Submitting Electronic Immunization Information to DSHS

Submitting Electronic Immunization Information to DSHS to Meet Meaningful Use Requirements

ImmTrac, the Texas Immunization Registry, accepts data using HL7 messaging, supporting the meaningful use of Certified Electronic Health Record Technology by Eligible Professionals (EPs), Eligible Hospitals (EH), and Critical Access Hospitals (CAH) participating in the Centers for Medicare and  Medicaid Services’ Electronic Health Records (EHR) Incentive Programs (EHR Incentive Programs). This HL7 Implementation Guide describes the standards used for information exchange with DSHS for immunizations. Additional information is available in the “Helpful Documents” section below.

Please note that a new implementation guide will be released for use with a new version of ImmTrac, ImmTrac2, scheduled for release in Spring 2016. Participants currently submitting HL7 data electronically to ImmTrac will not be required to use the new data format at the release of the new system, but may choose to convert to the new format. New participants should strongly consider using the new guide.

A new rule for meaningful use, available on the Federal Register website, is effective as of December 15, 2015. The rule has new requirements for participants in Stage 1 or Stage 2 and establishes requirements for Stage 3.

Please see the DSHS main Meaningful Use page at  for additional information regarding the rules changes as well as information about other programs at DSHS supporting EHR Incentive Program Participants, including requirements for meeting Stage 1 meaningful use.

DSHS is not authorized to grant exemptions to EHR Incentive Program participants from submitting data to meet program requirements. A program participant may claim an exclusion at the time of attestation to meaningful use. Maintaining appropriate documentation, if any, is the responsibility of the program participant.

Entities qualified to exchange data with ImmTrac but not participating in the EHR Incentive Programs may also use these data exchange standards, but will not receive incentive payments available through the EHR Incentive Programs.

As a participant in the submission of electronic data to ImmTrac, health care organizations will assist in improving the efficiency and quality of care to Texas residents while reducing costs.

Data submission must be in accordance with all applicable laws and practices.

More information about ImmTrac is available on the ImmTrac webpage.

Beginning December 15, 2015, to meet EHR Incentive Program requirements and attest positively to a measure requiring reporting of data to public health, EHR Incentive Program participants must be “actively engaged” with the public health agency (PHA) or registry receiving the data. Program participants must register separately with each registry.

There are three ways EHR Incentive Program participants can be “actively engaged with ImmTrac:”

  1. Register their intent to submit data to the registry within 60 days after the start of the reporting period. Once registered, a participant may be placed in a queue for testing/validation. Participants waiting in this queue are considered “actively engaged.”
  2. Be in the process of testing and validation of the electronic submission of data, once invited to test by DSHS. When testing is passed, the participant will be moved into production. Participants must respond to requests from DSHS within 30 days; failure to respond twice within an EHR reporting period would result in that participant not meeting the measure.
  3. Submitting data regularly into the specified production environment. Participants should not submit data to the production environment until they have successfully completed testing and validation with DSHS.

DSHS currently supports submission for both Stage 1 and Stage 2 Meaningful Use for immunizations under the rule modifications that became effective December 15, 2015.

Back to top

Meaningful Use Measure

The measure for participants in Stage 2 under Objective 10, Public Health Reporting, effective December 15, 2015, for reporting immunizations is:

The EP, EH, or CAH is in active engagement with a public health agency to submit immunization data.

Any EP, EH, or CAH meeting one or more of the following criteria may be excluded from the immunization registry reporting measure if the EP, EH, or CAH:

  • Does not administer any immunizations to any of the populations for which data is collected by its jurisdiction's immunization registry or immunization information system during the EHR reporting period;
  • Operates in a jurisdiction for which no immunization registry or immunization information system is capable of accepting the specific standards required to meet the CEHRT definition at the start of the EHR reporting period; or
  • Operates in a jurisdiction where no immunization registry or immunization information system has declared readiness to receive immunization data from the EP, EH, or CAH at the start of the EHR reporting period.

Back to top

Helpful Documents

The documents below may assist health care providers and their vendors in successfully implementing the exchange of immunization information.

Document Description
HL7 Implementation Guide Contains the specifications for submitting an HL7 data file to DSHS.
HL7 File Processing Slide deck that walks through the processing steps your files go through after ImmTrac receives them.
HL7 Common Errors and FAQs Contains descriptions of the most common errors that files and messages encounter, as well as an FAQ section for questions that are often asked by providers during the HL7 on-boarding process.
CVX Vaccination Code List Lists each CDC vaccination code and corresponding CPT code, if available. The legend on K1 indicates inactive codes and codes not accepted by the Texas Immunization Registry.
Job Aid for Fixing Errors Runs through several examples of locating and fixing errors.
HL7 Error/Issue List Helps you determine the exact location of the errors and warnings received in your file so you can analyze and fix them.
Return Notification File Job Aid Helps you understand the file that is produced for you after your data has been processed by the Texas Immunization Registry.
MU helpful links

Back to top


Questions relating to submitting immunization data from electronic health records should be directed to the ImmTrac Meaningful Use team at Please include the acronym for Meaningful Use, “MU” in the subject line, or call (800) 348-9158, option 2.

General questions relating to the Texas Medicaid EHR Incentive Program should be directed to the Texas Health and Human Services Commission. Please review the website information thoroughly at before contacting the support desk at

Back to top

Last updated August 16, 2018