Federal agencies in 2010 started work to create the Direct Project secure messaging protocols as a simple and standard way to exchange encrypted health information. Only now, however, are agencies starting to adopt the technology.

Over time, Direct messaging has evolved to be a supporting messaging option under the electronic health records Meaningful Use program, and is governed by DirectTrust, a coalition of 150 provider and vendor organizations.

Now, the Department of Veterans Affairs and Indian Health Services have received accreditation from the industry-sponsored Electronic Healthcare Network Accreditation Commission for meeting specific requirements for security and identity controls as health information service providers using Direct messaging services.

The VA did not respond to a request for information on why the organization, which now is seeking to greatly expand its data exchange with non-VA providers in its service regions across the nation, took so long to adopt Direct messaging.

Also See: VA Revamps VistA EHR with New User Interface, Functions

David Kibbe, M.D., president and CEO at DirectTrust, says there is no question that federal agencies are somewhat slow to move but these are large organizations that take time to get ready. That said, about two-and-one-half-years ago VA started taking the steps to move to Direct, he adds, speculating they and other agencies waited to see if the technology would be successful. Kibbe is confident other federal agencies, which could include Defense, Food and Drug Administration and the Centers for Medicare and Medicaid Services, will join in coming months.

Remember, Kibbe says, electronic prescribing took about seven years to start gaining traction as interfaces with EHRs initially were poor and it took time to implement improvements. “Direct is way ahead of where e-prescribing was at the same point.”

For instance, 60 million Direct exchanges were made during the second and third quarters of 2015, more than during the previous two years, he adds.

With relaxed Stage 2 Meaningful Use requirements that could entice more physicians to stay in the program, Kibbe believes physician and hospital use of Direct messaging could increase even more.

Initially, VA will have to use a browser-based approach to exchange data via Direct messaging protocols, Kibbe says, but he hopes the agency soon will integrate the messaging software to its VistA electronic health record system, a task that would not be difficult.

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