The Direct Project was launched by the ONC within Health and Human Services (HHS) on March 1, 2010. It was initially called NHIN Direct. The object of the Direct Project is to replace the use of faxes, phones, and paper transactions with a simple and... More is a government-sponsored initiative to promote the secure communication of patient health information. Its simplicity makes health data exchange possible for all providers.
Direct offers a simplified method for externally sharing health data in a variety of formats including Consolidated Clinical Document Architecture (CDA) HL7 CDA uses XML for encoding of the documents and breaks down the document in generic, unnamed, and non-templated sections. Documents can include discharge summaries, progress notes, history and physical reports,... More, HL7 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 and Digital 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 Communications... More.
Users of Direct will be patients and caregivers who will exchange secure emails to their providers and also EHRs that send and receive automated messages.
Direct Project is an attractive option for sending patient data because it:
- Fulfills a key requirement of Meaningful Use Stage 2
- Is an ideal substitute to costly VPN connections
- Has the potential to displace the need to utilize certain Web services are a standardized way of integrating applications. Using open standards, businesses can communicate without in-depth knowledge of one another’s systems, beyond the communication protocol. Because all communication is XML-based, web se... More for Health Information Exchange (HIE) focuses on the mobilization of healthcare information electronically across organizations within a region or community. HIE provides the capability to electronically move clinical information between disparate health... More participation
- Provides the ability to quickly fulfill data transport requests from the clinical team.
Direct Project is often compared to secure email because it uses the simple mail transfer protocol (SMTP) as its communication backbone. SMTP is a common Internet standard used for e-mail transmission.
Instead of faxing protected health information to external providers, providers using Direct will attach the PHI to an email and send to an external provider’s Direct email address. The email will be secure and a designated Health Information Service Provider (HISP, 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) will be utilized for authentication.
How secure is Direct communication?
Once a trust relationship is established with other Direct Project users, health data transmitted on a Direct network will be securely delivered to the trusted Direct user.
The Direct Project mandates the use of S/MIME, which provides:
- Message Authentication
Digital certificates assure messages are received from a known endpoint
- Message Encryption
Targeted encryption to only the destination endpoint
- Message Integrity
Signing capability assures receivers of the sender’s identity
Meaningful Use and Direct Project
The Office of the National Coordinator for Health Information Technology (ONC) – Located within the Office of the Secretary for the U.S. Department of Health and Human Services (HHS), the Office of the National Coordinator (ONC) coordinates nationwide ... More requires all Stage 2-certified complete EHRs to support Direct Project, making it the “minimum threshold” data communication method for exchanging health data.
Organizations can also use SOAP-based Web Services, but certified EHRs are only required to support Direct Project.
While it is required for certified Electronic Health Record (EHR), as defined in Defining Key Health Information Technology Terms (The National Alliance for Health Information Technology, April 28, 2008): An electronic record of health-related information on an individual that conform... More software to support the Direct Project for ToC scenarios, there are other areas where it can be applied for Meaningful Use Stage 2.
Benefits of Direct Project
The Direct Project has the capability to significantly change the way providers share information, including the potential to replace Transmission Control Protocol/Internet Protocol (TCP/IP) is a low-level communications protocol used to connect hosts on the Internet or a network. TCP/IP connections are established between clients and servers via sockets. TCP/IP is stream-oriented ... More over VPN.
Direct Project and healthcare standards
The Direct Project can handle a variety of data formats, including all standard healthcare formats, including Continuity 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, Consolidated CDA, HL7 v2, DICOM, and more. All of the metadata for the attached documents are defined in an attached file.
With Cross-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 receiving application can make decisions about how to process the content, which further simplifies integration.
Direct messages can be viewed without the need to parse the document. Consolidated CDA documents, for example, can be read without the need for computer processing.
With Corepoint Integration Engine, Healthcare IT managers have complete control over their monitoring decisions to ensure connections remain operational. We listen closely to our customers and continuously work to improve how we help them meet any integration initiative with complete confidence.