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Requesting Immunization Records CMS EHR Incentive Program and Meaningful Use |
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About ImmuNet
ImmuNet is the Maryland State Immunization Information System. ImmuNet is a free, web-based system which maintains immunization records of persons of all ages in a confidential and secure manner. It also allows enrolled Vaccines for Children (VFC) providers to submit vaccine inventories and order specialty vaccines. Article §18–109 of the Code of Maryland (Statutes) established the creation of ImmuNet to collect and store vaccination information.
By two years of age, more than 20% of the children in the U.S. have seen more than one health care provider. As a result, multiple medical records are created and parents often lack a complete and accurate record of their children's immunization status. ImmuNet acts as a connection between multiple providers and tracks which immunizations were given and which ones are needed.
ImmuNet helps sustain high immunization rates and low disease levels with more efficient management of information. It will also save money by ensuring that children get only the vaccine they need and improve provider office efficiency by reducing the time needed to gather and review immunization records. ImmuNet also eliminates the need to fill out school, camp, and other commonly requested vaccination forms.
ImmuNet offers many benefits to providers, some of which are listed below. ImmuNet will:
- Consolidate immunization information from multiple providers into a singe record, which can be provided as official immunization records for school, licensed day care center, and camp entry requirements;
- Aid in managing immunizations so children receive only the vaccines they need within the appropriate timeframes;
- Allow providers' offices with Electronic Health Records (EHR) systems to submit data without duplicate entry;
- Generate reminder and recalls to send to parents to remind them when their child's immunizations are due or have been missed;
- Decrease time spent by office staff looking for immunization histories from previous providers;
- Assist in the management of vaccine supply and ordering; and
- Generate timely immunization reports to assist with Vaccines for Children (VFC) reporting requirements.
As a result of these immediate benefits, providers will realize many long-term benefits such as a reduction in paperwork, staff time and costs associated with immunization related activities.
ImmuNet helps patients by consolidating immunization information into one reliable source. Up-to-date information on their vaccination history helps to prevent unnecessary immunization. Once fully populated with data, ImmuNet will allow you to find almost anything vaccine related for your patient. To become fully populated, every vaccine providers' participation is needed.
Yes. For journal articles documenting IIS effectiveness, visit CDC's IIS publications database.
ImmuNet Access and Enrollment
ImmuNet can be accessed by healthcare providers and schools.
You can sign up with our online enrollment form here.
Most computers with reliable internet access are adequate for ImmuNet use. You can ask the ImmuNet Help Desk to help you evaluate your current system technology and identify any gaps.
ImmuNet can be accessed by any internet-connected device, however, it is not developed for mobile devices, so the screens may be difficult to view.
Your account may need to be reactivated. You do not need to re-enroll. Contact the ImmuNet Help Desk to reactivate your account and provide your login information.
No, ImmuNet is free to healthcare providers and schools. The only cost that may be incurred is associated with maintaining internet access, and implementing an interface in your Electronic Health Records (EHR) system for data exchange.
No, each user should have have his/her own username and password for security reasons. Not everyone in your organization may need access, only those who need to look up patient records, enter data, or order vaccines.
Contact the ImmuNet Help Desk. It is available during regular business hours to address any problems you may be experiencing with ImmuNet. Moreover, this line will be available to receive your comments and suggestions as well.
There are user guides and online training videos available on the ImmuNet webpage
ImmuNet is available to all users 24 hours a day, seven days a week. ImmuNet staff are available Monday to Friday from 8am to 5pm to assist with any problems or questions.
No, you only need one ImmuNet account, but can view and administer all the locations. Please contact the ImmuNet Help Desk to add the other locations.
Review the training video for Administrator User Functionality on how to inactive or terminate staff here.
Patient Data in ImmuNet
Senate Bill 626, the Coordination of Immunization Services Act of 2001, established that ImmuNet is an opt-out system. This means that all immunization information can be entered into ImmuNet unless a parent refuses. Should this happen, a parent must complete the Opt-Out Form to make their child's record inaccessible to ImmuNet authorized users.
