Appendix D Cornerstone Data Import Function

Table of Contents

  1. D.1 Description of Data Import Capability and Usage
  2. D.2 Data Content and Format of the Import Files
  3. D.3 Description of Import File Data Formats
  4. D.4 DATA ELEMENT - FIELD DEFINITIONS
  5. D.5 DATA ELEMENT - CODE TABLE
  6. D.6 Example Reports
    1. D.6.1 Example of Edit Error Report (HSPR0410)
    2. D.6.2 Example of Update Error Report(HSPR0411)
    3. D.6.3 Example of Potential Duplicate Participant Report (HSPR0412)

D.1 Description of Data Import Capability and Usage

Introduction

The purpose of this document is to describe Cornerstone's data import capability and explain how this function may be used. This capability has been implemented so that agency users can transfer data from their other automated applications to Cornerstone. It addresses the concern raised by local agency users about entering the same participant information multiple times into different systems. Using this function can help reduce redundant data capture by allowing data to be electronically transferred between systems. For example, agencies may want to extract participant demographic data captured in their local participant billing or tracking system to import into Cornerstone in order to avoid reentry of the information. The import function will also allow immunization shot data captured in a local application to be transferred to Cornerstone to update participant records and provide for consolidated immunization reporting.

This document first explains how the import files will be processed, and it then defines the data content and format of the import files. Local agencies should be able to use this information to develop a program to export this data from their local applications as appropriate. These export programs will need to be specific to each agency's unique system requirements and data formats.

Processing of the Import Files

The import files are processed by using the Standard System Interface Import Screen (AD20). This screen is accessed from the File Maintenance selection off of the main Administrative menu choice. The layout of this screen is shown on the following page. (Please refer to Chapter 9 "Administrative Screens" under "9.20 Standard System Interface Import (AD20)" for more information about this screen, including field definitions.)

Screen Layout

Image001.jpg

The top portion of the screen allows the user to specify the location of the import files. The file location (drive and directory path) default to G:\APPL\IMPORT. If the user wants to specify a different file location, the drive or directory path may be modified as required. It is necessary to place the import files in the directory specified above as part of the file export procedure before invoking the import function.

The import function will check for two specific files in the location specified. The first file should be named CLINPART.TXT. This file is used to transfer general participant demographic data. The second file should be named CLINIMMN.TXT. This file can be used to transfer participant immunization shot data. Both of these files are optional. If present, however, they will need to conform to the formats defined in the next section of this document. The import process is initiated from the screen by pressing F4.

The first step of the import process will be to validate the data in the import files. Each field will be edited based on specific field definitions and formats. An error report will be printed listing any data elements that did not pass the edit checks. An example of this report (Edit Error Report (HSPR0410)) is displayed at the end of this document. The user will be prompted as to whether or not any import file errors were encountered. The user is then given the option to terminate the import function or to process all import records that passed each of the edits. If the user wants to continue processing, the Cornerstone import module will then update the Cornerstone database as appropriate with the data being imported. A confirmation message will be displayed at the end of this process. An example of this message (Update Error Report (HSPR0411)) is displayed at the end of this document. Records that did not pass the edit rules should be reviewed and the data should be corrected as appropriate before rerunning the import process.

An important function of the import program is to match the import data to the correct participant in Cornerstone. This is referred to as the import file matching process. It will be used to determine whether to add a new participant and assign a new Cornerstone participant ID number, or to update an existing participant. The following data elements on an import file will be used in this matching process: Participant Identifier/ID Number, Participant Name (Last, First and Middle Initial), Participant Birth Date, Participant Sex, Participant Social Security Number and Participant Recipient ID Number assigned by public aid.

The user's Participant Identifier/ID Number should contain the participant identifier the user's agency uses to uniquely identify each participant. This may also be called the patient or participant ID number. This field should be used consistently on every import record to match up the import information. The import program will use this field to establish a system cross-reference between the user's participant identifier and the unique participant ID assigned by Cornerstone to new participants. Once this cross-reference is establish, the import program will use the user's participant identifier to determine what Cornerstone participant is to be updated from subsequent import records. The user's participant identifier will be stored in Cornerstone's System Cross-Reference Table. The system code in the cross-reference table will be "LOCL" to designate the user's local application. The user can directly update the Cornerstone system cross-reference table with their local participant identifiers if desired. This could be done to assure the proper matching of participant information or to correct previous file matching problems. The system cross-reference table can be viewed and updated through the System Cross Reference List (PA17).

