Direct Secure Messaging

Direct Secure Messaging is an encrypted email tool that allows clinicians to send protected health information about their patients through a secure encrypted network. It is done through a standards‐based protocol called the Direct framework. The N.C. Health Information Exchange Authority offers this value‐added service at no charge to full participants in NC HealthConnex, the state-designated HIE.

Direct is a national encryption standard for securely exchanging clinical health care data via the Internet. It is also known as the Direct Project, Direct Exchange and Direct Secure Messaging. It specifies  the secure, scalable and standards‐based method for the exchange of PHI.
 

Direct Secure Messaging improves coordination of care between health care providers and their patients by providing the ability to securely communicate with other health care providers. Instead of mailing or faxing your patient’s information, which could take hours or days and is not secure, DSM enables sending and seeking information about your patient’s health record within minutes. DSM gives clinicians timely clinical details and helps address the significant gaps in information that occur during transitions of care. These are just a few key clinical documents for which DSM can be used:

• Transitions of care (CCD, CCD‐A documents)
• Lab tests/results
• Referrals
• Reports
   

All full participants in NC HealthConnex can sign up for this feature at no cost. NC HealthConnex leverages Secure Exchange Solutions as its health information service provider. Your Direct Secure Messaging account can either be integrated into your electronic health records system or accessed through the NC HealthConnex Clinical Portal. (Note: Additional fees apply for EHR integration.)

If you would like a DSM account, please reach out to your facility's NC HealthConnex participant account administrator to request an account be created. If you do not know how to reach your PAA or have general questions about DSM, please contact the HIEA team at hiea@nc.gov or call (919) 754‐6912.
 

NC HealthConnex participants have the option of using either Direct Secure Messaging Web or Direct Secure Messaging XDR (integrated with electronic health records).

DSM Web users access this messaging service through the messaging center within the NC HealthConnex Clinical Portal. Currently, the NC HealthConnex Web DSM service allows you to send messages to providers with DSM accounts across North Carolina and to receive messages from providers across the nation based on our directory setup.

A future enhancement will replace the NC Provider Directory with the national Direct Trust directory. This will allow any valid DSM address nationwide to be searched for and selected to both send and receive messages.

DSM XDR is a DSM service integrated within the participant's electronic health records system, allowing users to stay within their EHR workflow to send and receive messages.
 

The N.C. Health Information Exchange Authority offers full participants in NC HealthConnex access to the N.C. Provider Directory with the addresses of more than 21,000 health information service providers in North Carolina. The N.C. Provider Directory can be provided to participants as a .csv file upon request. The addresses are also in the NC HealthConnex DSM Web interface for Clinical Portal users.

The Program Year 2019 Stage 3 Promoting Interoperability (formerly Meaningful Use) Criteria require that health care organizations and providers meet data transfer requirements for electronic exchange of transition of care records using Direct Secure Messaging (DSM). These requirements can be demonstrated with electronic health records that comply with the ONC’s 2015 Edition EHR Certification Criteria. See how NC HealthConnex supports the DSM requirements specific to eligible hospitals and professionals and measure specifications for the Centers for Medicare and Medicaid Services’ PI program.