DC-HIE DIRECT Messaging is a service of DC-HIE that allows authorized health care providers to send and receive secure messages that include a patient’s protected health information ("PHI"). DC-HIE DIRECT Messaging is designed to ensure that PHI is sent and received using industry best practice security controls that are, at a minimum, in compliance with all applicable federal and state laws and regulations. All DC-HIE DIRECT Messaging Organizations must go through an identity verification process to confirm that they are either (1) valid, legal entities in good standing in the District of Columbia or (2) a local, state or Federal government agency that has a legitimate reason to send and receive PHI. Each organization must employ at least one health care provider who is a member of the District of Columbia health provider community. The information provided in this Organization Enrollment Form will assist in the identity verification process.
This Organizational Enrollment Form [PDF] must be completed by an individual who is authorized to act on behalf of the organization. Each Organization can identify up to three (3) individuals who can access the Organization’s DC-HIE DIRECT Messaging Inbox (“Delegate End Users”). One of the organization’s Delegate End Users must be designated to serve as the Site Administrator (SA). The Delegate End User(s) must be under the direction and control of the Organization. The Organization is responsible for all activities of their Delegate End User(s) with respect to DC-HIE DIRECT Messaging.
In order to ensure the success and optimal utilization of DC-HIE DIRECT Messaging, it is important that all users cooperate with each other, provide accurate information, promptly update information when circumstances change, and diligently monitor their own DC-HIE DIRECT Message usage. The Site Administrator for the DC-HIE DIRECT Organizational Primary End User is responsible for maintaining accurate enrollment information and notifying DC-HIE of changes to such information so long as the organization remains a DC-HIE DIRECT Organizational Primary End User. This includes notifying DC-HIE of changes to the organization’s Site Administrator and/or Delegate End User(s). ALL end users will be required to accept the DC-HIE DIRECT Messaging End User License Agreement prior to using DC-HIE DIRECT Messaging.
The organization, if a legal entity, must submit documentation from the District of Columbia Department of Health demonstrating that it is in good standing (e.g. a certificate of good standing (corporation) or a certificate of fact of existence or registration (limited liability company)).
INSTRUCTIONS
PART 1. Organization User Information
This information identifies the Organization (Primary) End User requesting access to DC-HIE DIRECT Messaging.
PART 2. Organization Preferred DIRECT Messaging Address
This information identifies the preferred DIRECT Messaging address
PART 3. Delegate End User(s) Information and Authentication Information
This information identifies the Site Administrator (SA) and Delegate End Users requested by the Organization to have access to the Organization’s DC-HIE DIRECT Messaging Inbox.
DC-HIE DIRECT Messaging uses two-factor authentication to enable users to access the DC-HIE DIRECT Messaging Service. Two-factor authentication is based on something known, a password, and something possessed, a token. The token used by DC-HIE is a soft token, also called a “one time password.” The one time password (OTP) is a nine digit number sent to either an email account or SMS- enabled mobile phone number, or both, every time a user logs in and is only valid for a short period of time, measured in minutes. USERS MUST HAVE ACCESS TO either an email account or mobile phone when they login to the DC-HIE DIRECT Messaging Service so that they can receive their OTP and use it to login. Please specify how each Delegate user would like to receive their OTP. Each Delegate End User may choose to receive an alert notification when a new message arrives in the Organization’s DIRECT Messaging Inbox. The alert notification will be sent to the same device(s) as the OTP.
PART 4. INSTRUCTIONS FOR NOTARY
The instructions for the notary are clearly identified in Part 3 of the form.
PART 5. TO BE COMPLETED BY THE NOTARY
SUBMISSION OF COMPLETED FORM
Please send the notarized form [PDF] and documentation of good standing to DC-HIE by one of the following methods:
Electronic Mail (email):
Scan the form after it has been signed, notarized and seal affixed. Email the scanned form and documentation of good standing to [email protected].
FAX: Fax the completed form to (202) 442-4790
U.S. Mail:
District of Columbia Department of Health Care Finance
Attn: DC-HIE Direct Messaging
899 N. Capitol Street, NE
6th Floor
Washington, DC 20002