CDPH Gateway/IZ Portal – FAQs (updated for 2016)

Key Facts About the CDPH Gateway/IZ Portal

The CDPH GatewayCAIR IZ Portal is the central point of contact for providers who wish to submit immunization data electronically to any of the 7 CDPH CAIR regional registries: Northern CalGreater SacBay AreaCentral ValleyCentral CoastLA-OrangeInland Empire.  To view the counties in a regional registry, click on the link.

Providers in non–participating countiesSan Diego , Imperial , Alpine, Amador, Calaveras, Mariposa, Merced, San Joaquin, Stanislaus, and Tuolumne – should access the CA Public Health Meaningful Use Capability Matrix  for county-specific information on public health data submission.  

The CDPH Gateway/IZ Portal offers a simple automated interface for registering for electronic immunization data exchange.  Other key facts about the CDPH Gateway/IZ Portal are:

  • Any health care facility location (known as a ‘Site’ once registered) that administers vaccinations and intends to submit HL7 immunization data to CAIR will need to register at the CDPH Gateway/IZ Portal.  Note: Only the Site needs to register; it is not necessary for individual health practitioners at each Site to register.
  • Registration at the CDPH Gateway/IZ Portal is required, even if a Site has already enrolled in CAIR.  
  • Sites registering at the CDPH Gateway/IZ Portal will be assigned data exchange credentials, including a CAIR Site ID, and receive all instructions necessary for submitting HL7 immunization information to CAIR2. Provider Organizations with multiple Sites (>5), should register their main Site at the CDPH Gateway/IZ Portal, and download and submit additional Site information by spreadsheet to CAIRDataExchange@cdph.ca.gov.
  • Data aggregators, such as HIEs/HIOs, vendor data warehouses, or health plans, that plan to submit immunization data to participating CAIR registries must also register at the CDPH Gateway/IZ Portal.
  • CAIR2 will manage all HL7 immunization message submissions, including providing message testing, validation, onboarding, and MU attestation.  Note: Attestations will be provided per Site, rather than per provider.
  • Data submission to CAIR2 will require the use of Simple Object Access Protocol (SOAP) web services. Instructions for SOAP installation is summarized in the CAIR2 Test Plan document.
  • See information below on the technical requirements for transmitting data to the CDPH Gateway/IZ Portal.

Health care providers should contact their EHR vendor to determine if they can send immunization messages to the CDPH Gateway/IZ Portal, based on current technical requirements, including HL7 formatted messages and the SOAP message transport protocol.  General information is available at the CDPH HIE Gateway/IZ Portal – 5 Steps to Data Exchange page. More specific instructions will be sent in a CDPH Gateway/IZ Portal registration confirmation email.

About CAIR and the CDPH Gateway

What is CAIR?

The California Immunization Registry (CAIR) System is a secure, confidential, statewide, computerized immunization information system for California residents. The CAIR system consists of ten distinct multi-county or county regional immunization registries.  The CAIR2 Project will consoldiated the 7 CDPH registires into CAIR2 by Spring of 2017.  Data sharing with the three other registries – CAIR San Joaquin, CAIR San Diego, and CAIR Imperial – will be compelted in the Fall of 2017. 

Participation in an immunization registry is voluntary and is open to healthcare providers, schools, childcare facilities, county welfare departments, family child care homes, foster care agencies, WIC service providers, and health care plans.  To participate, users (including data exchange users) must sign the CAIR Access & Confidentiality Agreement stating that they will maintain the confidentiality of the patient immunization information and will use the information only to provide patient care or to confirm that childcare or school immunization requirements have been met.

What it the CDPH Gateway/IZ Portal?

The CAIR Immunization Messaging Portal was developed In collaboration with the California Immunization Registry (CAIR), the California Department of Public Health (CDPH), and the California Health and Human Services Agency (CHHS), and the California Health eQuality (CHeQ) to receive immunization reports that meet the requirements of Meaningful Use (MU). The CAIR IZ Portal was developed to streamline enrollment and automate ongoing submission of immunization data for providers in the seven participating CAIR regional registries by replacing the former manual process for registering, testing and submitting electronic immunization data. The CAIR IZ  Portal is now used for regsistration only as testing and onboarding activites have moved to CAIR2.   

