A more Direct approach

Mary Stevens, Editor

Simple, secure, scalable, standards-based, point-to-point messaging via the internet. Common definitions of identity. It’s getting closer. Arien Malec, coordinator of the Direct Project—formerly known as NHIN Direct—offered an update on its progress during a National eHealth Collaborative webinar earlier this week. And progress has been made, he said, announcing the 1.0 release of the Direct reference implementation and the start of real-world testing.

Many of the questions that follow dealt with the role of patients and their control of information. I’ve included some highlights below, and you can access the presentation here.

CMIO: Do any Direct pilot projects look at integrating to personal health records (PHRs) specifically?
Malec: Most pilots do have a PHR component. Including reporting to immunization registers as well as to PHRs, so both have copy of that record. … we’re seeing a lot of interest in incorporating patient information in HIE workflows through pilots. [And] a number of PHR vendors have participated; [for example,] Microsoft has made an announcement that HealthVault users will have access to Direct.

CMIO: Do these efforts include a voluntary patient identifier?
Malec: The ability to control an address and vouch for that address, and in some cases have an anonymous address, or multiple, that coalesce to one… can be used for common identifier, and can be used to set up and manage a data home to which all of your information can be pushed. The concept for a universal address can serve a variety of health information needs and services.

CMIO: When you talk about an address like that, are you talking about a registry?
Malec: Maybe both: [Data could] be pushed to a longitudinal record, or a patient can designate an address controlled by a [patient-centered medical home] or [accountable care organization].

CMIO: Why change the name “NHIN Direct” to “Direct”?
Malec: We felt it was important to call it the Direct Project to recognize that some exchanges happen in [the Nationwide Health Information Network framework], and some happen outside NHIN. We’re not distancing ourselves from NHIN, [but we] recognized some exchanges will happen outside NHIN.

CMIO: How can we track Direct’s progress?
Malec: We have a wiki that has a ton of information. [For example,] the Documentation and Testing Workgroup has the project overview [and] set of reference information. That group’s also creating more general documents. We’re trying to do better job at packaging information [and pointing you] to the right place. We still have too much information, but we’re trying to do a better job there.


Simple, secure exchange of health information is no simple feat, but it could be a step closer. Let the testing begin. 
 
Mary Stevens, editor
mstevens@trimedmedia.com

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