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September 1, 2015 News 10 Comments

Top News

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MEA|NEA, whose platform allows providers and payers to securely exchange payment-related electronic documents, acquires The White Stone Group, whose Trace communication tools connect voice, fax, and electronic communication to the patient’s record. With the acquisition, MEA|NEA will create separate business units for its medical and dental customers.


Reader Comments

From Limoncello: “Re: receiving files from patients. Patients of our dermatology practice want to email us their records or use Dropbox. We can’t figure out how to receive them without violating HIPAA or threatening our electronic security. Our Top Five EHR vendor patient portal doesn’t allow patients to upload or attach files. We tried Carebox, but it appears they don’t participate in Direct Trust since test messages in either direction won’t go through. Does any company that’s willing to sign a BAA offer a HIPAA-compliant patient upload file site that scans for malware and accepts image files? We’re also interested whether practices have been able to get their local VA facilities to use Direct messaging instead of faxes. Our biggest barriers to using Direct messaging has been lack of a standard Direct address directory and eClinicalWorks requiring community health centers to buy an interface if they want to use Direct Trust-compliant messages instead of eCW’s Direct web portal. There’s definitely a bias against Direct messaging and towards expensive one-off interfaces at most vendors.”

From Woodpecker: “Re: McKesson. Will announce that its Horizon Clinicals product will not support Meaningful Use Stage 3.”

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From Boisterous Lad: “Re: Capsule Tech. Good sources tell me it’s been acquired by Qualcomm Life, which is expanding its 2Net device and sensor connectivity platform beyond sensors and home medical devices.” Unverified. I didn’t see any SEC filings from Qualcomm.

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From UGMer Roasting Weenies: “Re: Eskenazi Health (formerly Wishard) in Indianapolis. Going with Epic. Seems like a big deal as they are one of the last holdouts using the self-developed system of Regenstrief.”

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From Creative Differences: “Re: Partners and Epic. I’m on the Partners ambulatory rollout team. We offer practices three options: (a) stick with your current EHR, in which case we’ll integrate as necessary which includes billing for some through our Epic Resolute system; (b) use MyPractice, aka Epic Lite, a slimmed down version that I’ve hear is not fun to use although I’ve not seen it; or (c) go full Epic. This is happening in every city in America where the larger organization buys Epic. A great comment to Paul Levy’s original post reflects my thoughts: what do you suggest the AG tell Epic? Interoperability is better when all parties are on the same vendor no matter who the vendor is. This looks like capitalism at its best. Should the the AG tell Epic they can’t tell prospects about how they can improve interoperability between them and their partners? Should she tell Epic they need to change their product?”

Meanwhile, @Farzad_MD posts a reminder of Jonathan Bush’s Athenahealth earnings call comments about Epic at Yale-New Haven, which I ran in May 2013. Recall that Paul Levy is apparently doing work for Athenahealth these days, Athena is commercializing BIDMC’s WebOMR system, and Bush can’t seem to decide if Epic is evil incarnate or an admired competitor. 

I think we are seeing — particularly the folks who got pregnant with Epic — they’re going to this sort of desperate burn-bright tactics. We heard where Yale-New Haven has told all the doctors that have privileges that they will either buy this piece of shit Epic that none of them want or do you have their privileges revoked. So there’s that kind of tactic going on. “Oh, we can’t interface.” I’m like, “What you mean? Epic interfaces all the time. They actually do it really well.” So there’s a lot of sort of how are we going to pay for this thing? How are we going to make this thing drive more referrals, more high-profit diagnostics to our hospital? … The folks that have gone off and laid down more money than they have on Epic have, in the back of their mind, that they are going to make a real impact on referral patterns by getting doctors on to Epic that don’t want to be on it.

From Payer Watcher: “Re: Optum Exec Forum. UHG CEO Steve Helmsley declared that unlike Aetna, UHG will not purse the acquisition of other payers. Less important, it was puzzling to see both Colin Powell and Dr. Atul Gawande there.”


HIStalk Announcements and Requests

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The family of a reader who wishes to remain anonymous personally donated $1,000 to my DonorsChoose classroom grants project, triggering matching funds from another anonymous reader as well as other matching funds from specific classroom projects I funded. That means the family’s donation put at least $3,000 into classrooms in need. The donation and matching funds paid for these projects in their entirety.

