It's good to be Direct

Mary Stevens, editor, CMIO
The Office of the National Coordinator for Health IT’s (ONC) Direct Project has had a pretty good year: More than 65 organizations have announced support for implementing the Direct Project, and 20 states now have ONC-approved plans that include its mechanism for information exchange over the internet. So, the panelists in a March 21 National eHealth Collaborative webinar had reason to be optimistic when they were asked to comment on the growth prospects for Direct Project’s use cases.

Q: Can you comment on the relative growth prospects of Direct's simple provider-to-provider and EHR-to-HIE use cases?

Arien Malec, coordinator of the Direct Project and of the Standards & Interoperability Framework: I would expect to see most rapid growth with EHRs that have built integrated functionality for physicians to support clinical workflow and clinical automation. I would also expect to see rapid growth of simple, low-cost methods for reaching out to providers who have not yet adopted EHRs. We’re going to see a move from … just being able to do simple forms of information exchange, to a move for basis of competition, to EHRs that can support advanced clinical workflow, decision support and advanced medical home with clinically centered workflows.

Gary Christensen, chief operating officer and CIO of the Rhode Island Quality Institute (RIQI): There’s benefit to care coordination regardless of the platform you’re on. Embedding interconnectivity and interoperability right in EHR itself is a crucial driver for EHR vendors. We’re leaving it up to vendors [as to] when does it make the most sense, and build it into their products. The environment is so heterogeneous, it’s really impossible to control it and it’s much better to have practices thinking through their workflow and integration points themselves.

Rich Elmore, vice president of strategic initiatives at Allscripts and leader of the Communication Workgroup for the Direct Project: The compliance statement for Direct Project refers to its similarity to the telephone system. The [Health Information Service Provider] is the central network and helps enable transport from point A to point B. At the edge, lots of devices plug in. It’s the same with the Direct Project: You can plug in secure email, or plug in IHE profiles. One of the advantages is that many healthcare IT vendors have already committed to and implemented some of those Direct Project messages, others are doing that in their upgrades for meaningful use. So you get the immediate critical mass.

It’s really about the network effect, the fact that physicians with simplest of technologies [can] get access to an entire organization of care providers that might be using EHRs, is really exciting and gives that capability to propel [Direct Project] very quickly to widespread adoption.

The innovation is going to be the really interesting next step. Having a consistent transport mechanism, having a solution to that problem, really enables the innovators on the edges to be able to come up with solutions from one organization to another that could be really exciting.

Do you share that enthusiasm for the Direct Project? Let me know at mstevens@trimedmedia.com.

Mary Stevens
Editor of CMIO
 

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