Direct Project, The Basics

Direct Project Blog Series, 1 of 3. (See Part 2: Direct Project: The Benefits and Part 3: Direct Project’s Use of Healthcare Standards)

I predicted that in 2013 Direct Project will begin to gain traction among health IT professionals. During the first half of 2013, the industry will continue to focus on data exchange with outside providers and HIEs and maybe start making plans to join an ACO.

The next step in this Meaningful Use journey is the Direct Project, which is a required transfer protocol in Meaningful Use Stage 2 and is expected to be the primary transport option for exchanging transfer of care summaries.

What exactly is the Direct Project?

The Direct Project is a government-sponsored initiative to promote the secure communication of patient health information (PHI). To do this, Direct uses the SMTP protocol as its communication backbone. This has led many in the industry to refer to the standard as “secure e-mail.” However, Direct has the potential to be much more than just traditional e-mail.

While a common workflow could involve an administrative clerk e-mailing a patient’s file to another administrative clerk, the scope of workflows could extend much further. Using SMTP as the backbone, applications can share data using Direct without any human intervention, much in the same way that Web Services or TCP/IP using VPNs might be utilized. The belief is that a secure SMTP transfer will be easier to implement, while maintaining scalability.

Direct Project Users

Users of the Direct Project protocol will be humans – who will use it to send secure e-mails with attached PHI – and also machines, which will utilize the same protocol to send automated messages.

In the traditional e-mail sense, Direct is nothing more than a fax machine replacement. Instead of faxing PHI to other providers, the PHI will be attached to an e-mail and sent using SMTP as the protocol. The e-mail will be secure and a special e-mail provider called a HISP (Health Information Service Provider) will need to be utilized.

In a machine-to-machine workflow, Direct protocol will be used to automatically send information directly from application to application. In this case, there are no users in the traditional sense; applications use the Direct protocol to securely exchange data.

Direct Project Applications

Applications that are currently using Direct solutions are HIS and EMR/EHR vendors, but the demand is so low that they have very little – if any – mention of Direct on their websites. Direct project offerings are scarce because health organizations have yet to make it a priority.

Why should you consider utilizing Direct project? What are the benefits? I’ll explore those questions in part two of this blog series, which I will post next week.