Included in the strategies for demonstrating Meaningful Use of EHR systems is the submission of immunization data to immunization registries or immunization information systems. This measure applies to Eligible Hospitals (EH) and to Eligible Professionals (EP).
Since 2006, the Virginia Department of Health’s Division of Immunization (VDH/DOI) implemented a statewide Immunization Registry for the public and private sectors known as the Virginia Immunization Information System (VIIS). Immunization registries are confidential, secure, computerized databases by participating providers to individuals of all ages. VIIS works with various organizations and has participation from private providers, hospitals, free clinics, health plans, pharmacies, and more. VIIS is updated daily with immunization data from vital records and local health departments.
VIIS provides many benefits such as:
- Consolidates records on a secure site from private and public sectors
- Integrated ACIP vaccine tracking schedule,
- Provides an official immunization record acceptable as MCH-213G form Entrance substitute,
- Generates reminder notices for clients who are due for vaccines,
- Serves as a great tool for the Virginia Vaccines for Children (VVFC) providers to streamline vaccine management and improve accountability.
Because Virginia is able to receive immunization messages in HL7 2.3.1 or HL7 2.5.1, EPs and EHs cannot apply for an exclusion on this basis. If you administer vaccines to your patient population during your attestation time frame, you cannot be excluded from this measure. If you indicate that you do not administer vaccines to your patient population, please apply for an exclusion with the Centers of Medicare and Medicaid Services (CMS). Refer to FAQ for exclusion documentation.
VDH began to accept Meaningful Use Stage 3 ONC 2015 Edition immunization messages on January 1, 2017 for those Eligible Providers and Eligible Hospitals interested in participating.
Note: The use of the term “Meaningful Use” on VDH websites refers to the exchange of public health messaging with VDH for all CMS EHR Incentive Programs such as Promoting Interoperability, Meaningful Use, MIPS, or OPPS.
Onboarding Process for Immunization Message
For Meaningful Use (MU) Stage 1, providers must complete Steps 1-2, while in Stage 2 providers must demonstrate active engagement with Public Health. Some EP/EH have already made progress along this continuum in MU Stage 1. Providers registered in the VDH Meaningful Use Registration System will receive acknowledgement of the VDH MU status they have achieved at the end of their reporting period. Statuses of active engagement include Registered, Invited to Onboard, Testing and Validation, and In Production.
Meaningful Use (MU) providers registered in the VDH Meaningful Use Registration System will receive acknowledgement of the VDH MU status they have achieved at the end of their reporting period. Statuses of active engagement include Registered, Invited to Onboard, Testing and Validation, and In Production.
1. Registration: Eligible Hospital (EH) or Eligible Professional (EP) notifies public health of interest in submitting Immunization data for MU.
- Register in VDH MU Registration System.
- VDH will provide an acknowledgement of successful registration. Your MU status will be “Registered.”
- EHs are strongly encouraged to schedule a planning call with VDH. EPs can schedule a planning call with VDH at their discretion.
- Ensure site is also registered with Virginia Immunization Information System (VIIS).
- Ensure site has completed the VIIS Memorandum of Agreement (MOA).
- Complete VIIS training as needed to take full advantage of the benefits of VIIS.
- Prepare message according to VIIS HL7 2.5.1 specifications.
- Note: Sites that initiated successful ongoing submission of data exchange with VIIS before FY2014 may continue to send HL7 2.3.1/2.4 messages in Stage 2.
2. Message Structure Validation: EH or EP generates and evaluates Immunization messages with test data.
- VDH will provide documentation as status changes take place. Once you begin to submit messages, “Testing and Validation” will be in effect. This phase demonstrates active engagement.
- Submit sample messages (using test data) to VDH by e-mail for structural validation.
- Incorporate feedback from VDH to refine message structure to meet Meaningful Use and VDH message requirements.
3. Connectivity: EH or EP sets up transport option with public health.
- Select a transport method.
- Work with Virginia Health Information (VHI), formerly Connect Virginia HIE, to establish and test transport.
4. Message Content Validation: EH or EP establishes Immunization data feed to public health for data validation activities.
- Submit test messages to VDH through the selected transport method.
- These messages must use data from the production environment.
- Incorporate feedback from VDH to refine message content to meet Meaningful Use and VDH requirements.
5. Production: EH or EP submits Immunization data via electronic feed and participates in periodic quality assurance activities.
- Initiate regular production transmission of Immunization messages to VDH. Your MU status will be updated from “Testing and Validation” to “In Production”.
- Incorporate VDH feedback as necessary to ensure quality of data.
- VDH will provide EH and EP an acknowledgement of ongoing data transmission for attestation period at the completion of this step.
Frequently Asked Questions
If my practice does not vaccinate, do I still need to submit a test file?
No. Apply for an exclusion through Centers of Medicare and Medicaid Services (CMS). To receive documentation to support your request for an exclusion, please register in the VDH Meaningful Use Registration System. Guidelines can be found on the website.
Is there a site ID that must be presented in the HL7 file?
Yes. It is the VIIS Org Code that VDH will provide to the EP/EH or Vendor. The VIIS Org Code needs to be populated in the MSH4 segment.
I only administer flu vaccines, do I still need to send immunization data to the registry?
Yes. VIIS is a birth to death immunization registry designed to consolidate a resident of Virginia’s immunization records into one complete, accurate and definitive immunization record. New legislation was introduced in January 2021 which requires all healthcare providers who administer vaccines to participate with VIIS. This new mandate went into effect January 1, 2022.
Can I use public health messages to communicate directly with patients?
Immunization reporting is restricted to communicating information between specified entities allowed by law to access the registry. Should patients need immunization information from the registry, they can get this information from their physician, or from the health department. To request an immunization record, please contact VIISInfo@vdh.virginia.gov
Are pharmacies that administer vaccines contributing immunization data to VIIS?
New legislation was introduced in January 2021 which requires all healthcare providers who administer vaccines to participate in with VIIS. This new mandate went into effect January 1, 2022.