At a glance
The IZ Gateway is a program that includes a technology solution and infrastructure that facilitate immunization data exchange. It securely supports efficient exchange of immunization data among jurisdictional immunization information systems (IIS) and between IISs and public and private vaccine-providing organizations (e.g., Veterans Health Administration, physician’s offices, pharmacies).
About the IZ Gateway
The IZ Gateway is a program that includes a technology solution and infrastructure that facilitate immunization data exchange.
The IZ Gateway technology is a router that moves immunization data among jurisdictional immunization information systems (IIS) and between IISs and public and private vaccine-providing organizations (e.g., Veterans Health Administration, physician’s offices, pharmacies). The IZ Gateway also enables immunization data reporting to CDC.
The IZ Gateway program provides processes and resources to simplify making connections between the organizations sending data and those receiving the data. These processes and resources include centralized data use agreements that govern the data’s movement and use, policy support to IZ Gateway users, and streamlined procedures for onboarding and testing connections.
The movement of immunization data, also called data exchange, helps improve the completion and accuracy of an individual’s vaccination record as well as the availability to the individual and to their health care providers for use in health care recommendations and decision making.
Data exchange also helps public health agencies have more complete and accurate immunization data so they can understand the vaccine coverage and the risks for certain diseases in the communities they serve. These data inform routine public health decisions and preparations for disease outbreaks and emergencies.
The IZ Gateway does not read or store personally identifiable information (PII). It only transports immunization data between parties who have agreed to move the data through the IZ Gateway and who have signed legal agreements that ensure all users agree to the movement and use of the data by the receiving party. The IZ Gateway moves data; it does not store any immunization information and never acts as a database or data repository.
Currently, the IZ Gateway supports 4 public health scenarios
- Data exchange with vaccine providers is the reporting and querying of immunization data to a jurisdiction IIS by providers that serve more than one-jurisdiction through the IZ Gateway.
- The IIS has vaccination records from a provider organization, which enhances the completeness of the data in the IISs and helps the IIS and public health agencies understand who in their state is protected from disease.
- Health care providers can get patients’ vaccination records from the IIS, even when patients received vaccine at another provider, allowing providers to make informed decisions about clinical care for more patients.
- Example: A nurse at a hospital system needs to understand what vaccines their patient has received to determine the best tests to run so they query the IIS. The nurse realizes the patient is protected from flu but should consider an RSV vaccine due to their age. The patient agrees to get the RSV shot that day, and the hospital submits the record of vaccination to the IIS.
- The IIS has vaccination records from a provider organization, which enhances the completeness of the data in the IISs and helps the IIS and public health agencies understand who in their state is protected from disease.
- Data exchange between IISs enables IIS to send and receive immunization data to other IISs.
- This data exchange helps IIS data be complete and accurate for the people living in the jurisdiction.
- At the point of care, providers can access complete and accurate patient immunization history.
- Health departments can make informed plans to improve the health of their communities.
- Example: A family moves from state A to neighboring state B while their child is 3 years old. State B identifies a need for the child’s immunization record and queries the neighboring state’s IIS via the IZ Gateway. In response, state A sends the child’s record. Now providers in state B will have the child’s full immunization history to reference for decisions and will add to the record in the IIS when the child receives additional vaccines.
- This data exchange helps IIS data be complete and accurate for the people living in the jurisdiction.
- Data sharing with patients provides individuals with electronic access to their immunization records through querying an IIS using a consumer access portal.
- Patients have quick and easy access to complete and accurate immunization records for proof of vaccination and to help them adhere to vaccination schedules.
- Jurisdictions respond to fewer vaccination record requests via phone call and email saving time and resources.
- Example: When the child goes to summer camp in state B, their parent must provide immunization details. The parent uses a smart phone application to access a consumer access portal. The portal requests and receives the correct record via the IZ Gateway and provides that record to the parent’s app for use.
- Patients have quick and easy access to complete and accurate immunization records for proof of vaccination and to help them adhere to vaccination schedules.
- Data sharing with CDC enables jurisdiction IISs to submit record-level deidentified routine and aggregate flu vaccination data to CDC.
- Jurisdictions can opt to automate sending the data to CDC via the IZ Gateway routing service to streamline processes and save time.
- CDC uses deidentified IIS data to assess vaccination coverage of flu and routine vaccinations and inform public health decisions.
- Using the IZ Gateway for data sharing with CDC aligns with CDC’s cloud-based, modernized data architecture designed to address future public health emergencies.
- Jurisdictions can opt to automate sending the data to CDC via the IZ Gateway routing service to streamline processes and save time.
IZ Gateway Open-Source Code Available on GitHub
The IZ Gateway is a cloud-based message routing service that serves as a consolidated integration hub to facilitate immunization data exchange through standardized, repeatable onboarding and testing processes. It was developed as an open-source project to enable interoperability between immunization information systems (IISs). The IZ Gateway has been operational since 2019 and currently exchanges millions of immunization messages each year between federal agencies, multi-jurisdictional providers, public health jurisdictions, consumer access applications, and jurisdiction IISs.
The software is intended to be open source and is available to the public under the Apache 2.0 License.
Five components are available via open source on GitHub:
This repository contains the code to build the Docker image that is used to host all IZ Gateway delivered services. It contains Alpine, Node.js for user interface (UI) based applications, a FIPS certified version of OpenSSL for use with Node, and the logging utilities used to capture log data from the service.
2. izgw-core
This repository contains the core code for the essential infrastructure for Simple Object Access Protocol (SOAP) messaging in a Spring-Boot web service. It includes logging, authentication, authorization, access control, and soap messaging capabilities.
3. izgw-hub
This repository contains the IZ Gateway Hub service code. This code enables messages to be routed to multiple destinations using the IZ Gateway SOAP Web Services Definition Language (WSDL), a variation on the CDC WSDL. It depends on both izgw-core and alpine-node-openssl-fips components.
4. v2tofhir
This repository contains code enabling the transformation of HL7 Version 2.5.1 Implementation Guide: Immunization Messaging (Release 1.5) messages complying with the CDC used for sending and receiving vaccination data to and from HL7 FHIR Release 4.0.
This repository contains IZ Gateway Transformation Service, a service that enables senders to resolve minor variations between messages exchanged through the IZ Gateway to IISs in different jurisdictions.