What is ImmuNet?
ImmuNet is the Maryland State Immunization Information System. ImmuNet is a free, web-based system which maintains vaccination 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.
Why is ImmuNet needed?
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 vaccination records. ImmuNet also eliminates the need to fill out school, camp, and other commonly requested vaccination forms.
What are the benefits of ImmuNet to a provider's practice?
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 vaccination 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.
How can ImmuNet help my patients?
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.
Can an immunization information system like ImmuNet really improve immunization?
Yes. For journal articles documenting IIS effectiveness, visit CDC's IIS publications database.
ImmuNet Access and Enrollment
Who should have access to ImmuNet?
ImmuNet can be accessed by healthcare providers, schools and other authorized users.
How do I register to become a user of ImmuNet?
You can sign up with our online enrollment form here.
What do I need on my computer to use ImmuNet?
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.
Can I access ImmuNet via my phone?
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.
I had an ImmuNet account, but I have not used ImmuNet and have forgotten my username and password. Is my account still active and do I need to re-enroll?
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.
Is there a cost to use ImmuNet?
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.
Can more than one staff in our organization use the same username and password to sign in to ImmuNet?
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.
What do I do if I am having trouble accessing the ImmuNet system?
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.
Is training available for providers?
There are user guides and online training videos available on the ImmuNet
What hours will ImmuNet be available?
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.
My practice has more than one location; do I need a separate ImmuNet account for each office?
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.
How is an account deactivated for a staff who has left, retired or relocated?
Review the training video for Administrator User Functionality on how to inactive or terminate staff here.
Patient Data in ImmuNet
Is parent consent required to add or share a vaccination record in ImmuNet?
Can I browse ImmuNet for records of children that are not in my care?
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.
How is the accuracy of the data in ImmuNet validated?
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.
What if parents do not want their child's record in ImmuNet?
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.
What is being done to protect the confidentiality of patients?
ImmuNet meets HIPAA privacy and security requirements. Only providers of immunizations will be able to directly access a patient's vaccination 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.
How will ImmuNet help with school and child care facility certificates?
What if I find an inaccurate record for a patient?
You should be able to correct the record for the patient if the vaccine was administered in your office. You can also correct records not administered in your office if the patient has the documented record with them.
When I enter/send a historical record for a patient (vaccine administered by another provider), will this be a duplicate entry in ImmuNet?
ImmuNet has a de-duplication process (for patients and vaccination records), and may over-write the data based on a built-in algorithm.
A parent claims that their child completed the Hep B series, however, the third dose is not shown as completed in ImmuNet.
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.
If we see a duplicate for a patient in ImmuNet, how can we report it (since we are not allowed to email the patient name and details)
If a hospital report a birth dose to ImmuNet and a provider later also enter that record as a historical record, will that record show up twice?
ImmuNet uses a de-duplication algorithm so the same records should not show up twice.
Can we access the data for DC patients?
Some DC patients may be in ImmuNet if they see a Maryland provider. MDH is in the process of setting up cross-jurisdictional data exchange with other states. When that is completed, we can query for out-of-state patient data in ImmuNet.
Will we be able to pull vaccination records from 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 Vaccination Records
Why can't I find a record in ImmuNet?
Currently, ImmuNet does not contain all of Maryland's vaccination records since Maryland is an opt out state, and provider participation has been voluntary in the past.
How do I obtain a copy of my vaccination record from ImmuNet?
Go to Maryland MyIR and register to access your or your child's records.
Who can receive a copy of an individual's vaccination record from ImmuNet?
The Code of Maryland Regulations 10.06.03.07 allow vaccination 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
Maryland law requires that information in ImmuNet be kept confidential. Only you, your doctor, or healthcare workers who can assist you have access to the information. The information will not be shared with any other people or any other agency. If you are not interested in having your or your child(ren)'s records in ImmuNet, all you would need to do is complete an ImmuNet Opt-Out Form and request to “opt-out” of ImmuNet.
ImmuNet users must be authorized to have access to data stored in ImmuNet. Users must sign an agreement and follow strict confidentiality and security policies. Protection of ImmuNet data is managed through state privacy, confidentiality, and security laws and through compliance with federal privacy rules and regulations. Some important factors that have helped facilitate ImmuNet development include:
- Laws specifically authorizing the Maryland Department of Health to establish and maintain an immunization registry, include the requirement to report.
- Statutory provisions providing immunities from civil and/or criminal liability for providers who make good-faith disclosures to ImmuNet or rely on information in ImmuNet.
Other important statutory provisions include:
- penalties for improper disclosure of information - provisions defining with whom ImmuNet information can be shared (e.g., providers, schools, health department)
- provisions allowing parents to opt-out or limit access to ImmuNet information.
What is HB316 and when does it take effect?
HB316 states that as of October 1, 2019, all vaccinations administered in the State of Maryland are required to be reported to ImmuNet. See the State Statute §18–109(d)(6)(I)3 here.
Who are exempt from reporting?
Exemptions include health care providers who administered a vaccine in a nursing facility, assisted living program, continuing care retirement community, or medical day care program. See State Statute §18–109(d)(6)(II) here.
How do providers submit data to ImmuNet?
