In July 2010, the Centers for Medicaid and Medicare Services’ final rule on the Electronic Health Record Incentive Program defined measures for eligible professionals and hospitals in order to receive incentive payments. Submission of immunization data to an immunization registry meets one of the public health objectives.

• Beginner’s Guide to Meaningful Use

The City of San Antonio Metropolitan Health District supports the Meaningful Use Stage 2 Core Objective #16: Capability to submit electronic data to the San Antonio Immunization Registry System (SAIRS) for all eligible providers and hospitals located in Bexar County.

1. Complete all program requirements with CMS (www.cms.gov).

2. Complete a SAIRS Facility Enrollment Form (only needs to be completed once and must be completed for every clinic site) if your clinic is not already enrolled.

3. Facility must administer immunizations in Bexar County and surrounding areas.

Eligible providers that intend to meet the Meaningful Use Stage 2 public health core objective # 16 must:

• Complete the Registration of Intent Form.
• Submit the form within 60 days of the start of your Stage 2 reporting period.

The reporting period is the time frame that a provider seeking incentive payments must demonstrate meaningful use of their EHR/EMR. The earliest reporting period start date is January 1, 2014 for eligible providers. For most providers, the reporting period is three months long and fixed to the quarters of the calendar year.

On-boarding refers to the testing and validation process for providers and their EHR vendors to work with SAIRS staff to collaboratively implement an electronic interface between the EHR system and the immunization registry system. This process ensures that the message formatting and the electronic connection are compatible and will allow the provider to achieve ongoing submission (see below).

After you submit your Registration of Intent Form, you will receive an email with your current on-boarding status.

1. Waiting for an on-boarding invitation from SAIRS: this means that SAIRS is not ready to begin on-boarding with you right now. You may be placed on a waiting list with an estimated time frame for an invitation to on-board.
2. Invited to on-board: this means that you and your EMR vendor have not been working with SAIRS and have not started the testing and validation process for the immunization interface. You will need to get in touch with your EMR vendor to discuss next steps towards implementation.
3. Currently on-boarding: this means that SAIRS is already working with you and your EMR vendor on implementation. Be sure to check your email account frequently to stay on top of the testing and validation status- especially if it requires action on your part.
4. Ongoing submission: this means that your facility has completed the testing and validation process and is already “live” with ongoing submission of immunization data via your EMR system.

Ongoing submission is described by www.federalregistrar.gov as “electronic submission of reportable data during the normal course of a provider’s operations. This is not to say all data that is reportable is sent to the PHA. A provider who is submitting any reportable data during their normal course of their operations is engaged in ongoing submission. A provider that can only submit reportable data in a test environment or other circumstance that is not part of their normal operations would not be engaged in ongoing submission."

SAIRS will provide an acknowledgement of achieving successful ongoing submission via email. Please note that SAIRS will only acknowledge that a provider submitted the relevant public health data to SAIRS and will not state that a provider has achieved meaningful use or met the public health objective. Determinations regarding attestation will be made by CMS. All questions regarding attestation and incentive payments should be directed to CMS.

An eligible provider can meet meaningful use stage 2 requirements through any of the following four criteria:

1. Ongoing submission was already achieved for a reporting period in a prior year and continues throughout the current reporting period using either the 2014 Edition EHR certification standards or the standards included in the 2011 Edition EHR certification criteria adopted by ONC during the prior EHR reporting period when ongoing submission was achieved.
2. Registration of Intent + Ongoing Submission
3. Registration of Intent + Currently On-Boarding (active testing and validation)
4. Registration of Intent + Waiting for On-boarding Invitation from SAIRS

The measure will not be met if the provider:

• Fails to register their intent by the deadline; or
• Fails to participate in the on-boarding process as demonstrated by failure to respond to the SAIRS written requests for action within 30 days on two separate occasions.

• CMS Beginner’s Guide to Meaningful Use
• CMS Stage 2 MU Core Measure 16 of 17