No. Data is only to be used for the ongoing care of a current patient, and “browsing” for records of children not in your care is prohibited. Viewing of a new patient’s ImmuNet file is allowed only after a parent or guardian provides the necessary demographic information to access the record.
When data is submitted, ImmuNet has various 'edit checks' and de-duplication processes that are automatically executed to ensure the validity of the data. In some instances, it may be necessary to verify the information with the submitter. Care should be taken that information is entered accurately and completely, which is why electronic data exchange is preferred over manual data entry.
As an Opt Out state, the Law allows authorized parents or guardians to exempt their children from the registry. They will have the responsibility of completing an Opt Out Form to initiate their request.
ImmuNet meets HIPAA privacy and security requirements. Only providers of immunizations will be able to directly access a patient's immunization records. When searching for a record, the search criteria requires specific and accurate information and search results will yield a limited number of matches in order to protect patient confidentiality. Each user of ImmuNet will have to sign a User Agreement stating that they understand the confidentiality of ImmuNet data and that they will be penalized if they violate that confidentiality or in any way abuse the information to which they have access. Each user of ImmuNet has to have an individual user account and password. All access to the system and every transaction is recorded and such records will be reviewed and audited.
ImmuNet allows providers to print all required immunization certificates. The Code of Maryland Regulations 10.06.03.07 also allow schools to access the Registry to determine a child's immunization status.
You should be able to correct the record for the patient if the vaccine was administered in your office. Call or email the Help Desk to correct any records not administered in your office.
ImmuNet has a de-duplication process (for patients and immunization records), and may over-write the data based on a built-in algorithm.
The record needs to be updated; please ask the parent for the documentation on the third dose and update the record in your EHR or ImmuNet.
Call the ImmuNet Help Desk with the information and we will correct the record.
ImmuNet uses a de-duplication algorithm so the same records should not show up twice.
Some DC patients may be in ImmuNet if they see a Maryland provider. DHMH is in the process of setting up cross-jurisdictional data exchange with DC. When that is completed, we can query for out-of-state patient data in ImmuNet.
You can look up patients when you sign in to ImmuNet. If you report data to ImmuNet from your EHR, you can also set up bidirectional data exchange to pull the data from ImmuNet into your EHR.
Requesting Immunization Records
Currently, ImmuNet does not contain all of Maryland's immunization records since Maryland is an opt out state, and provider participation has been voluntary.
Fill out a Record Request Form here
The Code of Maryland Regulations 10.06.03.07 allow immunization records to be released to authorized users (such as providers, schools, health departments) unless a specific exemption is requested by the person or the person's parent or guardian.
Reporting Data to ImmuNet
Providers can submit data to ImmuNet in a variety of different ways. Methods of sending data include the use of SOAP web service, Secure File Transfer or manual data entry. Formats for sending data electronically can be in standard HL7 or flat file formats. For Meaningful Use (MU), standard HL7 format is required. Providers with Electronic Health Records (EHR) should work with their EHR vendors to automate their electronic data submission.
Providers can view the steps for data exchange at the bottom of this page. Step 1 (Registration) is only required if you participate in the CMS Electronic Health Record (EHR) Incentive Program. If you have an EHR, contact your vendor to help you generate a test file to send to ImmuNet. If you do not have an EHR, let the ImmuNet staff know if you can send your data in a flat file format, or if you need to do manual data entry directly into ImmuNet.
The Centers for Disease Control and Prevention (CDC) recommends certain core data elements to be reported to state immunization registries. These data elements include: Patient name, birth date, gender, race, ethnicity, Mother's name, Vaccine type, manufacturer, date and lot number. The specific list of data elements to be reported to ImmuNet can be found here.
Yes, ImmuNet supports bidirectional data exchange capability via web services. The capability include both HL7 QBP (Query by Parameter) and VXQ (Vaccination Query) messages to query ImmuNet in real-time.
