AN HIE TESTS SIMPLE INFORMATION
EXCHANGE USING THE DIRECT PROJECT
Some HIEs were surprised when the federal government announced a
project to enable direct provider-to-provider information exchange. But
CareSpark, an HIE piloting the lightweight exchange method, is seeing
the benefits for users and a logical integration into the services it offers.
By Chris Voigt and Susan Torzewski, RHIA
HEALTH INFORMATION EXCHANGE (HIE) has long been
touted as a silver bullet, streamlining patient transfers, reducing duplication, enlightening population health, and generally
improving health outcomes. It promises to connect clinicians,
empower patients, feed data repositories, and trigger decision
support alerts from a community-wide set of patient records,
among other things. Critical to these solutions is an HIE network that is broadly adopted within a patient community and a
rich flow of discrete clinical information.
Up until five or so years ago, most health information was exchanged via complex, highly customized interfaces, within the
boundaries of a single hospital or hospital system. Yet information exchanges that once required teams of interface developers, convoluted data flows, and multifarious data transformations are themselves evolving. Recent strides in the definition
and utilization of standards have led to a more standardized,
“plug-and-play” environment for exchange.
As a result, information exchange is becoming a broad-based
solution, not just linked to a specific research effort, business
function, or project. As the technology has taken steps forward,
so has the business of healthcare delivery, requiring health IT
to simplify information exchange and promote the flow of data
across applications and across organizational boundaries, care
settings, and circles of trust. The Direct Project is one of the new-est efforts in simplifying exchange technology to support that
The project is sponsored by the Office of the National Coordinator for Health IT (ONC) but led by volunteers in the industry.
Direct offers a simple, nonproprietary solution for direct information exchange between two healthcare entities. CareSpark,
an HIE serving northeastern Tennessee and southwestern Virginia, is having early success with Direct in a pilot test with the
Department of Veterans Affairs.
The Direct Project
Many of today’s interoperability constructs lack the fundamental elements to proactively send a simple message from one
provider to another, much like the ubiquitous fax machine does
today. The standards can summarize a patient record or event
or allow a provider to query for records across a community. Yet
fax, courier, patients, mail, and other sneaker-net types of exchange still predominate in the field.