Use of the Direct Project protocols for secure messaging of protected health information in a ubiquitous and “worry free” environment would represent a major breakthrough for interoperable health data exchange, according to the American Academy of Family Physicians.

For your consideration: Explaining the Direct Project

AAFP recently sent a comment letter to the Office of the National Coordinator for Health Information Technology in response to a request for information on governance of the Nationwide Health Information Network. AAFP cited three conditions necessary for optimal use of Direct protocols:

Direct standard integration with certified electronic health record technologies. “As the number of providers and hospitals who have adopted and are now using certified EHR technology grows, the tendency is for users to want all of the functionality for care management to occur within the ‘interface’ of their chosen EHR. Therefore, the integration of clinical messaging via the Direct protocols and specifications becomes more and more important with each passing month.”

Establishment and maintenance of a security and trust framework. “In order for this to occur, we believe that industry participants who provide Directed exchange services must be held accountable to a code of conduct that is enforceable, transparent to all parties, and flexible enough to accommodate change, innovation and competition within the market place. To build this trust, the infrastructure requires not only standards and technology, but also a coherent collective agreement.”

Predictability in the health information technology market. “If there is to be orderly and sustainable growth of Directed exchange in the United States, the market composed of the entities who are essential service providers, e.g. HISPs, CAs, EHRs and Personal Health Records, must be presented with clear and consistent signals regarding the commitment of the federal agencies involved in promoting health data and information exchange standards. Lacking those signals, the effects of uncertainty, confusion and non-standard or arbitrary instances of local governance of Direct may delay the investments and resources that these vendors need to make in order to be ready to meet market demand.”

AAFP’s comment letter to ONC is available here.

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