'Blue Button' Lets Medicare, VA Patients Download Records

Since the launch of the new "blue button" on the Medicare and Veterans Affairs patient Web sites this summer, tens of thousands of patients have downloaded their personal health records to computers, flash drives, and disks – including claims data, test results, and more.

Now, physicians’ groups and patients are calling for this practice to be commonplace for all.

Photo ©crystal kirk/Fotolia.com.

"If the patient has access to his or her [personal health] information, they become part of the decision-making process, they are more engaged in their care, and they’re empowered to make better decisions," said Dr. Steven Waldren, director of the American Academy of Family Physicians’ Center for Health Information Technology. "The blue button initiative is saying, ‘Let’s get started.’?"

The blue button, developed jointly by Veterans Affairs, the Centers for Medicare and Medicaid Services, and the Defense Department, is a "a Web-based feature through which patients may easily download their health information and share it with health care providers, caregivers, and others they trust," according to Todd Park, chief technology officer at the Health and Human Services department, writing in a post on the White House Office of Science and Technology blog.

The blue button went live in August on www.mymedicare.gov and www.myhealth.va.gov. Since then, more than 60,000 vets and more than 5,000 Medicare beneficiaries have made use of the feature, according to Mr. Park.

"This new option will help veterans and Medicare beneficiaries save their information on individual computers and portable storage devices or print that information in hard copy," Mr. Park wrote. "Having ready access to personal health information from Medicare claims can help beneficiaries understand their medical history and partner more effectively with providers."

The American College of Physicians, however, is wary of the initiative. “There are a lot of great ideas out there. How do we know that this idea is better than the others? So far, attempts to link patients with [their health care records] have been less than stellar” because they have yet to merge data from multiple sources to provide a tool that’s clinically useful for patients and physicians. Blue button also faces this limitation, said Thomson Kuhn, who as senior systems architect at ACP, plays a role in the college’s health IT policy.

“We’re not saying ‘no’,” to blue button, “but it’s too early to mandate something that doesn’t have real-world implementation information,” he added. It’s been proposed that participation in blue button be included in the next set of meaningful use criteria issued for health providers’ use of EHR systems, according to Mr. Kuhn. But at this point, not enough is known about its benefits to justify the time and effort physicians would spend to participate, he said.

A policy paper on the topic, "The Download Capability," published by the nonprofit Markle Foundation aims to promote the use of the blue button by calling on "organizations that display personal health information electronically to individuals in Web browsers to include an option for individuals to download the information."

Additionally, the paper recommended making the download capability a "core procurement requirement for federal- and state-sponsored health [information technology] grants and projects" that come about as a result of the American Recovery and Reinvestment Act of 2009, which allocated billions of dollars for the development of health care technology.

Dr. Waldren was a member of the work group that reviewed the foundation’s paper; he and more than a dozen physicians and other stakeholders endorsed it, including Dr. Jack Lewin, CEO of the American College of Cardiology, Dr. Brian F. Keaton, past president of the American College of Emergency Physicians, and Dr. Allan Korn, chief medical officer for the Blue Cross and Blue Shield Association.

Patients, too, seem to embrace the concept of downloadable personal health records. In an online survey commissioned by Markle, 70% of almost 1,600 adult respondents agreed that they should be able to download and keep copies of their personal health information.

The real benefit, however, lies in the potential of Internet and mobile phone–based "apps," or applications, which can access the data and increase its usefulness for patients and physicians alike.

For example, said Dr. Waldren, imagine a tool that parses through all of a patient’s downloaded health data, highlighting all potential and actual medical problems, making lists of all prescribed medications and doses, assessing them for drug-drug interactions and communicating that information to the physician at every visit.

He went on to say that such a smart app also could scan resource Web sites to find new scientific data and government findings that affect patient care. "Those are the things that can start to happen," with blue button technology, Dr. Waldren said.

Despite the myriad possible benefits of downloadable records, however, privacy remains a concern, for patients and physicians alike.

According to the Markle Foundation paper, "Any online download capability for personal health information must be provided via secure access. That means the identity of each individual given credentials to access their own data must be proofed to an acceptable level of accuracy, and the individual must present those credentials or some acceptable token of those credentials upon login in order to get access to the data for download."

Dr. Waldren agreed. "There’s no question that privacy and security are real issues," he said. And that means not only keeping the site secure, but educating patients, too.

"Every time the patient clicks on that blue button, they need to be reminded, ‘You’re doing something that puts your information at risk,’?" he said.

But he added that privacy concerns should not be something that keeps technology like the blue button moving forward.

"I personally view privacy as a balance between benefit and risk. We could put your records in an encrypted format or in a safety deposit box that no one could get to. It would be highly secure and I would bet it would never be released inappropriately," Dr. Waldren said. "But it’s never available to actually help make sure you get good care. And missing data can cause a lot of morbidity and mortality."

