These sites submit doses to CAIR either manually or electronically. Sites submitting records to CAIR electronically from their Electronic Health Record (EHR) systems are also called Data Exchange Sites (see below). Staff at Clinical Sites can have any of these CAIR user roles:
- Regular Users can add or edit patient information and doses, and run reports.
- Power Users can add or edit patient information and doses, run reports, and manage vaccine inventory.
- Read-only Users can look up patients and print immunization records but not add or edit doses or patients.
These sites are limited to Read-only Users who can look up patients and print immunization records in CAIR but cannot enter or edit patient information. Schools can additionally run compliance reports. Non-clinical Sites typically include schools, child care facilities, WIC, welfare offices, and foster care agencies.
Active CAIR User:
Anyone who has used CAIR in the last 6 months (or 12 months if a Read-only User). If users don’t log in during the previous 6 months (or 12 months for Read-only Users), their accounts are inactivated. Inactivated Regular or Power Users will need to obtain a new User Account and take CAIR2 New User training, available after CAIR 2 is launched in the region.
Sites that submit patient immunization records to CAIR electronically from their Electronic Health Record (EHR) systems.
Health Level-7 or HL7 refers to a set of data standards that allows healthcare providers using EHR systems to securely send and receive patient data electronically. HL7 is the messaging standard used by CAIR2 and is required by the federal EHR Incentive Program.
Bidirectional Data Exchange (BiDX):
Bidirectional data exchange involves an EHR system sending an electronic query to CAIR2 containing a patient's name and birth date. CAIR2 then finds the matching patient and returns an electronic response message back to the sending EHR containing the matching patient’s immunization record and recommendations for which doses are due. If you have a new patient or a patient with missing records, you will be able to search statewide records in CAIR2 from your EHR and add the doses you find to records in your EHR.
Bidirectional data exchange will become a Stage 3 Meaningful Use EHR Incentive Program requirement in 2018, although it will also be an option for sites wishing to qualify for Stage 3 in 2017. Find out more if your site is interested in setting up bidirectional data exchange with CAIR2. To see an example of how bidirectional messaging works in one type of EHR and registry view this video.
The process of subtracting doses from inventory as administered vaccinations are entered into CAIR manually or received through data exchange. Data Exchange Sites using CAIR1 do not have this capability but it will be available in CAIR2 as long as:
- The site has entered inventory into CAIR2 by lot number and funding source (e.g. VFC, 317, State General Fund, or Private – see below) and
- Administered vaccine doses sent to CAIR2 from your EHR contain matching lot numbers and patient vaccine eligibility.
Vaccine Eligibility Codes:
Certain federal and state vaccine programs have patient eligibility requirements. CAIR records a patient’s eligibility for each dose of vaccine given (VFC, 317, State General Fund, Private). Refer to the Vaccines for Children Program for vaccine eligibility requirements.
Current CAIR vs. CAIR2:
For historical reasons, CAIR is a consortium of 10 CAIR regional registries using 4 different softwares. Seven of the 10 regional registries (Northern California, Greater Sacramento, Bay Area, Central Valley, Central Coast, LA-Orange, and Inland Empire) are managed by the California Department of Public Health (CDPH) and use a single, legacy software. The CAIR2 Project will combine these 7 regions into a single, centralized registry to be known as CAIR2 that will use new software. While the three other CAIR regional registries (San Diego, San Joaquin, and Imperial) will continue to use their own software, all their patient records will be accessible through CAIR2 beginning in the summer/fall of 2017.
Health Plan User:
Health Plans and Physician Groups which include Independent Practice Associations (IPAs) or Medical Groups may set up this new type of user role in the summer/fall of 2017. Users will be able to submit immunization data from patient billing, claims, or encounters; run coverage reports and create reminder/recall notices for members.