  • Math activity stations for a low-income elementary school in Oklahoma City, OK in which many students were affected by a tornado last year.
  • STEM materials for a kindergarten class in Chicago, IL.
  • Two Amazon Fire tablets for STEM time exercises for an elementary school class in Tulsa, OK.
  • Ten Android tablets with pre-installed apps for an elementary school class in Mobile, AL that will meet the Bring Your Own Device policy for the children whose families can’t afford to buy them.
  • Hands-on STEM technology (Ozbot, green screen, Makey Makey kit, and Sphero) for Genius Time and MakerSpace activities in an elementary school class in Pensacola, FL.
  • Estes rocket kits and supplies for an elementary school class in Okeechobee, FL.
  • A listening center for an elementary school class in Mobile, AL.

I’ve already received emails from several of the teachers above. Ms. S said, “The math centers that you have funded will allow my students to be provided an interactive approach to the math standards that we are studying in depth this year. The ability for these students to not only hear about, but to apply themselves into a deeper level of learning through a variety of activities is so much more meaningful than sitting and being taught to. You have enabled my students to involve themselves in the teaching of these daily lessons.” Ms. S from Tulsa emailed to say, “Thank you so much for your generous donation! The impact of these items will be huge! I can’t wait to see the look on my students’ faces when they get their new Kindles for the classroom! We will be using these so much during science, accessing digital science materials. The students will have the opportunity to access so many things they wouldn’t have been able to access before. The fact that they’ll also be able to use them to read during their independent reading time is icing on the cake. Thank you so much!! You have made this Teacher’s day and maybe even the whole year!”

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I also received an email from Mr. H at Maynard Jackson High School in Atlanta, to which we earlier donated furniture to create a broadcasting studio news set. He says, “My students use the new resources every day to broadcast the school news. Last year, broadcasting the news was a dream but with our new resources, we are about reach our student population and the community through broadcasting. The new furniture gives students a clear understanding of the layout of a television studio, but at the same time, it allows us to compete with other schools in our district. I can honestly say that the learning levels in my class is at an all-time high and we have over 260 students in the program!”

I noticed that HIStalk page views hit 190,000 in August even though I slacked off a bit this past month given less news. That’s 2.3 million page views in 1.8 million visits in the past 12 months. I appreciate everyone who reads and sponsors HIStalk for making it fun every day for the past 12 years. I have quite a few new sponsors to announce thanks to our usual once-yearly back-to-school new sponsor special offer that Lorre can describe for interested companies, including for former sponsors interested in coming back. Then we buckle down for the always-busy Labor Day to Thanksgiving health IT rush.

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I’m watching “Narcos” on Netflix, which I like even though I’m distracted by the cheesy 1970s mustaches and the fact that Pablo Escobar looks like Andy Kaufman.

Note to providers: I’m perfectly aware that I should call 911 if this is a medical emergency, that my call may be recorded, and that the menu options have changed. You don’t have to waste 20 seconds of my time telling me that every time I call and then get put on hold.


How to Do a Webinar

We get asked a lot about doing webinars. Sometimes companies take our advice, sometimes not.  Here are some tips as requested by a reader.

  • Present a webinar to educate without obsessing about getting sales leads. A webinar that is mostly a company promo piece or demo is going to draw as attendees only people who want to buy your product. Don’t be surprised when only eight people register and none of those are prospects. It’s like a timeshare pitch without the free Chili’s gift certificate.
  • Nobody wants to hear a company’s marketing VP deliver a webinar, or for that matter, anyone from the company as a primary speaker. You earn a lot more credibility letting a happy customer do the talking about their real-life experience, assuming you have one.
  • Make sure the presenters have seen the slides and understand the topic ahead of time. The fact that I have to even say this tells you how poorly planned some webinars are.
  • Choose a snappy title that succinctly describes what the webinar will cover.
  • Don’t provide insultingly obvious background about the state of the industry in the abstract. Ditch the flowery language and just say what you’re going to cover and why people should attend.
  • Don’t include a roster of every hospital job description in the “who should attend” section. Sure you don’t want to turn people away, but your in-depth technical overview isn’t really going to appeal to most CEOs and floor nurses.
  • Don’t pitch the company or product for more than two minutes. We get a lot of complaints from attendees who are annoyed that the presented ignored our advice to keep the sales job at a minimum.
  • Don’t require a bunch of registration information. I’ve done polls here before and people are like me in refusing to give a bunch of information (phone number, job title, etc.) to nosy companies who will lose signups or just encourage to enter fake information to avoid the inevitable cold calls.
  • Record the video for later review. Our webinars get a lot more views on YouTube than they did in the live session. That’s why we do it.
  • Presenters, don’t read your presentation.
  • Don’t include slide transitions or animations, which may indeed look super cute when viewing locally but are painful to watch in a slowed-down live webinar.
  • Don’t fall into the trap of making PowerPoint a teleprompter. You already have your talking head, so add graphics or other visual to make what they say clearer and more memorable. If your slide contains full sentences, you don’t know what you’re doing.
  • Spread material over multiple slides so that no single slide is on the screen for more than 1-2 minutes. The attention of attendees wander when someone just drones endlessly with no visual break.
  • Lock down the title, presenters, and abstract at least 2-3 weeks before live day to give people time to sign up.
  • Deliver a presentation of no more than 30-40 minutes to leave time at the end for questions.
  • Have attendees submit their questions via the webinar platform’s chat box to allow the moderator to choose the best ones and to avoid having an attendee hijack the presentation with self-indulgent prattling.

