The Rhode Island Quality Institute, which operates the state's regional extension center to assist physicians in becoming meaningful users of electronic health records, is supporting secure messaging using protocols of the federally funded Direct Project.

The Direct Project has developed downloadable, secure e-mail software for exchanging clinical information. It enables clinicians to securely communicate with each other as long as they have a Direct e-mail account.

Early users of Direct messaging in Rhode Island include a group practice that's sending a Continuity of Care Document to a hospital treating a patient in the emergency department, and the hospital sending an updated CCD back upon discharge; and another practice sending patient data from its EHR to the statewide health information exchange for insertion into a longitudinal health record.

The Rhode Island Quality Institute also serves as a federally sponsored Beacon Communities site to accelerate and demonstrate the benefits of health information technology. Under that initiative, it soon will use Direct messaging to notify primary care providers when their patients are admitted or discharged from a hospital.


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