Direct Messaging: Secure Provider-to-Provider Email
Direct Messaging (also Direct Project, Direct Trust) is the HISP-mediated, encrypted email standard for healthcare provider-to-provider exchange. Required for MIPS Promoting Interoperability category measure scoring.
How Direct Messaging works
A Direct address looks like an email address (e.g., dr.jones@direct.example.org) but is hosted by a Health Information Service Provider (HISP) certified by DirectTrust. Messages between Direct addresses are encrypted in transit and at rest, with signed certificates verifying sender identity. Common attachments include C-CDA documents, referral letters, and discharge summaries.
Why Direct counts for MIPS
The MIPS Promoting Interoperability category measures referrals sent and received with a summary of care document via Direct (or other secure exchange method). The numerator is referrals with a documented summary of care exchanged; the denominator is total referrals. Practices below the required threshold (typically >30% of referrals) lose meaningful PI category points.
Where Vizier fits
Vizier reads Direct Messaging audit logs from the EHR connector and surfaces PI category measure performance — referrals sent / received with summary of care, by provider. The trajectory view helps practices catch declining performance before submission season.