Home Forums Discussions Meaningful Use Direct Messaging

Anyone using direct messaging addresses to send 10% of clinical summaries to other providers? What secure address do you use? I have one for AC, and another in Updox. And then, how do you implement it? Do you basically set up a portal for each other provider to whom you wish to share clinical summaries? I have looked in AC and Updox documentation but have not found out instructions yet.

Thanks,

Jack

how did you get a separate secure message address for AC?

We only have one physician which we do this regularly with since they have Updox. Others have closed systems or no system at all. I have yet to call a local office and anyone know what I'm talking about save the the one who we communicate with and one whose office manager says shes been trying to get this going but gets no support for it from the practice.

We're still struggling to get it to work with our local referral group. I'm not even going to attempt Direct Messaging with the local hospital network until we get the first connection figured out.
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L. Kies
Eagle Family Health
Nora Spring, IA

As you know, this is required apparently for Meaningful Use step II, so perhaps the Updox or AC Guru's could provide some direction.... Thanks for your replies!

Hi Jack,
The secure messaging is like "email" but on a secure network rather than regular email (which is bounced from server to server before reaching its destination). Each person (the sender and the receiver) has to have a secure direct address. This is on each practice to have this set up. If you are trying to send a secure message to a practice that does not have a secure address set up, then you will not be able to do so (think of it as trying to send a fax to someone who doesn't have a fax line, just a regular telephone line.. You can try, but its not going to happen).

So assuming both you and the practice have secure direct addresses, and you have been vetted by the Direct Trust (click your "Secure" button in AC, then "Menu-Tools-Direct Trust Activation"), then you can send your secure message to that person. I have made a video on how to complete this task and get credit for MU2. It is located here: MU2 Core 15: How To

If you run into any issues, reach out to me personally and I will see about getting an MU specialist to log in with you and walk you through this.

Secure button in AC?? What version is this on?

thanks Mark, but after viewing your video I think it would be faster for me to go to Rhode Island and dig you out of all that snow....

Please do, Todd! 2.5 Feet at the end of last week, plus another foot on Monday, with 2 more storms inbound. I don't mind a little snow, but this is getting ridiculous.

Mark, where can I get a detailed report for the reason for needing a credit card. Our physicians are suspicious of giving a credit card information to anyone. What can I hand them to read.

Hi Omar,

I will check with Updox on the reasoning behind the Credit Card. From my understanding it is an easy way to validate who you are, which is the reasoning behind the Direct Trust activation. I would sometimes have to do these when I worked in retail. Back then it was to make sure the information was valid that they were who they claimed for renting equipment.

Send me a PM with your email and I will see what I can dig up for you.

Not to confuse the issue, but if you have the paid version of Updox, I believe we do this without the credit card.

So I checked with the guys at Updox. They understand the concerns about entering credit card information and were already working on a new vetting process that has since gone live. Here is what they had to say:

"For DirectTrust, we are required to validate two forms of ID. The first one must be government issued and the second one must be financial/utility related. Since identity verification across the public sector is relatively new we are limited in the types of IDs that can be verified remotely. For example, a driver?s license would be an excellent government issued ID but some states don?t allow access to that info, other states only do if the person opts in.

Here are the ID options available in our new release:
? Government ID
o National Provider ID (NPI)
o Social Security (SSN)
? Financial/Utility ID
o Home telephone
o Personal knowledge questions
o Personal credit card

They do have some new documentation for this new process as well, that is located here: http://updoxdirect.com/docvetting-otherehr/WebHelp/index.htm

I hope this helps.

When an office sends information to the direct address where does it come in at?

Can Direct Messaging be set up and used in conjunction with AC without using Updox?

For example some of my patients have Microsoft HealthVault accounts. If I have Direct Messaging set up could I send a CCD to them at their HealthVault Direct address?

Cirrae: When someone sends a direct message to the address, you can click on the "Secure" button on the main screen of AC to see the message.

