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Connect: Provider and Immunization Information Systems Interoperability Project (formerly known as the IZ Gateway Project)

Project Goal

Currently, health systems operating in multiple jurisdictions must make multiple Immunization Information System (IIS) connections through disparate onboarding processes to submit and/or query for patient vaccination information. The Provider and IIS Interoperability Project aims to reduce provider burden while increasing vaccination coverage. To achieve this, a centralized IT architecture and technical solution called the IZ Gateway will be implemented to alleviate the need for multiple IIS connections and to streamline onboarding processes for public and private provider organizations. The team endeavors to centralize common legal agreements and streamline onboarding procedures between provider organizations and IIS for exchange of immunization data.

To better understand the current landscape of immunization data exchange and to develop an informed approach to address the challenge, the project team conducted semi-structured interviews with IIS, public and private provider organizations, health IT developers, and existing immunization initiatives. Over twenty-five organizations were interviewed, and results were synthesized into findings. Using this method, the team was able to identify gaps in IIS connectivity including federal agencies, independent pharmacies, and small adult-focused provider organizations. In addition, the environmental scan informed the technical approach and identification of early project participants.

A key element of this project is the proof-of-concept phase which aims to leverage existing technology supporting the Public Health Immunization Hub (Hub) to allow provider submission and/or query of vaccination data to multiple IIS using the same infrastructure. Currently the Hub supports the exchange of immunization data from IIS to IIS. The purpose of the proof-of-concept phase is to demonstrate exchange of vaccination data from two provider organizations to two IIS through the IZ Gateway. Selected provider organizations include DocStation (a pharmacy EHR) and Fond du Lac Tribal Health Services bidirectionally exchanging vaccination information with the North Dakota and Minnesota IIS’.

Provider and IIS Interoperability Project Architecture

Technology Requirements

This innovative project requires coordination from multiple organizations and will require both providers and IIS to have certain capabilities to exchange using the IZ Gateway. These capabilities include:

Providers must:

  • Use and pass Hub client-side certificate
  • Populate MSH segment with the appropriate facility ID
  • Implement the modified CDC WSDL
  • Support HL7 2.5.1 release 1.5

IIS must:

  • Use existing server-side certificate
  • Support a single account for the IZ Gateway
  • Recognize the facility ID that comes through in messages
  • Support HL7 2.5.1 release 1.5

Simplifying Onboarding

As part of the proof-of-concept, the project team will develop and refine IZ Gateway onboarding procedures. Provider onboarding will be simplified and streamlined as much as possible to avoid duplication of onboarding activities with each IIS. During the proof-of-concept phase, the team will test onboarding procedures and materials and refine the process based on participant feedback. Onboarding processes include discovery and planning activities with providers and IIS, development and testing including quality assurance activities, production approval, and ultimately, handoff to IIS to conclude final onboarding steps and interface monitoring. Provider participants will be required to sign a Business Associate’s Agreement and state specific trading agreements. It is the goal of the project to collaborate with provider organizations and IIS to develop a common, mutually agreeable onboarding process to alleviate burden on both provider organizations, their representatives, and IIS.


With support of the CDC, the team has developed a project evaluation plan to identify pain points, efficiencies, and lessons learned. Evaluation findings will inform the development of future pilots with provider and IIS participants. Evaluation activities include collection of monthly metrics from senders and receivers of immunization data, key informant interviews with stakeholders, and time tracking to inform future participant sustainability estimations.

Looking Ahead

The project team will continue to collaborate with stakeholders and identified partners to increase exchange of immunization data and decrease provider and IIS burden. Partners interested in participating in the Provider and IIS Interoperability Project may reach out to James.Daniel@hhs.gov.

Content created by Office of the Chief Technology Officer (CTO)
Content last reviewed on May 15, 2020