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Direct Network

Ensuring optimal edge system to edge system interoperability

Operating a National Direct Network

Launched in March 2010 as a part of the federal government’s Nationwide Health Information Network, the Direct Project was created to specify a simple, secure, scalable, standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. Direct maintains health information flow, offering true interoperability.

Direct supports Merit-based Incentive Payment System (MIPS) Promoting Interoperability requirements – a set of standards and best practices adopted by CMS to ensure health care providers implement optimal push interoperability.



Direct Accounts


Organizations Served


Cumulative Messages Sent & Received

Use Cases Covered:

MedAllies Direct Network Services

Considered a National leader by ONC and the EHR industry for use of Direct for EHR interoperability.

Direct Network
What's Included

Clinical Direct Messaging

  • Direct accounts operate exclusively on the Direct Network. The specialized digital certificate affixed to a Domain/Direct Address is recognized by Health Information Service Providers (HISPs) and can only be issued by an accredited HISP. The digital passport represented by the certificate makes Direct accounts unique. The Certificate also encrypts messages and confirms the identity of the sender and receiver, resulting in non-repudiation.

Direct Network Connectivity Options

  • Edge protocols (i.e.: XDR or S/MIME)
  • Web-based mail portal with accessibility support
  • Protocol transformation and routing: SMIME/SMTP, IHE XDR, web services

Identity Authentication

  • HISPs are required to confirm the true identity of participants in Direct Messaging prior to provisioning a Direct Account

National Provider Directory

  • Published Direct Accounts

Digital Certificate Issuance

  • MedAllies HISP manages, provisions and shares clients’ DirectTrust-authorized digital certificates 
  • Participation in the DirectTrust Accredited bundle
  • Certificate issuance and registration authority

Message Delivery Notification

  • Message completion acknowledgements collected and reported out by HISPs are considered to be irrevocable proof of message delivery and thus have legal weight and are used for CMS reporting.

Direct Network Support

  • Online and phone support for onboarding, connectivity questions, and other service needs
  • High-availability and disaster recovery

Enforcing DirectTrust Rules of the Road

  • Maintain accreditation attesting to trust relations
  • Security and Trust Framework

Certification, Accreditation, and Memberships

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