Who uses CAIR to report immunization data?

As of September 2016, there are over 6,000 sites registered at the IZ Portal and nearly 4,000 sites submitting data electronically to CAIR via HL7 messages sent from their electronic health records (EHR) systems  Organizations submitting data range from single physician practices to large medical groups and health plans, such as Sutter Health and Kaiser. In addition, health information exchanges organizations (HIEs/HIOs) submitting data on behalf of clinical partners also need to register at the CDPH Gateway/IZ Portal. See below for steps HIEs/HIOs should take. CAIR has posted a list of EHRs and HIEs/Sending Facilities currently submitting production data to CAIR.

How is the CDPH Gateway related to the CAIR IZ Portal?

The CAIR IZ  Portal was launched in August 2013 to be a centralized data exchange portal to facilitate electronic immunization reporting for the 7 regional CAIR registries managed by CDPH (NorCal, Greater Sac, Bay Area, Central Coast, Central Valley, LA-Orange, and Inland Empire). The CAIR IZ Portal is now part of the CDPH Gateway.  If you have not yet registered  to submit immunization data to one of the 'CAIR 7' regional registries, register at the CDPH Gateway/CAIR IZ Portal

Why was the CDPH Gateway needed?

Thousands of California providers currently participating in the Medicare and Medicaid EHR Incentive Programs are required to meet certain public health data reporting requirements, including registering with the public health authority to submit immunization data to an immunization registry. An updated, accountable registration and management data submission system was needed to help providers meet the “meaningful use” (MU) requirements. 

Using the CDPH Gateway/IZ Portal – Providers

What are the advantages of using the Portal?

Registration at the CAIR Gateway/IZ Portal is required of all Sites who intend to submit HL7 immunization messages to the seven CAIR regions, regardless of whether they participate in the EHR Incentive Program or not. Registrants will receive all appropriate credentials and instructions necessary for submitting immunization information electronically to CAIR.  Registration

Will I need new software to use the CAIR Gateway/IZ Portal?

Some Sites may need to upgrade their EHR software to be able to use the new CAIR Gateway/IZ Portal. The IZ Portal is designed to support the submission of MU-standard HL7-formatted immunization messages.  Refer to the CDPH Gateway/IZ Portal – 5 Steps to Data Exchange page for general information and the CAIR HL7 Data Exchange Specifications documents

  • Submission of immunization data as “flat files” does not qualify as meeting the public health objective and measure of data submission to an immunization registry.  Technical support for flat file data exchange with CAIR will end in 2016 when we transition to the CAIR 2.0 software.
  • HL7 messages must be sent to the CAIR2 using SOAP web services  Instructions for installing and configuring SOAP can be found in the CAIR2 Test Plan document.

  • Sites should contact their EHR vendor or IT advisor to evaluate their system and its ability to comply with the CAIR2 specifications, available from the CAIR web site, CDPH Gateway/IZ Portal – 5 Steps to Data Exchange

The EHR software I use stores my clinical data along with the clinical data of other clients at one central location and submits immunization data for users from that central location.  Will my practice need to submit individual test messages to qualify for 'meaningful use'?

No.  The Stage 2 Final Rule (CMS-0044-F) changed the way shared certified EHR technologies are handled for testing both for Stage 1 and Stage 2 public health. Previously, if multiple EPs are using the same certified EHR technology in different physical locations/settings (e.g., different practice locations), there must be a single test performed for each physical location/setting.

Under changes made in the Stage 2 Final Rule, providers that use the same EHR technology and share a network for which their organization either has operational control of or license to use can conduct one test that covers all providers in the organization.  For example, if a large group of EPs with multiple physical locations use the same EHR technology and those locations are connected using a network that the group has either operational control of or license to use, then a single test would cover all EPs in that group.  Similarly, if a provider uses an EHR technology that is hosted (cloud-based) on the developer's network, then a single test for Stage 1 public health measures or a single effort to register and onboard for the Stage 2 public health measures would allow all EPs, eligible hospitals, and CAHs using the EHR technology that is hosted (cloud-based) on the developer's network to meet the measure.

Our clinical organization uses a single networked EHR system.  Does each clinic/location need to submit a test message to qualify for 'meaningful use'?

