today

Uninsured

PT 3

PCV13

Historical at 12 mo

-

-

-

-

N/A

PT 3

PCV13

Today

-

Uninsured

PT 3

Polio (IPV)

Historical at 12 mo

-

-

-

-

N/A

PT 3

Polio (IPV)

Today

Uninsured

 

 

Patient 4: age 12 years

 

 

Vaccine

Administered Date

Lot

MVX

Body Site

Route

Vaccine Eligibility

PT 4

DTaP-IPV

Historical at 4 yrs

-

-

-

-

N/A

PT 4

HepA

Today

Medi-cal/CHDP eligible

PT 4

HepB

Historical on DOB

-

-

-

-

N/A

PT 4

HepB

Today

Medi-cal/CHDP eligible

PT 4

HPV9

Today

- -

Medi-cal/CHDP eligible

PT 4

Influenza (seasonal)

Today

Medi-cal/CHDP eligible

PT 4

MMRV

Historical at 4 yrs

-

-

-

-

N/A

PT 4

MMR

Today

Medi-cal/CHDP eligible

PT 4

Polio (IPV)

Today

Medi-cal/CHDP eligible

PT 4

Tdap

Today

Medi-cal/CHDP eligible

PT 4

MenACWY

Today

Medi-cal/CHDP eligible

PT 4

Varicella

Today

Medi-cal/CHDP eligible

PT 4

COVID (Pfizer)

Today

Medi-cal/CHDP eligible

 


Patient 5: age 16 years

 

 

Vaccine

Administered Date

Lot

MVX

Body Site

Route

Vaccine Eligibility

PT 5

Hep A

Historical at 12 mo

-

-

-

-

N/A

PT 5

Hep B

Historical at 12 mo

-

-

-

-

N/A

PT 5

HPV9

Today

-

Private

PT 5

Influenza (seasonal)

Historical at 12 mo

-

-

-

-

N/A

PT 5

MenACWY

Today

Private

PT 5

MenB

Today

Private

PT 5

MMR

Historical at 12 mo

-

-

-

-

N/A

PT 5

PCV13

Historical at 12 mo

-

-

-

-

N/A

PT 5

Polio (IPV)

Historical at 12 mo

-

-

-

-

N/A

PT 5

Tdap

Today

-


Private

PT 5

VZV

Historical at 12 mo

-

-

-

-

N/A

PT 5

COVID (Pfizer)

Historical (9/1/21)

-

-

-

-

N/A

PT 5

COVID (Pfizer)

Historical (9/22/21)

-

-

-

-

N/A

 

 


Adult Clinic/Pharmacy

Create five (5) test patients.

 

Patient 1: age 21 years

 

 

Vaccine

Administered Date

Lot

MVX

Body Site

Route

Vaccine Eligibility

PT 1

Hep A

Historical at 4 yrs

-

-

-

-

N/A

PT 1

HepA-HepB

Today

-

Private

PT 1

Hep B

Historical at 4 yrs

-

-

-

-

N/A

PT 1

HPV9

Today

Private

PT 1

Influenza (seasonal)

Historical at 4 yrs

-

-

-

-

N/A

PT 1

MenACWY

Today

Private

PT 1

MenB

Today

Private

PT 1

MMR

Historical at 4 yrs

-

-

-

-

N/A

PT 1

MMR-VZV

Today

Private

PT 1

PCV13

Historical at 4 yrs

-

-

-

-

N/A

PT 1

Polio (IPV)

Historical at 4 yrs

-

-

-

-

N/A

PT 1

Polio (IPV)

Today

-

Private

PT 1

Tdap

Today

Private

PT 1

VZV

Historical at 4 yrs

-

-

-

-

N/A

PT 1

COVID (Pfizer)

Historical (3/1/21)

-

-

-

-

N/A

PT 1

COVID (Pfizer)

Historical (3/22/21)

-

-

-

-

N/A

 

 

Patient 2: 30 years old

 

 

Vaccine

Administered Date

Lot

MVX

Body Site

Route

Vaccine Eligibility

PT 2

DTaP

Historical at 3 yrs

-

-

-

-

N/A

PT 2

HepA

Historical at 3 yrs

-

-

-

-

N/A

PT 2

HepA

Today

-


317

PT 2

HepB

Historical at 3 yrs

-

-

-

-

N/A

PT 2

HepB

Today

317

PT 2

Hib

Historical at 3 yrs

-

-

-

-

N/A

PT 2

HPV4

Historical at 20 yrs

-

-

-

-

N/A

PT 2

MCV4

Historical at 20 yrs

-

-

-

-

N/A

PT 2

MMR

Historical at 3 yrs

-

-

-

-

N/A

PT 2

MMR

Today

317

PT 2

PPSV23

Today

317

PT 2

Polio (IPV)

Historical at 3 yrs

-

-

-

-

N/A

PT 2

Varicella

Historical at 3 yrs

-

-

-

-

N/A

PT 2

Varicella

Today

317

PT 2

COVID (Moderna)

Historical (4/1/21)

