4 Use Cases for Direct Secure Messaging, Data Exchange in Healthcare

ADT Messaging

The CMS Interoperability and Patient access final rule’s admission, discharge, and transfer (ADT) messaging standard condition of participation requires all health facilities to send direct electronic notifications to a patient’s provider once the patient is admitted, discharged, or transferred from another facility.

In February, DirectTrust launched its Implementation Guide for Event Notifications via the Direct Standard, a Draft Standard for Trial Use (DSTU), to address compliance with the new regulations.

“The Event Notifications via Direct Implementation Guide is the shortest path to compliance with the CMS ADT Notifications Conditions of Participation, as it leverages existing Standards and implemented technologies,” Therasa Bell, Kno2 President and CTO, and chair of the DirectTrust IG for Notifications Consensus Body, said in a statement. 

“With Meaningful Use we saw every certified EHR since 2014 implement Direct Secure Messaging, and that fabric has been laid across the United States,” Bell continued. “The Directory has been established to utilize these connections, so there has never been a better time to meet technology where it’s at and take advantage of the tailwind the Direct Standard has already created. I am excited to see the use of Direct for Notifications take off and really make an impact in healthcare.”

DirectTrust facilitated 326 million direct secure messages during the second quarter of 2021, a 130 percent increase from the same time last year, and a 90 percent increase over the first quarter of 2021.

Scott Stuewe, president and CEO of DirectTrust, noted that the organization attributes the upsurge in the use of direct secure messaging in part to CMS’ ADT messaging condition of participation requirement, which went into effect on May 1.

“We’re delighted with the continued steady growth across all DirectTrust metrics, and especially with the significant uptick in Direct Secure Messaging,” Stuewe said in a public statement.

Electronic Case Reporting

Health systems have leveraged Surescripts Clinical Direct Messaging to improve interoperability with public health agencies during COVID-19.

Built using the Direct Standard, Surescripts is accredited under the DirectTrust Accreditation program which recognizes organizations that have met policy requirements and validated HIPAA, privacy, and security compliance standards.

Since February 2020, 41 health systems have leveraged Surecripts Direct Secure Messaging to send over 12 million electronic case reports for COVID-19 diagnoses to public health agencies in 64 jurisdictions.

“It’s clear that innovation and interoperability have accelerated as care providers nationwide battled the pandemic,” Stuewe said in a press release at the time of the announcement.

“The Direct Standard has been put to the test and is helping expand interoperability to fulfill the potential of care management and value-based care programs, bringing timely and secure patient insights into focus for clinicians and organizations across the country,” Stuewe explained.

COVID-19 Vaccination Efforts

Surescripts Clinical Direct Messaging has played a vital role in the country’s COVID-19 vaccination effort by boosting interoperability between pharmacies and primary care providers.

Since December 2020, pharmacies have used the digital tool to send over seven million COVID-19 vaccination notifications to primary care providers.

This electronic data exchange sets to reduce the need for pharmacies to fax paper forms or depend on patients to notify their PCP themselves about their COVID-19 vaccination status.  

"Participants across the Surescripts Network Alliance continue to find innovative ways to leverage existing technology to answer the nation’s call for help with COVID-19," Tom Skelton, chief executive officer of Surescripts, said in a press release at the time of the announcement.

"The increased adoption of interoperable technology like Clinical Direct Messaging helps facilitate the seamless and secure exchange of patient health information, delivering actionable patient intelligence when and where it’s needed most,” he continued.

The vendor’s direct messaging functionality is integrated directly into EHR and pharmacy software workflows, allowing clinicians and pharmacists to exchange information across the care continuum.

In February, President Biden announced the first phase of the federal pharmacy program to distribute vaccines directly to retail pharmacies nationwide.

Many pharmacies, such as Albertsons and CVS Health, integrated clinical direct messaging into their workflows to improve data exchange for PCP immunization notifications.

“We are committed to our customers and communities to deliver timely healthcare solutions, including administering COVID-19 vaccinations,” Omer Gajial, Albertsons Companies senior vice president of Pharmacy and Health, said in the press release.

“We have administered over 5.5 million COVID-19 doses and used Surescripts direct messaging service to report many of them to our customers’ primary care providers,” Gajial continued.

ePrescribing

ePrescribing allows healthcare providers to electronically transmit prescription information to pharmacies through a secure software program and connectivity to a transmission network, according to the Office of the National Coordinator for Health Information Technology (ONC).

Once a pharmacy receives a request for a prescription, it can start filling the medication immediately.

ePrescribing gained momentum when it was introduced in the Medicare Modernization Act (MMA) in 2003. It then became more prevalent when a July 2006 Institute of Medicine report said it reduced medical errors.

ePrescribing may also help cut down on administrative burden by eliminating the need for the use of fax machines, the most common way to traditionally send prescription information.

According to CMS, adopting the standards to streamline ePrescribing is an essential government item to accelerate the building a national health IT infrastructure in the US.

As COVID-19 overwhelmed the healthcare industry, providers have increased their use of ePrescribing to streamline patient care and cut down on administrative burden.

With patients potentially using various health facilities or telehealth to conduct visits, the Surescripts ePrescribing platform hit over 1 million prescribers in August. According to the vendor, this was a 25,000-prescriber increase since December 2019.

As the healthcare industry continues to move towards nationwide interoperability, direct secure messaging may boost data exchange for additional use cases.