Direct Project Rapidly Advancing Health IT Interoperability

More than 60 healthcare and health IT organizations are supporting the federal government's push for authenticated, encrypted health information to be shared with trusted recipients over the Internet.



Health IT Boosts Patient Care, Safety
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Slideshow: Health IT Boosts Patient Care, Safety
If the Direct Project's objectives continue to be advanced at a fast clip, widespread adoption of universal addressing and access to secure direct messaging of health information could soon be provided to healthcare stakeholders that serve up to 160 million Americans.

Those are the latest figures from officials at the Direct Project, a program that began one year ago to specify a secure, scalable, standards-based way for healthcare participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet.

To keep healthcare stakeholders abreast of the latest development, the Direct Project announced March 22 that over 60 healthcare and health IT organizations, including many state-based and private-sector health information exchanges (HIEs), leading IT vendors, and several leading integrated delivery systems, have planned support for the Direct Project.

One of the vendors supporting the Direct Project is Allscripts Healthcare Solutions, a health IT provider. As part of the Direct Project, Allscripts has partnered with Albany, N.Y.-based Albany Medical Center to transform disconnected paper processes into connected, electronic transactions that improve physician collaboration and make healthcare interoperability a reality. As a result of the project, the hospital's discharge summaries will soon be routed to the patient's primary care provider via an automated exchange over the Internet. The primary care provider will also be able to refer patients to specialists and receive results back upon completion of those consultations.

In an interview, Allscripts CEO Glen Tullman said the Albany Medical Center project breaks new ground since it relies upon new federal standards for information exchange. He added that the Direct Project will not only accelerate interoperability among health systems, but will also accelerate electronic health record (EHR) adoption.

"This program will drive EHR adoption because it will provide a level of comfort with the power of technology for those who have been slow to adopt, Tullman said. "For those who are only minimally using an EHR, this should increase utilization once providers see what the technology can do for them."

Among health IT vendors, support for the Direct Project represents approximately 90% of market share, officials said. Additionally, with over 20 states participating in the project, including many of the largest states in the country, nearly half of the total U.S. population can now benefit from the Direct Project's growing integration into the national health IT ecosystem, the organization said.

17 Leading EHR Vendors
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Slideshow: 17 Leading EHR Vendors
The Office of the National Coordinator for Health Information Technology (ONC) convened the Direct Project to expand the existing specifications incorporated in the Nationwide Health Information Network (NHIN) to be as inclusive as possible, regardless of the caregiver's technology used or the size of the organization. The Direct Project is facilitating "direct" communication patterns, meeting the providers where they are today, with an eye toward approaching more advanced levels of interoperability as they invest in health IT systems.

According to Tullman, by providing a real-time secure electronic transport mechanism for referrals and clinical documentation, integrated into the healthcare workflows and systems across different settings of care between healthcare providers, the Direct Project will have a lasting impact on the nation's health IT infrastructure.

"As the payment model moves from fee-for-service to fee-for-value and reimbursement criteria become more stringent, the transitions of patient care need to be made seamless," Tullman said. "Communication across all providers is the essential factor to make that level of care a reality. It is only when we have connectivity across what today are disparate silos of information that we will achieve the ultimate goal of coordinated care that provides better outcomes."

The Direct Project made two additional announcements:

-- Finalization of the Direct Project specifications, including the core Direct Project requirements and a specification which describes how EHRs and other health IT systems can leverage the Direct Project to securely exchange direct messages. Such communication is critical, especially when a primary care doctor in the United States on average has to coordinate care with 229 doctors across 117 different practices.

-- The Direct Project announced the release of two specifications and a draft compatibility statement that will help stakeholders create software that can speak with other Direct-enabled products and will help organizations deploy that software.

As Allscripts plans ahead, Tullman said basic connectivity is just the start. Workflow integration is another critical success factor for a practice. To respond to that need, the company recently announced the Allscripts Referral Network (ARN). ARN allows physicians to easily send, receive, and track round-trip patient referrals to physicians and post-acute providers, as well as collaborate via secure messages throughout the referral process.

"The service enhances care coordination, promotes quality of care, and reduces administrative time and hassle associated with referral management, one of the most time-consuming tasks for a physician. Tullman said. "We intend to integrate the Direct Project standards with ARN to deliver robust communication and connectivity to all users."

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