nateThe National Association for Trusted Exchange (NATE) brings the expertise of its membership and other stakeholders together to find common solutions that optimize the appropriate exchange of health information for greater gains in adoption and outcomes. is a leading cloud-based platform for storage, collaboration, and content management.


Carebox is proud to be an active member in NATE and part of the NATE Blue Button for Consumers (NBB4C) Direct Messaging trust bundle that makes it easy for any doctor or hospital with an Electronic Health Record (EHR) that meets the US Government requirements of “Meaningful Use” to send anyone their clinical summary, discharge summary, and other medical records directly into Carebox.


Get Your Healthcare Records with Carebox and NATE

Carebox enables anyone to get copies of their electronic healthcare records from their doctor or hospital with Direct Messaging – thanks to our partnership with NATE


The Carebox DIRECT Box add-on application – part of the Carebox for Box application suite – enables anyone with a Box account to send and receive Direct messages from within Box.

Anyone can sign up directly for a Carebox account and immediately have a Direct address that they can share with any doctor, hospital, or other healthcare provider. This enables them to get a copy of their electronic health records from the provider’s EHR system directly into Carebox.

Now that Carebox is part of the NATE Blue Button for Consumers Trust Bundle, it’s even easier for any healthcare provider to use their EHR to send clnical summaries directly to Carebox!

Get Started Now

Understanding Direct Messaging

Direct Messaging

health_recordThe 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, due to its special secure nature, it doesn’t work that way with Direct Messaging. For one Direct Messaging domain (e.g. 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.

NATE Blue Button
for Consumer (NBB4C) Trust Bunde


The leading Direct Trust Bundle for consumer-facing applications like Carebox is managed by NATE. Carebox is part of the NATE Trust Bundle known as the NATE Blue Button for Consumers “NBB4C” Direct Trust Bundle.

Our membership in NATE and our recent onboarding to the NBB4C Direct trust bundle are core to the Carebox story of patient-centric healthcare data interoperability. Every consumer with a Carebox account now has an associated Direct address that is part of the NATE NBB4C. That in turn means that any healthcare provider, using any MU2-compatible EHR or HIE product, can securely send a consumer’s healthcare record directly into their Carebox – as per the HIPAA-mandated right we all have to get copies of our own health records.