Webinars

September 9 (Wednesday) 2:00 ET. “Need to cleanse, unify and manage the provider data in your EMR master file and other IT systems?” Phynd’s Unified Provider Management platform allows healthcare organizations to maintain a single, verified, customized profile for each provider across legacy IT systems. This 30-minute presentation will explain how Phynd’s system can help synchronize internal provider information in real time; create provider interoperability among systems; and manage, update, and analyze provider information with workflow tools to improve revenue cycle and clinical communication.

We’re doing a September 22 webinar with The Breakaway Group, who filmed a commercial for “Just Step on the Scale: Measure Ongoing EHR Success and Focus Improvements using Simple but Predictive Adoption Metrics.”

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.


Acquisitions, Funding, Business, and Stock

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Ivenix secures $42 million in funding to continue rollout of its next-generation smart infusion pump.

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Cardiopulmonary Corp., which offers the Bernoulli medical device integration, alarm management, and virtual ICU applications, will merge with medical device integration vendor Nuvon.

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Patient portal vendor Medfusion raises $3 million in venture funding after announcing new patient responsibility collection tools.


Sales

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Western Connecticut Health Network chooses Cerner’s Millennium EHR, will upgrade its Soarian revenue cycle applications, and implement Cerner’s HealtheIntent population health management system.


People

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Alexander Eroe (LinkEHR) joins Health Data Specialists as business development executive of the Cerner/Siemens practice in the Western region.


Announcements and Implementations

A Nuance survey finds that Millennials (ages 18-24) are more likely to choose a PCP based on the recommendations of friends and family members, are quicker to tell friends about their doctor experiences, and are more likely to look up doctors on online review sites.

Craig Hospital (CO) implements a clinical communications and mobile alerts solution that integrates its Draeger and Connexall alarm systems with the mobile network of PatientSafe Solutions, allowing clinicians to access alerts, secure messages, voice communications, and patient information from a single device.

Mayo Clinic Center for Social Media will offer a “Social Media Basics for Healthcare” online certificate program for healthcare professionals that includes CME credits. The four-hour course is free for members ($495 per year) or $400 otherwise.

Tenet, Dignity Health, and Ascension will take over management of Carondelet Health Network and connect it with the Arizona Care Network in the turbulent  Southern Arizona market.

InterSystems will release a next-generation laboratory business management system in early 2016.


Government and Politics

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The Dayton, OH newspaper profiles the Cincinnati VA’s tele-ICU service, which has expanded from monitoring 72 Ohio beds to 213 beds in several states.


Technology

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Google unveils its new logo (old on the left, new on the right). The font veers dangerously close to Comic Sans territory.


Other

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Jewish Hospital (OH) reduced ICU length of stay by 28 percent in a pilot that used GE Healthcare’s nutrition monitoring software that works with its ICU ventilators and sends nutrition measurements to the EHR. The software was being used in other countries and earned FDA approve in June.

UC Health (OH) will run a six-month pilot in which patients can get free video consultations with physicians after scheduling a time slot in advance.


Research Implications of the Conversion to ICD-10

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I spoke with Andrew Boyd, MD, assistant professor in the Department of Biomedical and Health Information Sciences at the University of Illinois at Chicago, who has published several articles about the impact of the conversion to ICD-10 on medical research. He predicts problems when researchers conduct studies spanning the October 1, 2015 switch, as researchers miss patients because the code logic has changed. He even speculates that some researchers may avoid performing historical studies because they may fear that the pre-October 1 codes are unreliable or because they won’t want to invest the time required to double check the codes and data queries.

