2008-2010: From “pull” to “push”

With the emergence of advanced primary care and increased focus on care coordination, physicians were eager to move beyond fax machines and start sharing health information electronically with each other. MedAllies has been developing “push” style health information exchange (HIE) transactions since 2008 when it developed services for EHRs to send patient Continuity of Care Documents (CCDs) between primary care providers and specialists in what is known as a closed-loop referral.


The Direct Project was the next logical step.


The Direct Project is a groundbreaking national effort, under the auspices of the Office of the National Coordinator for Health Information Technology (ONC), to fast-track electronic information exchange. It benefits providers and patients by improving the transport of structured and unstructured health information across disparate EHR systems. The information transfer is secure, fast, inexpensive and interoperable. Importantly, it supports providers as they strive to meet Meaningful Use requirements.


The ONC invited MedAllies to join the Direct Project and help define new protocols for sharing health information. MedAllies was among the pioneers who helped develop and assemble consensus standards that support secure exchange of basic clinical information and public health data. Through collaboration across the health care technology spectrum, they came up with a series of protocols and standards necessary to securely push content from a sender to a receiver.


In 2010, the ONC selected the Hudson Valley as one of seven pilot sites to demonstrate health information exchange using Direct standards. Learn more in our issue briefs.


Each pilot was different; in MedAllies’ hands, Direct became a tool to advance primary care models that emphasize care coordination and improved care transitions. MedAllies’ Direct Project focuses on common care transition episodes: patient discharge from the hospital back to the primary care physician, a referral from a primary care physician to a specialist, and the clinical consultation report from the specialist back to the primary care physician, known as a closed-loop referral.

Read more:
2001: The beginning
2007: The “Genius Bar” of the Hudson Valley Initiative
2010-present: MedAllies Direct advances care coordination