One billion. Today, the DirectTrust community, the Office of the National Coordinator, and the healthcare industry at large can celebrate and reflect on the achievement of a landmark milestone in interoperability – one billion secure messages sent and received over the DirectTrust network since 2014.

Take a moment to consider what these one billion messages represent - easing care coordination for patients, avoiding medication interactions, connecting acute, ambulatory, and post-acute care settings, reducing provider and staff documentation burden, sharing information with public health agencies for the common good, communicating quickly with payers, even reducing our consumption of paper and ink through the reduction of paper fax – and more. Ultimately these one billion Direct secure messages represent getting the right information to the right person at the right time, and in near real-time.

Quarter after quarter, usage of the DirectTrust network continues to increase with additional cases for utilization; in Q2 alone, over 250 million messages were sent. If you work for a provider organization, you may not even be aware you are part of this growth. You may not know that when your patient’s record shows up in your inbox from a recent inpatient stay that is was enabled by our network. You may not be aware that when you select a specialist to refer your patient to that in the background the message is being delivered by DirectTrust. You may also not know how much easier it is for your colleague when they receive a referral electronically in their inbox rather than on their fax machine. While many of these exchanges may happen in the background of your EHR, we want to make the use of the DirectTrust network easier than any alternative.

As we celebrate the tremendous growth of the network, we are also reflecting on what we can do to utilize it to its fullest potential, and we believe it begins with increasing the ease of finding addresses.

While the number of DirectTrust addresses has grown to nearly 2 million, we’re often asked why the directory to access those addresses isn’t completely public. Our agreement with our network operator HISPs only allows directory data to be shared with the customers of other member HISPs. Currently, over 189,000 organizations can access the DirectTrust directory through the services of their member HISP.

The aggregated directory contains about half of all DirectTrust addresses. Why? Our agreement with our HISPs allows for privacy: addresses are only published if an organization chooses to share their addresses with the directory as a whole. DirectTrust member HISPs report their public addresses to us, and we in turn provide them the full aggregated directory to make available to their clients and users. As we think about expanding use of the network to help facilitate care, it’s clear we need to encourage users to opt in to sharing their addresses.

Additionally, we know the capabilities for users to locate addresses, and locate them quickly, vary from EHR to EHR. We’ve created a new version of our directory aggregation service which has more required searchable data elements and better error checking so we can improve the data we are aggregating, allowing users more robust search capabilities. Additionally, we’re working with EHR vendors to identify best implementation practices for Direct Secure Messaging and continuing to collaborate on how best to deploy Direct to their end-users. Ultimately, sending a Direct secure message should be as simple as sending a fax.

We’re not done with one billion Direct secure messages exchanged! As we look forward to the next billion transactions, we need to harness the power of our broader community to improve our network’s usability, to grow its use for patient and provider benefit. Will you join us in improving the directory?

— Scott Stuewe, President and CEO, DirectTrust