If the user's participant identifier is not found in the Cornerstone cross-reference table, the participant name fields in combination with the date of birth and sex code will be used to look for a matching participant in Cornerstone. Therefore, consistency in the formatting of the name fields will help facilitate the matching process. If a matching participant is found, this participant's information will be updated. This is referred to as a "hard match." Note that matching will also be done using the Participant's Social Security Number and/or Recipient ID Number if entered.

If no matching participant is found, the participant name in conjunction with the date of birth and sex code will be used to generate a new Cornerstone participant ID before updating the Cornerstone database. After the update process is complete, a report will be printed showing any other participants that could be potential matches (i.e., potential duplicates) because they have similar names. These are referred to as "soft matches." Since Cornerstone cannot be certain that a soft match is actually the same person, a new participant is added to avoid updating an incorrect participant. If there are any potential duplicates listed on the report, they should be reviewed to determine if they are the true duplicates. If any duplicate participants are found, they should be resolved using the Cornerstone duplicate resolution procedures. An example of this report (Potential Duplicate Participant Report (HSPR0412)) is displayed at the end of this document.

D.2 Data Content and Format of the Import Files

The import program will process two different import files. Each import file consists of one record format as shown in the following table.

Import File Description File Name Record Format
Participant Demographic Data File CLINPART.TXT Demographic Record
Participant Immunization Data File CLINIMMN.TXT Immunization Record

The import files should be ASCII text files using comma delimited character data elements enclosed in double quotes. The remainder of this document provides a description of the data elements contained in the import files for each record format. The import program treats each data element as a character field even if it normally contains a numeric value. Each field will be validated based on the data element field definitions contained in this document. The maximum length for each data element is shown on the record layout. All data elements should be left justified unless otherwise noted. Spaces should be used for optional fields when there is no value. Data elements may be padded with spaces up to the maximum field size. Padding, however, is not required. Code fields must be encoded exactly as they are contained in the code tables. New code values added to Cornerstone will automatically become valid for the import program. Code fields used strictly as alphanumeric characters and leading zeroes are necessary. Date fields should be in the following format: "MM/DD/YYYY" including the imbedded slashes. Dates will be accepted in either the complete format such as "03/07/1996" or truncated as "3/7/96."

Examples of actual import file printouts are shown on the following page.

Examples of Import File Printouts

Image002.jpg

D.3 Description of Import File Data Formats

Demographic Record Layout

File Description and Data Elements Format Description
Participant Demographic Data File File Name: CLINPART.TXT
Clinic Number CHR 6 Cornerstone Clinic Number
Participant Identifier/ID Number CHR 14 Local Agency Participant ID
Participant Last Name CHR 15
Participant First Name CHR 13
Participant Middle Initial CHR 1
Participant Address Line 1 CHR 20
Participant Address Line 2 CHR 20
Participant Address Apartment Number CHR 5
Participant Address City CHR 20
Participant Address State CHR 4 "XX" (two digit postal codes)
Participant Address Zip Code CHR 9 "999999999"
Participant Contact Person Name CHR 25 Guardian or contact name
Contact Person Relationship Code CHR 4 See field definition code values
Participant County of Residence Code CHR 4 "999" (three digit county codes)
Participant Telephone Number CHR 10 "9999999999"
Participant Social Security Number CHR 9 "999999999"
Participant Years of Education CHR 2 See field definition code values
Participant Marital Status CHR 4 See field definition code values
Participant Birth Date CHR 10 "MM/DD/YYYY"
Participant Sex CHR 4 See field definition code values
Participant Race Code CHR 4 See field definition code values
Participant Ethnic Code CHR 4 See field definition code values
Participant Household Size CHR 2 "99"
Participant Annual Income CHR 6 "999999"
Participant Immunization Status CHR 4 See field definition code values
Participant Recipient ID Number CHR 9 "999999999" Assigned by HFS
Date of Initial Contact/Registration Date CHR 10 "MM/DD/YYYY"
Date of Last Update to This Data CHR 10 "MM/DD/YYYY"
Record Status Code CHR 1 Leave Blank
Total Characters: 249

