Community Record of Care for Accountable Communities of Health

June 13, 2014

Direct is about the Directory

Written by Duncan West

Direct is about the Directory

As part of our commitment to connecting the community of providers in the North Sound, MIN-NS offers a certified Direct secure messaging solution.  Direct is a secure email standard approved by ONC and managed by DirectTrust. Both email sender and recipient are vetted by a certified Health Information Service Provider (HISP).

This service, when coupled with our Health Information Exchange, connects your organization electronically to other local, regional and national healthcare organizations providing access to your patients’ care plans and other clinical records.

This secure messaging solution is central to meeting Meaningful Use 2 care plan exchange requirements - care plans are exchanged across organizations in 10% of a practice’s patient care transitions. In order to meet this requirement and others related to electronic care plans, certified Electronic Health Record (EHR) vendors are rolling out versions of their products which can create electronic care plans in the Consolidated CDA (CCDA) format. Those CCDAs can be printed, exported or posted to your patient portal to meet the 50% requirement. Care Summary / CCDA exchange requirements for Eligible Professionals are available in the “Stage 2, Eligible Professional Meaningful Use Core Measures, Measure 15 of 17.”

To meet the requirement of electronic sharing with other providers, EHR vendors are providing email functions within their applications. The newest releases of EHRs allow users to create and attach a CCDA to secure email. That email uses the Direct email protocol.

MIN-NS wants to be your HISP. Our local team works with you to get your organization’s email address and security certificate registered. Then, we work with your EHR vendor or consultant to integrate that email address into your EHR. Once you are connected you will have access to our Directory, or list, of the secure email address of local and important regional and national providers.

MIN-NS is signing up local providers and is committed to gathering the Direct addresses for regional partners such Children’s and Harborview. In addition, MIN-NS is committed to supplying Direct addresses to non-eligible providers such as local SNFs, PTs, and other members of the care community. As more and more providers obtain Direct addresses, we intend to find and add the Direct email addresses of key providers in Yuma, AZ, and other areas where Skagit snowbirds flock. If you sign up with a national HISP, your Directory will include other users of that HISP who are scattered around the country. It will be up to your staff to gather the new, Direct email addresses from your regular correspondents.

For a demonstration of our Direct and HIE capabilities contact us using this online form.

How will you implement Direct? MIN-NS staff are currently working with practices and hospitals using different models of email account distribution.  See this post at the blog “EMR & HER” for a discussion of whether you want one Direct address for your medical records department, or you want a separate email address for each of your providers. The former mimics current fax implementations, the latter supports secure exchange of clinical email with other providers and with patients.

If you want to spend time understanding the math that protects Direct messaging watch the first 26 minutes of this animated lecture on public private key encryption and digital signatures. After a brief interlude aimed at developers about how to set up your own key authority, there is a discussion of Certificate Authorities starting at 28 minutes. The lecturer is English which somehow adds charm and gravitas to this relentlessly dry topic.