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DirectTrust Eclipses Health Information Exchange Milestone

The organization behind health information exchange using the Direct standard has grown its directory service to half a million entries.

By Kyle Murphy, PhD

- DirectTrust announced midweek that its directory service has reached “critical mass” with more than 500,000 entries. The entries range from Direct addresses (necessary for Direct health information exchange) and provider physician addresses to specialty information and provider identifiers.

Health information exchange at DirectTurst

“The Directory has grown steadily over the past two years and we expect the number of entries to nearly double by early 2017 as an increasing number of health information services providers (HISPs) participate and additional health care providers become more comfortable releasing clinician Direct addresses to other clinicians and their organizations through DirectTrust,” said President & CEO David Kibbe, MD, MBA. “The Directory is poised to be a foundational component of the National Health Information Network infrastructure.”

In October,  alliance supporting secure, interoperable exchange of personal health information reported significant year-over-year increases in the number of organizations connected to HISPs and using Direct exchange, which increased by 69,000 (62 percent). The number of trusted Direct addresses also grew over that time by 37 percent, surpassing 1.3 million. Meanwhile, the number of transactions totaled around 22 million, a 64-percent increase over 2015.

At that time, Kibbe attributed the growth of Direct use to new and emerging use cases for the health IT standard made popular by the EHR Incentive Programs and meaningful use requirements.

“We’ve entered a new phase of growth for Direct exchange; one in which Meaningful Use (MU) is no longer the single major driver of adoption," he said. "New and often innovative use-cases are springing up in which Direct replaces fax, phone, and/or mail in the workflows of healthcare-related organizations whose professionals don’t necessarily use EHRs and don’t directly benefit from the MU incentive bonuses."

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In the most recent announcement, DirectTrust listed the various benefits its service provides:

Utility – More than 100 electronic health record (EHR) vendors, including those of recognized brands (e.g., Cerner, Athenahealth, Allscripts, EPIC) upload Directory information to enable easy search and location of Direct addresses of colleagues at other organizations including those using different EHR technologies.

Accurate, Current Information – More than 20 DirectTrust-accredited health information services providers (HISPs) regularly contribute their own and their EHR customers’ information to the Directory, and routinely update these data. 

Identity Validation – HISPs assign Direct addresses to individuals and organizations included in their data only after a rigorous identity-verification process has been performed and attested to. According to Dr. Kibbe, the DirectTrust Directory is the only Directory able to make this claim.

Quality Assurance – In an effort to improve and standardize its Directory, DirectTrust has undertaken a pilot project to test and compare the quality and accuracy of the data it contains against data contained in other national provider directories, e.g., the Centers for Medicare & Medicaid Services’ National Plan and Provider Enumeration System (NPPES).

Continuous Improvement – DirectTrust is participating in a series of Directory issues-focused meetings sponsored by the ONC/National Institute of Standards and Technology (NIST).

According to Kibbe, the challenge ahead for DirectTrust is making this data more widely available to its users.

Elsewhere in health data exchange

Chicago’s Rush Health and New York’s Rochester RHIO selected HIE solutions from InterSystems and eHealth Technologies, respectively.

The regional health information organization in western New York expanded its health data exchange services to include sharing of images. Radiologists and cardiologists now have access to external imaging studies via the Rochester RHIO query function. Likewise, they can incorporate these studies into their local imaging systems.

"It is much faster than using CDs and it is very convenient that the images go directly to the patient medical record, rather than having to reconcile the record after a patient's images are imported,” said Diana Frillici, Medical Records and PACS Administrator at Elizabeth Wende Breast Care. “We are looking forward to finding ways of working together with the Rochester RHIO to increase opportunities for use."

Rush Health, meanwhile, has adopted an interoperability solution for care coordination which will allow the integrated health network to set up a private health information exchange. According to Rush Health CEO, the move is key for the transition to value-based care.

“Implementation of our HIE is critical to Rush Health’s transition to value-based care. It will serve as the hub for all care coordination activities, triggered by real-time monitoring of quality, resource use and cost,” he said in a public statement. “It will fill in any gaps in our members’ EHRs.”

Dig Deeper:

HITECH Continues Funding Meaningful Use Health Data Exchange
Solutions for Addressing Health Information Exchange Challenges



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