Yes, the provider accepts the responsibility for the submission of immunization records and may authorize additional members of the office staff to enter the records.
Yes, any immunization administered can be reported to ImmuNet. ImmuNet will also be a source of information available to consult before administering your tetanus and flu shots, helping to avoid unnecessary duplicates.
Please contact your EHR vendor and the ImmuNet Help Desk to connect both parties so we can help you move forward.
The records are automatically sent only if your EHR is set up for automatic reporting. If you do not see your patients' data in ImmuNet, it is likely that you are not yet set up to report to ImmuNet. Please contact your EHR vendor and the ImmuNet Help Desk to set up the connection from your EHR to ImmuNet.
Please contact your EHR vendor to check that they added the historical indicator to the records.
Please contact your EHR vendor to see if they can send data to both registries. The practices located in Maryland should report to ImmuNet and the ones in DC to the DC registry.
Please contact your EHR vendor to check why those patient records are missing. It’s possible their records may be missing a required field and have been rejected by ImmuNet.
ImmuNet will add those new patients as needed or modify the information if the patient already exists in ImmuNet.
Any optional data element (such as mother's maiden name) can be left empty if your EMR does not capture the information.
All Maryland hospitals are reporting to ImmuNet so the birth dose should show up in ImmuNet. The only exception is if the birth dose was sent with ‘Baby Boy’ or ‘Baby Girl’ as the name and the record is not updated. ImmuNet will reject records sent with those names. Providers who have the updated record should report it to ImmuNet.
CDC recommends at least once a week at a minimum, however, it is best if you can add it to your daily workflow to keep the records from accumulating by the end of each week.
Please contact your EHR vendor to fix the issue (emergency contact is not a required field in ImmuNet). See here for the list of required data elements in ImmuNet.
All Maryland pharmacies are required to report every administered dose to ImmuNet.
This depends on your EHR setup; please check with your vendor.
This depends on how your EHR is set up to send the data, whether real-time or in batches (once daily, etc.)
CMS EHR Incentive Program and Meaningful Use
The U.S. government introduced the program in 2009 to encourage providers to adopt an Electronic Health Records (EHR) system, and show that they are 'meaningfully using' their EHRs. In doing so, eligible providers can receive incentive payments.
'Meaningful Use' means providers need to show they're using certified Electronic Health Records (EHR) technology in ways that can be measured significantly in quality and in quantity. One of the 'measures' of Meaningful Use is to report Immunization data to a state registry from a certified EHR. Providers need to achieve these specific measures to qualify for the CMS EHR Incentive Program.
Visit the CMS website here to learn more about the EHR Incentive Program and Meaningful Use.
Providers can determine their eligibility on this CMS webpage.
Yes, you do not need to participate in the EHR Incentive Program to use ImmuNet or report/send data to ImmuNet.
Go to the DHMH MU webpage to register your intent to send data. Once registered, you can work with your EHR vendor to generate a test file to send to ImmuNet. If your test file passed, you can start sending real patient data to ImmuNet. Your EHR vendor can automate the process so you do not have to do it manually.
Providers who do not administer vaccines can claim an exclusion from the Immunization measure. This means you do not need to submit a test file or any data to ImmuNet.
Vaccines for Children (VFC) and ImmuNet
The Maryland VFC Program is a federally-funded program that provides vaccines at no cost to children who otherwise might not be vaccinated because of an inability to pay. Currently, the national VFC program covers the purchase of $4 billion in vaccines each year. Because the VFC program is need-based, strong accountability and program stewardship among VFC providers are essential to maintaining a robust program.
Yes, ImmuNet interacts with the VFC program. When a provider utilizes the full capabilities of ImmuNet, the provider is able to manage his or her complete VFC vaccine inventory. The provider will be able to electronically report monthly vaccine usage to the VFC program office.
