This week, BIDMC implemented it.
While I was in Washington, co-chairing the HIT Standards Committee meeting, BIDMC engineers installed the open source Direct Gateway inside the BIDMC firewall. They worked with Healthvault engineers to exchange certificates so that the digital signing and encryption aspects of Direct's S/MIME implementation would guarantee data security and integrity.
BIDMC engineers then sent my Continuity of Care Record and Continuity of Care Document via the Direct gateway to my secure Health email address - firstname.lastname@example.org
A few seconds later, I received a notification on my personal gmail account
"New health information is available
While you can view this document at any time, you can't work with the information in it until you add each item into the right place in John Halamka's HealthVault record. This optional step makes the information more easily available to you and any health tools you use.
See the information you can add to keep John Halamka's record up-to-date."
I clicked on the URL embedded in the email, logged into Healthvault, viewed the incoming CCR and CCD, then incorporated the records as structured data into my Healthvault account.
The resulting data is displayed in "data atomic form" as suggested by the PCAST report. The screenshot above illustrates my data sent from BIDMC to Healthvault via Direct.
A one day implementation of an open source gateway that securely sends patient data (mine) to a PHR using industry proven S/MIME standards, creating a personally controlled health record that I can export and reuse per my privacy preferences.