Contributed by Kristian Feterik, MD, MBA, FAMIA, Diplomate, Clinical Informatics, ABPM Clinical Associate Professor of Medicine, UPSOM, Medical Director of Enterprise Interoperability, UPMC and Katherine Lusk, FAHIMA, Vice President Strategic Partnerships at Texas Health Services Authority, DirectTrust Board Chair

A recent article in Computerworld addressed the enduring use of fax technology. The secondary headline reads: “And, until someone comes up with a more secure and prolific method for transmitting patient information and prescription requests, the aging systems aren’t going anywhere.”

However, a viable alternative already exists — Direct Secure Messaging. Direct is an affordable, secure, and widely available technology to securely send protected health information between practitioners and organizations, including referrals, continuity of care documents (CCDs), and more.

Direct is mandated for certified electronic health records (EHR) systems, and yet many clinicians may not be aware that these capabilities exist. Direct Secure Messaging is more versatile than fax but without the HIPAA concerns related to physical document handling or wrongly being intercepted. It is also easy to use, like sending an email — but much more secure.

More than 222 million Direct messages were exchanged in Q1 2023 alone. Here are six reasons why Direct Secure Messaging is the preferred choice when sending healthcare data to other clinicians and facilities.

  1. Streamlines workflows. With fax, someone has to gather either physical documents or electronic ones and attach them to that patient’s medical record. Data often must be retyped into the appropriate form or patient records, which takes time and can introduce errors. Direct eliminates these pitfalls, saving staff time while empowering clinicians to make more accurate treatment decisions.
  2. Better support for physicians. We all know that physicians are busy, and the more information they can access from a central portal the better. Because Direct Secure Messages are interoperable, the information contained in them can be readily parsed, distributed, and ingested into EHRs. As a result, physicians can take advantage of clinical decision support tools referencing relevant data from Direct Secure Messages.
  3. Decreases clinician burden. Physicians, especially primary care physicians, face high administrative burdens related to transitions of care, referrals to post-acute care providers, and approvals of treatment plans that often require signatures. Creating Direct addresses for specific purposes or departments, like referrals or admission/discharge/transfer (ADT) notifications, can shift administrative burdens from clinicians onto nurse pools and scheduling. This easy change can help clinicians concentrate on patient care, rather than having to wade through electronic or physical paperwork.
  4. Technology is already widespread. Direct Secure Messaging has long been an integral part of certified EHRs. Post-acute care providers didn’t receive the same incentives as hospitals and health systems to implement EHRs, but many post-acute care management systems feature Direct Secure Messaging anyway. With Direct, practitioners in skilled and long-term care can enjoy the same streamlined workflows that acute and ambulatory care providers have.
  5. There’s a Directory for that. There is no directory for fax numbers, which can create issues when trying to send information. DirectTrust maintains a directory of Direct addresses that’s continuously being updated and improved. Practitioners obtain their unique National Provider Identifier (NPI) through the National Plan and Provider Enumeration System (NPPES), which also serves as a national public directory. Clinicians are expected to include a digital endpoint, like a Direct address, on their NPPES profile. Be sure to list your Direct address on business cards, signature lines, and other places where physician-to-physician or physician-to-facility communication occurs too.
  6. Promotes interoperability. Federal efforts are ongoing to connect practitioners across the country and the care continuum — a challenging task among widely divergent clinicians, facilities, locations, and technologies. The security of data flowing through a seemingly endless number of connections is a critical concern. Direct Secure Messaging promotes interoperability through the direct exchange of patient information.

Integrating the Healthcare Enterprise (IHE) is developing a series of closed loop transitions of care (360X) scenarios. 360X requires “ubiquitously adopted technology standards” that organizations should be able to readily adopt. 360X for Referral Management is an IHE approved specification that uses Direct as the communications transport medium.

End-to-End Security with Direct

Direct Secure Messaging represents next-generation communications technology that fax machines can’t readily emulate. More than 70 million secure messages are sent and received each month, underscoring the widespread availability of Direct and the degree to which providers rely on this critical communications method.

DirectTrust and many health IT vendors provide resources on how to implement and use Direct Secure Messaging. To get started or optimize your use of Direct, contact your health IT vendor or reference DirectTrust’s “Get to Know Direct” or “Steps for Success” infographics.