As the cost of childhood vaccines increases and immunization programs become more complex, there is a greater need to ensure strict adherence to program guidelines. The Maryland VFC Program believes mandating the use of ImmuNet will support your existing efforts to be effective stewards of VFC vaccines.
Once orders show as shipped in ImmuNet, the vaccine order screen will show the company (FedEx or UPS) tracking number.
ImmuNet is for all patients, not just VFC.
ImmuNet does not have this capability at this time.
You can register to use ImmuNet at any time. Go to the ImmuNet website and scroll down to ‘Start Using ImmuNet Today’ to fill in the online form.
VFC 2017 Mandate
The VFC mandate for providers to use ImmuNet and report data to ImmuNet will take place on January 2017.
No, VFC providers will enter their VFC vaccine inventories directly into ImmuNet. Faxing paper inventories will be unnecessary come January 2017.
Yes, however you will still have to document your need for specialty vaccine orders.
VFC providers should report all vaccine data if possible; if you set up electronic reporting from your Electronic Health Records (EHR) system, it is easiest to send all vaccine data than to ask your EHR vendor to filter for specific vaccine data.
Yes, VFC providers will be able to enter all VFC supplied vaccine inventories into ImmuNet, starting in January 2017.
The button will not be visible to users until January 2017.
You can switch him/her to VFC or Admin User; both roles will be able to manage Inventory and Orders.
A series of trainings are being held in November and December 2016 to help providers learn how to use the Order Vaccines functionality before January 2017. There will also be online tutorials posted on the website.
Check that your username and password are active. We have recently implemented a new password reset functionality, and you will need to set up your security questions if you have not signed in to ImmuNet recently.
If you are not reporting data to ImmuNet, and you have an EHR, please contact your vendor to start the process. If you do not have an EHR, you must determine your option for reporting before Jan 2017. Will you adopt an EHR, or enter data manually, or upload a flat file?
You do not need to enter any data into ImmuNet. You should check your access to ImmuNet (sign in with your username and password) to be ready for Inventory and Orders in Jan 2017.
DHMH does not provide help for manual data entry. We recommend you look into getting an EHR (apply for federal incentives or get a free/low-cost EHR). Another option is to do flat file upload, or outsource a data entry service to help you enter your data into ImmuNet. Note that only VFC vaccines are required to be reported under the mandate, although entering all your patients data will be a service to them.
The VFC mandate does not require you to have an EHR or connect your EHR to ImmuNet (as there are other ways to report to ImmuNet), however, EHRs are the least labor-intensive method as you can automate the process with an EHR.
You can add private vaccine data to ImmuNet. The VFC program does not require administered doses from private inventory to be reported, however, it is preferable to report all administered doses so the patient data is complete and you can get better Clinical Decision Support.
The mandate requires you to report administered doses starting in 2017 and for VFC vaccines only, however, you can start reporting now, and include previously administered doses so that the patient has a complete record.
We recommend you report all patients’ immunizations to ImmuNet, however, for the VFC mandate, only patients with VFC vaccines must be reported.
If the patient is not in ImmuNet, you can add the patient to ImmuNet.
The current process to order flu vaccines will not change; the only change is the transition from paper faxing to entering into ImmuNet. You will be automatically sent an initial allocation of flu vaccines at the start of flu season and will request additional flu vaccines through ImmuNet.
The current workflow will not change; the only change is the transition from paper faxing to entering into ImmuNet.
The current best practices will not change; the only change is the transition from paper faxing to entering into ImmuNet. The vaccines sent to you by VFC should last about two months and you should order when your VFC inventory is low.
Yes, each office will still be separate and need to order vaccines separately. That means that each office must have users able to log on for each office.
Flu vaccines administered by your office should not be entered as historical (unless you lack required information). However, at this time we are asking that doses of Flucelvax be entered as historical as ImmuNet does not currently have the correct approved ages. This will be corrected by the end of 2016.
That is correct. All the vaccines which currently require a signed justification letter to order will now be ordered through ImmuNet.