Immunization Record Layout

File Description and Data Elements Format Description
Participant Demographic Data File File Name: CLINPART.TXT
Clinic Number CHR 6 Cornerstone Clinic Number
Participant Identifier/ID Number CHR 14 Local Agency Participant ID
Participant Last Name CHR 15
Participant First Name CHR 13
Participant Middle Initial CHR 1
Participant Address Line 1 CHR 20
Participant Address Line 2 CHR 20
Participant Address Apartment Number CHR 5
Participant Address City CHR 20
Participant Address State CHR 4 "XX" (two digit postal codes)
Participant Address Zip Code CHR 9 "999999999"
Participant Contact Person Name CHR 25 Guardian or contact name
Contact Person Relationship Code CHR 4 See field definition code values
Participant County of Residence Code CHR 4 "999" (three digit county codes)
Participant Telephone Number CHR 10 "9999999999"
Participant Social Security Number CHR 9 "999999999"
Participant Years of Education CHR 2 See field definition code values
Participant Marital Status CHR 4 See field definition code values
Participant Birth Date CHR 10 "MM/DD/YYYY"
Participant Sex CHR 4 See field definition code values
Participant Race Code CHR 4 See field definition code values
Participant Ethnic Code CHR 4 See field definition code values
Participant Household Size CHR 2 "99"
Participant Annual Income CHR 6 "999999"
Participant Immunization Status CHR 4 See field definition code values
Participant Recipient ID Number CHR 9 "999999999" Assigned by HFS
Date of Initial Contact/Registration Date CHR 10 "MM/DD/YYYY"
Date of Last Update to This Data CHR 10 "MM/DD/YYYY"
Record Status Code CHR 1 Leave Blank
Total Characters: 249

D.4 DATA ELEMENT - FIELD DEFINITIONS

Demographic Record Elements

Clinic Number CHR 6 Required

The Clinic Number needs to correspond to the Cornerstone clinic number assigned to the local site for each Cornerstone file server location. This field is used to verify that the import file is being processed at the proper location and that the data is being applied to the correct database. The Clinic Number can be found on Cornerstone's Clinic Administration Data Screen (AD14).

Participant Identifier/ID Number CHR 14 Required

This field should contain the participant identifier the user's agency uses to uniquely identify each participant. This may also be called the patient or participant ID number. The field should be left justified and may be padded with spaces. This field should be used consistently on every import record to match up the import information. Refer to the introductory description of the import file matching process on page 3 and 4.

Participant Last Name CHR 15 Required

Participant First Name CHR 13 Required

Participant Middle Initial CHR 1 Optional

The participant name fields should contain the participant's current name as used in the user's system. These fields should be left justified and may be padded with spaces. If the participant identifier is not found in Cornerstone on the cross-reference table, the participant name in combination with the date of birth and sex code will be used to look for a matching participant in Cornerstone. Therefore, consistency in the formatting of the name fields will help facilitate the matching process. Refer to the introductory description of the import file matching process on page 3 and 4.

Participant Address Line 1 CHR 20 Required

Participant Address Line 2 CHR 20 Optional

Participant Address Apartment

Number CHR 5 Optional

Participant Address City CHR 20 Required

Participant Address State CHR 4 Required (two-digit postal code)

Participant Address Zip Code CHR 9 Required (five-digit minimum)

The participant address fields should contain the participant's current home address as used in the user's system. These fields should be left justified and may be padded with spaces. The state field should contain the two-digit postal state code such as "IL" for Illinois. The state codes are listed in the following Codes Table. The zip code must be numeric and should be either 5 or 9 digits.

Participant Contact Person Name CHR 25 Optional

This field can contain the name of a contact person for the participant such as a child's guardian. If this field is entered, there must also be a value in the contact person relationship code.

Contact Person Relationship Code CHR 4 Optional

This field can contain the relationship code for the contact person. The valid relationship codes are contained in the Codes Table. If this field is entered, there must also be a value in the participant contact person name.

Participant County of Residence Code CHR 4 Optional

This field can contain the county code for the county where the participant lives. The valid county codes are contained in the Codes Table. The field should be entered as either "999" or "999." For example, Cook County should be entered "031" or "031", but not "31."

Participant Telephone Number CHR 10 Optional

This field can contain the participant's home telephone number. This field should be all numeric and include the area code.

Participant Social Security Number CHR 9 Optional

This field can contain the participant's social security number (SSN). This field should be all numeric. If entered, the SSN will be used for participant matching purposes.

Participant Years of Education CHR 2 Optional

This field can contain the number of years of education that the participant has had. The field values are from "01" to "32" years of education, "00" to indicate no education or "99"for unknown. Leading zeros are not required.

