New Draft Standard for Trial Use created to address CMS requirement for ADT event notifications enhances Direct Standard™ messaging with Context; expedites message routing, strengthens continuum of care

WASHINGTON, Feb. 23, 2021 (GLOBE NEWSWIRE) — DirectTrust™ today announced the publication of the Implementation Guide (IG) for Event Notifications via the Direct Standard™, a Draft Standard for Trial Use (DSTU). DirectTrust is a non-profit healthcare industry alliance created to support secure, identity-verified electronic exchanges of protected health information (PHI) between provider organizations, and between providers and patients, for the purpose of improved coordination of care.

“The Event Notifications via Direct Implementation Guide is the shortest path to compliance with the CMS ADT Notifications Conditions of Participation, as it leverages existing Standards and implemented technologies,” stated Therasa Bell, Kno2 President and CTO, Chair of the DirectTrust IG for Notifications Consensus Body. “With Meaningful Use we saw every certified EHR since 2014 implement Direct Secure Messaging, and that fabric has been laid across the United States. The Directory has been established to utilize these connections, so there has never been a better time to meet technology where it’s at and take advantage of the tailwind the Direct Standard™ has already created. I am excited to see the use of Direct for Notifications take off and really make an impact in healthcare.”

The IG is intended for use by all parties involved in sending and receiving hospital patient status changes. It was created by a DirectTrust Standards Consensus Body to address the Admission, Discharge, and Transfer (ADT) Event Notifications of the CMS “Interoperability and Patient Access” rule. The CMS ADT requirement is a modification of the Conditions of Participation (CoPs) that requires hospitals to send electronic notifications of a patient’s admission, discharge, and/or transfer to another healthcare facility or to another community provider or practitioner. Hospitals are obligated to meet the new rule by May 1, 2021.

The IG exceeds the CMS regulation by requiring the inclusion of Context in all Event Notification Direct Secure Messages. Context is information about the Direct message, such as message type, and other metadata (e.g., patient demographics) that allows it to be handled properly when received. This feature takes advantage of, extends, and hardens existing standards for Context, and allows instant determination of what the Event Notification message is and who it’s about, thereby enabling the potential for message routing to the appropriate care team member.

The Event Notifications via Direct IG:

  • leverages existing standards and technologies to provide the shortest path to compliance with the CMS ADT Conditions of Participation
  • creates near real-time visibility into changes in patient care
  • improves communication between providers about shared patients for a stronger continuum of care
  • empowers care teams to make informed decisions that positively impact patient care
  • includes Context to enable message routing to the appropriate person on the care team

“Encouraged by the DirectTrust EHR Roundtable, the Consensus Body engaged in a robust collaborative effort to produce this IG, which ultimately was approved by unanimous consensus. Forty participants representing all potential actors and interested constituents, including technology vendors, providers and patients, convened weekly to produce this work,” said Scott Stuewe, DirectTrust President and CEO. “Participants are now eager to build and test their implementation of the IG into their compliant systems at the Adoptathon in April. We believe the attention paid to the workflow for receivers—like Primary Care, Specialist, Long-Term Post-Acute Care, or other patient-designated providers—will empower them to make informed decisions and positively impact patient care.”

DirectTrust will host a virtual Event Notifications Adoptathon on April 8, 2021 for organizations to participate in testing the specifications, and to identify improvements to the IG. To learn more and register, visit

To access the Implementation Guide for Event Notifications via the Direct Standard™, as well as related resources, visit

About DirectTrust
DirectTrust™ is a non-profit, vendor-neutral alliance initially created by and for participants in the Direct community, including Health Information Service Providers (HISPs), Certificate Authorities (CAs), Registration Authorities (RAs), healthcare providers, consumers/patients, and Health IT vendors. DirectTrust serves as a governance forum, trust community, standards organization, and accreditation body for persons and entities engaged in exchange utilizing the Direct Standard™, supported by DirectTrust’s robust security and trust framework. The goal of DirectTrust is to develop, promote, and, as necessary, help enforce the rules and best practices necessary to maintain security and trust within the Direct Secure Messaging community. DirectTrust is committed to fostering widespread public confidence in the interoperable exchange of health information. To learn more, visit

Media Contact
Ed Emerman
Eagle Public Relations
[email protected]

View the full Press Release here.

FInd more information and resources on our Event Notifications via the Direct Standard™ page. You can also learn more about the Implementation Guide in this video series.