!!! Overview
DirectTrust is a collaborative non-profit association of 150 health IT and health care provider organizations to support secure, interoperable health information exchange via the Direct message protocols.  

DirectTrust has created a "[trust framework|Identity Trust Framework] that extends use of Direct exchange to over 40,000 health care organizations and 760,000 Direct addresses/accounts.  This trust framework supports both provider-to-provider Direct exchange and bi-directional exchange between consumers/patients and their providers.

DirectTrust’s trust framework makes it easy for health care professionals, health IT vendors, [Health Information Services Provider]s and their patients/customers to communicate securely, with identity proofing and regardless of end-user application.  Over 300 [Electronic Health Record] and [Personal Health Record] vendors’ products, and over 50 [Health Information Exchange]s, participate in the DirectTrust network, ensuring interoperability and security via Direct for exchange of health information to more than half the professionals in the U.S. health care system. (Can this be documented? Sounds implausible. Is this extrapolation from client base of [EHR]/[PHR]s? If so, they enable but may not "provide.")

!! More Information
There might be more information for this subject on one of the following:
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* [#1] - [_|Wikipedia:_|target='_blank'] - based on data observed:2015-05-18