What is Direct Technology?
Directed, or point-to-point, health information exchange (HIE) relies on The Direct Project secure messaging protocol, which was created by a public-private consortium in 2010.
Direct technology is a transport solution for HIE and does not focus on the content being exchanged. Therefore, anything from simple text narratives to structured documents, such as CCDs, lab results, or images can be exchanged using Direct.
Direct uses a HISP (health information service provider) just as other email services use an ISP (internet service provider) to manage the flow of email transmissions.
Direct messages are made secure by employing a Public Key Infrastructure (PKI) that encrypts messages and enables trust between two or more parties without manual exchange of encryption codes.
For Stage 2 of Meaningful Use, all certified EHR systems must include Direct capability (i.e. upgraded to EHR versions that incorporate Direct into the EHR functionality).
Common Scenarios of using Direct messaging to support the transport of clinical information
Direct messaging supports common scenarios where one person or organization needs to send clinical information to another person or organization securely.
This simple push of information covers clinical scenarios like:
Many scenarios, each with a point who has the data, sending it to another point that needs the data. The Direct Project doesn't focus on what the data is, only the way it's transported.
Establishing Trust between HISPs
A trade organization called Direct Trust (DTO) launched a national accreditation program for HISPs, certificate authorities, and registration authorities in collaboration with the Electronic Health Network Accreditation Commission (EHNAC). The goal of this program is to create a foundation of trusted data exchange and performance guarantees by operating under the same fundamental transport guidelines and security procedures. This thereby, eliminates the need for each HISP to contract with other HISPs by completing BAs (Business Agreements) or TPAs (Trading partner Agreements) currently required by point-to-point exchange entities that operate data transport with differing guidelines.
Tennessee will be endorsing those HISPs listed in Accredited status for the DTAAP-HISP program on the EHNAC website, under the Accreditation Status Link. (http://www.ehnac.org/status) This ensures that Tennessee’s market-based HISPs are fully invested in maintaining the foundation of trust established under DTO by adhering to strict transport and security standards.
Learn more about Direct and The Direct Project – the original Direct project led by the Office of the National Coordinator for Health IT (ONC). (link to current Direct Project pdf)
Learn more about Direct Trust and the foundation of trust being established for HISPs.
Learn more about Tennessee’s Health eShare Direct Project, the benefits of using Direct for secure health information exchange, and how to register your personal Direct address with the Directory so others know you are a Direct user.
Also visit the Tennessee Health eShare Direct Project website: www.HealtheShareTN.com