Since the launch of the new "blue button" on the Medicare and Veterans Affairs patient Web sites this summer, tens of thousands of patients have downloaded their personal health records to computers, flash drives, and disks – including claims data, test results, and more.

Now, physicians’ groups and patients are calling for this practice to be commonplace for all.

Photo ©crystal kirk/Fotolia.com.

"If the patient has access to his or her [personal health] information, they become part of the decision-making process, they are more engaged in their care, and they’re empowered to make better decisions," said Dr. Steven Waldren, director of the American Academy of Family Physicians’ Center for Health Information Technology. "The blue button initiative is saying, ‘Let’s get started.’?"

The blue button, developed jointly by Veterans Affairs, the Centers for Medicare and Medicaid Services, and the Defense Department, is a "a Web-based feature through which patients may easily download their health information and share it with health care providers, caregivers, and others they trust," according to Todd Park, chief technology officer at the Health and Human Services department, writing in a post on the White House Office of Science and Technology blog.

The blue button went live in August on www.mymedicare.gov and www.myhealth.va.gov. Since then, more than 60,000 vets and more than 5,000 Medicare beneficiaries have made use of the feature, according to Mr. Park.

"This new option will help veterans and Medicare beneficiaries save their information on individual computers and portable storage devices or print that information in hard copy," Mr. Park wrote. "Having ready access to personal health information from Medicare claims can help beneficiaries understand their medical history and partner more effectively with providers."

The American College of Physicians, however, is wary of the initiative. “There are a lot of great ideas out there. How do we know that this idea is better than the others? So far, attempts to link patients with [their health care records] have been less than stellar” because they have yet to merge data from multiple sources to provide a tool that’s clinically useful for patients and physicians. Blue button also faces this limitation, said Thomson Kuhn, who as senior systems architect at ACP, plays a role in the college’s health IT policy.

“We’re not saying ‘no’,” to blue button, “but it’s too early to mandate something that doesn’t have real-world implementation information,” he added. It’s been proposed that participation in blue button be included in the next set of meaningful use criteria issued for health providers’ use of EHR systems, according to Mr. Kuhn. But at this point, not enough is known about its benefits to justify the time and effort physicians would spend to participate, he said.

A policy paper on the topic, "The Download Capability," published by the nonprofit Markle Foundation aims to promote the use of the blue button by calling on "organizations that display personal health information electronically to individuals in Web browsers to include an option for individuals to download the information."

Additionally, the paper recommended making the download capability a "core procurement requirement for federal- and state-sponsored health [information technology] grants and projects" that come about as a result of the American Recovery and Reinvestment Act of 2009, which allocated billions of dollars for the development of health care technology.

Dr. Waldren was a member of the work group that reviewed the foundation’s paper; he and more than a dozen physicians and other stakeholders endorsed it, including Dr. Jack Lewin, CEO of the American College of Cardiology, Dr. Brian F. Keaton, past president of the American College of Emergency Physicians, and Dr. Allan Korn, chief medical officer for the Blue Cross and Blue Shield Association.

Patients, too, seem to embrace the concept of downloadable personal health records. In an online survey commissioned by Markle, 70% of almost 1,600 adult respondents agreed that they should be able to download and keep copies of their personal health information.

The real benefit, however, lies in the potential of Internet and mobile phone–based "apps," or applications, which can access the data and increase its usefulness for patients and physicians alike.

For example, said Dr. Waldren, imagine a tool that parses through all of a patient’s downloaded health data, highlighting all potential and actual medical problems, making lists of all prescribed medications and doses, assessing them for drug-drug interactions and communicating that information to the physician at every visit.

He went on to say that such a smart app also could scan resource Web sites to find new scientific data and government findings that affect patient care. "Those are the things that can start to happen," with blue button technology, Dr. Waldren said.

Despite the myriad possible benefits of downloadable records, however, privacy remains a concern, for patients and physicians alike.

According to the Markle Foundation paper, "Any online download capability for personal health information must be provided via secure access. That means the identity of each individual given credentials to access their own data must be proofed to an acceptable level of accuracy, and the individual must present those credentials or some acceptable token of those credentials upon login in order to get access to the data for download."

Dr. Waldren agreed. "There’s no question that privacy and security are real issues," he said. And that means not only keeping the site secure, but educating patients, too.

"Every time the patient clicks on that blue button, they need to be reminded, ‘You’re doing something that puts your information at risk,’?" he said.

But he added that privacy concerns should not be something that keeps technology like the blue button moving forward.

"I personally view privacy as a balance between benefit and risk. We could put your records in an encrypted format or in a safety deposit box that no one could get to. It would be highly secure and I would bet it would never be released inappropriately," Dr. Waldren said. "But it’s never available to actually help make sure you get good care. And missing data can cause a lot of morbidity and mortality."

