DirectTrust Clinicians’ Steering Group for Direct Interoperability in Care Transitions and Coordination Consensus Statement Overview

Background: Secure clinical messaging and document exchange utilizing the Direct Protocol (Direct interoperability) has been widely implemented in health information technology (HIT) applications and by healthcare providers and organizations in the United States. While Direct interoperability has allowed clinicians and institutions to satisfy regulatory requirements and has facilitated communication and electronic data exchange as patients transition across care environments, feature and function enhancements to HIT implementations of the Direct Protocol and Electronic Health Records (EHRs) are required to optimize the use of this technology.

Objectives: To describe and address this gap we developed a prioritized list of recommended features and functions desired by clinicians to utilize Direct interoperability for improved quality, safety and efficiency of patient care. This consensus statement is intended to inform policy makers and HIT vendors to encourage further development and implementation of system capabilities to improve clinical care.

Methods: An ad hoc group of interested clinicians came together under the auspices of DirectTrust to address challenges of usability and to create a consensus recommendation. This group drafted a list of desired features and functions that was published online. Comments were solicited from interested parties including clinicians, EHR and other HIT vendors and trade organizations. Resultant comments were collected, reviewed by the authors, and incorporated into the final recommendations.

Results: This consensus statement contains clinically desirable features and functions categorized and prioritized for policy makers and HIT vendors.

Conclusions: Fully featured, standardized implementation of Direct interoperability will allow clinicians to utilize Direct messaging more effectively as a component of EHR interoperability to improve care transitions and coordination.

Read the Consensus Statement