When Direct is used, The standard should be used

Please add this to "Dependencies, Limitations and Pre-conditions":  "When Direct Secure Messaging is utilized for Event notifications to providers, senders should always utilize the full specification as stipulated in the latest version at this link.  Many intermediaries are sending unformatted, text only notifications to Direct Addresses in the network.  Most systems will not be able to process these messages without metadata.  A great many EHR companies built receiving support for the specification routing notifications to unique workflows in their system.  The specification also requires that the message body contain a text-only rendition of required elements that supports receivers that cannot process the metadata or the attachments.   Intermediaries that send plain text event notifications via Direct need to know that most of these never reach the intended recipient. " 

Updates to Event Notifications Via the Direct Standard (R)

This entry should be updated to reflect current adoption and status of the standard.

Here is a link to the published Standard:

Direct Standard(r) is now a Registered Trademark. 

Process Maturity Level should be "Final"

Adoption Level should be "Medium" - three "dots".

Update the Limitations in the following matter:

  • A variety of transport protocols are available for use for event notifications delivery. Trading partners will need to determine which transport tools best meet their interoperability needs, however, Direct (referenced further in Exchange/Services - "Push" Exchange), has been adopted by both EHRs and by intermediaries as a prominent option for transport. Even when HIE networks are in place, Direct is often used as a transport protocol to deliver notifications to EHRs in provider workflows. 
  • DirectTrust Standards Implementation Guide "Event Notifications via the Direct Standard(R)" provides a profile for the payload included in event notifications when Direct is the transport. The guide standardizes HL7 2.5.1 usage and maps metadata elements to support appropriate routing and workflow for receiving systems. Human readable text is also stipulated as a part of the specification to support uncomplicated edge systems. The Implementation Guide was published and ANSI approved May 11, 2022. 

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