CAIR2 – Next Steps to DX Onboarding

Find your Site Type in the Table below and take the necessary Next Steps

Site Type
Site Description
Next Steps 
1 Site will send data directly from EHR to CAIR2. A, B, C, D
2 Site will use a distinct Sending Facility (e.g. HIE/HIO, vendor data warehouse, health plan data center, etc.) to submit data to CAIR2.
A, C, D   (SF is responsible for B, and possibly C)
3 Site will act as Sending Facility (e.g. HIE/HIO, vendor data warehouse, health plan data center, etc.) to submit data for multiple Sites (may include same Site). A, B, C, D

Next Steps:

  1. Review the CAIR2 HL7 v2.5.1. Data Exchange Specifications for required data fields and HL7 message formatting.
  2. Download and install CAR2 SOAP WSDL {only if submitting ‘directly’, Type 1 or 3]
    If a ‘direct’ submitter, download and install the CAIR2 SOAP Web Services Definition Language (WSDL at this address:
    Refer to the CAIR2 Test Plan for HL7 VXU Submission document for instructions on installing and testing  CAIR2 SOAP web services.
  3. Incorporate Correct ‘MSH-4’, ‘MSH-22’, and ‘RXA-11’ Values into Your VXU Messages
    Your Site chose one of the Site Roles listed above when registering at the CAIR IZ Portal. Depending upon your Site Role, configure your ‘MSH-4’, ‘MSH-22’, and ‘RXA-11’ segments as noted in the Table below.
Site Role HL7 VXU Message Segment Value (Usage)
‘MSH-4’ (R*) ‘MSH-22’ (R*) ‘RXA-11’ (RE^)
CAIR Sending Facility  ID
CAIR Sending Facility  ID
CAIR Client Site ID
CAIR Client Site





R is a required field. ^ RE is required but can be empty.In messages where SF is also submitting own data.

  1. Troubleshooting Messages

As each test message is received by CAIR2, an ACK (if no error) or NAK (if error) is returned to the submitter.  If you are an ‘indrect submitter, you should consult with your Sending Facility and vendor to determine whether these HL7 ACK/NAKs can be returned and displayed in your EHR system for data quality monitoring purposes.

After a number of test messages pass validation, including some containing real patient data, CAIR DX Staff will switch successful submitters to ‘production’ data submission and submitted data will be uploaded to CAIR2. Your Site should assign a staff member to monitor ongoing data exchange activity in case any connectivity or data quality issues arise, either via ACK/NAKs returned to your EHR or via the ‘Check Status’ ACK/NAK review functionality available in CAIR2.