In our previous post about Direct Messaging, we covered the major benefits of Direct Messaging. One of which being that Direct Messaging is part of Meaningful Use Stage 2 requirements. In this post we are going to dig into a few of the details behind what criteria is required for Meaningful Use Stage 2 and give a brief description of each, along with how MDToolbox helps with the criteria in our Direct Messaging system.

There are three different Meaningful Use Stage 2 criteria that require Direct Messaging:

 1) 170.314(b)(2) Transitions of care – create and transmit transition of care/referral summaries

In Stage 2, providers must be able to send Continuity of Care Documents (CCD/CDA) formatted summary files using Direct Messaging when they transition a patient or refer a patient to another provider or organization. B2 involves first creating the care summary file, which is required to have a minimum field set as well as be formatted in a certain XML format that all other health record systems will understand. And then secondly, transmitting the document via Direct Messaging. The objective requires that the messages are sent using the Direct Protocol which uses secure direct mail addresses and encryption exchange between the servers.   

Electronic Health Record systems can have a separate “Direct inbox” for sending the message or many implement a Send button right from the Chart workflow for the provider – making transfers of chart records streamlined. Some HISP/Direct Messaging vendors (like MDToolbox) offer an API or web services that allow sending the message from anywhere in the application per the EHRs needs. This allows an EHR testing on B2 to have a process that creates the care document and attaches it to a Direct Messaging email for the provider that not only meets the criteria but is a huge benefits to the end users. When the message is sent it becomes encrypted and can only be decrypted by the intended recipient’s system, keeping the patients data safe and secure.

 2) 170.314(b)(1) Transitions of care – receive, display and incorporate transition of care/referral summaries

In Stage 2, providers must also be able to receive these CCD/CDA and other care summary files from other providers and facilities. The first part of the criteria basically just requires having the ability to receive Direct messages. The messages can be received in a standalone inbox provided by your HISP or an embedded inbox within the EHR. Secondly, for this criteria, the EHR must be capable of displaying the received files (most of them XML formatted) in “Human Readable” or a nice formatted output for providers. The EHR needs to apply a stylesheet or other formatting so that the provider can see what was received for many types of files including the CCD/CDA, and other files like CCR (a different XML format).  And finally the criteria also involves incorporating the received attachments. The EHR must be able to upload both the document itself, and for CCD/CDA files be able to allow clinical information reconciliation of things like allergies and problem lists (allowing providers to optionally import data elements to the chart).

Electronic Health Records can incorporate an inbox right inside of the EHR with built in tools for incorporating when signing up with a HISP that offers an API/Web services (like MDToolbox). This gives huge benefits to the provider and makes this their most important (and best) inbox they monitor on a daily basis. With a few clicks, referral charts can be reviewed and filed in the electronic chart.

 3) 170.314(e)(1) View, download, and transmit to 3rd party

In Stage 2, patients must also have access to their CCD Summary of Care files and chart data. Not only do EHRs have to add the ability to view and download the summary from their “patient portal”, but they also need to give patients and their authorized agents the ability to securely transmit the care summary to other providers. The Transmit of the data is required to be done through direct messaging. Some third party vendors patient portals come with direct messaging, but for EHRs that have their own patient portal this becomes a challenge. EHRs must give their patients a new “Send” button that would allow entering another provider or facilities direct address and send it via the secure Direct messaging method.  

As thousands of providers and facilities around the country start taking advantage of the secure “Direct” messaging, it really gives them more than just a couple of check boxes on their meaningful use attestation - it’s a new and better way to transfer records, discuss patient care and communicate. It's more secure, more efficient and can be a great time saver over the traditional communication methods. 

Want more info on Meaningful Use or Direct Messaging API with MDToolbox? Check out our Direct Messaging page and contact us today at info@mdtoolbox.com. 

 Stay tuned for more posts in our 5 Part Direct Messaging Blog Series:

1. Direct Messaging 101
2. Top 5 Benefits of Direct Messaging
3. Direct Messaging and Meaningful Use Stage 2 – Transition of Care (this article)
4. How does Direct Messaging work – Details on how PHI stays secure
5. Direct Messaging and Data Exchange:  What types of files and data can EHRs exchange?

Last week we covered the basics of what Direct messaging is in the healthcare field.  This week we focus on some of the biggest benefits of using Direct messaging. 

1.     Improves Care Coordination

By eliminating the need for outdated communication methods, such as faxing and mailing, and enabling electronic health information exchange with Direct messaging, communication is greatly improved between health care providers. Protected Health Information (PHI) is not only easier to send and receive electronically, but faster.  Instead of waiting for a fax or even worse, snail mail, Direct messaging allows for sending and receiving information almost instantaneously, increasing the efficiency and effectiveness of care coordination. 

