What is Health Level Seven (HL7)?
Health Level Seven (HL7) is a standardized format for exchanging health-related information including patient records, laboratory results and immunization history between different electronic health systems. For more information, visit www.hl7.org.
What is an HL7 interface to Nevada WebIZ?
An HL7 interface allows immunization data to flow from an electronic health record system (EHR) system into NV WebIZ, the statewide immunization information system (IIS). This can reduce the time and effort needed to document immunizations and can reduce data entry errors. Establishing an HL7 interface plays a major role in the CMS EHR Incentive Program’s Meaningful Use (MU) requirements. Please see below for more information on declaration of intent for Nevada’s immunizing eligible providers and hospitals.
Why establish an HL7 interface?
All immunization records must be entered into NV WebIZ. Many providers enter immunization data into their own EHR system. To comply with Nevada Revised Statute (NRS) 439.265 and Nevada Administrative Code (NAC) 439.870-897), they must also enter that data into NV WebIZ. With the establishment of an HL7 interface, information is taken from the EHR, sent over the internet electronically, and processed by NV WebIZ, updating the IIS immediately (or within hours of EHR entry, depending on the EHR’s capability). Using this data submission method eliminates the need for double entry.
What version of HL7 can be used (to interface with Nevada WebIZ)?
How long does an HL7 interface project take?
An HL7 project typically takes 3-4 months from “kickoff” to “go-live.” It is not uncommon for projects to take longer as a result of shifting vendor or provider priorities, or challenges with formatting or content. Some projects have taken less time as a result of highly-engaged participants, good data quality, and flexible vendor technology.
What does it cost to implement an interface with Nevada WebIZ?
NV WebIZ does not charge a fee of any kind for establishing an HL7 interface; however, it is important to speak with your EHR vendor about what they may charge for development and/or ongoing maintenance of an interface.
Does Nevada WebIZ offer bi-directional messaging (two way messaging)?
The First Step! Contacting the EHR Vendor
A provider should contact their EHR vendor and discuss their desire to establish an HL7 interface between their EHR and NV WebIZ. The provider should ask the following questions:
1. Will the EHR vendor provide support for development of an HL7 interface with a statewide IIS?
2. Will a fee be charged for development or maintenance (including future coding changes or upgrades) of an HL7 interface?
3. Does the EHR vendor employ an HL7 interface specialist or project manager? If so, how can that person be reached?
4. When will the EHR vendor be ready to assist in the development of the interface? Immediately, next month, next year, etc.?
What are the steps in the HL7 process?
1. HL7 Application: An organization/practice wishing to establish an interface should download, complete, and fax or scan/email the HL7 Project Application (NEW!) form to NV WebIZ at 775-687-7596 or firstname.lastname@example.org.
2. Waiting list: Due to the high volume of organizations wishing to establish an HL7 interface, a waiting list is maintained. HL7 Project Applications received are added to the waiting list and organizations contacted when NV WebIZ staff are able to launch a new interface project. Considerations for selecting the next HL7 project can include (but is not limited to) readiness to interface, ability to dedicate IT support, and/or patient volume.
3. Kickoff Meeting: A meeting is held to review the steps in the project, document the responsible parties, determine the details of the Data Sharing Agreement(s) to be drafted, and provide configuration/connection specifications.
4. Progress Meetings: Meetings are held monthly (or more frequently) to ensure the project is progressing and to address any issues.
5. Configuration/Connection: The provider organization, through their designated representative (IT support, EHR vendor representative, etc.), configures their system to generate HL7 messages and establishes a connection (if via web service) to the NV WebIZ “Test” system. For the most robust testing experience, it is required that the organization connect their Production (“live”) EHR to NV WebIZ’s Test environment.
6. Submission Method/Frequency: NV WebIZ offers web service submission only; SFTP submission is not supported or available. “Real-time” is the preferred frequency, but hourly or daily submissions are acceptable.
7. Testing/Reviewing: As immunization data is entered into a provider organization’s “live” EHR system, it is sent to the NV WebIZ “Test” system. Acknowledgement messages (ACK’s) are returned to the EHR system in response. The organization (or their designee) should monitor the ACK’s and take actions to correct submissions as needed until errors no longer occur. The NV WebIZ HL7 staff also monitors the HL7 test messages and communicates issues to the provider (or their designee). *Note: NV WebIZ requires that interface testing be done if changes/upgrades are made to an organization's EHR system to ensure ongoing submission of data. Organizations are encouraged to maintain the availability of a "test" version of their EHR system to accommodate this requirement.
8. Data Cleansing: NV WebIZ staff will generate data quality reports to resolve duplicates and other issues created by the organization’s manual data entry, and will contact the appropriate office for assistance if needed.
9. Go-Live: “Go-Live” is a term used to refer to the date on which the organization begins to submit real patient data to the “live” NV WebIZ system. On the go-live date, NV WebIZ user accounts for the organization’s office staff will be retained, but will be limited to viewing data and generating reports- add, update and delete abilities will be removed.
10. Ongoing Submission: Organizations are expected to regularly monitor their interface to ensure ongoing, accurate submission, and should notify NV WebIZ staff as soon as possible if changes to their EHR system occur or are planned
How do I get started?
Download, complete and fax or scan and email the HL7 Project Application form to Nevada WebIZ at 775-687-7596 or email@example.com.
***Providers wishing to establish an HL7 interface are expected to be able to dedicate staff to the project for interface configuration (IT support), data clean up (typically office staff), meeting attendance and ongoing support and maintenance of the interface (once “live”).***
Once an HL7 interface is in place:
- All patient immunization information that is entered into an EHR will flow into NV WebIZ (including, dependent upon the EHR’s ability, documented historical vaccinations).
- It takes (typically) less than 10 seconds for the record to be processed through a “real-time” interface and added to NV WebIZ, but hourly or daily submissions are also acceptable.
- NV WebIZ user accounts are changed to “view-only” (with the ability to generate reports). If necessary, one or two users at a provider office maintain the ability to edit patient records in NV WebIZ. We call this a “superuser.” A provider’s need for superusers will be determined in project progress meetings.
- Providers enrolled in the Vaccines for Children (VFC) Program must capture and send VFC eligibility (in the HL7 message) for all patients aged 0 through 18 years.
- Patients still retain the right to opt-out of participation in the IIS. Compliance with this requirement is discussed during progress meetings.
Meaningful Use Attestation
Eligible Professionals (EP’s) and Eligible Hospitals (EH’s) who administer immunizations and wish to declare their intent to submit data electronically to NV WebIZ (the statewide IIS) for Meaningful Use purposes should:
- First, verify that immunization data is currently being manually entered into NV WebIZ in accordance with State law.
- Then, complete and submit an HL7 Project Application form.
Upon receipt of the completed form, an email will be sent to the contact listed on the form confirming the “declared intent” to submit data electronically to an IIS. This email can be used for attestation and is currently acceptable evidence for ongoing submission. Organizations will be contacted when NV WebIZ is able to begin an interface project.
EP’s and EH’s that do not administer immunizations are automatically excluded from the requirement to submit to/exchange data with an IIS.
HL7 Data Support