Direct exchange transactions reach nearly 3.5 billion since tracking began in 2014; average 73+ million per month

WASHINGTON, DC, UNITED STATES, November 7, 2022 / — DirectTrust today announced third quarter 2022 metrics and Interoperability Heroes. 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.

According to end of third quarter 2022 metrics:

• Direct exchange transactions: There were more than 208 million Direct Secure Messages sent and received within the DirectTrust network during the third quarter of 2022, an increase of just over 9% compared with the same period last year. This brings Direct exchange transactions since DirectTrust began tracking transactions in 2014 to nearly 3.5 billion at the end of the third quarter; an average of more than 73 million transactions per month.

• DirectTrust organizations served: The number of healthcare organizations served by DirectTrust health information service providers (HISPs) and engaged in Direct Secure Messaging dipped (3%) to more than 273,000, compared with the same quarter last year.

• DirectTrust patient/consumer use: The number of patients/consumers using Direct Secure Messaging decreased (4%) to more than 685,000, compared with the same time last year.

• DirectTrust trusted addresses: The number of trusted Direct addresses able to share PHI decreased (8.3%) to remain at slightly over 2.6 million, compared with the same period last year.

• DirectTrust membership: Recent new members include:

– Kuma
– Navierre
– Health Care Remotely

“The decrease in some of our third quarter metrics is the result of our continuing efforts to improve data quality as part of our Directory Improvement Initiative (DII),” stated Scott Stuewe, DirectTrust President and CEO. “Many of our members contributing to the Directory are reviewing and revising previously submitted data. Given the concerted effort to improve Directory data quality, combined with the number of organizational mergers and acquisitions in healthcare, we’re not surprised to see these decreases.”

“We’ve identified four key fields that hold significant opportunity to improve the quality of the Directory. We’re working with our community on communicating the significance and impact that updating and ensuring quality information in these fields has on Directory quality. Our overall goal is to improve the use and usability of Direct Secure Messaging, by making it easier to discover the best Direct address to use for a given purpose,” Stuewe concluded.

DirectTrust has published a Directory Improvement Initiative report card, which will be updated as the Initiative advances. It may be accessed at

DirectTrust also announced its fifth class of Interoperability Heroes. The Interoperability Hero Initiative recognizes organizations, teams, and individuals integral to advancing interoperability. DirectTrust takes Interoperability Hero nominations based on significant contributions in a variety of categories, including fax alternatives, collaboration with others, interop as a health equity tool, identity-proofing, organizational efficiencies, and using Direct with other standards and networks (e.g., FHIR, Query).

The individuals, teams, and organizations nominated and recognized as Interoperability Heroes during the third quarter of 2022 are:

• Courtney Baldridge, USAging
• Susan Clark, Briljent
• Delaware Health Information Network
• Tim Ingram, Axxess
• Steve Kohrs, Cync Health
• Lowell Community Health Center – Padma Sastry
• Palliative Community Resources (Hospice Homecare) – Kristi Kenslow and Kimberly Garlington
• David Pyke, Audacious Inquiry, a PointClickCare Company
• Krystal Schramm, MiHIN
• Travis White, Kno2

“Our Interoperability Hero Initiative shines a light on heroes—those in health IT who, regardless of organizational affiliation or specific standards deployed—are laser-focused on advancing interoperability,” said Kathryn Ayers Wickenhauser, DirectTrust Director of Communications. “We’re eager share the stories of these Interop Heroes to both demonstrate what is possible with interoperability and inspire others to explore additional use cases.”

Charts detailing end of fourth quarter results are available here or by contacting Robin Schoen at [email protected] or 215.595.7542. Additional information about the third quarter 2022 Interoperability Heroes may be accessed here. More on the Interoperability Hero Initiative can be found at, and video spotlights on Interoperability Heroes are available at

About DirectTrust

DirectTrust™ is a non-profit, vendor-neutral alliance initially created by and for participants in the healthcare and technology communities, including Health Information Service Providers (HISPs), Certificate Authorities (CAs), Registration Authorities (RAs), healthcare providers, pharmaceutical companies, 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 PKI mechanisms for trusted, secure information exchange like Direct Secure Messaging and trusted, compliant document submission. 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 its trust community. DirectTrust is committed to fostering widespread public confidence in the interoperable exchange of health information. To learn more, visit:

Ed Emerman
Eagle Public Relations
+1 609-240-2766
[email protected]

View the full Press Release here.