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Carebox DIRECT Inbox

Last Updated: May 20, 2015 06:52AM EDT

Carebox for Box

​Refer to the article ​Introduction to the "Carebox for Box" Applications for an overview of the Carebox for Box suite of applications, which extend Box functionality for healthcare solutions.

Note that if you have never launched any other Carebox for Box application, the first time you launch the Carebox DIRECT Index application, you will be guided through the process for creating a new Carebox account associated with he same e-mail as that which is associated with your Box account, as described in detail in the article The First Time You Use a Carebox for Box Application.

Carebox DIRECT Inbox

The Carebox CDA Viewer is launched from the "More Actions / More Options" for a folder (not a file!) within Box. Note that it makes no difference what folder you use to launch Carebox DIRECT Inbox - this is simply the Box convention for launching add-on applications that are not file-specific.

When the menu item is selected, a new browser tab will open with the Carebox DIRECT Inbox displayed:
Carebox for Box - DIRECT Inbox

DIRECT Messaging

The DIRECT Messaging protocol is mandated for use by the US government Electronic Health Record (EHR) incentives program's "Meaningful Use" requirements. EHRs are require to be capable of sending and receiving using the DIRECT Messaging protocol.

DIRECT Messaging can be thought of as a form of "secure e-mail" although technically it is not only implemented that way. DIRECT Messaging addresses look just like regular e-mail addresses. By convention (although it is not required), the domain (the part after the "@" symbol) of a DIRECT Messaging address begins with "direct."  Unlike regular e-mail, DIRECT Messaging is a HIPAA-compliant way to transmit protected health information (PHI) from one system to another.

DIRECT Trust Bundles

With regular e-mail, you can enter any valid e-mail address in the world, press "send", and expect the message to be delivered. However, it doesn't work that way with DIRECT Messaging. For one DIRECT Messaging domain (e.g. direct.carebox.it) to be able to send to another - the two domains must "know" about each other and exchange secure encryption credentials in advance.

To facilitate this exchange of credentials and recognition of other domains by DIRECT Messaging systems, something called a "DIRECT Trust Bundle" is created whereby many organizations get together and publish their DIRECT Messaging credentials (in a secure way) so that their systems can communicate with each other using DIRECT Messaging.

The leading DIRECT Trust Bundle for consumer-facing applications like Carebox is managed by an organization called NATE. Carebox is part of the NATE Trust Bundle known as "NBBC4C". Another leading DIRECT Trust Bundle is managed by an organization called DirectTrust. Carebox is a member of DirectTrust and is in the process of joining their Trust Bundle.

Carebox for Box DIRECT Messaging

Carebox for Box enables any Box account to send and receive DIRECT Messaging communications. The term HISP is often used to describe an organization (Carebox, in this case) that provides DIRECT Messaging communication services.

Carebox DIRECT Inbox and Carebox DIRECT Send work together (both are part of the Carebox DIRECT add-on that is part of the Carebox for Box application suite) to enable both sending (Carebox DIRECT Send) and receiving (Carebox DIRECT Inbox).

To Whom Can You Send/Receive with Carebox for Box DIRECT Messaging?

You can use the Carebox DIRECT Messaging features to send any file via DIRECT Messaging from one Box account to another - provided that both have installed the Carebox DIRECT add-on.

Once you install Carebox DIRECT in your Box account, you can receive DIRECT messages from any EHR or other system that supports DIRECT Messaging and sending to DIRECT addresses in the NATE Trust Bundle - most leading EHRs and HISP providers support this.

Once you install Carebox DIRECT in your Box account, you can send a DIRECT message to any Personal Health Record (PHR) application that is part of the NATE Trust Bundle - a many are.

Using Carebox DIRECT Inbox

You do not need to launch the Carebox DIRECT Inbox screen in order to receive DIRECT Messaging communications into your Box accout. Just by installing the Carebox DIRECT application in Box, any document sent to the DIRECT Messaging address that you are automatically assigned, will appear in the Carebox folder in your Box account.

You will want to launch the Crarebox DIRECT Inbox screen for two reasons:
  • To know what your DIRECT Messaging address is - it is displayed near the top of the screen in bold/purple (in the screen shot shown above earlier in this article, the DIRECT Messaging address is demo.user3@direct.carebox.it).
  • To see a history of DIRECT messages that you have received (much like a regular e-mail inbox).

The Carebox DIRECT Inbox Screen

As shown in the screen shot earlier in this article, the top portion of the Carebox DIRECT Inbox screen is purely informative. At the bottom list of the DIRECT messages that have been received in this account, to-date.

Each row represents one DIRECT-recieved document  and shows the document date, the sender, and the receipt date. Click the down-arrow at the far right of the screen to expand the row and view the content of this DIRECT message:
Carebox for Box - DIRECT Inbox - Expanded Item
You can click on the file-box to open the file. If it is a CDA file, it will open in the Carebox CDA Viewer. Other files will be displayed or downloaded as per the configured behavior and capabilities of your web browser. 

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