This document discusses the emerging landscape of programmatic direct marketing beyond real-time bidding (RTB). It notes that while RTB has grown significantly, the majority of digital display spending still occurs through manual transactional processes. It explores how new programmatic approaches aim to automate these manual processes to connect buyers and sellers more efficiently. The document provides context on the complexity currently involved for both advertisers and publishers. It also examines the key questions around how programmatic direct may develop, including what technologies and standards will enable it to operate at scale for higher-value inventory beyond RTB. Overall, the document analyzes the opportunity and challenges for automating the "middle slice" of digital media transactions.