Direct Messaging
A secure, HIPAA-compliant email protocol used to exchange clinical documents (typically C-CDA) between healthcare organizations.
Direct messaging uses S/MIME encryption over standard SMTP to exchange clinical documents. Each participant has a Direct address (e.g., provider@direct.hospital.org) backed by a certificate from a HISP (Health Information Service Provider). Direct is the primary transport for transitions of care documents, referral letters, and public health reporting. While it looks like email, Direct messages are machine-processable: the C-CDA attachments are parsed and imported into receiving EHRs automatically.
FAQ
- Is Direct messaging the same as regular email?
- No. Direct uses S/MIME encryption, certificate-based trust, and typically carries structured C-CDA documents. It runs over SMTP but requires a HISP and certificates — regular email clients cannot send or receive Direct messages.