No.  The Stage 2 Final Rule (CMS-0044-F) changed the way shared Certified EHR Technologies are handled for testing both for Stage 1 and Stage 2 public health. Previously, if multiple EPs are using the same certified EHR technology in different physical locations/settings (e.g., different practice locations), there must be a single test performed for each physical location/setting.

Under changes made in the Stage 2 Final Rule, providers that use the same EHR technology and share a network for which their organization either has operational control of or license to use can conduct one test that covers all providers in the organization.  For example, if a large group of EPs with multiple physical locations use the same EHR technology and those locations are connected using a network that the group has either operational control of or license to use, then a single test would cover all EPs in that group.  Similarly, if a provider uses an EHR technology that is hosted (cloud-based) on the developer's network, then a single test for Stage 1 public health measures or a single effort to register and onboard for the Stage 2 public health measures would allow all EPs, eligible hospitals, and CAHs using the EHR technology that is hosted (cloud-based) on the developer's network to meet the measure.

Will the CAIR Gateway/IZ Portal update my EHR?

Not at this time.  Full bi-directional functionality will be possible in CAIR2 but niot until asometime in 2017. 

Will the immunization information my practice sends to CAIR2 be immedately accessible ?

Yes.  If your EHR is sending immunizaiton data real-time, information will be available in CAIR2 at the point of service/immediately., probably within a few seconds. 

Does my EHR system need to comply with the CAIR2 standards to share immunization data with CAIR?

Yes.  Your messages must comply with the CAIR2 HL7 2.5.1 Data Exchange Specifications.

Do I need to register with the CAIR Gateway/IZ Portal?

Yes. If you want to exchange HL7 data with any of the 'CAIR 7' regions , you will need to register at the CDPH Gateway/IZ Portal.  

I already registered at the CAIR IZ Portal to submit immunization data.  Do I need to register at the CDPH Gateway/IZ Portal?

No. If you are already registered with CAIR and only plan to submit immunization data to one of the 7 regional CAIR registries, you do not need to register at the Gateway. The CAIR IZ Portal was integrated into the CDPH Gateway on October 1st  2013, so any credentials and instructions you received from the CAIR Immunization Messaging Portal  will remain the same. .However, if you plan to report other types of public health data, you will need to register at the CDPH Gateway before you can begin data submission.  You can use the CDPH Gateway to submit infectious disease laboratory reports to CALREDIE now.  In the near future, you will also be able to submit cancer cases to the California Cancer Registry and childhood blood lead testing results to the CDPH Childhood Lead Poisoning Prevention Program.  Refer to your specific CDPH Public Health Program for details on when to register and when to begin submitting information through the CDPH Gateway.  

What is involved in registering at the CDPH HIE Gateway/IZ Portal?

Navigate to the CDPH Gateway/IZ Portal – 5 Steps to Data Exchange page and click the link for the CDPH Gateway/IZ Portal under Step 1. Enter the required information and submit your registration. If not a current CAIR participant, simply complete the registration and submit it.  You will also be asked to indicate your MU Stage in 2015.

Once registration is completed, a request to verify your Site contact email address will be sent, followed by a secure CDPH Gateway/IZ Portal registration confirmation email. The secure email will contain your Site data exchange credentials as well as information on additional steps your Site must take to prepare for data exchange with CAIR. Make sure to retain the confirmation email for future reference.

Will previously submitted immunization data be available on the CDPH Gateway/IZ Portal?

No, the Portal is for registration only.  Users interested in accessing CAIR data will need to have an account  electronic data to any of the CDPH CAIR regional registries, but does not allow patient lookups.   Login access to your regional CAIR registry is available for Sites that request it.  Login access allows your Site to look up patients and to determine their immunization status and to receive recommendations on which vaccinations are needed. 

To use the CDPH HIE Gateway/IZ Portal, must I change how I gather or input immunization data?

The two main requirements for successful data submission to the CDPH Gateway/IZ Portal are: 1) conformance with the CAIR HL7 specifications and 2) use of SOAP transport protocol. CAIR HL7 Specifications documents are available on the CDPH Gateway/IZ Portal – 5 Steps to Data Exchange page. The CDPH Gateway/IZ Portal registration confirmation will include instructions on how to configure SOAP transport.

