DirectTrust alliance developing standard for trusted healthcare instant messaging

The goal of the Trusted Instant Messaging+ standard is to enable secure real-time electronic transmission of healthcare information.
By Bill Siwicki
11:12 AM
DirectTrust alliance developing standard for trusted healthcare instant messaging

DirectTrust, a non-profit, vendor-neutral alliance initially created by and for participants in the Direct communications standard, has announced the development of Trusted Instant Messaging+, or TIM+,, an industry-first standard to enable real-time communication of health information that incorporates trust network concepts to ensure secure transmissions between known, trusted entities within and across enterprises.


DirectTrust is a healthcare industry alliance created to advance the electronic sharing of protected health information between provider organizations, and between providers and patients, for the purpose of improved transitions of care, care efficiency and coordination, patient satisfaction, and reducing healthcare cost.

While unsecured messaging may occur via text message, iMessage, products like Slack and others, there currently is no standard for secure instant messaging in healthcare, especially between disparate systems. Furthermore, use of unsecured messaging poses risk that HIPAA and other privacy regulations may be violated.

According to Direct Trust, the benefits of the TIM+ standard include, but are not limited to:

  • Integrated workflow: The TIM+ standard will bridge the communication gap between technology providers while keeping all participants within their native workflows and technology provider choices to maximize efficiency.
  • Cross enterprise and technology communication: TIM+ users will be able to communicate both within a given enterprise messaging implementation and across multiple technology providers using a common standard.
  • Common security and trust framework.


Instant communication and collaboration tools are becoming essential equipment in today’s modern healthcare setting. So DirectTrust has also issued a call for participation for the TIM+ Consensus Body, a group of industry stakeholders that will help finalize development of the TIM+ standard, finalize policies regarding TIM+ use, and assist with its ongoing maintenance.

Participation in DirectTrust standards initiatives is open to any person or company that has a direct and material interest within the respective scope of the work of standards development. DirectTrust membership includes eligibility for participation in DirectTrust standards activities. Non-members interested in participation can click here to complete an application.

TIM+ is the second initiative of DirectTrust Standards, a division of DirectTrust. DirectTrust received accreditation from the American National Standards Institute (ANSI) in March 2019. DirectTrust Standard’s goal is to develop standards and specifications that enable and enhance healthcare interoperability and identity.


Frequently, the continuum of care crosses multiple institutions and organizations, where communication is hobbled by technical, security, privacy and policy constraints, said Greg Meyer, director and distinguished engineer at EHR vendor Cerner, a DirectTrust member.

“The TIM+ initiative aims to create a standards-based secure and trusted instant communication network that can easily grow dynamically and at scale, both within and across organizational boundaries, and can overcome the security and privacy challenges of today’s digital healthcare environment,” he added.

“The goal of the TIM+ standard is to create a secure and protected instant messaging standard for providers to communicate with each other, as well as with patients and other care team members,” explained Scott Stuewe, DirectTrust president and CEO. “This is critical to eliminating the risk of violating HIPAA and other privacy regulations, and for the storing and sharing of protected health information.”

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