Webinar: Come implementare una campagna di direct marketing di successo
What is Direct Webinar
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Direct Secure Messaging
Communicating in the Healthcare WorldAndy Nieto, Health IT Strategist, DataMotion
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Agenda
• Email and Direct in healthcare, a little history
• So what is Direct, really
– Certificates
– PKI
• Two forms of Direct
– Provider to provider
– Provider to patient
• Controls in place
• Direct ecosystem
• Integrating with Direct
• A look forward
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Evolution of healthcare IT
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1972 First EHR Introduced
1996 HIPAA
2001 EHR system usage at 18%
2003 HIPAA Security Rule
Feb 2009 HITECH - ARRA
2013 Meaningful Use 2 Rules included Direct
2011 Meaningful Use Stage 1 attestation begins
Jan 2013 Final HIPAA Omnibus ruling
2014 attestation for Meaningful Use 2 begins
1971 first email sent
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Email in healthcare - 2008
“The Privacy Rule allows covered health care providers to communicate electronically, such as through e-mail, with their patients, provided they
apply reasonable safeguards when doing so”(http://www.hhs.gov/ocr/privacy/hipaa/faq/health_information_technology)
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2013 refinement of HIPAA
• Privacy concerns
• Security concerns
• BAA – who is liable
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Looks like email, acts like email –but ONLY for healthcare
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You may end up with multiple Direct addresses.
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So what’s the difference: Standard Email versus Direct
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Standard Email
Standard message protocol
Internet delivery
Direct
Standard message protocol
Internet delivery
Identity validation
Secure encryption
End-to-end trust & liability
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What is Direct Secure Messaging
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Sender
Direct (SMTP/SMIME)
Identity Validation
Secure Messages & Files
RecipientReceiving HISPSending HISPMobile Device
EHR System
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The KEY - X.509 Digital Certificate
• Registration Authority (RA) confirms identity
• Certificate Authority (CA) issues certificate
• Healthcare Information Service Provider (HISP) manages certificate
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What is PKI or public key infrastructure
Let’s say your safe deposit box is the information to be encrypted.
• Public key (bank’s key to safe deposit box)
• Private key (your key to safe deposit box)
Both are required to open and close the box, allowing you to see what is inside.
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PKI with Direct
• Sender and receiver trust validated (identity confirmed with certificate)
• Message encrypted with receiver's public key
• Encrypted message sent via Internet to recipient
• Receiver’s private key used to decrypt
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2 types of Direct
• Provider to Provider
• Provider to Patient
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Between providers
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[email protected](Has been identity vetted, has X.509Digital certificate bound to address.)
[email protected](Has been identity vetted, has X.509Digital certificate bound to address.)
EHR EHR
encryption
identity validation
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Between provider and patient via PHR or portal
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[email protected](Has been identity vetted, has X.509Digital certificate bound to address.)
[email protected](Has been identity vetted, has X.509Digital certificate bound to address.)
encryption
identity validation
EHR PHR
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Blue Button®
health record retrieval system
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‘Blue Button’, the slogan, ‘Download My Data’ the Blue Button Logo, and the Blue Button Combined Logo” are registered Service Marks of the U.S. Department of Health and Human Services
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Who is in charge
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ONC’s view of Direct
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Focus view
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HISP
Integration
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Integration pathways for Direct
XD* interface
Email client
Web portal
Web service
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POP & SMTP
APIs
HTTPS://
Typically to an EHR or HIE
Not directly to a user
Typically to an EHR or HIE
Not directly to a user
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Is there a Provider Directory
• Multiple addresses per provider
– EHR
– HIE
– Hospital
– Association
• XD connections don’t require mailboxes
• No universal directory format
• Cellphone directory? Email directory?
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How do I know it was delivered
• Message Disposition Notification (MDN)
– Dispatched
– Processed
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The success view
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Certification
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Direct today
• 44 States have adopted Direct
• Major Growth*
*as reported by the Direct Trust May, 2014
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Who is Using Direct
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What does the future hold
• Standard for healthcare communication and dialog
– EHR, HIE and Public Health Integration
• Patient engagement
– Self-reporting
– Syndromic surveillance support
• Product integration
• Electronic Submission of Medical Documentation System (esMD)
• eSigning – Digital Certificate as Identity
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Thanks
Andy Nieto
Healthcare IT Strategist
973-455-1245 x240
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