Electronic Health Record (EHR) Electronic Data Exchange with CT WiZ

Connecticut’s Immunization Information System (CT WiZ)

HL7 Onboarding Process

Blue and White CT WIZ logo the I in Wiz is a syringe

 

On September 17, 2018, DPH migrated the data from the Connecticut Immunization Registry and Tracking System (CIRTS) into the new CT WiZ! This new Immunization Information System (IIS) enables bi-directional electronic data exchange between your electronic health record (EHR) and CT WiZ.

 

**Connecticut follows National Standards for Electronic Health Record (EHR) Reporting**

 

If you are:
  • A provider/clinic who orders vaccines from the Connecticut Vaccine Program (CVP), reports immunizations administered to children ages 0 through 18 and is mandated to report immunizations to CT WiZ, you can apply for electronic data exchange with CT WiZ. DPH will send email notifications as you progress through each phase of the onboarding process. These email notifications can be used for Meaningful Use attestation.

    Note: As CT WiZ accepts bi-directional data exchange with EHRs, if you are attesting to Meaningful Use (MU) and you are a CVP Provider, you may no longer use the MU exemption letter below to claim an exclusion for Public Health Reporting for Immunizations.

  • A provider/clinic who does not vaccinate children ages 0 through 18 and is not mandated to report immunizations to CT WiZ, you do not need to report to CT WiZ. If you are attesting to Meaningful Use, click here for the exemption letter.

          Meaningful Use Attestation Information Click here for more information on Meaningful Use.

Follow the steps below to establish an electronic interface between your EHR and CT WiZ. An interface with CT WiZ can be established for a single clinic (regardless of size) or an organization representing multiple clinics that will report through a single interface. The interface can be set up as uni-directional or bi-directional:

  • Uni-directional is data exchanged in one direction, from the EHR to the IIS. Data exchanged refers to Message Submission (VXU) and Acknowledgment (ACK).

  • Bi-directional is data exchanged in two directions, from the EHR to the IIS and from the IIS to the EHR.  Data exchanged refers to Query (QBP) HL7 message submissions that are sent to an IIS and Response (RSP) HL7 message submissions that are returned by an IIS in response to a querying system.

EHR vendors who have onboarded. If your clinic has the same EHR vendor, establishing an interface with CT WiZ will be easier than ever for your clinic. Whether your vendor is on the list or not, just complete the CT WiZ HL7 application form to get started!

 

 1. Getting Started

Before you start your application, review the following documents.

 
Onboarding Terms & Acronyms describes common terms that will be used throughout the onboarding process.
  
The Roles & Responsibilities helps determine who needs to be involved during and after the onboarding process and what they will be doing.
 
The HL7 Instructions Document walks you through the entire onboarding process.  It describes:
  • The onboarding application and NIST reports
  • Waiting for testing to begin
  • Meetings throughout the process
  • The configuration and connection of your EHR to CT WiZ
  • The testing and validation of HL7 messages
  • Data quality review of HL7 messages
  • Going Live in Production
The Transport Layer Protocol Recommendation Formal Specification provides guidance on connectivity and transport. CT WiZ only accepts submission through SOAP Web Services using the CDC WSDL.
 

The CT WiZ Local Implementation Guide for HL7 2.5.1 Immunization Messaging Release 1.5 define what fields and segments the Immunization Information System will and will not accept in an HL7 message.

 

The NIST Cases Validation Instructions provides guidance on performing the necessary testing and validation of messages in the NIST Tool in order to demonstrate that your EHR System complies with the requirements of HL7 Version 2.5.1 for Immunization Messaging, Release 1.5. 

 

The CVP Patient Eligibility Screening provides guidance on how the clinic should be mapping the vaccine funding program eligibility and funding source for the vaccine in your EHR.

 

The Vaccines Supplied by CVP (June 2019) provides a list of vaccines supplied by the State of Connecticut. The report contains the vaccine name, brand name, packaging, NDC, manufacturer, CVX code and CT WiZ dropdown selection.

 

Uni-directional Exchange: VXU Messages documentation

Bi-directional Exchange: Query and Response documentation

 2. Complete the Application
Uni-directional Exchange: VXU Messages
Bi-directional Exchange: Query and Response

Ready to apply? Remember, you must successfully complete the NIST tests and save the reports.

Complete the CT WiZ HL7 Application Form.  Review the 1st tab and complete the other 4 tabs in the spreadsheet.

 

Email the Application Form and the NIST Reports to Helpdesk.dph@ct.gov.  In the email's subject line, please type "Intent to submit data electronically to CT WiZ".

 3. Application Status
After the application has been submitted, the Connecticut Immunization Program will process the application and contact you if any further information is needed.

If you have any additional questions about the application process, please email HelpDesk.dph@ct.gov and include your complete name, organization/clinic name, email and phone number with your detailed question.

Application review and approval typically takes 3-5 business days. Once your application has been approved, you will receive an invitation and additional instructions to begin the testing process.
 
 4. Testing Phase
Uni-directional Exchange: VXU Messages
When you are ready, "real" patient immunization data (Production) will be submitted in real-time from your EHR system to the CT WiZ QA (Test) environment to test the interface connection and message data quality.  Acknowledgement (ACK) messages will be returned to your EHR system in response. The organization (or their designee) should monitor the ACKs and take action to correct submissions as needed until errors no longer occur.
 

    Phase 1: Confirm that CT WiZ can accept a test message from your EHR System.

    Phase 2: Validate messages from your EHR to confirm that required fields are populated with proper codes.

    Phase 3: Assess data quality of message content to ensure accurate patient data has been sent.
 

    There must be 2 weeks of error and warning free messages before moving into the CT WiZ Production environment.

 

Bi-directional Exchange: Query and Response

Once the interface has been configured, providers will actively participate in the testing process to ensure correct results and confirm that clinical records are properly updated.

 

    Phase 1: Testing credentials/URL, connectivity test

    Phase 2: Query and Response configuration and testing preparation

    Phase 3: Workflow testing

 

Testing for QBP/RSP is typically composed of the following elements:

  1. Query from the provider organization (QBP) to CT WiZ
  2. Response (RSP) from CT WiZ to the provider organization
  3. Update (VXU) from the provider organization to CT WiZ
  4. Acknowledgement (ACK) from CT WiZ to the provider organization    

Providers should apply multiple layers of testing:

  • Submit 25-50 records via VXU to query against for a guaranteed response (exact match and forecast)
  • Query using CT WiZ engineered test scenarios (multi-match or too many matches)
  • Query CT WiZ for real patients receiving vaccinations at the clinic (match/no match, VXU update after vaccination)
 5. In Production
When the EHR interface goes into CT WiZ Production, and the clinic is actively exchanging data with CT WiZ, the clinic (or their designee) must continue to review the ACK messages to ensure ongoing submission and data quality. Failed submissions or error messages should be corrected and resubmitted to CT WiZ.
 
Review the Roles & Responsibilities for who should be handling which tasks.
 
Follow and complete the Onboarding Go-Live Checklist in order to successfully enter and remain in the CT WiZ Production environment for HL7 messaging.

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