The Red, White Together With Blueish Buttons

On August tertiary President Obama announced the advent of a novel button: The Blue Button. The Blue Button is a wellness information download button. Consumers tin presumably click on the Blue Button too their medical records volition thence commence downloading to their reckoner (securely, of course). Anybody tin acquire a consummate medical tape on demand; amongst no delays from the busy medical records subdivision too no especial fees too no rims too rims of newspaper records to send around. Sounds similar an awesome footstep forrad for medical records portability.

The Centers for Medicare & Medicaid Services (CMS) volition brand Blue Buttons available for Medicare beneficiaries too thence is the Veterans Administration (VA). The Markle Foundation issued a policy newspaper too a challenge to developers to produce something meaningful amongst the Blue Button information (in partnership amongst Health 2.0). Crunching the numbers yields almost 30% of us amongst total electronic access to our medical records yesteryear virtue of a Blue Button. This is all really exciting too definitely warrants a closer look.

The VA delivers wellness attention too it has an EHR (VistA) too gigantic amounts of electronic medical records to share. The VA also has a website, My HealtheVet, where members tin access their latest medical records, persuasion benefits too perform unproblematic transactions, such every bit requesting meds refills too updating information. My HealtheVet, which is really a PHR, volition at nowadays last sporting a Blue Button, thence members tin download their electronic medical records inwards ASCII text format. The VA has a sample download file too it looks really useful.

CMS, on the other hand, is basically a payer. CMS volition last adding the Blue Button to their fellow member portal, MyMedicare, where claim information volition last available for download too also, what seems to be, Self Entered clinical data. Presumably Medicare beneficiaries volition update their clinical histories too thence force the push to download the file, also inwards ASCII text format. Unlike the VA, CMS is non quite gear upward to allow beneficiaries to download this information to their ain computers, but prefers that the information is transferred to a commercial PHR instead (e.g. Google Health, Microsoft Health Vault). Why CMS thinks beneficiaries cannot last trusted amongst their ain data, piece commercial PHRs can, or how they suggest to foreclose consumers from keeping copies of their ain data, is a flake unclear to me at this point, but CMS “may last conducting a projection called "the BlueButton"” to exam the concept. As nosotros all know, CMS is really skillful at airplane pilot projects, thence nosotros volition likely larn to a greater extent than inwards time.

The Blue Button is a footstep inwards the correct direction, but straight off exposes i big problem, a occupation that has plagued wellness attention computer science from the start. The VA Blue Button too the CMS Blue Button are creating incompatible text files. There is no mutual touchstone for the downloadable information.  Fields get got dissimilar names (e.g. DOB vs. Date of Birth) too dissimilar definitions (e.g. First Name, Last Name vs. Full Name) too objects (e.g. Allergies, Problems) get got dissimilar subfields. If y'all compare the VA file too the CMS file, y'all would last difficult pressed to guess that their intended purpose is identical. Any commercial PHR interested inwards receiving too incorporating Blue Button files volition get got to write 2 carve upward sets of software to procedure both VA too CMS files. If mortal EHRs too payers start adding Blue Buttons to their portals, each providing dissimilar information inwards dissimilar formats, nosotros volition halt upward amongst even thence approximately other bewildering array of incompatible data. Shouldn’t the rear “company” of both the VA too CMS (the Federal Government) get got defined a Blue Button touchstone first?

While the Feds move out the Blue Button kinks, I would similar to suggest 2 other buttons that may last fifty-fifty to a greater extent than beneficial than the Blue one, too together volition brand quite a patriotic splash on whatever website.

The White Button, thence named for those wearing white coats piece at work, should allow a physician to acquire all records for the patient inwards front end of her/him amongst i click of the White Button. We get got the beginnings of a White Button inwards the shape of the, almost complete, medication listing that tin last obtained inwards existent fourth dimension from Surescripts. We should construct on that concept, which interestingly enough, evolved without the back upward of massive infrastructure financed yesteryear Federal stimulus money. It simply made skillful occupation organisation feel too it plant similar a charm.

The Red Button, which volition hopefully last used less too less every bit technology improves, should allow whatever clinician too whatever patient who uses wellness attention technology to study security issues to the FDA, from inside the software, too every bit they occur. Much has been written lately on the involve for physicians too hospitals to acknowledge errors, apologize too larn from mistakes. We desire to stair out character of physicians’ move too pay them according to outcomes. The same logic should apply to EHR vendors. The Red Button volition last our character measuring tool too should last viewed yesteryear HIT vendors every bit a learning tool every bit well.
Pay 4 Performance is a 2 agency street.

Appropriately, the twenty-four hours when EHRs routinely come upward amongst Red, White too Blue Buttons volition last the twenty-four hours nosotros volition know that HIT victory has been achieved.