Andy says researchers are generally aware of the upcoming ICD-10 problem, but haven’t necessarily grasped its significance or the effort and uncertainty required to use information originally entered as ICD-9 codes. He’s also concerned that analytics vendors are underestimating what will be lost if they just perform simple one-to-one ICD mappings.

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ICD-10 mixes concepts that were separate under ICD-9. He gives as an example “sickle cell crisis,” which maps to the ICD-10 code for “sickle cell disease with crisis unspecified.” That looks fine on paper, but there were two associate ICD-9 codes that mapped backwards to it. Some researchers might want to look at all sickle cell crisis patients and would therefor have searched for all three codes, while others might only care about sickle cell crisis with acute chest, for example. Every data query will need to be analyzed by a researcher who knows what they’re looking for, not a junior analyst who only knows the old and new codes.

I asked Andy if he thought new studies might reach incorrect conclusions because of either researcher ICD mistakes or improperly converted data. He said he wouldn’t be surprised.

There’s also the issue that the US version of ICD-10 (ICD-10-CM) is more complex than the versions the rest of the world has used for years. For instance, Canada has 20,000 ICD-10 codes while our ICD-10-CM has 68,000. It will be easier in some ways to graduate to the same ICD level as the rest of the world, but anyone performing international studies will have to do their ICD mappings all over again.

Andy also points out that the ways hospitals code under ICD-10 may make them appear safer than they really are, unintentionally or otherwise.

Andy concludes that in a few years we’ll wonder how we got along without ICD-10, but the transition will be rough for researchers and medical research may temporarily suffer.

Some of Andy’s articles covered:

Cohort discovery in ICD-10-CM
Patient Safety Indicators in ICD-10-CM
Discriminatory cost of ICD-10-CM transition between clinical specialties


Sponsor Updates

  • CTG is ranked as one of the largest healthcare management consulting firms.
  • Orion Health is named the “New Zealand Healthcare IT Company of the Year.”
  • Santa Rosa Consulting is named as one of the “Best Places to Work in Healthcare.”
  • AdvancedMD announces the six winners of its video contest.
  • Eric Venn-Watson of AirStrip Technologies is featured in a San Diego Source profile of tech innovations.
  • CapsuleTech receives the Surgical Information Systems Partner of the Year award for its DataCaptor and SmartLinx Medical Device Information System solutions.
  • Extension Healthcare wins the Indiana Innovation Award.
  • Anthelio is included as a sample vendor in two Gartner hype cycle reports in the legacy decommissioning category.
  • CitiusTech will exhibit at the Smart Healthcare Technology Summit 2015 September 9-10 in Dubai.
  • Surescripts announces that 20 Epic health systems have implemented its CompletEPA electronic prior authorization service.
  • CoverMyMeds will exhibit at the EpicRx Annual Stockholders Meeting & Trade Show September 11-13 in Fort Lauderdale.
  • The Tennessean features Cumberland Consulting Group in its profile of workplace culture at local healthcare technology companies.
  • MedCPU CMO Yoni Ben-Yehuda is featured in an IBM/CMO Club marketing study.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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Currently there are "10 comments" on this Article:

  1. “Interoperability is better when all parties are on the same vendor no matter who the vendor is.” If it’s the same vendor then it really isn’t ‘inter’operability is it? I also like the option to keep what you have but be billed for integration. Sounds like a great option for the practice.

  2. To Limoncello: Direct restrictions are very challenging. I have experience with RelayHealth’s Clinical Record/Patient portal which DOES allow patients to upload documents and photos securely. They use non-Direct secure messaging, but it works very well. We are pushing it out across a community for a shared community portal, but are constantly battling with EHR-driven patient portals, Meaningful Use constraints, and Direct messaging inefficiencies related to vendor implementations. It is a shame that some great technologies that are truly more ‘meaningful’ are being shoved aside out of necessity to achieve Meaningful-ness.

  3. 1) Limoncello needs some HIPAA guidance. If the patient wants to email you everything under the sun, that’s A-OK. THEY can use Dropbox, email, sky writing – it doesn’t matter. If THEY initiate the communication, all bets are off. What you can’t do is tell them to email you and not make clear it’s potentially insecure. Or send them PHI insecurely (without their permission).