-

-

-

-

N/A

PT 2

COVID (Moderna)

Historical (4/29/21)

-

-

-

-

N/A

 


Patient 3: 45 years old

 

 

Vaccine

Administered Date

Lot

MVX

Body Site

Route

Vaccine Eligibility

PT 3

DTP

Historical at 5 yrs

-

-

-

-

N/A

PT 3

HepA

Historical at 20 yrs

-

-

-

-

N/A

PT 3

HepA

Today

State General Fund

PT 3

HepB

Historical at 20 yrs

-

-

-

-

N/A

PT 3

Influenza (H1N1)

Historical, given in 2009

-

-

-

-

N/A

PT 3

Influenza (seasonal)

Historical at 20 yrs

-

-

-

-

N/A

PT 3

Influenza (seasonal)

Today

State General Fund

PT 3

MMR

Historical

-

-

-

-

N/A

PT 3

PCV13

Today

State General Fund

PT 3

Polio (Oral)

Historical at 5 yrs

-

-

-

-

N/A

PT 3

Td

Historical at 20 yrs

-

-

-

-

N/A

PT 3

Tdap

Today

State General Fund

PT 3

Varicella

Historical at 20 yrs

-

-

-

-

N/A

PT 3

COVID (Pfizer)

Today

State General Fund

 

 

Patient 4: 50 years old

 

 

Vaccine

Administered Date

Lot

MVX

Body Site

Route

Vaccine Eligibility

PT 4

HepA

Today

- -


Private

PT 4

Influenza (seasonal)

Today

- -



Private

PT 4

PCV13

Today

Private

PT 4

Tdap

Today

Private

PT 4

COVID (Moderna)

Today

Private

 

 

Patient 5: 65 years old

 

 

Vaccine

Administered Date

Lot

MVX

Body Site

Route

Vaccine Eligibility

PT 5

HepA

Today

State General Fund

PT 5

Influenza (seasonal)

Today

State General Fund

PT 5

PCV13

Historical, age 60

-

-

-

-

N/A

PT 5

PPSV23

Today

State General Fund

PT 5

Tdap

Today

State General Fund

PT 5

Zoster

Today

-

317

PT 5

COVID (J&J)

Today

State General Fund

 

 

Once test messages have been validated by CAIR Data Exchange staff and found to contain zero errors, CAIR asks that the Site send production data from their EHR to CAIR2 production. CAIR will monitor production data until it is determined that the data quality is found to be satisfactory. All errors found during both the testing process and the production process should be addressed by the Site and data resubmitted. If there are any errors occurring that require further discussion, a CAIR Data Exchange Specialist (DXS) is available to assist. The CAIR DXS can be reached via email at CAIRDataExchange@cdph.ca.gov. Please include your assigned CAIR Org Code and Sending Facility ID (if you have one) in the email.

 

NOTE: Vendors, HIOs, and other data aggregators that are connecting to the Portal through a hub or cloud based system will only need to complete the testing process once for their hub interface testing. Once the hub testing is completed, all provider sites having their data sent using this method will automatically be placed into production and monitored as outlined above.

 

Production Data Submission

 

As the site prepares to move to production data submission, all parties should know how often production data will be reviewed and who to contact for assistance in case issues arise.

 

Identify contacts for the following:

  •  Who will review acknowledgments (ACKs) sent back to the submitter and submit corrections?

  •  Who is the best site contact for follow up if CAIR or EMR/IT staff have questions?


Once the Site is officially in production in CAIR2, no further test data should be submitted. While in production, CAIR2 will continue to monitor submissions for data quality to ensure that data coming into CAIR2 meets minimum data quality standards. Beyond the basic HL7 content validation that occurs during message submission, the CAIR’s Data Quality Assurance (DQA) staff will look deeper into the data fields of the incoming HL7 messages for accuracy, completeness, and timeliness. Part of a future DQA follow-up process will involve generating data report cards for the Sites to let them know how their Site is doing and if there are any issues that need to be addressed. If a Site is found to have data quality below a minimum standard, CAIR DXS staff reserve the right to downgrade the Site to ‘testing’ status until the DQ issues are resolved.

 

If your site would like to monitor data exchange messaging via the ‘Check Status’ functionality in CAIR2, go to the CAIR Account Update site and add a ‘Data Exchange Quality Assurance’ (‘DX QA’) user. This read-only account does not require training and allows a user to search for patients, run reports, and monitor data exchange activity.

For data exchange questions and support, please send an email to CAIRDataExchange@cdph.ca.gov.  

 

Data Exchange Resources

 

CDC Code Sets – One stop shop for immunization related code sets (CVX, NDC, MVX, etc.).

CDC HL7 Version 2.5.1: Implementation Guide for Immunization Messaging, Release 1.5 – Contains the tables referenced in the CAIR2 HL7 2.5.1 VXU Implementation Guide.

CAIR2 HL7 2.5.1 v1.5 Data Exchange Specifications (PDF) - Document for a complete and detailed overview of HL7 message requirements for CAIR2.


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