Direct Project Series, 3 of 3 (See Part 1: The Basics and Part 2: The Benefits)

The Direct Project has the capability to handle a variety of data formats, including all the standard healthcare formats. Computer to computer sharing of patient health information is simplified by XDM packaging. All of the metadata for the content, such as CCDContinuity of Care Document (CCD) The HL7 CCD is the result of a collaborative effort between the Health Level Seven and American Society for Testing Materials (ASTM) to “harmonize” the data format between ASTM’s Continuity of Care Record (CCR)... More/CDA, CCRContinuity of Care Record (CCR) is an XML-based standard for the movement of “documents” between clinical applications. Furthermore, it responds to the need to organize and make transportable a set of basic information about a patient’s health ... More, HL7HL7 is a Standards Developing Organization accredited by the American National Standards Institute (ANSI) to author consensus-based standards representing a board view from healthcare system stakeholders. HL7 has compiled a collection of message form... More V2, DICOMDigital Imaging and Communications in Medicine (DICOM) is a common format for image storage. It allows for handling, storing, printing, and transmitting information in medical imaging. Visit DICOM website. Synonyms: Digital Imaging and Communicati... More, etc., is defined in a metadata file. This allows the receiving system to decide rather simply how to process the content.

In addition, content can be displayed without the need to parse apart the document. Take for instance the very simple prospect of displaying a CCD document. Without metadata, even when the document is in an XML format (such as CCD/CDA or CCR), the receiving application would still need to "look inside" the content before it can decide how to render the contents. But with XDMCross-enterprise Document Media Interchange (XDM) – What itss used for: According to IHE, XDM transfers documents and metadata using CDs, USB memory or email attachments. This profile supports environments with minimal capabilities in terms of usin... More metadata available, the application can do that, and a lot more decision making about how to process the content, without ever looking inside it. This allows for a much simpler processing path.

Roles of an Interface Engine with Direct Project

The Direct protocol will simply be another connection method into and out-of integration engines. However, the integration engine can determine how involved it will be in the formation of the Direct message.

A base level of Direct support would involve creating an unsecure MIME message and handing this off to a HISPHISP, or Health Information Service Provider, is an email service provider that follows Direct Project standards and provides a mechanism to grant users a Direct email address. The HISP provides the framework to secure messages and define a circle of... More. The HISP would then be responsible for encrypting the data with a public key, signing the payload with hash and a private key, and routing the message via SMTP to the receiving HISP.

a full participation in direct would involve the integration engine performing all the functions of a hisp, including encrypting and signing on the sending side and decrypting and authenticating on the receiving side along with managing all the certificates.

if the integration engine acts as a full hisp, then the engine could choose to only act as a hisp for messages that flow thru the integration engine, or it could also act as a hisp for any other application that wants to send secure e-mails.

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