OK, it seems I'm a bit behind the times. Yesterday, I mused about a capability based on Direct Project specifications for EHRs to send information to a personally controlled Direct Address, and I immediately learned that it's already happening. That's, incidentally, one of the "emergent" properties of standards: people and organizations independently do innovative things around them. We intentionally designed Direct to be a specification for "any-to-any" secure, universal directed exchange based on a universal address to enable that kind of emergent behavior.
Dr. Paolo Andre yesterday blogged about how he is using the Care360 EHR to send information to a patient's personally controlled health record on HealthVault. This illustrates a number of interesting things:
- We got "rough consensus, running code" starting in July and August, and saw production usage in January/February across a diverse and growing range of systems.
- The same features that Dr. Andre is using to push a patient's information to HealthVault can be used to push information to any PCHR, or to push information to wherever a patient designates (an HIO, a medical home, etc.)
- The same features that HealthVault is using can also be used by any EHR to accomplish the same purpose
- (Not to belabor the point but...) The same features can also be used to send information on transitions of care to other providers, or to push information to an immunization registry, or to receive lab results, or....
- Dr. Andre's example shows the power of both structured and unstructured information. The patient receives a nice narrative and a structured clinical document that can be incorporated into the HealthVault record and reused by any of the HealthVault apps.
To recap across the set of announcements the last couple of weeks:
- We saw health system to public health communication for reporting of immunization records. The same interface can also be used to send immunization records to the patient (we hope to see that very soon).
- We saw provider to provider communication of information on transitions of care. The same interface can also be used to push information to a longitudinal HIO for quality improvement.
- We saw provider to patient communication (this post).
We are almost playing production bingo with the Direct Project User Stories.