Top Menu

How Does Direct Work?

Configuration | Provider Directory |  Trust Framework


Direct is a simple way to securely exchange health information. Providers send encrypted Direct messages from their EHR or from a Direct mailbox to other members of a patient’s care team. Messages may contain attachments such as Continuity of Care Documents (CCDs) summarizing a recent patient encounter and other critical information.

This data exchange method was build on national standards developed through the The Direct Project, an initiative sponsored by the Office of the National Coordinator for Health IT (ONC)


There are two ways to configure a California Direct account:

In your EHR- Direct integrates with the messaging functionality of an increasing number of EHRs. In 2014, all EHRs certified by ONC must be able to integrate with Direct streamlining EHR workflows. Please be sure to note your current EHR system and version on your registration form.
Using a Secure Mailbox–  Using the California Direct secure mailbox is a great way for providers without an EHR, or with an EHR that does not support Direct, to communicate with other caregivers. Our Direct mailbox is similar to that of a traditional email account such as Gmail, Outlook, or Yahoo. It is simple, secure and easy to use.

Either method allows you to communicate quickly and securely with other providers inside and outside of your organization, whether they use the same EHR or no EHR at all.
Return to Top

Provider Directory

Test slider 2California Direct includes a provider directory, making other participating providers searchable by name, organization, or specialty. A provider’s entry in the directory is established upon successful registration. Provider directory entries include: name, specialty, mailing address, practice address, phone and fax numbers, and license information.

“Axesson’s involvement in NATE’s efforts to expand the appropriate use of health information exchange, including NATE’s Provider Directory and PHR activities, will directly benefit all types of providers, including those in rural regions of California.”

-Aaron Seib, CEO of NATE
Return to Top

Trust Framework

Direct provides a safe and electronic way to share information with the right person at the right time, offering an attractive alternative to faxing.

When you sign up for California Direct, you gain access to a network of approved exchange partners that goes beyond those who subscribe to our service. This network includes providers in large health systems, providers in Greenfield_shutterstock_47249722participating Health Information Exchanges (HIEs), and providers in other states.

Exchange via Direct must conform to applicable federal and state laws. Direct assumes that the sender and receiver have legal authorization to view the data exchanged, such as the Personal Health Information (PHI) of a common patient that is shared for treatment purposes under HIPAA.

Direct is compliant with HIPAA security guidelines. Health Information Service Providers (HISPs) such as California Direct enable the secure transport of Direct messages by issuing digital certificates to registered users and encrypting messages in transit. The receiver is responsible for the security of message content once the message is opened, as they would be for any other sensitive patient data. Before being onboarded and receiving a digital certificate from a HISP, users must assert their identity through the notary process.

Vinyard_shutterstock_92820379In our state, the California Association of Health Information Exchanges (CAHIE) and the state’s Office of Health Information Integrity (CalOHII) are establishing a policy framework for trusted exchange between approved HISPs, HIEs, and health systems. This policy framework aligns with the guidelines being developed by the National Association of Trusted Exchanges (NATE) so that California providers can safely exchange data with providers in other states. A technical infrastructure including a federated provider directory is also under development at the state level, and Axesson has participated in a pilot of this infrastructure.

Axesson is also a member of DirectTrust, a national certification body for HISPs, which will enable users of California Direct to securely exchange information with an even broader array of partners, including any provider in the United States that is a Direct Trust member.

Return to Top

Connect. Collaborate. Care.