Providers can submit data to ImmuNet in a variety of different ways. These include the use of SOAP web service, Secure File Transfer, flat file upload, 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. See this page for more information about reporting.
What should I do to get ready for data exchange?
Providers can view the steps for data exchange at the bottom of
this page. All providers should register to get in the queue to be onboarded. 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, you can send your data in a flat file format, or manual data entry directly into ImmuNet. You will need an ImmuNet account, which you can enroll here.
What immunization data elements are required to be reported to 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.
Does ImmuNet support bidirectional data exchange?
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.
Can clinic office staff enter records into the Registry?
Yes, the provider accepts the responsibility for the submission of vaccination records and may authorize additional members of the office staff to enter the records. Get ImmuNet access here.
We provide only tetanus and flu shots in our office. Do we still have to report to ImmuNet?
Yes, all vaccinations administered in Maryland are required to be reported to ImmuNet per Maryland law. ImmuNet will also be a source of information available to consult before administering your tetanus and flu shots, helping to avoid unnecessary duplicates.
I tried to set up reporting to ImmuNet a year ago, but have not been successful with my EHR vendor. How can I move forward?
Please contact your EHR vendor and the ImmuNet Help Desk to connect both parties so we can help you move forward.
Do vaccination records that are entered into my practice's EHR automatically get sent to ImmuNet?
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.
Why do historical data entered in to our EHR not get sent to ImmuNet?
Please contact your EHR vendor to check that they added the historical indicator to the records.
My practice has locations in both Maryland and DC, does my EHR need to send data to both registries?
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.
My EHR is connected and reporting to ImmuNet, however, I do not see all my patients in ImmuNet?
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.
When we update our EMR with new patients, will these patients come across to ImmuNet if we are doing data exchange?
ImmuNet will add those new patients as needed or modify the information if the patient already exists in ImmuNet.
Our EMR does not capture the mother's maiden name; is it required in ImmuNet?
Reporting optional data elements (such as mother's maiden name) is highly recommended for better patient matching, however, if your EMR does not capture the information, it can be left blank.
Will a birth Hepatitis B dose given in a hospital show up in ImmuNet?
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.
If I enter data manually, how often should I enter the data?
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.
We transmit data from our EHR to ImmuNet, but the transmission is failing because the patient's emergency contact is missing in the record.
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.
Is ImmuNet doing data exchange with pharmacies?
All Maryland pharmacies are required to report every administered dose to ImmuNet.
Are patients with inactive status transferred from my EHR to ImmuNet?
This depends on your EHR setup; please check with your vendor. If you no longer see a patient, you can also update the patient status directly in ImmuNet.
How soon after we enter the data in our EHR does it get to ImmuNet?
This depends on how your EHR is set up to send the data, whether real-time or in batches (once daily, etc.)
Promoting Interoperability (CMS EHR Incentive Program and Meaningful Use)
What is the CMS EHR Incentive Program?
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.
What is Meaningful Use?
'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.
Where can I find more information about the CMS EHR Incentive Program or Meaningful Use?
Visit the CMS website here to learn more about the EHR Incentive Program and Meaningful Use.
How can I know if I am eligible for the CMS EHR Incentive Program?
Providers can determine their eligibility on this CMS webpage.
Can I still use or send data to ImmuNet if I am not eligible for the CMS EHR Incentive Program or if I do not wish to participate in the CMS EHR Incentive Program?
Yes, you do not need to participate in the EHR Incentive Program to use ImmuNet or report/send data to ImmuNet.
How can I meet the Immunization measure for Meaningful Use?
Go to the MDH Public Health Reporting 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.
What if I do not administer any vaccines in my office?
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
What is the Vaccines for Children (VFC) Program?
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.
Does ImmuNet interact with the Vaccines for Children (VFC) 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.
Why are Vaccines for Children (VFC) providers being mandated to use ImmuNet and report data to ImmuNet?
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.
How can I track my vaccine order through ImmuNet?
Once orders show as shipped in ImmuNet, the vaccine order screen will show the company (FedEx or UPS) tracking number.
Is ImmuNet only for VFC patients?
ImmuNet is for all patients, not just VFC.
Does ImmuNet have data exchange with thermometers?
ImmuNet does not have this capability at this time.
Can we register to use ImmuNet now?
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.
Do I switch my manager to VFC User since I order our VFC supply? Or do the order myself?
You can switch him/her to VFC or Admin User; both roles will be able to manage Inventory and Orders.
Will there be training on how to enter vaccine inventories?
All VFC participants are required to undergo annual training (see here for more information). There will also be online tutorials posted on the website.
Do you provide help to enter data manually into ImmuNet?
MDH 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.
Does the VFC mandate require us to have an EHR or connect our EHR to ImmuNet?
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.
Can we add private (non-VFC) vaccine data to ImmuNet?
Yes, you can add private vaccine data to ImmuNet.
What if the patient is not in ImmuNet when I go to enter data for a patient search?
If the patient is not in ImmuNet, you can add the patient to ImmuNet.
Is there a time frame for placing orders, can we just place when we are low?
The vaccines sent to you by VFC should last about two months and you should order when your VFC inventory is low.
Our office has several different locations-- same pin number but with a different alpha suffix. will each office still be separate?
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.