WISHIN Direct+ is part of your WISHIN Pulse Access

WISHIN Direct+

An efficient flow of information among providers creates a solid foundation for effective patient care. Direct messaging is a simple, easy-to-use mechanism for providers to communicate securely with each other.  Direct messaging works much like email except that it has the added technical protections necessary for sensitive patient clinical information. It is highly secure and HIPAA-compliant.

What It Does

WISHIN’s Direct messaging solution is called WISHIN Direct+. With WISHIN Direct+ providers have the ability to quickly and easily connect and communicate with one another electronically, regardless of their health system affiliation and across electronic medical records systems. It’s as easy and user-friendly as email. In addition to point-to-point communications about the patient, WISHIN Direct+ provides for a seamless, open exchange of patient information to support referrals and care transitions—healthcare hand-offs where complete and timely information is critical to ensuring quality patient care and patient safety.

How It Works

To use Direct messaging, each provider must have a Direct address.  Direct addresses look like email addresses and can be configured to identify the provider’s organization as part of the address, like this:




Health Information Service Providers (HISPs) manage the secure transport of Direct messages from one provider to another. Every provider that wishes to send or receive Direct messages must have a HISP service.

WISHIN offers both Direct addresses and HISP services.

WISHIN’s HISP services can integrate into a provider’s EHR so messages can be sent and received directly into the EHR, eliminating the need for a provider to go outside his/her workflow to view and send messages. For providers that do not have an EHR, WISHIN has a web portal that providers can use to send and receive Direct messages.

Security and Trust

The sensitive nature of the information shared via Direct messages requires that the messages be transported using HIPAA-compliant technology.  This means that messages cannot just be sent freely over the internet – a network of connected HISPs must be used. To ensure the broadest possible network for WISHIN Direct+ customers, WISHIN and our technical vendor, Secure Exchange Solutions (SES), are members of DirectTrust. DirectTrust is a national nonprofit alliance of health technology and healthcare organizations that have established a security and trust framework for the exchange of Direct messages. Through SES, WISHIN is part of the Trust Bundle that allows providers using WISHIN’s HISP to securely exchange messages with providers using different HISPs.

Minnesota HDI Certification

Health care doesn’t stop at the Wisconsin border. Providers can practice in multiple states, health systems and clinic groups have clinics and/or hospitals across state lines, and patients may seek care in multiple states.

On a practical level, where care is received shouldn’t have to matter. But on a technical, legal, and policy level it can be a big deal. Each state has its own set of laws and policies that govern how health care in that state must operate. Sometimes the laws or policies in one state will conflict with the laws in another. This is true for everything from patient consent laws to emergency department chart-access policies, to data-sharing processes. Technology must be able to accommodate the laws and policies of the states where it is used and if it is transmitted across states, it must be able to accommodate the unique requirements of all the states using it.

Late in 2014, WISHIN did an evaluation of the technical, policy, and legal ramifications of sharing data with our border and snow-bird states. As a result of our evaluation and the current functional status of our border and snow-bird state HIEs, WISHIN decided to start our efforts for connectivity and interoperability with Minnesota. With several hospitals and clinic systems spanning the Wisconsin-Minnesota border, connectivity and interoperability with Minnesota could offer tangible benefits to WISHIN participants operating – and patients living – on the “west coast” of the state.

Minnesota has several laws and policies related to HIE and the sharing of patient data through an HIE entity.  Certification from the Minnesota Department of Health is required for any HIE to operate in Minnesota.

WISHIN’s received our official Minnesota health data intermediary (HDI) certification at the end of May 2015 – allowing us to provide HIE services to Minnesota providers.

WISHIN’s Minnesota HDI certification is another successful step toward true interoperability, providing critical health information where it is needed when it is needed for seamless, complete, and improved patient care.