Electronic health records (EHRs) give providers instant access to all the patient health information stored within their system, from lab results and prescriptions to medical history and progress notes, anytime and anywhere. Yet currently there is no widespread method to electronically send patient health information between two EHRs from different vendors or between unaffiliated provider systems — so when information needs to be shared, the digital record is often printed and faxed. CHCF, in collaboration with Palomar Health and Sujansky and Associates, are testing a better way.

The DIRECT protocol is an open source set of standards for the secure exchange of medical records between different EHR systems. Based on secure electronic messages similar to emails, the DIRECT protocol has been proposed as a national standard to enable EHR interoperability.

Phase 1: Pilot Evaluation

To test its technical and operational feasibility, the DIRECT protocol was used to transmit clinical summaries generated during hospital-based emergency department (ED) visits to the patients’ community-based primary care provider.

The 10-week pilot included three hospitals and six outpatient provider groups, ranging from 1 to over 50 physicians. An evaluation of the pilot by Sujansky and Associates found that while it is feasible to use DIRECT messaging to share health data electronically, adoption may be limited by the lack of messaging software within current EHR systems. The full evaluation is available as a Document Download.

Phase 2

Palomar Health and Sujansky and Associates are testing the DIRECT protocol and other technologies to reliably deliver lab results to community primary care providers. The pilot could potentially help reduce the cost and complexity of electronically delivering lab results to EHR systems. An evaluation report for Phase 2 will be available in late 2014.