Participant Marital Status CHR 4 Optional

This field can contain the marital status code of the participant. The following code values are allowed:

Code Marital Status
"01" Never Married
 "02" Married
"03"  Widowed
"04" Divorced
"05" Separated
"09" Unknown

  Participant Birth Date CHR 10 Required

This field must contain the participant's birth date in the format "MM/DD/YYYY."

Participant Sex CHR 4 Required

This field must contain the sex code of the participant. The following code values are allowed:

Code Gender
"F" Female
"M" Male
 "O" Other
"U" Unknown

Participant Race Code CHR 4 Optional

This field can contain the racial code for the participant. The following code values are allowed:

Code Race
"10"  White
"20" Black or African American
"50"  Asian
"60" American Indian/Alaska Native
"70" Native Hawaiian/Other Pacific Islander
"80" Unknown

  Participant Ethnic Code CHR 4 Optional

This field can contain the ethnic code for the participant. Currently it is only used to indicate Hispanic origin. The following code values are allowed:

Code Ethnicity
"00" Not Hispanic or Latino
 "01" Hispanic or Latino

 Participant Household Size CHR 2 Optional

This field can contain the number of persons in the participant's household. The field values are from "01" to "15" people. Leading zeroes are not required.

Participant Annual Income CHR 6 Optional

This field can contain the participant's annual income in whole dollars as defined for program purposes. The field values are from "000000" to "999999" dollars. Leading zeroes are not required.

Participant Immunization Status CHR 4 Optional

This code field may be used to record the participant's immunization program status. This field should normally be left blank unless the participant is active or has been active in the user's immunization program. The following code values are allowed:

"A" Active

"T" Terminated

Participant Recipient ID Number CHR 9 Optional

This field can contain the participant's recipient ID number as assigned by the Illinois Department of Public Aid. This field should be all numeric including leading zeroes. If entered the recipient ID will be used for participant matching purposes.

Date of Initial Contact/Registration Date CHR 10 Optional

This field can contain the date that the participant made initial contact with the clinic or the date the participant was registered or enrolled into the user's local application in the format "MM/DD/YYYY."

Date of Last Update To This Data CHR 10 Optional

This field can contain the date that the information on this record was last updated in the user's system using the format "MM/DD/YYYY." If a corresponding record is already in Cornerstone and the date of last update is greater than Cornerstone's, the corresponding data elements can be updated. If this field is blank or not greater than Cornerstone's, the user's information will not override data that is already on Cornerstone. New records will, however, be added without using this field.

Record Status Code CHR 1 Leave Blank

This field is reserved for future use and should be left blank.

Immunization Record Elements

Clinic Number CHR 6 Required

Same as Demographic Record element.

Participant Identifier/ID Number CHR 14 Required

Same as Demographic Record element.

Immunization Shot Type CHR 4 Required

This field must contain the immunization shot type code. The following code values are allowed:

Code Value Code Description
01 DTP-DIPHTHERIA
02 TD-TETANUS-UNSPCFD FRMULA
03 ORAL POLIO VIRUS
04 MMR
05 MR-MEASLES/RUBELLA
06 MEASLES (SINGLE ANTIGEN)
07 MUMPS (SINGLE ANTIGEN)
08 RUBELLA (SINGLE ANTIGEN)
09 HIB-UNSPCFD FRMULA
10 TB SKIN TEST-UNSPCFD FRMULA
11 DT-DIPHTHERIA (PEDI FORM)
12 DTP-HIB
13 HIB-MSD
14 HEP B - PEDIATRIC (3 DOSE)
15 HEP B - ADULT (3 DOSE)
17 IPV
19 VARICELLA
20 DTAP - ACELLULAR PERTUSIS VACC
21 HBIG
22 HIB/HEP B
23 ROTAVIRUS (ROTARIX)
24 HEP A - PEDIATRIC (2 DOSE)
25 HEP A - ADULT
26 PNEUMOCOCCAL CNJ(CHILD)PCV7
27 PNEUMOCOCCAL POLY (ADULT)
28 HEP B - ADOLESCENT (2 DOSE)
30 TWINRIX(HEP A/HEP B)
31 MENINGOCOCCAL-UNSPCFD FRMULA
32 PEDIARIX(DTAP/IPV/HEP B)
34 INFLUENZA-SPLIT 6-35 MONTHS
35 MENINGOCOCCAL (MCV4)
36 TDAP - BOOSTRIX
37 TDAP - ADACEL
38 MMRV - PROQUAD
39 ROTAVIRUS (ROTATEQ)
40 RABIES-UNSPCFD FRMULA
41 TYPHOID (ORAL)
42 TYPHOID-UNSPCFD FRMULA
43 YELLOW FEVER
44 HPV-UNSPCFD FRMULA
45 INFLUENZA - LAIV
46 ZOSTAVAX
47 PENTACEL(DTAP-HIB-IPV)
48 KINRIX (DTAP-IPV)
49 ROTAVIRUS-UNSPCFD FRMULA
50 H1N1-09 ALL FORMULATIONS
51 H1N1-09 NASAL
52 H1N1-09 PRESRV FREE
53 H1N1-09 INJECTABLE
54 HIBERIX
55 PNEUMOCOCCAL CNJ(CHILD)PCV13
56 INFLUENZA-AGRIFLU
57 INFLUENZA-FLUZONE HIGH-DOSE
58 FLUVIRIN-UNSPCFD FRMULA
59 INFLUENZA-FLUVIRIN PFREE
60 INFLUENZA-SPLIT >3YRS
61 INFLUENZA-PFREE 6-35MNTH
62 INFLUENZA-PFREE >3YRS
63 INFLUENZA-AFLURIA
64 INFLUENZA-AFLURIA PFREE
65 FLUARIX-UNSPCFD FRMULA
66 INFLUENZA-FLULAVAL
67 INFLUENZA-FLUMIST
68 INFLUENZA-FLUZONE >3YRS
69 INFLUENZA-FLUZONE >3YRS PFREE
70 INFLUENZA-FLUZONE 6-35 MNTH
71 INFLUENZA-FLUZONE 6-35MN PFREE
72 INFLUENZA-SEASONAL INJECTABLE
73 INFLUENZA-SEASONAL INJCT PFREE
74 ACEL-IMMUNE
75 ACTHIB
78 ANTHRAX
80 AVAC-1
81 BCG
83 BIORAB
84 BIOTHRAX
85 BOTULINUM ANTITOXIN
86 CERTIVA
87 CERVARIX
89 CMV-IGIV
90 COMVAX
91 DAPTACEL
92 DECAVAC
94 DIPHTHERIA ANTITOXIN
95 DRYVAX
97 DTAP-HEP B-IPV
98 DTAP-HIB
100 DTAP-HIB-IPV
101 DTAP-IPV-HIB-HEP B-HISTORICAL
102 ENGERIX-B ADULT
103 ENGERIX-B DIALYSIS 4 DOSE
104 ENGERIX-B PED/ADOL
105 FLUZONE INTRADERMAL
106 GARDASIL
116 HEP A/HEP B
119 HAVRIX ADULT
121 HEP B DIALYSIS (3 DOSE)
125 HIB (PRP-OMP)
126 HIB (PRP-T)
128 HPV (BIVALENT)
129 HPV (QUADRIVALENT)
130 IG IM
131 IG IV
133 IG-GAMASTAN
134 IG-GAMMAR
135 IMOGAM RABIES HT
136 IMOVAX
137 INFANRIX
139 IPOL
140 IXIARO
141 JAPNSE ENCEPHALITIS - SC
142 JAPNSE ENCEPHALITIS - IM
143 JE-VAX
151 MENACTRA
152 MENOMUNE A/C/Y/W-135
153 MENVEO
154 MERUVAX II
155 MMR II
156 MMRV
157 MYCOBAX
162 PLAGUE
164 PNEUMOVAX 23
165 PNU-IMUNE 23
167 PREVNAR 13
168 PREVNAR 7
171 RABAVERT
172 RABIES INTRADERMAL
173 RECOMBIVAX-HB ADULT
174 RECOMBIVAX-HB DIALYSIS
175 RECOMBIVAX-HB PED/ADOL
176 RECOMBIVAX-HB PED/ADOL 2 DOSE
177 RESPIGAM
180 RIG
181 RIG - HT
182 ROTASHIELD
183 ROTAVIRUS-ORAL
184 RSV-IGIM
185 RSV-IGIV
187 SMALLPOX
189 SYNAGIS
190 TD - P FREE
191 TD (ADULT)-NOT ABSORBED
193 TDAP
194 TETANUS TOXOID
195 TETANUS TOXOID-NOT ABSORBED
197 TICE BCG
198 TIG
199 TRIHIBIT
200 TRI-IMMUNOL
201 TRIPEDIA
202 TRIVIVAC
204 TYPHIM VI
205 TYPHOID PARENTERAL-AKD
206 TYPHOID-VICPS
208 VACCINIA IG
209 VAQTA ADULT
210 VAQTA PED/ADOL
211 VARIVAX
215 VIVOTIF
216 VZIG (VARICELLA IG)
217 YF-VAX
218 MUMPSVAX
219 TYPHOID PARENTERAL (H-P)
220 ADENOVIRUS TYPES 4 & 7
229 DTAP - 5 PERTUSSIS ANTIGENS
232 MENINGOCOCCAL MPSV4
238 RABIES, INTRAMUSCULAR
239 TD ABSORBED
240 PEDVAXHIB
241 MENINGOCOCCAL (MCV4O)
242 MENINGOCOCCAL (MCV4P)
243 HEP B - ADULT
244 HEP B - DIALYSIS (4 DOSE)
245 INFLUENZA-FLUARIX >3YRS
246 INFLUENZA-FLUARIX 6-35MNTH
247 INFLUENZA-FLUVIRIN >3YRS
248 INFLUENZA-FLUVIRIN 6-35MNTH
250 VACCINIA (SMALLPOX) - DILUTED
252 DT PRESERVATIVE FREE

