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All Things HIT

Feb 15 2011   12:32PM GMT

Direct Project “User Stories” are full of push!

Posted by: AllinHIT
direct project

The Direct Project, a NHIN effort to provide a simplied, scalable, transport method for exchanging PHI will now be tested by the Rhode Island Quality Institue and the Hennepin County Medical Center in Minnesota. However, as I explained to a physician recently who confused the Direct Project with the state HIE, there are limitations to the Direct Project.  It is designed only as a secure mechanism to transport and push PHI between two parties (It could be three parties if there is a Health Information Service Provider or HISP).  For example, this project enables physicians that do not adopt EHR’s, to push PHI to referring physicians. It allows for physicians to push office visit information to their patients, and will enable Critical Access Hospitals to push patient discharge summaries to their personal physician.   Hence, pulling information, such as in a HIE, is not the goal of the project.

The three fore-mentioned “push” scenarios are referred to as “User Stories” by the NHIN. The project is in three (3) stages, each developing transport for different “user stories”, starting with Stage 1 for meeting MU.  The Rhode Island pilot will be testing some stage 1 user stories, physician PHI to another physician.  The  Minnesota pilot will be testing a stage 2 user story, sending immunizations to the State of Minnesota (probably Medicaid data).   Regardless of the maturity of the project, its important to stress the pushing of this data is in every stage, and not the pulling of data.  Hence, a scenario with an unconscious patient in the ED, and a hospital needing PHI to properly care for the patient, the Direct Project can not be accessed to get important PHI, like allergys!  This is a huge distinction, compared with a HIE, and its important to educate physicians on the difference!

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