Friday, August 10, 2012

Automate Blue Button Initiative

There has been significant progress in the Blue Button Initiative and some new initiatives that will tie into this work. Out of a collaboration convened by the Markle Foundation, several agencies of the federal government have taken leadership roles in developing Blue Button. The U.S. Department of Veterans Affairs, Medicare, and TRICARE developed their Blue Button offering as part of a robust public and private sector collaboration and now offer hundreds of thousands of individuals the ability to download their medical records or claims information from their secure websites. Now several other organizations from both the public and private sector have pledged to offer similar download capabilities for their patients and members. The whole concept of Blue Button came about from the idea that people should be able to access and download their own health information.

Blue Button lets patients download their own health information in a simple, readable format that they can share with their doctors or other people they trust. Blue Button actually began back on August 2, 2010 when the President announced that Department of Veterans Affairs beneficiaries would be able to download their personal health information from their online accounts due to the new Blue Button offering. After the VA's Blue Button became operational the initiative was made nationally available in October 2010. Since then, Medicare and TRICARE have begun offering their beneficiaries a Blue Button, and private payers have implemented the technology as well. In January 2012 the Office of Personnel Management asked health insurers in the Federal Employees Health Benefit Program to add Blue Button functionality to their websites. UnitedHealthcare and Aetna have also begun offering Blue Button access to their Personal Health Record (PHR). President Barack Obama signed Executive Order 13571: Streamlining Service Delivery and Improving Customer Service in April 2011. This Executive Order called on U.S. government agencies to improve how they delivered customer service and required each agency to announce a "signature initiative" to improve customer service using technology.

I attended the Health Data Summit at the Whitehouse in June of 2012 where we discussed the idea of allowing automated Blue Button downloads based on trigger events and patient preferences. An array of individuals, groups, and organizations signed up at the meeting to help in a project to achieve this. We also heard about the new Presidential Innovation Fellows program, which seeks developers for short-term technology assignments, and includes a project designed to spread the use of the Blue Button. Shortly after the summit a new S&I Framework Initiative called RESTful Health Exchange (RHEx) was launched which seeks to develop specifications for secure RESTful transport for healthcare exchange.

ONC has now announced the new effort called the Automate Blue Button Initiative (ABBI) to develop standards and specifications that would allow patients to not only download their health information, but also to privately and securely automate the sending of that data to their preferred holding place. This is going to be a really big deal. This project needs developers to pilot the technology and patients and providers to then test that it works. There will be some valuable use cases that will potentially be deployed. For example, this initiative could enable patients to have their doctors or insurance companies automatically “copy them” on any updates to their personal health information. In another scenario, patients could “subscribe” to feeds that privately and securely give them updates to their health information, much as they currently subscribe to podcasts and news feeds.

The kick off call for the project is on August 15th at 4:00 pm Eastern Time. Then in September ONC will host the 2012 Consumer Health IT Summit where we should hear about the rapid progress I am expecting this initiative to achieve. A highlight from last years summit (which was webcast live) was the talk from former CMS Administrator Don Berwick, MD where he discusses the properties of goodness of a healthcare system:
safe, effective, patient-centered, timely, efficient, and equitable care. He also shares some personal stories about health IT and the importance of empowering patients with data and making them partners in their care. The ABBI will help bring his vision to fruition.


  1. Replies
    1. Excellent Greg! Hawaii will make great use of this technology and could potentially be an excellent pilot :-)

  2. Brian tiny typo. BB was introed in April 2010 not 2011