Since the launch of the new "blue button" on the Medicare and Veterans Affairs patient Web sites this summer, tens of thousands of patients have downloaded their personal health records to computers, flash drives, and disks – including claims data, test results, and more.

Now, physicians’ groups and patients are calling for this practice to be commonplace for all.

Photo ©crystal kirk/Fotolia.com.

"If the patient has access to his or her [personal health] information, they become part of the decision-making process, they are more engaged in their care, and they’re empowered to make better decisions," said Dr. Steven Waldren, director of the American Academy of Family Physicians’ Center for Health Information Technology. "The blue button initiative is saying, ‘Let’s get started.’?"

The blue button, developed jointly by Veterans Affairs, the Centers for Medicare and Medicaid Services, and the Defense Department, is a "a Web-based feature through which patients may easily download their health information and share it with health care providers, caregivers, and others they trust," according to Todd Park, chief technology officer at the Health and Human Services department, writing in a post on the White House Office of Science and Technology blog.

The blue button went live in August on www.mymedicare.gov and www.myhealth.va.gov. Since then, more than 60,000 vets and more than 5,000 Medicare beneficiaries have made use of the feature, according to Mr. Park.

"This new option will help veterans and Medicare beneficiaries save their information on individual computers and portable storage devices or print that information in hard copy," Mr. Park wrote. "Having ready access to personal health information from Medicare claims can help beneficiaries understand their medical history and partner more effectively with providers."

The American College of Physicians, however, is wary of the initiative. “There are a lot of great ideas out there. How do we know that this idea is better than the others? So far, attempts to link patients with [their health care records] have been less than stellar” because they have yet to merge data from multiple sources to provide a tool that’s clinically useful for patients and physicians. Blue button also faces this limitation, said Thomson Kuhn, who as senior systems architect at ACP, plays a role in the college’s health IT policy.

“We’re not saying ‘no’,” to blue button, “but it’s too early to mandate something that doesn’t have real-world implementation information,” he added. It’s been proposed that participation in blue button be included in the next set of meaningful use criteria issued for health providers’ use of EHR systems, according to Mr. Kuhn. But at this point, not enough is known about its benefits to justify the time and effort physicians would spend to participate, he said.

A policy paper on the topic, "The Download Capability," published by the nonprofit Markle Foundation aims to promote the use of the blue button by calling on "organizations that display personal health information electronically to individuals in Web browsers to include an option for individuals to download the information."

Additionally, the paper recommended making the download capability a "core procurement requirement for federal- and state-sponsored health [information technology] grants and projects" that come about as a result of the American Recovery and Reinvestment Act of 2009, which allocated billions of dollars for the development of health care technology.

Dr. Waldren was a member of the work group that reviewed the foundation’s paper; he and more than a dozen physicians and other stakeholders endorsed it, including Dr. Jack Lewin, CEO of the American College of Cardiology, Dr. Brian F. Keaton, past president of the American College of Emergency Physicians, and Dr. Allan Korn, chief medical officer for the Blue Cross and Blue Shield Association.

Patients, too, seem to embrace the concept of downloadable personal health records. In an online survey commissioned by Markle, 70% of almost 1,600 adult respondents agreed that they should be able to download and keep copies of their personal health information.

The real benefit, however, lies in the potential of Internet and mobile phone–based "apps," or applications, which can access the data and increase its usefulness for patients and physicians alike.

For example, said Dr. Waldren, imagine a tool that parses through all of a patient’s downloaded health data, highlighting all potential and actual medical problems, making lists of all prescribed medications and doses, assessing them for drug-drug interactions and communicating that information to the physician at every visit.

He went on to say that such a smart app also could scan resource Web sites to find new scientific data and government findings that affect patient care. "Those are the things that can start to happen," with blue button technology, Dr. Waldren said.

Despite the myriad possible benefits of downloadable records, however, privacy remains a concern, for patients and physicians alike.

According to the Markle Foundation paper, "Any online download capability for personal health information must be provided via secure access. That means the identity of each individual given credentials to access their own data must be proofed to an acceptable level of accuracy, and the individual must present those credentials or some acceptable token of those credentials upon login in order to get access to the data for download."

Dr. Waldren agreed. "There’s no question that privacy and security are real issues," he said. And that means not only keeping the site secure, but educating patients, too.

"Every time the patient clicks on that blue button, they need to be reminded, ‘You’re doing something that puts your information at risk,’?" he said.

But he added that privacy concerns should not be something that keeps technology like the blue button moving forward.

"I personally view privacy as a balance between benefit and risk. We could put your records in an encrypted format or in a safety deposit box that no one could get to. It would be highly secure and I would bet it would never be released inappropriately," Dr. Waldren said. "But it’s never available to actually help make sure you get good care. And missing data can cause a lot of morbidity and mortality."