VA expands data sharing with private providers with DirectTrust

The Department of Veterans Affairs received new accreditation from the nonprofit group DirectTrust that will expand data sharing and improve care coordination. (eggeeggjiew/Getty Images)

The Department of Veterans Affairs is improving its data-sharing capabilities with VA hospitals and private sector providers with new accreditation from the nonprofit association DirectTrust.

The VA has joined DirectTrust’s accredited trust anchor bundle, enabling VA clinicians to more easily coordinate care with the 1.8 million providers that are already part of the bundle. The development will improve care coordination between the VA and private healthcare providers, VA and DirectTrust officials said.

DirectTrust is an association that brings together healthcare providers, insurers and technology vendors as part of the Direct exchange network. Direct is a technical standard to exchange patient data.

The VA has been a member of DirectTrust and one of its accredited network operators since September 2015, according to Scott Stuewe, DirectTrust president and CEO. However, until now, the VA needed to negotiate separate connections in order to “trust” facilities outside the VA for clinical information exchange, he said. 

The key value proposition of this accreditation is to facilitate data exchange between organizations in a uniform and scalable manner that is consistent with industry best practices for security and trust, thereby avoiding the need for further one-off negotiations, according to Stuewe.

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“The addition of the VA to the accredited trust anchor bundle means that it will be much easier for doctors and care coordinators in the VA to securely exchange health data with the private sector without special effort,” Stuewe said.

He added, “This is an important milestone for the VA on its health IT modernization journey. We applaud the VA’s arrival in the fold.”

“This is a major step to increase care coordination with community (non-VA) providers who also provide care for our veterans,” said Margaret Donahue, M.D., director of the VA’s Veterans Health Information Exchange program, in a statement. Donahue noted that this new development will open significant new opportunities for VA personnel to securely share veterans’ health information using the Direct standard in every community in the country.

Use of the DirectTrust trust framework enables a single trusted “on-ramp” for providers exchanging health information across a network that currently connects over 1.8 million providers using over 350 certified electronic medical records nationally, Stuewe said.

Direct message transactions increased by 63% in 2018 with steady growth in the number of healthcare organizations utilizing Direct exchange over the past year, the organization reported. In all, there were nearly 274 million Direct message transactions between DirectTrust addresses in 2018, a significant increase from the 2017 total of 168 million transactions,

“Admission to the DirectTrust accredited trust anchor bundle certifies that an organization has established and upheld a superior level of trust for its stakeholders, which is a significant distinction,” Stuewe said. “Inclusion in the bundle means that all of these parties are immediately reachable by their Direct address—a special email address that can only connect to the parties that an organization trusts based on their known inclusion, accreditation, and compliance with the trust framework and standards.”

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Likewise, community providers are able to communicate with the VA, and its Direct addresses will be available to look up in the DirectTrust directory. 

The Mission Act, which Congress passed in June 2018, allows veterans to see private physicians for primary or mental care if they live up to 30 minutes away from a VA facility or face up to a 20-day waiting period to receive care.

To facilitate care coordination, it is important that electronic health information be accessible to these private sector practices, hospitals, and other facilities, Stuewe said. “Referrals to community providers and the return of information about care received in the community are one way this full participation in the DirectTrust network can transform how healthcare is delivered for veterans,” he said.