Endo: Updox is the program that allows us to direct message out of the program. That being said, you do not have to have the full version of Updox to use the direct messaging or portal. With V7 and above, you can simply activate the portal through the admin options and star using the features (Click here for a walk through on setting it up and using: Patient Portal ) As far as sending the CCDA directly to the patients HealthVault account, that cannot be done and still get credit for Meaningful Use. The only thing you could send to them would be a transfer of care document. I am not sure how this functionality will be built out in the future, but if you have a product request like that, you can click on "Help" and "Recommended Improvements" in the AC program and fill out the form. Those go directly to Chris Conrad, who has posted on the board before. That is the best way to tell the developers what you want to see in the program.

Thanks for the answer Mark, very helpful.

so I am doing this , expect to be able to meet the 10% when I choose my 3 month period but am not working it right now
I had to bug my biggest volume referral partner ( GI for colonoscopy ) until they got a DIRECT address
Have two referral practices now that I can DIRECT to
the DIRECT referral process in AC takes a little more time than faxing but seems to work fine
the practices in question set someone from their giant team to check the inbox a few times a day
eCW practices have their own DIRECT addresses ( if you are NY and lots of eCW people there) but they wont let non eCW people get on their DIRECT TRUST bundle)
so the eCW specialists here had to get another direct address from the TRUST network so I could DIRECT with them( you need to satisfy requirement to be able to DIRECTly communicate with providers with a different EMR )

Yeah, I was reading about eClinical blocking access from non-users. Which defeats the purpose of the DIRECT project and having DIRECT addresses. Because anyone can make a closed system for DM for their own users.

The only 2 DIRECT addresses we have are 2 other practices using Updox. They are both GIs.

Is anyone here using Direct Messaging to communicate with other physicians? No one that we know even knows of Direct Messaging. So the only physician that we communicate electronically with is a GI, David Feldman, who uses AC and Updox. And so we really are just using his Updox capability but not necessarily his Direct address.

We would like to use it because I'd much prefer consultation notes to be sent to Updox rather than me having to stop and actually open and envelope and scan a document (oh, I've gotten so lazy over the years).

Here is an article from this month's Medical Economics on adoption of Direct Messaging.


http://medicaleconomics.modernmedicine.com/medical-economics/news/how-get-started-direct-messaging?page=0,0

Due to recurrent problems with our digital fax setup [brother mfc], We sent invitations to a number of local private docs and surprisingly many of them signed up. So we get a fair amount of correspondence via direct messaging;

I sent out some DIRECT invitations a couple days ago and received 0 responses. oh well.

Out of curiosity, I tried the directory search capability in Updox using the web app.

I keyed my search on "direct" and "new york" attempting to find direct addresses in new york city. I received 2 results.

This DIRECT messaging service is federally sponsored project that is supposed to allow physicians to securely send patient health information to other physicians, regardless of what EMR/EHR platform they are using. So if the PCP is using AC, and the GI is using Practice Fusion or Epic or eClinical or Fred's EMR they can still easily exchange patient health information.

It seems that some (or perhaps Many) EMR/EHR vendors are intentionally blocking this capability and configuring their systems so that they can only send messages to other users of the same EMR/EHR.

Alice has started working part-time at this clinic that uses Practice Fusion. I got her set up on Direct messaging. I then sent her a direct message from Updox using our direct address. She received this and can reply to it. But....
s
1) She cannot add the sender to an address book, and once she replies the message disappears from her inbox.

2) She can only initiate a direct message to other Practice Fusion users. Now, this clinic does not have in-house specialists. So lets say she wanted to refer a patient with abdominal pain to a GI. The GI uses AC (or Epic, or just NOT PRACTICE FUSION) as their EMR. She wants to send a copy of the patients labs and sonogram report to him. SHE CAN'T.

She actually has to print all of this stuff off an and then fax it. This is just freaking ridiculous! I've now read that eClinicalWorks does the same thing. Then some other EMR has some silly configuration where you can only send a Direct message if you attach a CCDA.

I'm curious if any other EMR vendor other that AC is actually cooperating with this. If they aren't, it is a waste of my time. I'd like to ask if a few of you guys (and gals) are working at a second facility that uses a different EMR and has direct messaging, to please try and send me a direct message. About anything. Just a test message.

My direct address is: waynempc@doctorcoghill.amazing-direct.com

Thanks guys!