Statewide health information exchanges in Illinois, Kansas, Missouri and Nebraska will be able to send and receive basic healthcare messages between each other using the federally developed secure messaging protocol, the exchanges announced Tuesday.

The Office of the National Coordinator for Health Information Technology at HHS launched an effort in 2010 to develop a simplified method of “peer-to-peer” health information exchange under American Recovery and Reinvestment Act of 2009. Dubbed Direct, federal health IT authorities saw the system as the key component of its broader program to establish a nationwide Nationwide Health Information Network that could serve a highly mobile population or regions that encompass multiple states.

“By connecting with Kansas and Nebraska, Missouri Health Connection is leading the way toward improved care for patients who cross state lines for medical care,” Mary Kasal, president and CEO of Missouri Health Connection, said in a news release. “We're excited to now be connected to Kansas, Nebraska and Illinois and look forward to connecting with all our border states.”

Direct enables hospitals and physicians with already-established trust relationships to send and receive basic clinical messages such as referral letters, lab results or patient-care summaries. It contrasts with the broader NWHIN technology of query-and-response enabling a clinician or researcher to query a universe of records for a single patient across multiple providers through regional health information organizations, or a network of RHIOs, and obtain copies of those records.

Missouri, Kansas and Nebraska are the latest states to link together using Direct. Missouri and Illinois previously announced they were exchanging test messages, according to the release.

Last April, ConnectVirginia, a statewide exchange based in Richmond, Va., launched its services with Direct and offered a year of free messaging s an inducement to get members to use it.