1. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 1:00 pm ET, July 10, 2015 https://global.gotomeeting.com/meeting/join/930802605 (626) 521-0013 -- 930-802-605# 1

2. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Agenda Welcome and new member greetings DTAAP, industry update, and news from members. – Directory Services Pilot – HIMSS Survey – Certificate Discover Tool from MaxMD demo Workgroup updates Open discussion and comments “You are the most trusted names in Healthcare Exchange” 2

3. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 DirectTrust Members 151 and Counting….. 3 3 Lucy Johns, MPH

4. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 DirectTrust Members 151 and Counting…. 4

5. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 New Members Urgent Consult LLC Mount Airey Group, Inc. 5

6. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Renewing Members 6

7. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 7 Full newsletter from CareAccord Website https:www.careaccord.org

8. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 8

9. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Calendar of Events – August 18 th at 2:00 pm ET Join Us for a Webinar: “Health Information Governance: A Discussion on the Regulations and Policies Governing the Release of Health Information,” led by DirectTrust Member, David Borden from MRO Corporation. 9

10. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Accredited DirectTrust Members 10 New Accreditations in 2015 Quest Diagnostics Orion Health Nitor Group Health Unity iShare Medical Cozeva – Applied Research Work, Inc. eClinicalDirect Pulse Systems Glenwood Systems Shifox

11. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Accredited Trust Anchor Bundle 11 Let’s toast to the HISPs in the Accredited Trust Anchor Bundle. Congratulations! **Note: Pulse Systems and Integrated Care Collaboration are in the process of joining the Accredited Bundle. **

12. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 12 Fully Accredited HISPs/CAs/RAs

13. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 13 Candidate and Applicant HISPs/CAs/RAs

14. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 If you are interested in participating in the Directory Services Pilot please contact Stephen Weiss at Stephen.Weiss@DirectTrust.org. Stephen.Weiss@DirectTrust.org Fees for the Accredited Trust Anchor Bundle are due by July 15, 2015. Please email Admin@DirectTrust.org if you have any questions.Admin@DirectTrust.org 14 Things to Remember

15. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 HIMSS Survey Current market view of the usage, value and future of Direct Messaging Themes from the survey results:survey results substantial use of Direct in support of care coordination use cases, broad availability to a provider directory but great variability in the method of access, continued challenges incorporating structured data into the EHR, extensive membership in a HISP, some knowledge of the availability of Direct messaging among the clinician community, and that most participating organizations support Direct as the method choice for exchanging data. 15

16. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 HIMSS Survey The top five reported uses of Direct include: (i) transitions of care, (ii) ADT notifications, (iii) patient communication, (iv) secure email for other purposes and (v) consult requests between physicians The top three reported benefits of using Direct include (i) improved speed of info access, (ii) reduce paper handing, more accurate and (iii) complete patient information Major challenges impacting Direct implementations include: (i) high cost, (ii) changing workflows and (iii) other providers not ready to interface 60% of respondents report use of hosted webmail accounts (available via a browser) 76% of respondents reported access to a provider directory, further 64% report they can access internal providers from that directory from within their EHR, whereas 52% report they can access external providers within their EHR 28% report their EHR offers an integrated directory, whereas 28% report they pull in the directory via web services and 17% perform a manual download 83% of respondents are part of a HISP; 85% of HISPs can route information to another HISP 85% of HIOs are part of a scalable trust network (e.g., DirectTrust, NATE, HealtheWay) and most respondents report it extremely important their HISP is part of such a network 51% agree that the cost of using Direct is worth the benefit of information exchange There remains no standard provider directory format – 14% report using LDAP, 14% use IHE HPD, 18% have no plans to adopt a standard, 18% are considering their options, while others use another proprietary standard or simply a relational database. Incorporating C-CDA data, identifying trading partners and funding implementations are reported as modestly challenging; completing the directory is reported as prohibitively challenging, In the absence of MU, respondents reported the following technical preferences for sending electronic health information: CONNECT (27%), SMTP/S-MIME (23%), Direct + XDR/XDM (15%), SOAP+XDR/XDM (6%) 16

17. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Very significant press notice 17

18. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Workgroup Reports Patient and Consumer Participation in Direct – Lucy Johns and Renee Smith Directory Policy – Bruce Schreiber and Jim Fisher Security and Trust Compliance – Luis Maas and Jeff McDonald Trust Anchor Bundle Operations – Greg Meyer Certificate Policy and Practices – Don Jorgenson Clinical Transitions of Care – Holly Miller and David Kibbe DirectTexting - Bruce Schreiber esMD Workgroup – Scott Rea and David Kibbe FHIR Security and Trust – Brian Ahier and Calvin Beebe First workgroup meeting – June 11 th at 3:00 pm ET 18

19. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Discussion David C. Kibbe MD MBA President and CEO DirectTrust.org David.Kibbe@DirectTrust.org kibbedavid@mac.com 913.205.7968 19