CDPH Gateway/IZ Portal – 5 Steps to Data Exchange

In order to meet the HITECH  'Meaningful Use' requirements for submission of immunization information to an immunization registry, Eligible Professionals (EPs), Eligible Hospitals (EHs), and Critical Access Hospitals (CAHs) in 7 of the 9 CAIR regions (Northern Cal, Greater Sac, Bay Area, Central Valley, Central Coast, LA-Orange, Inland Empire) will need to submit their immunization information through the CDPH Gateway/IZ Portal.  EPs, EHs, and CAHs in CAIR San Diego, the CAIR San Joaquin region, and Imperial county should contact their Local Data Exchange Representatives for further information.  To qualify for incentive payments, immunization information will need to be submitted in HL7 format from a certified EHR.   For additional information about the CDPH Gateway/IZ Portal, go to the CDPH Gateway/IZ Portal – FAQs page. Note: Patient disclosure is required before immunization data can be entered into/ submitted to CAIR.  For more information, please refer to the CAIR Disclosure/Sharing Policy page.  

For an official letter stating when CAIR (7 regions only) became able to receive 'meaningful use'-qualifying immunization data, click here.

Below are the 5 Steps your Site will need to complete in order to submit electronic data to any of the 'CAIR 7' regional registries listed above:

Step 1 – Site Enrollment

  1. To participate in electronic immunization data submission to any of the CAIR registries listed above, you must register at the CDPH Gateway/CAIR IZ Portal. At registration, each Site will need to choose one of the following Site types when registering (consult with your EHR vendor to determine which Site type you are before registering):
  1. Site will submit data directly from their EHR to CDPH HIE Gateway/IZ Portal;
  2. Site will submit data via a distinct Sending Facility (e.g. HIO, vendor/EHR data warehouse, heatlh plan data warehouse, other data aggregator);
  3. Site will act as a Sending Facility (e.g. HIO, vendor/EHR data warehouse, health plan data warehouse, other data aggregator).

During CDPH HIE Gateway/IZ Portal registration, Sites will be asked to review and agree to the CAIR Organization/Site Access & Confidentiality Agreement. Once registration is completed, a request to verify the Site Contact's email address will be sent, followed by a secure Portal registration confirmation email to both the Site Contact and Data Exchange Contact email addresses. Make sure to retain this CDPH HIE Gateway/IZ Portal registration confirmation email for future reference.  Note: These emails may be mistakenly sorted to your email account SPAM folder, so please look for them there. The secure email will contain Site credentials as well as information on the follow-up steps your Site must take to prepare for data exchange with CAIR. These 'next steps' may include, depending on your Site type, installing a CDPH Client Certificate on the computer/server that will send data to the CDPH HIE Gateway/IZ Portal and configuring the sending system to use SOAP web services for data submission. Both of these steps may require technical support.  Instructions for installing and configuring a free SOAP application that enables a Site to submit test messages to the CDPH HIE Gateway/IZ Portal are hereThis free app should only be used for Stage 1 test submissions.

To view/download step-by-step instructions on how to register at the CAIR Gateway/ CAIR IZ Portal, click here.

Step 2 – Pre-Testing Preparation

  1. Download and review the CAIR HL7 Specifications documents. Your submitted test and production data will need to conform to either the CAIR HL7 2.5.1 Data Exchange Specifications or the CAIR HL7 2.5.1 Data Exchange Specifications (Pharmacy Only). Note: the CAIR HL7 Specifications documents reference additional Tables available in the CDC Implementation Guide for Immunization Messaging.
  2. Use your certified EHR system to create test messages in accordance with the CAIR HL7 specification.
  3. To pre-test your HL7 messages, you are invited to use the CAIR HL7 Web Validator Tool which checks your message for correct formatting.  Note: this is only to be used for pre-testing since to qualify for ‘meaningful use’, official ‘test’ messages will need to be submitted via the Portal using SOAP transport (see below).

Step 3 – Initial Test Submission

  1. Test messages must be sent to the CDPH HIE Gateway/IZ Portal using Simple Object Access Protocol (SOAP) over HTTPS. Make sure that your Site (if sending directly) or your Sending Facility has a CDPH Client Certificate installed and is configured to use SOAP web services. The CDPH HIE Gateway/IZ Portal registration confirmation email you receive after registration contains a link to the CAIR  'Next Steps' page where instructions for obtaining and installing a Client Certificate and SOAP are provided. Instructions for installing and configuring a free SOAP application that enables a Site to submit test messages to the CDPH HIE Gateway/IZ Portal are here.
  2. Test messages should be submitted at least a month before the end of the 90-day attestation reporting period, to allow time to address any unforeseen problems.
  3. Once your test messages have been submitted to the CDPH HIE Gateway/IZ Portal, they will be validated against the CAIR HL7 specifications.  An automated email will return message test results and provide additional diagnostic information if a message fails.
  4. Following the successful submission of one test message for Stage 1 meaningful use, eligible providers and hospitals must pass validation testing before actual submission can occur. It is important to note that EHR certification for Stage 1 does not guarantee that the EHR export meets your business needs or the CAIR requirements. Furthermore, in order to ensure complete and correct data is recorded, CAIR has set high standards for data completeness and quality.

Step 4 – Continuing Test Message Validation

  1. There are two components to the CAIR message validation process – validation to ensure that the message is properly formatted according to the CAIR HL7 specification and validation of real patient data from the Site's EHR to ensure data quality.
  2. To begin this process, a new set of test messages will need to be sent to the CDPH HIE Gateway/IZ Portal for validation of ongoing data submissions. CAIR recommends that 50 unique test messages be submitted to the Portal using a variety of coded values in the HL7 VXU messages. The CDPH HIE Gateway/IZ Portal will validate all test messages against the CAIR HL7 specifications and any errors found will be returned to the Site in an email for review. Address any errors found. If there are any errors occurring that require further discussion, a CAIR Data Exchange Specialist (DES) is available to assist. The CAIR DESs can be reached via email at  Please include your assigned CAIR ID and Sending Facility ID (if you have one) in the email.
  3. After 50 test messages pass the first validation component, CAIR will require the Site to send actual patient data from their EHR to ensure data quality. This ‘pre-production’ step is designed to address any unforeseen issues that could arise. During ‘pre-production’, CAIR will monitor production data for a period of one week or until it is determined that the data quality is found to be satisfactory. Any errors found during this process should be addressed by the Site and data resubmitted.
  4. Once the data has passed both the format validation and the quality validation, CAIR DESs will move the facility from test to production in CAIR and inform the Site.

Step 5 –  Ongoing Submission of Patient Data

  1. Once a Site is switched to production data submission, the Site will only receive an email if a message fails.  Failed messages should be correctred and re-sent.  

Questions?:  Please contact


Local Data Exchange Representatives

Data Exchange Rep

CAIR Regions Covered



Arlisha Adams
Eric Dansby
Iris Cheever

Northern Cal
Greater Sac
Bay Area
Central Valley
Central Coast
Inland Empire

Use email


San Joaquin (Alpine, Amador, Calaveras, Mariposa, Merced, San Joaquin, Stanislaus, and Tuolumne counties)


Rob Wester

San Diego County


Denise Andrade

Imperial County