Improving Patients' Access to RecordsVA, Medicare Initiate 'Blue Button' Projects
Starting this fall, military veterans served by the U.S. Department of Veterans Affairs, as well as Medicare beneficiaries, will be able to download text versions of certain records using the blue button, a concept that the Markle Foundation is promoting.
Meanwhile, 46 organizations recently declared their support for the privacy and security practices included in the blue-button concept.
This month, the VA is enabling veterans to test-drive the blue button function by logging onto their My HealtheVet account. The account, which creates a personal health record, includes test results, health history and other information.
In early October, the VA, as well as Medicare, plan to officially roll out the blue-button download feature, according to the VA. The blue button will be available this fall on MyMedicare.gov, providing access to claims-related information, a Medicare spokesman confirms.
Leading the WayThe VA and Medicare initiatives, which have the potential of reaching tens of millions of Americans, "provide an excellent example for the health sector" on how to improve patient access to records, says Josh Lemieux, director of personal health technology at the Markle Foundation.
The blue button can help organizations comply with certain federal obligations, Lemieux says. Proposed modifications to the HIPAA privacy, security and enforcement rules, as called for under the HITECH Act, require healthcare organizations to provide patients with electronic copies of their records. Plus, requirements for earning incentive payments from Medicare and Medicaid for using electronic records include providing patients with electronic copies of their information.
"It makes perfect sense that the public, which is providing a taxpayer subsidy of health IT, should see some direct benefits from these investments, including secure, convenient and timely access to information that can make a difference in your health," Lemieux says.
The Markle Foundation and the 46 organizations backing the blue-button project also have called for making the download capability a core requirement for federal- and state-sponsored health IT grants and projects.
Addressing PrivacyThe blue-button concept, which the Markle Foundation developed in collaboration with other groups, calls for the use of a set of privacy and security policies building on the Markle Common Framework for Networked Health Information.
For example, the concept recommends alerting patients to the implications of downloading information, such a warning against downloading records to a shared computer. It also includes details about authentication methods and requires that requests for records be logged with an audit trail so they can be tracked.
The foundation hopes that hospitals, physicians, pharmacies, insurers, health information exchanges and others eventually will offer a blue button on their secure websites, Lemieux says. "The blue button is a basic fair information practice."
Once they download records, patients will be able to check them for errors and enter information into spreadsheets or personal health records to help manage their health. They can print the information, save it on a computer or storage device, or share it with healthcare providers.
Information available via the blue button will vary widely by organization, LeMieux says. For example, a pharmacy might provide easy access to medication histories; an insurer, such as Medicare, could provide payment history from claims; and a physician could provide test results and sections of a patient record.
Listen to an interview with LeMieux to learn more about how the Blue Button works.