The Direct Project has the capability to significantly change the way providers share information, including the potential to replace TCP/IP over VPN.
TCP/IP has traditionally been the go-to data communication method used by hospitals when they need a live, direct connection to their provider community. This is because the hospital can utilize the same protocol they are using within the four walls of their facility and securely extend it outside the facility using VPN. VPN connections, however, can be time consuming to set up and costly to maintain.
The Direct protocol is an ideal substitute for VPNs. Patient health data can be sent securely, sent on demand, and sent using the SMTP protocol. The HL7 message payload can be parsed and sent/received automatically.
Direct project also has the potential to replace, or displace, some of the need for Web Services. For example, when a patient is discharged from the hospital the workflow may require that the Discharge Summary document be forwarded to the local HIE. In order to do this, point-to-point SOAP-based Web Services might be utilized, or the POST command for RESTful Web Services would work as well. But, Direct has the same capability to attach a document to a secure e-mail and send it to the HIE.
What direct cannot replace is the query-based web services, which are often seen as more complex to implement. Query-based communications are common in an emergency department scenario: a patient arrives at the hospital and the physician needs to query the local HIE for all medical information available about the patient.
Check back next week for part 3 of my series on direct, which will focus on its use of healthcare standards.