    2) Partners is _not_ telling people they can use their own EHR. That’s BS. This is why I’m anon. I am from an EHR vendor and we have multiple clients in the 495 loop. It’s Epic or the highway. Originally, you could use Athena, eCW, or their homebrewed LMR (which wasn’t so bad). Although we are both PM and EHR, our clients were forced to use one of the above, so we have a number of split practices. Now, they are being told it’s Epic and Epic only. Multiple attempts to go up the ladder to find out what can be done have been rebuffed. We’re talking about moving community primary care practices away from specialty specific tools they’ve grown to use well to…Epic. GOOD LUCK, we’ll see them when they leave in 3-5y.

    Meanwhile, in OTHER parts of the country, systems allow the community docs to choose their own EHRs and are creating their own data repositories in order not to force them onto Epic. It’s still all in the nascent stage, and I’m not providing details to avoid being identified, but some health systems realize that Epic _does not work_ in most independent primary care practices. Or, to be nice, no system is willing to configure it to do so.

  4. With the comment : “Yale-New Haven has told all the doctors that have privileges that they will either buy this piece of shit Epic that none of them want…”

    It is now clear that JB desperately wants to be The Donald’s running mate. We can only wish…

  5. Direct Messaging, DirectTrust, and NATE
    ——————————————————-
    A quick, over-simplified primer on Direct Messaging “trust bundles”…. Direct Messaging is conceptually similar to email in that one address of the form somebody@somedomain sends a message to another address at somebodyelse@someotherdomain. What makes Direct Messaging secure is that it uses certificate-based encryption that helps ensure that the receiver knows who the sender is and the sender knows who the receiver is – and the content of the message is encrypted by the sender in such a way that only the intended receiver can decrypt it. For this security to work the two endpoints have to “trust” each other. One way to formalize this trust is for the sender and receiver to talk to each other, decide they trust each other, and exchange security certificates. That is quite cumbersome and doesn’t scale. So, the notion of “trust bundles” exists. A “trust bundle” is a community of Direct Messaging endpoints that sets up “rules of the road” and validation/certification processes that all members of the community adhere to.

    There are two primary trust communities for Direct Messaging today. One is called NATE (www.nate-trust.org) and the other is called DirectTrust (www.directtrust.org). Of the two, NATE is the trust bundle favored by most consumer-facing applications (CFAs). That is because it has policies that are aligned with the requirements and business realities of consumer-facing solutions.

    As a matter of policy, DirectTrust will not support Limoncello’s use-case of dermatology practice patients sending to their EHR, unless an individual security certificate is issued for each patient, in a cumbersome and expensive process. I’m not aware of any CFAs that do this. Thus, you can’t (practically) use the DirectTrust community/bundle to send from a consumer/patient to an EHR. The trust bundle/community that Limoncello needs to look at (and which most CFAs, including Carebox, is part of) which will support this use case, is NATE.

    Indeed Limoncello is right. There is a bias against Direct Messaging in general, and a very strong bias against its use by consumers/patients in particular. In general, the interoperability discussion today is dominated by the large providers, the EHR and HIE vendors, the high-end “provider interoperability networks”, and the committees and standards bodies that they fund and dominate. They all “talk a good game” about interoperability (especially in front of Congress) but ensure that the only kind of interoperability that actually happens (to the very limited extend it happens at all) is amongst themselves without patient/consumer involvement (and with questionable levels of consumer/patient awareness and consent). In my experience to date, NATE is trying hard to be part of the solution to this problem, while DirectTrust talks about wanting to be part of the solution, but remains a very big part of the problem. Guess which of those two is the larger, more powerful, better funded entity?

    That said, Carebox is going to be joining the DirectTrust bundle. We understand and accept – though we neither like nor approve of – the DirectTrust policies on ENHAC certification (and its associated high costs), disallowing use of public cloud infrastructure (even if super-secure and HIPAA compliant from leading vendors like Google, Microsoft, or Amazon), consumer/patient authentication requirements, etc. However, since our primary business is supporting provider use cases like the ones Limoncello has outlined, it’s in our interest to join.

    Limocello’s Use Cases
    ——————————-
    I suspect the reason Limoncello couldn’t send to Carebox from their EHR is that their EHR vendor has not configured the NATE trust bundle as a trusted destination. Some EHR vendors (like Epic) require that their provider customers use a third party company (like Surescripts or Data Motion) for Direct Messaging as required by Meaningful Use. Some (like Cerner) provide it natively. Either way, very few EHRs come pre-configured with both DirectTrust and NATE members as allowed destination. So a provider that wants to use Direct Messaging to communicate with patient CFAs has to go through extra steps. Some solutions come pre-configured to allow for sending to DirectTrust members, but not to NATE members. Most still do neither. I suspect Limoncello’s EHR falls into one of the latter two categories.