2.     Secure

Faxes and envelopes could fall into the wrong hands.  Direct messaging increases the security of sending PHI information by encrypting messages and files and ensuring they are only accessible by the intended recipient.   

3.     Increases Workflow

When a patient’s information is sent by mail or fax, it still needs to be manually entered into the provider’s EHR.  By sending the information electronically, Direct messaging eliminates the need for this data entry and reduces the administrative workload.  Providers can spend more time with their patients, and less time on paper charts. 

Some Direct messaging systems, like MDToolbox-Direct, can also be integrated right into an EHR's workflow.  This increases the workflow even further by allowing providers to send and receive Direct messages in their EHR without having to log into a separate system, as well as incorporate any received information into the patient’s chart right at the time of receiving it. 

4.     Saves Money

In addition to the time saved with Direct messaging, providers can also save money by not having to pay for faxing or postage.  Furthermore, with the improved communication between providers that Direct messaging provides, duplicate procedures and tests can be avoided. 

5.     Reduces Errors

Direct messaging ensures clear and more complete information reaches the correct locations. Illegibility issues due to faxing or handwriting are eliminated by sending the information electronically and providers can be confident the information they send and receive is accurate.

Another huge benefit (and a main factor in the growth of Direct messaging) that we left off this list is that using Direct messaging meets Meaningful Use Stage 2 requirements.  We want to feature this benefit and so in our next Direct messaging blog series post, we delve into this topic in great detail.  Here’s a look at what other topics we have in our series:

5 Part Direct Messaging Blog Series: 

1. Direct Messaging 101
2. Top 5 Benefits of Direct Messaging (this article)
3. Direct Messaging and Meaningful Use Stage 2 – Transition of Care
4. How does Direct Messaging work – Details on how PHI stays secure
5. Direct Messaging and Data Exchange:  What types of files and data can EHRs exchange?

At MDToolbox, we focus on providing easy-to-integrate Meaningful Use tools.  We recently expanded our product offerings to include MDToolbox-Direct, a Direct Messaging Module that meets Meaningful Use Stage 2 criteria.  With our flagship product, MDToolbox-Rx, we focus on sending and receiving e-Prescribing messages between providers and pharmacies.  We are excited now to be able to facilitate a different type of messaging - Direct messaging.  So, what exactly is Direct messaging?

What is Direct Messaging?

Direct Messaging is a secure way for healthcare providers and organizations to send clinical messages and exchange Protected Health Information (PHI).  Providers and organizations can send secure electronic messages to each other, including attachments such as Continuity of Care Documents (CCD) files, Referral Documents, images such as X-rays, and other types of medical files.  This eliminates the need for using less secure methods that can put patient data at risk such as faxing, e-mailing, phoning, or standard mail. 

How is Direct Messaging different than email?

Direct messaging sounds very similar to regular email, and generally speaking, it is.  Providers and organizations have a Direct address (just like an email address) that they send and receive messages to/from.  However, there are some very important differences.  Direct messaging requires all users to have a designated Direct address that can send and receive authenticated, encrypted messages.   All messages and attachments sent must meet certain encryption standards that allow only the intended recipient(s) to decrypt and read the messages and attachments.  These standards were developed by the Office of the National Coordinator for Health Information Technology (ONC) as part of the Direct Project.

What is the Direct Project?

The Direct Project is an open government initiative that was started in 2010.  The purpose of the Direct Project is to create a set of technical standards, protocols, and services for secure, point-to-point electronic healthcare messaging.  The ultimate goal is to create advanced levels of interoperability by having all healthcare systems use the same Direct standards and protocols. This will make it is easy for healthcare providers and organizations to directly exchange information, no matter what software system they are using.  For further information on the Direct Project and the specific technical requirements, check out http://directproject.org/ 

How do I get Direct Messaging?

Organizations called Health Information Services Providers (HISP) provide the Direct addresses to providers and organizations and facilitate the encrypted messaging.  So instead of an email provider like Google or Outlook handling the message exchange, a HISP is responsible for securely routing and encrypting/decrypting the messages.  MDToolbox has partnered with Surescripts, a trusted industry leader, to provide HISP services and our MDToolbox-Direct module can be utilized stand alone for providers and organizations or easily integrated with EHRs and other Health IT systems. To find out more contact us at info@mdtoolbox.com or use our contact page. 

 Stay tuned for more posts in our 5 Part Direct Messaging Blog Series:

1. Direct Messaging 101 (this article)
2. Top 5 Benefits of Direct Messaging
3. Direct Messaging and Meaningful Use Stage 2 – Transition of Care
4. How does Direct Messaging work – Details on how PHI stays secure
5. Direct Messaging and Data Exchange:  What types of files and data can EHRs exchange?