Direct messaging not yet widely adopted by physicians

(HealthDay)—Direct secure messaging (Direct), which is a standardized protocol for exchanging clinical messages and attachments, has not been widely adopted by physicians, despite its potential for improving care coordination, according to an article published in Medical Economics.

Despite government promotion of the secure messaging protocol, there has been slow uptake of Direct. The latest electronic health record certification requires Direct messaging capability, but physicians who use Direct seem to be doing so mainly to meet meaningful use incentives.

According to the article, barriers to Direct include lack of education about the technology, costs, and technical difficulties such as only accepting messages that have attachments in a specific format. Physicians must have a Direct address to receive messages and the Direct address of their trading partners, but finding addresses can be challenging. Direct allows for fast and easy communication, but much of the communication already takes place via e-faxes, which are encrypted and Health Insurance Portability and Accountability Act (HIPAA)-compliant. However, Direct messages are more secure and fall under the HIPAA security rule as well as the privacy rule. Secure texting via Direct allows easy communication with other specialists and follow-up of patients.

"The lesson of secure texting is that when a new technology is simple to use and meets an immediate need, physicians will use it," according to the article. "Direct messaging is nowhere near as intuitive and simple as regular e-mail or Facebook."

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