Posted on behalf of Christel Fowkes, Regional Sales Manager
The term “Health Information Exchange” (HIE) continues to symbolize a critical means of communication in today’s complex healthcare environment. In order to understand the necessary workflows, technologies and communication protocols to support HIEs, it is important to think about the Health Information Exchange (as a noun) and Health Information Exchange (as a verb).
The number of HIE’s (the noun) has expanded tremendously across the states but in order for these HIE’s to truly facilitate better patient care and clinical outcomes from a communication and collaborative perspective, there is a need for efficient and effective Health Information Exchange (the verb).
Although Electronic Health Record adoption has grown tremendously over the past few years, many providers continue to rely on paper, phone and fax to exchange patient information between and among organizations. As primary care physicians are expected to do a better job of care coordination and collaboration, it’s important to understand the various protocols and standards for automating this health information exchange.
One of the ways to quickly, securely, and cost effectively transport health information electronically is via Direct Messaging. Direct Messaging is an initiative promoted by the Office of the National Coordinator (ONC) and was adopted as the key information exchange technology required to comply with Meaningful Use State 2, and soon to be Stage 3. Direct Messaging uses proven secure standards that have been used by other industries for years and add some additional healthcare specific standards.
The below terms and definitions are important components, contributing to the Direct Messaging Architecture, as the health care community continues to enhance and perfect the way health care data is electronically exchanges.
Direct (also known as Direct Project; Direct Exchange; Direct Secure Messaging) – a national encryption standard for securely exchanging clinical health data via the Internet. The standard specifies the secure, scalable and standards-based method for the exchange of PHI (Protected Health Information).
The Direct project specifications use SMTP (Simple Mail Transfer Protocol) as the backbone protocol between HISPs ( Healthcare Information Service Provider). Organizations join HISPs in order to locate a recipient’s Direct address, securely encrypt the information and ensure the information is delivered. Think of a HISP as an Internet Service Provider.
STA – ( Security Trust Agent) The encryption of patient data can be performed by the user’s software system or by the HISP. The system performing the encryption is called the STA.
SMTP – Stands for Simple Mail Transfer Protocol.
S/MIME (also known as secure MIME) – secure email standard used for the exchange of encrypted emails.
The benefits of Direct Secure Messaging are undeniable and numerous. It can replace obsolete, non-secure faxing, phone, mail, and other courier methods for delivering PHI. It helps reduce the cost for physician offices and hospital medical record departments, when sharing PHI amongst a patient’s care stakeholders. In the process of leveraging simple, secure standards, it also supports providing structured data for importing into electronic health records (EHRs).
With all of these benefits, it shouldn’t be a surprise that the number of Healthcare Organizations (HCO) served through DirectTrusts’s HISPs increased 62% in Q3 2016, with the total number of HCOs operating under DirectTrust surpassed 69,000, and the number of Direct Messaging addresses have grown to over 1.3Million, averaging over 20Million data exchanges each quarter.
Has healthcare finally solved the Health Information Exchange puzzle? Or, can we still do better, faster, more seamless data exchange for patients, providers, and communities?