{"id":3761,"date":"2017-02-10T09:38:08","date_gmt":"2017-02-10T14:38:08","guid":{"rendered":"https:\/\/knowlegebase-b5heb6b2esbghgd4.eastus2-01.azurewebsites.net\/?post_type=ht_kb&p=3761"},"modified":"2025-04-15T18:04:13","modified_gmt":"2025-04-15T22:04:13","slug":"direct-faqs","status":"publish","type":"ht_kb","link":"https:\/\/knowlegebase-b5heb6b2esbghgd4.eastus2-01.azurewebsites.net\/?ht_kb=direct-faqs","title":{"rendered":"Direct FAQs"},"content":{"rendered":"Est. reading time:<\/span> < 1<\/span> minute<\/span><\/span>\n

DataMotion™ Direct allows healthcare providers to send and receive Protected Health Information (PHI) with other Direct address holders to meet MU2 requirements, comply with HIPAA, and enhance health information exchange.<\/p>\n

Check out the frequently asked questions<\/a> about DataMotion Direct, below.<\/p>\n \t\t

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What is Direct Secure Messaging<\/div>\r\n \t\t\t
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The Direct Project established a set of standards to support workflows in which a patient transitions from one health care provider to another. Direct Secure Messaging (Direct) allows an EHR user to “push” a patient’s information to a clinician and for that clinician to receive the information in his or her EHR. “Push” refers to sending a patient’s information proactively, as opposed to a \u201cpull\u201d model, which information is requested when needed. Direct uses Public Key Infrastructure (PKI) to establish trust between its participants by applying digital certificates.<\/p>\n

There are many ways to initiate a Direct Secure Message:<\/p>\n

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  1. XDR<\/strong> (Cross-enterprise Document Reliable Interchange) – This method uses a web service according to specifications defined by Integrating the Healthcare Enterprise (IHE). XDR requires an established relationship between the sender and receiver through a certificate exchange. DataMotion can establish one destination to send XDR Messages to (Endpoint) per company.<\/li>\n
  2. SMTP Native Connection<\/strong> (Simple Mail Transfer Protocol) – This is the protocol used to send email over the internet, and the Direct Project added message-level encryption for use in healthcare. SMTP provides a means of discovering how to route a message based on the recipient\u2019s address, using Domain Name System (DNS) services, so you don\u2019t need an organization record for each recipient\u2019s organization. DNS, like SMTP, is a staple of Internet connectivity.<\/li>\n
  3. SMTP Web Interface<\/strong> (DataMotion Direct Messaging Portal) – While utilizing the same DNS and Lookup process as native SMTP, DataMotion provides a full featured web interface for sending and receiving Direct messages.<\/li>\n
  4. API<\/strong> (Application Programming Interface) – These are a set of programming instructions and standards for accessing a Web-based software application. DataMotion has a full suite of APIs available for implementing an integrated experience with your application. These APIs allow you to create new messages, verify sent messages, manage users and more. Messages are still delivered via SMTP through the Direct Protocol.<\/li>\n<\/ol>\n

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    What is Direct address<\/div>\r\n \t\t\t
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    A Direct address is used to route a Direct message to a specific recipient. It looks just like an email address and, like email, has two parts separated by an \u201cat\u201d (@) symbol.<\/p>\n

    Before @ is the local part<\/strong> of the address. The local part lets the health care organization receiving a Direct message know what user or In Basket pool should get the message. After @ is the domain part<\/strong>. The domain part serves two purposes:<\/p>\n

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    1. The domain lets the system sending a Direct message find the system to which it should send that message.<\/li>\n
    2. If the message is being sent through a HISP (see below), the domain lets the HISP know to which of its members the HISP should route that message.<\/li>\n<\/ol>\n

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      What is Health Information Service Provider (HISP)?<\/div>\r\n \t\t\t
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      A Health Information Service Provider (HISP) is an intermediary that routes Direct Secure Messages to and from your organization.<\/p>\n

      When a HISP sends a Direct Secure Message, it will:<\/p>\n

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      1. Use DNS (Domain Name System \u2013 A service that translates domain names into IP addresses) to look up the server that the HISP should send the message and the certificate the HISP should use to encrypt the message.<\/li>\n
      2. Check whether the HISP trusts the recipient’s digital certificate. If it does not, the HISP rejects the message.<\/li>\n
      3. Encrypt the message using the recipient’s certificate.<\/li>\n
      4. Sign the message using the sender’s certificate.<\/li>\n
      5. Send the message<\/li>\n<\/ol>\n

        When a HISP receives a Direct Secure Message, it will:<\/p>\n

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        1. Check that it trusts the certificate used to sign the message. If it does not, the HISP rejects the message.<\/li>\n
        2. Decrypt the message.<\/li>\n
        3. If it is a third-party HISP, use the domain part of the Direct address to determine which of its member organizations is the intended recipient and send the message to that organization<\/li>\n<\/ol>\n

          Note that if two organizations happen to share the same HISP, the routing is simpler. In that case, the HISP would receive the message from one of its members and send it directly to the other member.<\/p>\n

          When you communicate with your HISP using XDR, DataMotion as a receiver\u2019s HISP will use Direct SMTP to communicate with the rest of the world as illustrated in the diagram below.<\/p>\n

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          \"\"<\/a><\/div>\n<\/div>\n

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          Is a HISP always needed for sending or receiving a Direct Secure Message?<\/div>\r\n \t\t\t
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          Yes.<\/p>\n

          A HISP not only provides the actual software for sending messages it also provides a suite of other services required \u201cbehind the scenes\u201d such as DNS hosting, certificate lookup and the rights of being part of the DirectTrust bundle(s).<\/p>\n

          A DirectTrust Bundle is a collection of trust anchors (high level digital certificates utilized to establish initial trust during Direct exchange, as opposed to end-entity Direct certificates) that meet a common set of minimum policy requirements within a Trust Community Profile.<\/p>\n

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          What is included in DataMotion's Direct product\/service offering?<\/div>\r\n \t\t\t
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          \r\n \t\t\t\t\t<\/p>\n

          DataMotion is a full service HISP for Direct, compliant with the Direct Project Protocols, with products\/services including:<\/p>\n