Frequently Asked Questions (FAQs)

Q. What is Direct Secure Messaging?

A: Direct Secure Messaging (Direct) is simply a secure email used to exchange health information between other healthcare providers and patients and/or their personal representatives. Direct is the only accepted email system in the Indian Health System to transmit and receive Protected Health Information/Personally Identifiable Information (PHI/PII) to meet the Meaningful Use 2 requirement. This secure email provides users with a standards-based way of sending authenticated, encrypted health information directly to the known and trusted recipient over the internet. Potential use cases for the Direct include:

• Provider-to-Provider Messaging: This use case includes message exchange between Indian Health System's Direct healthcare providers, message agents, and other external trusted Direct partners. This includes exchange between Federal and non-Federal providers. Uses of the Direct may include referrals, health documents, clinician-to-clinician messages, or other patients' health related communications that are currently sent via fax, mail, or courier within and outside Indian Health System community.
• Provider-to-Patient Messaging: This use case includes sending and receiving messages between members of the health care team (often through a message agent) and patients or their personal representatives.

Q. Who can get Direct Secure Messaging access?

A: The Indian Health System's healthcare providers, staff, and patients or their authorized representatives can get access to the Direct Secure Messaging.

Q. How can I request Direct Secure Messaging address?

A: Only authorized healthcare providers and staff can request access to Direct Secure Messaging. This request would need to be approved by the Facility Security administrator and/or Service Unit/Facility administrator prior to issuance of the Direct Secure Messaging address.

Patients and/or their authorized representatives will receive the Direct Secure Messaging access at the time they sign up for the Personal Health Record (PHR). A PHR account is required for patients to use the Direct Secure Messaging.

Q. Can I use MS Outlook and/or my IHS.gov email address for Direct Secure Messaging?

A: No. Although Direct Secure Messaging is similar to a regular email, it allows healthcare providers to exchange Protected Health Information/Personally Identifiable Information (PHI/PII) securely to their trusted Direct recipient(s). For this reason, secure messaging requires a separate Direct address.

Q. Can I send messages to a non-Direct secure email account?

A: No. Although Direct messaging is similar to a regular email, it requires a separate Direct address of trusted partners. Contact your Service Unit/Facility Administrator for Indian Health System Direct Secure Messaging Participants.

Q. To whom can I send Direct messages?

A: You can send Direct messages to the Indian Health System's Federal, Urban, and Tribal facilities participating in the Direct Secure Messaging and external partners with whom IHS Health Information Service Provider (HISP) has a trust relationship established. Contact your Service Unit/Facility Administrator for Indian Health System Direct Secure Messaging Participants.