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The Direct Project

What is the Direct Project?
The Direct Project develops specifications for a secure, scalable, standards-based way to establish universal health addressing and transport for
participants (including providers, laboratories, hospitals, pharmacies and patients) to send encrypted health information directly to known, trusted recipients over the Internet. The Nationwide Health Information Network is a set of standards, services and policies that enable secure health information exchange over the Internet. The project itself will not run health information exchange services. Several Federal agencies and healthcare organizations are already using NHIN standards to exchange information amongst themselves and their partners. The Direct Project will expand the standards and service descriptions available to address the key Stage 1 requirements for Meaningful Use, and provide an easy "on-ramp" for a wide set of providers and organizations looking to adopt. At the conclusion of this project, there will be one nationwide exchange, consisting of the organizations that have come together in a common policy framework to implement the standards and services. This project is open government, and as such, contains avenues for a broad range of public participation. See below for more information on participation.

Who is Direct?
Direct Project stakeholder members come from across the healthcare IT industry to make up the Implementation Group Committed Organizations. The key deliverables of the project currently being developed by stakeholder members are standards and service definitions, implementation guides, reference implementations, and associated testing frameworks. The project itself will not run health information exchange services.
Project members belong to the Direct Project Implementation Group (IG) and at least one of the following workgroups under the Direct Project:

  • Best Practices Workgroup:
    takes recommendations of the Privacy and Security Tiger Team and creates a specific set of policy recommendations for the pilots, and during and subsequent to the pilots, monitors the policies to determine how effective and workable they are in the real world.
    • Workgroup Lead: David McCallie
  • Communications Workgroup:provides clarity about what the Direct Project is and how it fits into the health information and transformation ecosystem. Key audiences include State HIEs, RECs, HIOs, health systems, providers, and the larger general health community and media.
    • Workgroup Lead: Rich Elmore
  • Documentation and Testing Workgroup: creates effective documentation and testing guidance for various audiences.
    • Workgroup Lead: Janet Campbell
  • Implementation Geographies Workgroup: provides a powerful demonstration of cross-organizational continuity of care.
    • Workgroup Lead: Paul Tuten
  • Reference Implementation Workgroup:creates a solid open-source reference implementation and associated libraries implementing the Direct Project specifications.
    • Workgroup Lead: Brian Behlendorf
  • Security and Trust Workgroup: provides alternatives and highlights issues relating to security and trust enablement via technology (e.g., certificates and signatures).
    • Workgroup Lead: Sean Nolan


The policy direction for the Direct Project is defined in concert with the NHIN Workgroup and the Privacy and Security Tiger Team underneath the HIT Policy Committee. Many of the core concepts for the Direct Project were first explored is a series of blog postings by Wes Rishel and David McCallie. The Direct Project is coordinated by Arien Malec with the guidance of the Office of the National Coordinator. See the Direct Project FAQ for more details.

When will Direct be implemented?
This site collects the User Stories and Specifications and Service Descriptions for the Direct Project. These stories, specifications and service descriptions will then serve as the basis for exploratory implementation work and pilot projects. The objective is to have pilot projects demonstrating simple, direct exchange during 2010, leading to widespread adoption by 2011. See the Overall Process page for more details.
How to get Involved
Keep me Informed

  • To be notified about significant events and announcements from the project, follow the Direct Project blog.
  • Join in community discussion in the Direct Project discussion group.
  • If you'd like to stay actively involved, subscribe to an RSS feed or use the "Notify Me" tab to stay on top of updates to the wiki pages that interest you.


How can I contribute?


Add my organization as an official Direct Project member

  • Contact [[1]] for information about submitting a statement of commitment, the first step to becoming a member organization of the Direct Project.