DirectTrust hits major milestone with 2B exchange transactions

DirectTrust hits major milestone with 2B exchange transactions

DirectTrust announced this week that there were 719 million Direct Secure Messages sent and received this past year, bringing the total number of transactions since the nonprofit began tracking them in 2014 – up past 2.1 billion at the end of 2020.  

The non-profit healthcare alliance created to support electronic exchanges of protected health information among provider organizations, and between providers and patients, reported that more than 265 million Direct Secure Messages were sent and received between DirectTrust addresses in the fourth quarter alone.   

“Notably, it took five and a half years for the number of Direct Secure Messages exchanged to reach one billion, and just 18 months to surpass two billion,” said Scott Stuewe, DirectTrust president and CEO, in a statement.   

“This milestone illustrates interoperability of electronic health information is here and continuing to gain traction as a means to facilitate better coordinated patient care,” Stuewe continued.  


Direct Secure Messaging, which the organization refers to as “Direct,” is a secure communication transport mechanism for sensitive information – namely, health data – over the internet. 

According to the company, the number of patients and/or consumers using Direct jumped to 565,000 by the end of 2020 – an increase of 89% from the previous year. The number of organizations served by DirectTrust accredited health information service providers grew nearly 9% to just over 259,000, compared with 238,000 in 2019.  

A dozen new healthcare organizations also joined DirectTrust over the year, bringing the alliance’s total membership to 110.  

The increase in message rates echoes other jumps in the use of health information exchanges around the country.   

This week, leaders at the Western New York-area HEALTHeLINK released a report noting that patient data lookups had skyrocketed to nearly 600,000 in 2020.   

“Having this health information available in real time is crucial for care management, as providers can more easily conduct pre-visit planning, avoid repeat or duplicate tests, and make better medical decisions,” read the report.  


DirectTrust positions its secure messaging protocol as a key driver of interoperability, aided by public-private partnerships and historical collaboration with CIO groups.  

“Over a decade ago, the Office of the National Coordinator for Health IT kicked-off the Direct Project,” said Steve Posnack, deputy national coordinator at ONC, in a statement this week. “The increased use of Direct across the health care system is a testament to the power of community and public-private collaboration.”  

This past year, the company rolled out Trusted Instant Messaging, or TIM+ aimed at offering real-time communication between known, trusted entities within and across healthcare organizations. That software is still in its testing phase.  

“We’re thrilled to have a draft of the TIM+ standard ready for testing,” said Stuewe in July 2020. “We’re eager to learn the industry’s response as various entities explore this timely and necessary new standard.”  


“As the number of messages exchanged increases, we also are hearing valuable feedback on opportunities. For instance, the DirectTrust Standards work underway is proposing that messages should contain some additional metadata to inform receivers what a particular message is about and how to handle it. These opportunities promise a robust future of secure and trusted health information exchange,” said Stuewe in a press release this week.


Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: [email protected]
Healthcare IT News is a HIMSS Media publication.

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