Direct, a secure clinical messaging protocol launched by the federal government in 2010, provides secure emailing of sensitive patient information between Direct-enrolled clinicians or between them and their Direct-enrolled patients, for example, to patients enrolled in Microsoft HealthVault.

SMART Direct takes this a step further: a Direct-enrolled clinician can email to any Direct-enrolled recipient not just the patient information but secure access to one or more sender-designated SMART apps. With SMART Direct, clinicians can transmit medical information to their colleagues or patients interactively.