The value of "LEAD" may also be used in this field to record the completion of a lead screening test. Refer to the field for Lead Screening Test Method.

Immunization Shot Date CHR 10 Required

This field must contain the date the immunization shot was administered in the format "MM/DD/YYYY." It is also required for the TB skin test or lead screening test.

Immunization Number in Series CHR 1 Optional

This field can contain the sequential number used to designate the occurrence of an immunization shot when there can be multiple shots of a single type given in a series. This field may be left blank since Cornerstone does not use this field directly to determine immunization status.

Immunization Exemption Code CHR 4 Optional

This code field may be used to record immunization shot exemptions or contraindication codes. This field should normally be left blank unless the participant does not actually receive the intended shot. The following code values are allowed:

"M" Disease History

"R" Religious Contraindication

"U" MED Contraindication-Unprotected

Provider ID Number CHR 9 Optional

This field may contain the provider identifier assigned to the provider in Cornerstone as contained in the provider code table. This field will be used to identify the specific agency that administered the shot. If the shot was administered by the user's clinic, the provider ID number as assigned in Cornerstone must be used to indicate that this shot was given at the user's clinic.

Biologic Lot Number CHR 10 Optional

This field may contain the biologic inventory lot number assigned to the user's immunization inventory for shots administered. This field will be used for information purposes only and will not be used to update the Cornerstone biologics inventory.

Clinic Location Code CHR 2 Optional

This field should normally be left blank unless the user is using the Location Code in Cornerstone to designate multiple service locations for the user's clinic operations. If this is the case, this field can be used to identify a specific service location for the immunization shot.

TB Result Reaction Code CHR 4 Optional

This field should be used to record the result of the TB skin test for shot type "10 ." The following reaction code values are allowed:

"TBNG" Negative TB Skin Test

"TBNR" Not Read TB Skin Test

"TBPS" Positive TB Skin Test

This field may also be used to record the result of the lead screening test for shot type "LEAD." In this case the field may contain a numeric field in the format "999." The lead result is measured in micrograms per deciliter and should be rounded to a whole number. Note that lead screening test will be posted to the Cornerstone child visit health record. If this is not a TB or lead test record, this field should be left blank.

Lead Screening Test Method CHR 4 Optional

This field should only be used to record alead screening test method for shot type "LEAD." Otherwise, it should be left blank. The following code values are allowed:

"0" Blank

"1" Venous

"2" Finger Stick

"3" Unknown

Place of Service Code CHR 4 Required

This field can be used to designate the type of organization where the shot was administered. If the user's clinic administered the shot, use the code value for Clinic. The following code values are allowed:

"1" Inpatient Hospital

"2" Outpatient Hospital

"3" Doctor's Office

"4" Patient's Home

"5" Day Care Facility

"6" Clinic

"7" Other

"8" IBBCP Lead or Consortia Agency

Provider Name CHR 50 Optional

This field can contain the provider's name. It would normally be used if a provider ID number were not available.

