Electronic Health Records

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DirectTrust Projects Exponential PHI Transaction Growth

“Clearly, electronic messaging via the Direct protocol has reached a tipping point because it simply keeps on working.”

By Frank Irving

Health information exchange via the Direct protocol is surging to unprecedented levels, according to metrics released Jan. 20 by non-profit alliance DirectTrust, which supports and governs secure, interoperable exchange of personal health information (PHI) between provider organizations and between providers and patients.

DirectTrust announced record growth in the number of healthcare organizations using Direct exchange services during 2015, as well as a surge in the number of Direct addresses and transactions nationwide.

DirectTrust reported more than 44 million Direct transactions between Direct addresses during 2015. The total number of transactions since DirectTrust’s 2013 inception had reached 67 million by the end of 2015. For the fourth quarter of 2015 alone, more than 13 million Direct messages were transmitted. Based on the rate of increase, DirectTrust projects the number of Direct transactions to reach 230 million by the end of 2016. By the end of 2017, that transaction total could approach 800 million, according to the organization.

“2015 was a stellar year for Direct and what is fast becoming a national health information highway,” commented DirectTrust CEO David Kibbe, MD, in a public statement.

The number of trusted Direct addresses able to share PHI across the DirectTrust network increased by 66 percent (137,000 addresses) in the fourth quarter of 2015, and now exceeds 1 million.

“Clearly, electronic messaging via the Direct protocol has reached a tipping point because it simply keeps on working,” added Kibbe. “Direct is a relatively inexpensive means of moving health data from point A to point B securely and, most often, within the context of providers’ EHR technologies.”

DirectTrust noted that its network of 44 accredited health information service providers (HISPs) served more than 52,000 health care organizations at the end of 2015, an increase of 47 percent over year-end 2014. At the start of 2014, slightly more than 5,600 health care organizations were served by DirectTrust HISPs.

Kibbe said DirectTrust expects continued uptake and adoption of Direct exchange “as the drivers of care coordination, patient engagement and measures reporting gain criticality under MIPS and MACRA, and as value-based and incentive-based payment programs become more important to providers.”

DirectTrust has also made inroads in enabling information exchange among government agencies. In October 2015, DirectTrust announced that the Department of Veterans Affairs (VA) and Indian Health Services (IHS) had gained certification from the Electronic Healthcare Network Association under the Direct Trusted Agent Accreditation Program (DTAAP) for HISPs. VA and IHS became the first federal organizations to meet DTAAP requirements.

One of the expectations for networked information-sharing under the government connections is that healthcare provider would be less likely to duplicate tests and procedures.

Kibbe commented at the time: “Bringing secure, identity-validated, Direct health information exchange to these federal agencies is a major milestone in this country’s journey toward full national interoperability of our health IT systems.”

He also predicted that the Department of Defense, the Centers for Medicare and Medicaid Services, and other state and federal agencies would follow the path of VA and IHS in exchanging electronic health information via Direct.





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