Using the CDPH Gateway/IZ Portal– HIEs/HIOs and Other Data Aggregators

Do other organizations submitting data on behalf of providers need to register?

Yes. Any entity that will submit immunization data to any of the seven CDPH CAIR regional registries, including any Health Information Exchange Organizations (HIOs) and other data aggregators, whether or not they participate in the EHR Incentive Program, will need to register at the CDPH Gateway/IZ Portal.

HIEs that submit immunization data on behalf of their stakeholder organizations do not need to be certified by ONC as an EHR module if they are acting as a pass-through and simply batching and transmitting HL7 messages.  However, certification would be required if the HIE is doing data transformation in order to produce the HL7 messages from some other format (i.e. CCD, flat-file, etc). 

We are an EHR vendor organization that stores all our client clinical data centrally?  Is it necessary to submit test messages from each client location to qualify for ‘meaningful use’?

No.  The Stage 2 Final Rule (CMS-0044-F) changed the way shared Certified EHR Technologies are handled for testing both for Stage 1 and Stage 2 public health. Previously, if multiple EPs are using the same certified EHR technology in different physical locations/settings (e.g., different practice locations), there must be a single test performed for each physical location/setting.

Under changes made in the Stage 2 Final Rule, providers that use the same EHR technology and share a network for which their organization either has operational control of or license to use can conduct one test that covers all providers in the organization.  For example, if a large group of EPs with multiple physical locations use the same EHR technology and those locations are connected using a network that the group has either operational control of or license to use, then a single test would cover all EPs in that group.  Similarly, if a provider uses an EHR technology that is hosted (cloud-based) on the developer's network, then a single test for Stage 1 public health measures or a single effort to register and onboard for the Stage 2 public health measures would allow all EPs, eligible hospitals, and CAHs using the EHR technology that is hosted (cloud-based) on the developer's network to meet the measure.

I participate in Vaccines for Children. I do not use CAIR. Do I have to use it now?  

There is no mandate to use CAIR, but participation is encouraged.   

I do not have an ONC-certified EHR. Can I still use CAIR?

Yes, but you will not be able to receive payments for ‘meaningful use’ unless you are using a certified EHR.  The official list of certified EHRs is at http://oncchpl.force.com/ehrcert?q=chpl

Meeting Meaningful Use (MU) Stage 1 and Stage 2 Requirements

For participants entering MU Stage 2 in 2014, there was a 90-day reporting period.  Is this also the case in 2015?

No, in 2015 there will not be a 90-day reporting period .  Instead, 'ongoing data submission' for the entire year is the MU requirement.    

I will be entering MU Stage 2 in 2105 and I notice that ‘ongoing submission’ of immunization data is required.  How is ‘ongoing submission’ defined?

During MU Stage 2 in 2015 – which begins on 10/1/2014 for some eligible hospitals (EHs) and on 1/1/2015 for some eligible providers (EPs) – to meet the “ongoing submission” immunization-reporting objective, participants must be registered at the CDPH Gateway/IZ Portal, and must achieve either 1) ongoing submission of patient data or 2) be actively engaged in testing and validation of patient data for the entire 1-year reporting period..    

My Site is in Stage 1 and needs to submit a test message before the end of the year.  How do I proceed?

Register at the CDPH Gateway/IZ Portal and work with your EHR vendor to enable you to send a test using HL7 and SOAP protocols.  Instructions for using the free SOAP UI application to send  test messages CAIR are here.

What is the MU Stage 1 immunization reporting objective measure?

The core objective for eligible providers and hospitals in Stage 1 is to perform at least one test of a certified EHR's capacity to submit electronic data to immunization registries and follow-up submission if the test is successful. The submitting Site is expected to do additional validation testing and make additional efforts to achieve 'ongoing submission'. 

Who can I contact to ask other questions?

If you are in one of the 7 CAIR regional registries, send an email to CAIRDataExchange@cdph.ca.gov.  If not, contact your Local Data Exchange Representatives (cairweb.org)


[1] ONC requires “regular” submissions if a provider passes their test. Regular has been interpreted by California’s RECs as “monthly.”