Comments CHR 70 Optional

This field may be used for other comments regarding the immunization shot record.

Date of Last Update To This Data CHR 10 Optional

Same usage as for the Demographic Record element.

Record Status Code CHR 1 Leave Blank

This field is reserved for future use and should be left blank.

D.5 DATA ELEMENT - CODE TABLE

Participant Address State CHR 4

AK Alaska

AL Alabama

AR Arkansas

AS American Samoa

AZ Arizona

CA California

CO Colorado

CT Connecticut

DC District of Columbia

DE Delaware

FL Florida

FM Federated States of Micronesia

GA Georgia

GU Guam

HI Hawaii

IA Iowa

ID Idaho

IL Illinois

IN Indiana

KS Kansas

KY Kentucky

LA Louisiana

MA Massachusetts

MD Maryland

ME Maine

MH Marshall Islands

MI Michigan

MN Minnesota

MO Missouri

MP Northern Mariana Islands

MS Mississippi

MT Montana

NC North Carolina

ND North Dakota

NE Nebraska

NH New Hampshire

NJ New Jersey

NM New Mexico

NV Nevada

NY New York

OH Ohio

OK Oklahoma

OR Oregon

PA Pennsylvania

PR Puerto Rico

PW Palau

RI Rhode Island

SC South Carolina

SD South Dakota

TN Tennessee

TX Texas

UT Utah

VA Virginia

VI Virgin Islands

VT Vermont

WA Washington

WV West Virginia

WI Wisconsin

WY Wyoming

Contact Person Relationship Code CHR 4

AD Adopted Daughter

AN Aunt

AS Adopted Son

BR Brother

CO Cousin

DA Daughter

DF Daughter in Foster Care

FA Father

FD Foster Daughter

FF Foster Father

FL Father in Law

FM Foster Mother

FP Foster Parent

FR Financially Responsible Contact

FS Foster Son

GD Grand Daughter

GF Grand Father

GM Grand Mother

GS Grand Son

HU Husband

LG Legal Guardian

LR Legally Responsible Contact

ML Mother in Law

MO Mother

NE Nephew

NI Niece

OT Other

SD Step Daughter

SF Son in Foster Care

SFTR Step Father

SG Surrogate Parent

SI Sister

SMTR Step Mother

SO Son

SP Spouse

SS Step Son

UN Uncle

WF Wife

Participant County of Residence

Code CHR 4

001 Adams

003 Alexander

005 Bond

007 Boone

009 Brown

011 Bureau

013 Calhoun

015 Carroll

017 Cass

019 Champaign

021 Christian

023 Clark

025 Clay

027 Clinton

029 Coles

031 Cook

033 Crawford

035 Cumberland

037 Dekalb

039 Dewitt

041 Douglas

043 Dupage

045 Edgar

047 Edwards

049 Effingham

051 Fayette

053 Ford

055 Franklin

057 Fulton

059 Gallatin

061 Greene

063 Grundy

065 Hamilton

067 Hancock

069 Hardin

071 Henderson

073 Henry

075 Iroquois

077 Jackson

079 Jasper

081 Jefferson

083 Jersey

085 JoDaviess

087 Johnson

089 Kane

091 Kankakee

093 Kendall

095 Knox

097 Lake

099 LaSalle

101 Lawrence

103 Lee

105 Livingston

107 Logan

109 McDonough

111 McHenry

113 McLean

115 Macon

117 Macoupin

119 Madison

121 Marion

123 Marshall

125 Mason

127 Massac

129 Menard

131 Mercer

133 Monroe

135 Montgomery

137 Morgan

139 Moultrie

141 Ogle

143 Peoria

145 Perry

147 Piatt

149 Pike

151 Pope

153 Pulaski

155 Putnam

157 Randolph

159 Richland

161 Rock Island

163 St Clair

165 Saline

167 Sangamon

169 Schuyler

171 Scott

173 Shelby

175 Stark

177 Stephenson

179 Tazewell

181 Union

183 Vermilion

185 Wabash

187 Warren

189 Washington

191 Wayne

193 White

195 Whiteside

197 Will

199 Williamson

201 Winnebago

203 Woodford

217 Upspec in IL

900 Out of State

D.6 Example Reports

D.6.1 Example of Edit Error Report (HSPR0410)

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D.6.2 Example of Update Error Report(HSPR0411)

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D.6.3 Example of Potential Duplicate Participant Report (HSPR0412)

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