The DirectTrust secure messaging initiative created by industry stakeholders is asking electronic health records companies and other health information technology vendors to up their game.

Use of the DirectTrust secure messaging protocols has been ramping up over the years, but increased significantly in 2016 with 98 million message transactions, which is the bulk of the 165 million transactions since being launched in 2013.

David Kibbe, MD
David Kibbe, MD

In large part, electronic health records and other health IT products have been certified under the EHR meaningful use program to send and receive Direct messages, “but the problem with certification is it doesn’t test usability and certain features,” says David Kibbe, MD, president and CEO at DirectTrust.

Also See: DirectTrust messaging use soars in 2016

In a new report, DirectTrust offers a series of recommendations for improved functionality of Direct messaging covering transitions of care, clinical messaging and administration of the program. Direct works, Kibbe contends, “but EHR usability is highly variable.”

For instance, some recommendations for improving transitions of care include all Direct messages sent in real-time and never batched for timed sends, certain types of messages may be automatically triggered by specific events such as discharges or referrals, automated sending of messages to providers of record with Direct accounts in the sending system, and inclusion of patient-specific attachments.

Also See: 8 trends affecting how physician practices will use IT in 2017

For Kibbe, the most important recommendations cover clinical messaging and lay out the must-have features and functions necessary for optimal use of the technology.

The recently enacted 21st Century Cures Act includes provisions to measure EHR interoperability and usability in real episodes of use and Kibbe hopes framers of the act will look at Direct’s recommendations. The organization also may work with medical specialty groups to develop an EHR vendor grading system.

“We want to give vendors a good idea of what improvements are needed to take better care of patients,” he adds.

Representatives of the HIMSS Electronic Health Record Association were not immediately available for comment. The report is available here.

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