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Direct Standard™ Consensus Body

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DS2019_01: The Direct Standard™

ANSI PINS Abstract: The Direct Standard was created to specify a simple, secure, scalable, and standards-based mechanism for participants to send authenticated, encrypted health information to known trusted recipients over the Internet. It builds upon existing standards and deployed internet scale infrastructure such as RFC5322 for message structure, RFC5751 for message security, and RFC5280 for public key infrastructure (PKI). The Direct Standard specifies not only a profiled use of these technologies but adds requirements and specifications for quality of service notifications, public key discovery, and building scalable trust relationships among message exchange partners.

The Direct Standard Wiki

To access historical information about the Direct Standard from the Direct Project, please use the following link to access the Wiki page. Please note this site is not actively updated, rather only used for historical context.

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DS2019_02: Trusted Instant Messaging Plus

ANSI PINS Abstract: Trusted Instant Messaging (TIM+) defines a protocol that facilitates real-time communication and incorporates secure messaging concepts to ensure information is transmitted securely between known, trusted entities both within and across enterprises. TIM+ will determine the availability or presence of trusted endpoints and support text-based communication and file transfers.

TIM+

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Trusted Instant Messaging Plus GitHub

To access the open source information about DirectTrust Standards, including Trusted Instant Messaging Plus (TIM+) servers and internationalization files, please refer to our GitHub page.

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Notifications Consensus Body

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DS2020_03: Implementation Guide for Event and Encounter Notifications

ANSI PINS Abstract: DirectTrust Standards seeks to develop an implementation guide for actors in the healthcare ecosystem who will use the Direct Standard™ for the communication of various transactions in support of Encounter and Event Notifications as established in CMS Interoperability and Patient Access rule. This project will establish content and workflow standards for Direct Secure Messaging between inpatient facilities and downstream providers, as well as subscription services that act as intermediaries in this flow. In order to ensure effective interoperability and tolimit burdensome workflows, standardization of these messages is essential.

Why develop an IG for Notifications?

In today’s healthcare environment, care teams are frequently distributed across organizational boundaries – a primary care physician or consulting specialist may not be on the staff of a hospital where care is initially delivered. Likewise, payers and care managers may have relationships with the patient but may have not be formally aligned with the inpatient facility where an encounter takes place. In order to facilitate more effective coordination of care team activities, the CMS Interoperability and Patient Access rule recently established a Condition of Participation for the Medicare program for Hospitals, Emergency departments, Critical Access Hospitals, and Psychiatric Hospitals to send notifications to other care team members for Admissions, Discharges, and Transfers (ADT). Today, many hospitals do this utilizing third-party solutions, most of which offer Direct Secure Messaging as an approach to delivering notifications into the workflow of providers. While the Direct Standard™ is one of the most common mechanisms for this delivery, there is no standard for the contents of messages or for workflow expectations in sending and receiving systems. This project will establish content and workflow standards for Direct Secure Messaging between inpatient facilities and downstream providers, as well as subscription services that act as intermediaries in this flow. In order to ensure effective interoperability and to limit burdensome workflows, standardization of these messages is essential.

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