The Direct Project in Meaningful Use Stage 2
The ToC requirement has received much attention in the preparation for Meaningful Use Stage 2 attestation, as it is a Core Objective that requires Eligible Hospitals (EHs) and Eligible Professionals (EPs) to send an electronic Summary of Care document to the next care provider 10 percent of the time. To accommodate this criteria, all EHRs certified for this criteria must at a minimum provide support for the Direct Project protocol.
The Direct Project, often referred to as secure e-mail, is based on the SMTP protocol and utilizes S/MIME and certificates for security purposes. For more information on the Direct Project, please read the three-part series introducing the Direct Project.
While it is required for certified EHR software to support the Direct Project for ToC scenarios, there are also other areas where it can be applied for Meaningful Use Stage 2.
- There is a patient access criteria for certified EHRs that provides the ability for patients to download, view, and transmit their Summary of Care document (DVT). The transmit part of this criteria allows the patient to forward their Summary of Care record to the provider of their choosing, and this would be accomplished through the Direct Project protocol.
- The Direct Project protocol may be used for public health reporting as well. While each state will define the available protocols for providers to upload their reports, it is likely that the Direct Project protocol might be one of the options.
- A new criteria for Meaningful Use Stage 2 is the electronic return of lab results. This is a menu objective for providers that dictates that EHs return structured electronic lab results to EPs more than 20% of the time.
A summary of some of the ways in which the Direct Project protocol might be utilized within the rules of Meaningful Use Stage 2 are: