DirectTrust workgroup takes aim at secure clinical messaging shortcomings

New recommendations from a DirectTrust workgroup aim to improve Direct messaging capabilities, calling on EHR software vendors to address significant gaps in clinical messaging usability and security.  

The new recommendations, released in a report (PDF) by the DirectTrust Clinicians’ Steering Group, include a range of clinical messaging issues for organizations utilizing Direct Interoperability standards, which remain “poorly understood by many clinicians.”

Direct messaging standards are included in the Interoperability Standards Advisory published by the Office of the National Coordinator for Health IT (ONC) and were integrated into the CMS Meaningful Use program in 2014. The ONC’s Direct Project, launched in 2010, has focused on providing guidance for secure clinical messaging.

The report, which is open for public comment until March 30, separated the recommendations into three categories: Required/urgent, highly desired/future priority and advanced/future development. The most pressing features include automatic triggers, standardized terminology and the ability to link messages to other aspects of a patient’s EHR.

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“Right now, in the typical medical community, there is great diversity in the brands of EHRs and other health IT systems used by clinicians for Direct messaging,” Steven Lane, M.D., clinical informatics director at Sutter Health and co-chair of the Clinicians Steering Workgroup, said in a press release. “We’re calling for all these vendors to make available more consistent and standardized software features to manage Direct clinical messages and their attachments. The existing variability in usability among different vendors’ products is unacceptably high and poses a barrier to Direct interoperability, and thus to the adoption of secure messaging by clinicians to support common care coordination workflows.”

The report noted that some vendors have already incorporated some of the recommendations, but urged EHR manufacturers to use the list as a reference document for improving secure messaging features.