e-MDs New Immunization Interface

Last week I received an email from e-MDs about their new immunization interface. The email was addressed to state registries and asked for feedback on their new messages. Here is a summary of what I found in their messages and what they indicated in their email:

1. They will not be able to support Opt-In states that require patient consent to be recorded by the provider and then submitted as part of the HL7 message. They assume that states will be able to filter the messages themselves.

2. e-MDs will only export the data out to a user defined directory. It will be the responsibility of the provider to upload the file to the state registry.

3. They put the account number (MRN) in PID-3 and in PID-2. The PID-3 field repeats and the PID-2 field doesn't . This way they figure state registries that don't like repeating fields can read the account number out of PID-2.

4. They qualify their account number (MRN) with the designation "PI" and place it in the first repetition. The SSN is sent in the second repetition and also in the old location PID-19 for backwards compatibility.

5. They send the ORC segment before sending the RXA segments. This is a little unusual as most VXU implementation I have seen do not send this. While this field is required in HL7 version 2.5 it optional according to the CDC guide. Some registries may not expect this field and may not handle it properly. This field is sent by e-MDs to indicate that the vaccination was ordered.

6. They do not have guardian information, instead they are sending guarantor information in GT1 segments. Immunization registries should accept this message but may or may not ignore these segment. My recommendation would be to read these as if they were guardians if the relationship indicates them to be so. Most state registries use guardian information for matching and do not have a strict definition of guardian. For most cases the person identified as the guarantor will work sufficiently well as a guardian.

Overall their messages looked very good and thoroughly put together. e-MDs seems to have made a very good effort to put together an accurate and complete HL7 message.