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Frequently Asked Questions (FAQ)
Information Updated on May 2, 2013
*Please check back frequently for future updates
Please review the questions below before contacting the N.C. Immunization Branch. If you do not find a response to your question, please send your question in an e-mail to the contact listed below and a response will be included in the next update of this FAQ. The intended audience for this FAQ are provider organizations as well as electronic health records (EHR) vendor personnel.
FAQs are organized in the following four categories:
1. Does the North Carolina Immunization Registry (NCIR) have data exchange capabilities with EHR systems?
Yes. Currently the NCIR supports two interface methods, both of which are unidirectional. In the future, the NCIR will support a bi-directional interface.
2. How do different data exchange types compare?
Refer to the table below for a quick at-a-glance comparison of different methods currently available or under development. Additional information is available for each method in the sections below.
| Unidirectional [NCIR can transfer data to EHRs; EHRs cannot transfer data to the NCIR.] | Bi-directional [Data transfer both ways.] | ||
| Batch | Real Time | Both Batch and Real Time | |
| Purpose | Data transferred once a day. All data modified or added since last download sent out. | Data transferred in real time. Only new data added transferred. | The NCIR can transfer data to EHRs and EHRs can transfer data to the NCIR. Transfers can occur in real time. |
| File Formats | HL7 standards version 2.3.1 and 2.4 | HL7 standards version 2.3.1 and 2.4 | HL7 [Version to be published] |
| Transaction Types | Unsolicited Vaccination update (VXU) or Health level 7 (HL7) | Unsolicited Vaccination update (VXU) or Health level 7 (HL7) | In development |
| Transport Protocol | n/a | PHINMS. Vendor requires some knowledge of PHINMS to implement. | In development |
| Currently in Use? | Yes | In pilot testing phase | No |
3. What is a unidirectional interface?
A unidirectional interface allows the NCIR to send information to an EHR system. This interface helps prevent duplicative data entry. The EHR system used by a provider office must have the capability to import data from the NCIR.
4. What are the two unidirectional interface methods the NCIR currently supports?
The NCIR supports a Batch interface method and a Real Time interface method. Provider organizations using Batch interface download a file from the NCIR daily, either at the start of the day or at close of business. The Real Time interface sends immunization information to an EHR system as soon as it is entered in the NCIR.
5. What file formats do the unidirectional interfaces work with?
Both Batch and Real Time interfaces use HL7 standards version 2.3.1 and 2.4 to communicate between the NCIR and EHR systems. The transaction types used are Unsolicited Vaccination update (VXU) or Health level 7 (HL7). HL7 is the standard used for communication between health systems. Immunizations are identified by CVX codes and optionally by CPT code or vaccine group.
6. Is there a fee to use a unidirectional interface with the NCIR?
No, the N.C. Immunization Branch does not charge a fee for this service. However, your certified EHR vendor may charge a fee to set up the interface.
7. What is the Batch interface method and how is it different from the Real Time interface method?
The Batch interface method is a unidirectional interface. Provider organizations using Batch interface download a file from the NCIR daily, either at the start of the day or at close of business. Information on NCIR clients selected for download in a Batch interface includes all new and historical data on those clients. This method has minimal set up requirements and the EHR can start receiving data almost immediately.
The Real Time interface method is also unidirectional interface. The interface sends immunization information to an EHR system as soon as it is entered in the NCIR. Only the new immunization information added to the NCIR is sent to the EHR. Set up of a Real Time interface with the NCIR requires configuring both the EHR and NCIR system by a technical person familiar with the Public Health Information Network Messaging System (PHINMS) transport protocol.
8. What transaction type does the Batch interface method use?
The Batch interface uses the HL7 VXU transaction type. This is the same transaction type used by the Real Time interface method. So, a provider can start with the Batch interface method and then transition to the Real Time interface method once they are comfortable with file formats and data.
9. Can we obtain a one time data download from NCIR?
Currently, we are unavailable to help providers with this request. NCIR is in the process of developing our bi-directional data exchange as well as working on meaningful use requirements with various stakeholders. Please check back to this FAQ section periodically, as we hope to have an update on this topic once the bi-directional data exchange is available.
10. Are any providers currently using the batch interface method?
Yes, the Batch interface is used by both local health departments and private providers. The Real Time interface method is being tested by providers involved in our pilot project. If your office would like to take part in the pilot project for the Real Time interface method, please let us know.
11. What information is available for download as part of the Batch interface?
All active clients associated with the provider organization that have information added or updated since the previous download are eligible for download. Information downloaded for each eligible client includes client demographics, address, all immunizations (new and historical) and any applicable client comments.
