A 10 Year Old Child Shows Us Why A Direct Project Directory Is Unnecessary

I recently hosted a panel of direct project experts. During the panel, Greg Meyers (@greg_meyer93) talked about why the need for a Direct Address directory was overstated. He argued that doctors could collect the direct addresses for the network of providers they refer to on their own quite easily. A directory would be nice, but you could still easily get value from direct without one.

To prove this point, Greg sent over this great story about his niece.

This past weekend, my wife’s family held their Christmas dinner and gift exchange, and the actions from my 10 year old niece were the highlight of my day. She has been desperately wanting a iPod Touch for quite some time for simple tween workflows such as taking pictures/video, downloading apps, and emailing/video chatting with her friends. With me being the corruptive spoiler of my sister-in-law’s children, I got permission a few months back to get her daughter the prized iTouch as a Christmas present.

From the moment she opened it, her excitement almost exploded out of her face. She spent the first hour asking Siri silly little girl questions, but the next hour was a display of simple intuition and what appears to achieve what some in the Health IT domain describe as almost impossible.

The tasks was simple: setup her email and FaceTime so she could start communicating with her family and friend immediately. Keep in mind this a child whose only electronic presence is her GMail account mandated via her 5th grade class; no Facebook, no SnapChat, no Twitter, no WhatsApp, and no access to a repository of electronic endpoints other than what she could find with a google search.

We went down the path of getting FaceTime associated with an AppleId and configuring the email app with access to her GMail account. What happened next was my moment of the year. She went around asking all her family members for email addresses and entering them into her contacts list. Anybody that had an apple device, she asked if they were on FaceTime and tried to initiate a test video conversation. If she had issues connecting to them, she would ask them to initiate a conversation by giving them her address and added them into her contacts after terminating a test chat. She tried adding some her classmates via the email addresses she knew, but when she failed, she said she would just call them or ask when she went back to school on Monday. By the time the day was over, she had built a respectable network (with validated endpoints) with her closest contacts and formed solid plan of how to continue to build her network. Oh, and she did this without the assistance of a directory; just plain old simple leg work.

I’m kicking myself for not following her with a video camera, but I think this poetically demonstrated the ability to build useful networks via the trivial thought processes of a tween girl.

Thanks Greg for sharing the story. Sometimes we seem to forget that not all solutions have to be technical and we don’t have to be hand fed everything. Here’s the video interview with Greg Meyers, Julie Mass and Mark Hefner for those that want to learn more about Direct Project:

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Exactly why IT people are out of touch with physicians and providers.
    1. We do not know or have memorized our Direct address
    2. Its a total pain to set up a Direct address, meaning almost no one has one
    3. We do not have time to walk around, call and such to manually enter Direct addresses into our system
    4. How do we even do that in our system (enter direct addresses)
    5. Many if not all my referral points do not have direct addresses
    6. Some direct addresses are group only, not individual

    This is totally unrealistic and found myself completely annoyed at this article as a front line provider. Its literally the last thing I would want to undertake, manually entering Direct addresses after trying to contact other providers for their Direct addresses.

  • I concur, I am a big and I mean big fan of this. Many remember my argument with Mark at the CCHIT Townhall in Baltimore, MD. I argued the biggest issue is connectivity. ON this front they have made a great change, they call it Direct and the Direct Project. The bigger and more important aspect is the CCDA Document itself.

    I agree that it would be easy to simply get the email (secured) of another practice and email. But Practices don’t know how to setup Secure Mail. All of this costs money and time. This is a good solution, but not cheap, at $9 or more per provider per month. I know that is a cheap cost, but the Government wants it, they should provide the HISP Functions via a national API that is free. One more example of how the Government can make a simple process hard.

    That said, this article misses one big problem. Now the Sexual Predators, Daughters Enemies all have access to her without your knowing. Further they can do harm or good via this new world she has found. Add on the fact that now all of her information is Public, and not private.

    This is exactly the same as this email of records, so some very secure method is needed. However, as many know my thoughts on this, we really need to throw away the concept of privacy in healthcare, every major entity (Ins, Govt, Private Practice, Hospital Community Health System) has been breached. Bottom line, we are a long way from ever really getting two juxtopossed positions to work, that is sharing of information and security of information.

    My two cents as a early vendor CEO and CIO in the Healthcare industry. I deeply understand the issues, but at the same time, think HISP is great idea, as is CCDA. On that we all should agree. Now how do we get there?

  • meltoots,
    You have a pretty glaring contradiction in your analysis. You say that you don’t have time to go around and figure out your referral network’s direct address and then you say that none of them have it. If you don’t have time to go and get them, how do you know if they have them or not?

    I’ve seen the way a doctor gets a direct address in many EHR and it’s extremely simple in the ones I’ve seen. Plus, it’s a one time thing you have to do. I’m sure many people said getting the fax number of a doctor was harder than just mailing them the letter too. It is harder until you’ve done it a few times and then you realize it’s much easier.

    It’s worth also noting that the doctor isn’t the one that goes around and collects the addresses from your referral network. It can be any one of your staff that does it. It’s also a one time task and then you benefit for a long time after.

    The one point you make that’s good is that many offices might not know their direct address and that can be a pain. However, that’s changing in a number of ways and will continue to get better over time. Plus, we’re seeing a variety of solutions that are coming out which bypass whether they have a direct address or not.

  • Brendon,
    I agree the government could have done more to make direct project a reality and much easier to take part. I think the powers that be got in the way and mucked that up.

    It’s interesting that you bring up privacy. I’ll leave the consumer privacy discussion alone. When it comes to direct project, I believe a direct message is more secure than what it replaces, a fax. Certainly we could talk about healthcare’s inability to secure patient information. There are plenty of gaping holes. However, I think direct messages are more secure than what people are doing today.

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