    Configuring an EHR to send to NATE addresses is free and easy and can be done with any EHR that supports Direct Messaging. I’m happy to work with Limoncello directly, offline, to get this working. This is what we did a while back when Mr. H reported that he tried but failed to send from CareSync to Carebox using Direct Messaging. it took only a couple minutes to work this out with CareSync – and would not have been necessary at all if CareSync had been pre-configured to support NATE members as destinations – hopefully they now are.

    If Limoncello’s EHR is pre-configured to send to DirectTrust addresses, then this is a good example of why Carebox needs to join DirecTrust (and as noted, will do so) – because as a practical matter DirectTrust is ahead of NATE when it comes to pre-configured readiness of EHRs and HIEs to send to their community addresses – even though we feel strongly that NATE is the better community for CFAs.

    Carebox for Limoncello
    ——————————
    In any case, sending from Limocello’s EHR to Carebox won’t help with the use cases outlined by Limocello such as patient send via Direct Messaging to their EHR, fax-replacement for exchange with local VA facilities, etc. Using an EHR that is part of NATE and allows for receipt of Direct Messaging files from CFAs into the EHR is one possibility. But most EHRs don’t do that, as noted.

    The other option is to set up a solution like Carebox alongside (and integrated with) their EHR. Carebox does indeed offer a HIPAA-compliant solution (and will sign a BAA) that can do the following for Limocello:

    1) Allows any patient to upload their files (including scans/PDFs, structured CCDs, DICOM imaging CDs, etc.) – or e-mail them from their personal e-mail address TripIt style, or have sent via Direct Messaging from any EHR, or automatically imported from one of hundreds of supported patient portals or Blue Button sites like MyMedicare.gov (Medicare) or MyHealtheVet (VA) – into a Carebox account managed by Limoncello’s practice

    2) Enables Limoncello to provide as many Direct Messaging address as desired as an alternative to Fax for receiving records from any provider that has a system that supports Direct Message send (including all MU2-compliant EHRs)

    3) Integrates with Limoncello’s EHR

    4) A bunch of other stuff that will turn this into more of a commercial than it already is

    In recognition and appreciation of Limoncello’s unsuccessful first attempt to get a Carebox solution working with Direct Messaging and their EHR – especially in view of the fact that at one direction (EHR to Carebox) might have worked “out of the box” if Carebox was already part of DirectTrust, which is our fault – I’d like to offer Limoncello a complete Carebox solution (including requirements analysis, design and implementation, and support services) for their practice, at no charge for 12 months (and no commitment or strings attached beyond that). I believe that we can potentially address all of the use cases outlined above.

    We can’t changes the industry challenges and how the deck is stacked against things like patient/consumer use of Direct Messaging. But our business philosophy at Carebox is to deliver practical interoperability solutions aligned with current market realities (where our head is at), even as we advocate for a future that is very different from today (where our heart is at).

  6. “(c) go full Epic”
    Is this a line from the movie Tropic Thunder? I just can’t stop laughing at the correlation.

  7. Secure Exchange Solutions is a HISP with a patient root certificate in the Direct Trust bundle. On our website you can see the press release from Hershey doing almost exactly what Limoncello is asking for. This use case is supported both by SES webmail, SMPT mail and several PHR clients.

  8. To Limoncello
    Yes, eClinicalWorks has made it more challenging than necessary for their providers to have access to DirectTrust. After months, almost a year actually, we have been able to successfully send a CCD to an eClinicalWorks practice and their respective eClinicalWorks direct address without an interface. No interface needed. We utilize a DirectTrust HISP connected to our hospital EHR.

    The eClinicalWorks practice had to: Login to My.eclinicalworks.com > open a new case > breakfix tickets > MAQ Dashboard > Stage 2 Core Measures > How to connect to another HISP and identify our DirectTrust HISP.
    Follow up, follow up, and follow up….
    Later they had to complete a form or two to get a direct address (outside of P2P) assigned.
    Good luck!

  9. Who wrote that line about the new Google logo? It’s pretty uninformed to compare a clean, geometric, 1920’s-inspired typeface to Comic Sans.

  10. Limoncello,
    Integrating and exchanging (including receiving) with patients should not be this hard. DataMotion offers patient Direct addresses and participates with both Direct Trust and NATE. I would be happy to help.







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