Direct Project and Integrating the Healthcare Enterprise (IHE)

What is Direct?

Direct is a national encryption standard for securely exchanging clinical healthcare data via the Internet. It specifies a secure, scalable, standards-based method for the exchange of Protected Health Information (PHI). It is also known as the Direct Project, Direct Exchange, and Direct Secure Messaging. Implementation of Direct protocol is required for Promoting Interoperability (PI) Stage Two CEHRT.

Direct Secure Messaging is used to securely transmit health information over the internet using specific a Direct email address and different certificates to achieve security, privacy, data integrity, and authentication of the sender and receiver. This process sufficiently meets the data transport needs of health information exchange in support of Promoting Interoperability (PI) .

Transition of Care (ToC) documents are created by healthcare organizations or providers if they refer their patients to another setting of care. These documents are then securely transmitted using Direct to the intended organization/provider.

Direct Secure Messaging

TSG’s IHE/CCD Integration Suite (DIRECT)

TSG’s IHE/CCD Integration Suite, is designed to easily integrate with health IT systems. We offer a quick and affordable way to add Promoting Interoperability (PI) Stage Two-compliant Direct messaging. Based on the national encryption standard for securely exchanging clinical healthcare data via the Internet, our suite enables secure messaging for healthcare providers, patients, business associates, and clinical systems. Using TSG’s IHE/CCD Integration Suite, PHI can be sent and received securely, in a manner that conforms to PI guidelines. It supports a variety of sensitive data, including a summary of care documents, large images, and personal messages. Best of all, it integrates easily with existing EMR/EHR solutions to fully support communication both within and outside a network.

By using DIRECT, healthcare providers will be able to:

  • Access to patients’ records from multiple providers online no matter where they are
  • Reduce medication errors through care coordination and record sharing
  • Avoid duplicate tests and procedures
  • Streamline workflow and cut administrative costs
  • Spend more one-on-one time with their patients

TSG IHE Integration Solutions (IHE)

TSG is committed to the IHE’s objectives, which focus on promoting computer systems in healthcare that seamlessly share information with one another, are easier to implement, and enable care providers to use information more effectively with established healthcare IT standards (such as DICOM and HL7). This results in a more efficient workplace and improved patient care.

By using IHE, Healthcare providers will have:

  • Seamless data sharing
  • Cost-effective, flexible, integrated solutions
  • A common framework based on established messaging standards for sharing critical medical information
  • The means to make better-informed clinical decisions

IHE Profile

IHE Profiles organize and leverage the integration capabilities of communication standards, such as DICOM, HL7 and W3C security. They provide precise definitions of how standards can be implemented to meet specific clinical needs.

HIE vs Direct

HIE is used to exchange CCD with other providers in your area who are also participants, whereas Direct is used to communicate with remote providers who may or may not participate in an HIE, but still refer patients to or from your facility. Both methods are important in order to cover CCD exchange and handle secure messaging and communication.

TSG is certified to assist an EP, EH, or CAH in achieving the “Transition of Care” PI Objective, including associated measures for transport standards.

TSG EHR Suite 6.0 and ASTRO Integration have interfaces that can extract patient information from a Health Information Exchange (HIS) and create CCD documents for submitting clinical data to another HIE securely over HTTPS/SSL. In addition, providers may also retrieve available documents from their HIE that are submitted by other participant organizations.

TSG’s ASTRO Integration engine (certified for PI Stage 1 and PI Stage 2) can also use Direct to send and receive email messages and attachments containing clinical information and summary record, using HL7 CDA/CCD (HITSP 32 specification) standards to other providers or HISPs.

TSG EHR Suite 6.0 has been tested and certified under the Drummond Group’s Electronic Health Records Office of the National Coordinator Authorized Certification Body (ONC-ACB) program. This EHR software is compliant in accordance with the criteria adopted by the Secretary of the U.S. Department of Health and Human Services.

TSG is currently collaborating with Conway Medical Center to implement an IHE profile to exchange CCD documents with their HIE (using PIX/PDQ and XDS.b to exchange CCD with SCHIEx).

TSG has successfully established connectivity with the South Carolina Health Information Exchange (SCHIEx) by sending and receiving information through the statewide health exchange based on the implementation standards. This connectivity was established over secure communication channels and was validated by SCHIEx servers for each transaction. The connectivity will help healthcare organizations in the “on-boarding process” with SCHIEx EXCHANGE as per IHE standards. “On-boarding” to SCHIEx implies that an organization can securely exchange clinical information for a patient with other healthcare organizations that are also part of the exchange.

Connecting to SCHIEx means that an organization will be able to send and receive health information amongst other SCHIEx participant organizations. The advantage of SCHIEx is that the end user has access to a more complete patient record, providing participants with a standard-based “highway” to securely share documents in a united peer-to-peer model.