Direct Project Rapidly Advancing Health IT Interoperability

The Office of the National Coordinator for Health Information Technology (ONC) convened the Direct Project to expand the existing specifications incorporated in the Nationwide Health Information Network (NHIN) to be as inclusive as possible, regardless of the caregiver's technology used or the size of the organization. The Direct Project is facilitating "direct" communication patterns, meeting the providers where they are today, with an eye toward approaching more advanced levels of interoperability as they invest in health IT systems.

According to Tullman, by providing a real-time secure electronic transport mechanism for referrals and clinical documentation, integrated into the healthcare workflows and systems across different settings of care between healthcare providers, the Direct Project will have a lasting impact on the nation's health IT infrastructure.

"As the payment model moves from fee-for-service to fee-for-value and reimbursement criteria become more stringent, the transitions of patient care need to be made seamless," Tullman said. "Communication across all providers is the essential factor to make that level of care a reality. It is only when we have connectivity across what today are disparate silos of information that we will achieve the ultimate goal of coordinated care that provides better outcomes."

The Direct Project made two additional announcements:

-- Finalization of the Direct Project specifications, including the core Direct Project requirements and a specification which describes how EHRs and other health IT systems can leverage the Direct Project to securely exchange direct messages. Such communication is critical, especially when a primary care doctor in the United States on average has to coordinate care with 229 doctors across 117 different practices.

-- The Direct Project announced the release of two specifications and a draft compatibility statement that will help stakeholders create software that can speak with other Direct-enabled products and will help organizations deploy that software.

As Allscripts plans ahead, Tullman said basic connectivity is just the start. Workflow integration is another critical success factor for a practice. To respond to that need, the company recently announced the Allscripts Referral Network (ARN). ARN allows physicians to easily send, receive, and track round-trip patient referrals to physicians and post-acute providers, as well as collaborate via secure messages throughout the referral process.

"The service enhances care coordination, promotes quality of care, and reduces administrative time and hassle associated with referral management, one of the most time-consuming tasks for a physician. Tullman said. "We intend to integrate the Direct Project standards with ARN to deliver robust communication and connectivity to all users."