There is an intriguing program dubbed Blue Button® that was launched by the Obama administration in 2010 to enable individuals to download their personal health information as an ASCII text file directly to their computers, mobile devices and tablets. The idea of Blue Button is to provide individuals with their specific health data in a readable format so that they can use it and share it with their providers and care planners. Blue Button data also helps physicians rapidly understand the health status of a new patient and quickly evaluate recent treatment. The idea is viable, in concept, but for it to be effective it has to work for all users transparently.
Blue Button ties directly into a key component of Stage II Meaningful Use of electronic health records which says that patients must be able to download, view and have access to their health information within four days of when that information was generated or within 36 hours after a hospital discharge. However, before there is broader use and acceptance of Blue Button, millions of health care consumers in U.S. need to be educated about why having health data in their own hands is important. They also need to understand what they can do with that information. Finally, they need easy access to Blue Button.
A Markle Foundation Survey on Health in Networked Life, Jan 31, 2011, indicated that roughly two in three individuals, as well as most doctors, agree that people should be able to download their personal health information.
A goal of the Office of the National Coordinator for Health IT is to move the bar from the current one million users of Blue Button, to ten million and eventually to all citizens.Currently, over 500.000 veterans are using the Blue Button program that is available on their laptops, tablets and even their mobile phones to download data including appointment information, prescriptions and medications, laboratory results, vital signs and readings, military health history and military occupations. They access this health information on the MyHealtheVet patient portal, click the Blue Button on the portal and download or print their health records for the purpose of sharing them with doctors and other health providers.
Medicare launched its own version of Blue Button in September 2010 on the My Medicare portal theoretically giving 40 million beneficiaries access to their Medicare claims forms. There are two problems here: (1) most Medicare beneficiaries have never heard of Blue Button and (2) it is not easy to use. I personally went to the mymedicare.gov site, signed in and tried to press the Blue Button to download my data twice and nothing happened.
Blue Button is also available to users of Microsoft Health Vault and Dossia as well as Aetna, Kaiser Permanente, and McKesson, all of whom offer patient-controlled personal health records. Once again when I tried to click on the Blue Button to download my data in Microsoft Health Vault, it did not work and asked me for a veteran identification. I am not a veteran.
The goals of Blue button: (1)Give consumers Access to health information (2) catalyze market innovation to allow consumers to take Action toward better health using health information; and (3) shift consumer and provider Attitudes in support of consumer engagement in health are admirable. But we have to ask:
Are patients clamoring for their personal health data?
Are patients going to know what to do with their data?
Do we not need extensive education programs behind the Blue Button initiative?
Are physicians going to work with their patients to attain better communication and cooperation once patients have their data?
Is this just another example of the system forcing a program on the American public that people do not want, do not understand, or are oblivious to?
Let’s hope not. As e-Patients many of us do want to have our personal health data downloaded to our computers or other devices. We want to be able to easily access our health information at the point of care so it can be shared with our providers. However, the launch of this program requires training and communication that seems to be missing.