One of the Meaningful Use Stage 2 core objectives is the Immunization Registries Data Submission objective. In the majority of regions in California, this involves data exchange with the California Immunization Registry, also known as CAIR.

This first came on our radar when two of our hospital users, Mission Community Hospital in Los Angeles and Marshall Medical Center in El Dorado County, both contacted our support team for help implementing these CAIR interfaces. Within just three days, we had a working solution. Both of these sites were using Paragon as their EMR and are happy to share some of their code.

Before we get to the module itself, here’s a little background on the interface in question. The interface is a SOAP-based web interface that involves security certificates (provided by CAIR). The people at CAIR are a friendly bunch and we were able to get our own security certificates for testing.

The CAIR website (http://cairweb.org) contains the necessary instructions to get started. You will need to register with the California Department of Public Health (CDPH) HIE Gateway. It is important to note that this process applies to all providers within the following regions: Northern Cal, Greater Sac, Bay Area, Central Valley, Central Coast, LA-Orange and Inland Empire.

After you’ve registered with the CDPH HIE Gateway, you will need to enroll with CAIR. You’ll then receive further instructions via email. These instructions will explain how to get a certification and specific instructions for your particular site type.

You’ll also have the option of setting up SOAP UI, which is a very good SOAP troubleshooting tool. This is option if you are using IGUANA since the XML fragment generate by SOAP UI is already incorporated into our translator project. SOAP UI is very useful for debugging soap issues.   IGUANA is a perfect platform for setting up a production, real-time SOAP interface. The nice thing about using IGUANA is that you own the entire interfacing process. It’s transparent at all levels.

An important step is to convert the PFX certificate (received from CAIR) into the PEM certificate format. This is required as IGUANA only understands the PEM format. This is a very easy process. All you need to do is use the OpenSSL utility found here: http://slproweb.com/products/Win32OpenSSL.html. We also had to install the Visuals C++ 2008 Redistributables (found on the same page) to get this to work. The end result is that the PFX certificate is converted into three PEMs. The commands to perform this conversion are in the comments of the project within main.lua.

You can use another tool we have developed to import the channel called the Channel Manager.  Go to that page for instructions on installing the channel manager and importing the CAIR channel.

Please feel free to give it a go and don’t hesitate to contact us with questions. We will get you connected and sending immunization data in no time!