PROJECT BRIEF: REDWOOD MEDNET DIRECT IMPLEMENTATION

Grant Funding:

This project is funded by a grant from the California HealthCare Foundation to Cal eConnect

Will Ross, Project Manager, Redwood MedNet

To field test the DIRECT transport protocol in the Redwood MedNet ("RWMN") health data service cloud
To harmonize the DIRECT content transport capabilities with the clinical practice workflow of small, under-resourced health care delivery sites
To seek opportunities to test up to four health data transport patterns
- Sender inside RWMN-HISP pushes DIRECT message to Receiver inside RWMN-HISP (1 HISP)
- Sender inside RWMN-HISP pushes DIRECT message to Receiver outside RWMN-HISP (2 or more HISPs)
- Sender inside RWMN-HISP pushes DIRECT message to Receiving PHR using Microsoft HealthVault (1 HISP)
- Sender outside RWMN-HISP pushes DIRECT message to Receiver using RWMN-HISP (2 or more HISPs)
To specifically test two Direct Messaging use cases funded by a grant from Cal eConnect
- Cal eConnect IZ Demonstration
- Cal eConnect ToC Demonstration
To seek the "Aha!" moment that allows a health care provider to choose DIRECT over the fax machine as a preferred health message routing option

Pilot Scope

Collaborate with State HIE governance entity (Cal eConnect) in an investigation of two use cases for Direct Messaging
State Immunization Registry Use Case
- Identify an Eligible Provider with a Certified EHR capable of originating Direct Message payloads
- Investigate the possible use of Direct Messaging as a transport option for reporting immunizations to the state registry
- Establish a pilot test of Direct Messaging (if appropriate)
Transitions of Care Use Case
- Develop a work flow and an inventory of clinical documents exchanged during care handoffs between an acute care hospital and an unaffiliated long term care facility
- Identify opportunities to replace printing and faxing of documents with Direct Messaging
- Establish a pilot test of Direct Messaging (if appropriate)

Direct Messaging Targets

Push IZ messages from Certified EHR at Eligible Provider to California Immunization Registry (CAIR)
Push IZ report status messages (including errors) from CAIR to the sending provider
Push relevant clinical documents to support patient transfer from hospital to long term care
Push relevant clinical documents to support patient admission from long term care to hospital

Version 5 of Redwood MedNet Directed Messaging pilot project.

Redwood MedNet operates a full CONNECT gateway and can produce or consume standard IHE content formats
- In February 2010 the Redwood MedNet CONNECT gateway was used for direct bilateral exchange of patient data (proof of concept demonstration)
- In March 2010 Redwood MedNet demonstrated CONNECT as part of the FHA booth in the HIMSS Interoperability Showcase
In July 2010 Redwood MedNet bench-tested an SMTP gateway with an early prototype of the NHIN-D security agent and the XDM content model; for this operational phase a new SMTP gateway will be integrated with the RWMN Mirth MUx technology stack.
Redwood MedNet will operate its own Certificate Authority while awaiting the creation of directtrust.org

Use Direct transport protocol to push production electronic health data from a sender to a receiver
- Conform with policy articulation by the Privacy & Security Tiger Team
- Conform to privacy and security requirements from California HHS
Participate in ONC Initiatives
- Direct Project (RotR, X.509 Certificate Policy)
- S&I Framework
Keep wiki page current through end of pilot