Each batch download file contains data added or changed since the previous download. The daily downloads help keep these two systems in sync on a daily basis.
12. How do I begin using the Batch interface method?
You will need to verify that your EHR system has the capability to import HL7 VXU messages. Work with your EHR vendor to make any necessary changes as per NCIR General Transfer Specifications (GTS) (view link below). In addition, each practice may have its own internal testing requirements before accepting data from NCIR.
13. Where can I find HL7 General Transfer Specifications (GTS)?
Refer to the NCIR HL7 - General Transfer Specifications (PDF, 297 KB) for more information.
14. What is the responsibility of the Provider organization before creating a user id in NCIR?
Before NCIR access can be established for a provider organization, the following items must be completed:
The provider will keep the confidentiality agreement(s) for each specific user in their organization. These agreements should be made available during site visits.
15. In addition to regular users, what are some of the responsibilities specific to Data exchange user?
NCIR administrator will need to ensure that the person downloading data for the NCIR organization will only use the data for its intended purpose (loading to EMR) and as well take all necessary safeguards related to security and confidentiality of downloaded data. NCIR administrator will obtain necessary confidentiality forms before requesting Data exchange access.
16. Once the technology is in place, what steps should a practice take to begin using the Batch interface method?
17. What are the steps to run a batch file download in the NCIR?
First, complete the steps outlined above to obtain Data exchange access and to complete necessary set up within NCIR. Then, follow the steps given below to run a data exchange file.
) using the user id and password obtained in previous step.REAL TIME ONE-WAY INTERFACE METHOD
18. What is Real Time interface method and how is it different from the Batch interface method?
The Real Time interface method is a unidirectional interface. The interface sends immunization information to an EHR system as soon as it is entered in the NCIR. Only the new immunization information added to the NCIR is sent to the EHR. Set up of a Real Time interface with the NCIR requires configuring PHINMS software at EHR system by a technical person familiar with the PHINMS transport protocol.
The Batch interface method is also a unidirectional interface. Providers using this method download a file from the NCIR daily, either at the start of the day or at close of business. Information on NCIR clients selected for download in a Batch interface includes all new and historical data on those clients. This method has minimal set up requirements and the EHR can start receiving data almost immediately.
19. What transaction type does the Real Time interface method use?
The Real Time interface uses the HL7 VXU transaction type. This is the same transaction type used by the Batch interface method. So, a provider can start with the Batch interface method and then transition to the Real Time interface method once they are comfortable with file formats and data.
20. What is the transport protocol is used for the Real Time interface method?
The NCIR uses PHINMS software as the transport protocol to send real time transactions to EMR. The PHINMS software was developed by the U.S. Centers for Disease Control and Prevention (CDC) and serves as a transport protocol to exchange information securely between health systems over the internet. Additional details on PHINMS may be obtained at the following website: http://www.cdc.gov/phin/tools/PHINms/index.html
21. Will the state install and implement PHINMS software for providers?
No. The state will only install and operate PHINMS software on the NCIR side. The state will not install or maintain PHINMS software on the EHR side. However, the state will share necessary information related to PHINMS to aid set up in provider offices. If you do not have the necessary technical personnel to install and maintain PHINMS on an ongoing basis, consider using batch interface before transitioning to real time.
22. Are any providers currently using the Real Time interface method?
Yes. The Real Time interface method is being tested by a provider involved in our pilot project. If your office would like to take part in the pilot project for the Real Time interface method, please contact us.
BI-DIRECTIONAL INTERFACE METHOD
23. Does NCIR accept data from a certified EHR or other IT systems?
The NCIR does not currently accept data through data exchange. However, the state is taking preliminary steps to develop a bi-directional interface method. This method will allow the NCIR to receive and send information to EHR systems.
24. What is the timeline for when a bi-directional interface will be ready?
The State is working towards having this interface available by summer of 2013. However, a definite timeline is not available. Please check this website periodically (suggested monthly) for updates.
25. What format will the bi-directional interface method use?
The NCIR will support HL7 transactions for the bi-directional interface method. The specific transaction type supported and detailed specifications will be updated in this FAQ as soon as information is available.
26. Do I need attestation by the state for meaningful use?
No, attestation by the state is not required. It is self-attestation by providers.
27. Will the state publish the testing protocols and expectations before a launching the bi-directional interface method?
Yes, the state will publish testing protocols and internal certification/data validation process when bi-directional interface method is ready for roll out. Provider organizations will need to meet or exceed the standards for data quality to be eligible to send data to the NCIR.
If you have questions not covered in this FAQ, send an e-mail to:
