Direct Messaging Overview

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What is Direct Messaging?

Direct Messaging is an initiative that aims to reduce the use of paper to transmit Protected Health Information (PHI) through fax or mail. Using Direct Messaging gives practitioners, practices, and patients a secure way to send PHI via email.

Accessible through your OP Message Center, Direct Messaging lets providers send and receive messages securely with other members of the Direct community, irrespective of location or the EHR being used. Patients and parents can send secure health information to other community members via their OP Portal account. It’s that easy!

The impact of Direct Messaging across the medical community increases with the number of individuals who obtain and use a Direct email address. The ability to easily and securely exchange PHI will have a positive impact on patient care, so we encourage you to reach out to pediatric specialists and hospitals in your area to learn how they intend to incorporate Direct Messaging in their practices. Our Medical Director has provided a sample letter that you can send to your colleagues for your convenience.

In order to send/receive Direct Messages from OP, the user must utilize a Direct Messaging address issued by us via EMR Direct. Practices that plan on using a Direct Messaging address not issued by OP must generate a CCD, download it to their desktop then open up the application they are using for Direct Messaging and upload it into the message they compose. QIC can not capture this action and therefore the client can not meet the MU requirements.

Onboarding Process

A representative from the practice must fill out an organizational application that identifies them and the practice. EMR Direct, the partner that we have chosen for this process, will verify the identity of the practice and the individual who signs the organizational application. This process of Identity Proofing may be completed through a notarized form or remotely via an emailed link.  If the practice moves steadily through the required paperwork, the Direct Messaging onboarding usually takes two to three weeks. 

Once Identity Proofing is completed, Office Practicum provides Training Documentation from our Help Center. OP's Implementation team will set up the Direct Email addresses in the address book for the users in your practice. Next, the practice will need to set up external direct email addresses via the Address tab of an entry within the address book. You will need to ask recipients for their direct preferred address. You must enter a secure email address, otherwise, the deliveries will fail.

 If your practice is interested in implementing Direct Messaging, contact your Account Manager at

Note: A Direct Messaging address is assigned to a specific individual within a practice. If that user changes practices, they must obtain a new address with the new practice. A Direct Messaging address can only have one person who uses it. To receive a Direct Messaging address, each user must have a verifiable need to transmit or receive Protected Health Information.

Direct Messaging Accounts for Medical Staff Members

Each practice can obtain Direct Messaging addresses for any members of the medical staff who have a legitimate need to transmit or receive PHI (for example, for referrals). Members of the medical staff who obtain a Direct Messaging address must have their own address, which costs $15 per month, per address.

Requesting Direct Messaging Address Based Upon Role

Practices can use a Direct Messaging address that uses the purpose or role within the practice as opposed to named individuals (for example, However, only one individual can be linked to each Direct Messaging address. If a practice wishes to follow this format, they will need to obtain a Direct Messaging address for each user (for example,,

Notifying OP after a Direct Messaging User Leaves the Practice

If a Direct Messaging user leaves their practice, the practice must notify OP immediately. When any user no longer needs to access PHI via Direct Messaging, the practice is obligated to notify OP. After receiving notification that a Direct Messaging user has left their practice, OP makes the necessary updates to the EMR Direct Messaging account.

Pricing of Direct Messaging Addresses

If a practice purchases Direct Messaging bundled with an OP package, all fees are included in the purchase and monthly maintenance contract. If a practice purchases Direct Messaging outside of an OP package, the practice must pay a one-time fee of $300 for the practice to be set up with Direct Messaging. This fee covers the cost of Identify Proofing for the practice and the set up of a subdomain (“opdirect”) for the practice to use for Direct Messaging. There is also a recurring fee (on a monthly basis) of $15 that is charged per address, per month.

Format of Direct Messaging Email Addresses

Practices can choose to use a subdomain of opdirect or a subdomain of a domain they already own. If a practice chooses to create its own subdomain, the practice must complete additional paperwork and must pay an additional one-time premium. There is no additional cost to use the opdirect subdomain.


OP Subdomain:

Custom Subdomain:

Obligation of Practices and Providers

OP requires that any practice that participates in Direct Messaging have one Direct Messaging address for each provider. OP will gather user data to calculate Stage 2 MU Core Measure for production and delivery of Summary of Care records. Each MU-eligible provider must have their own Direct Messaging email address and must use it appropriately for the measure to be calculated correctly.

Direct Messaging Videos

External Messages