Blue Button's simple, intuitive design could help spur adoption. "We believe that the more people see that logo, that symbol, the more adoption there will be," Officer said. In fact, the Blue Button approach is now being mimicked by the energy industry, which is developing a web applet called Green Button that provides energy usage information to consumers.
As more companies get behind Blue Button, maintaining interoperability becomes a more critical requirement. Health Level Seven International (HL7), the international health IT standards body, has adopted Blue Button as an "authoritative interoperability exchange format," and the VA, the Office of the National Coordinator for Health IT, and others are now building an XML-based standardized version of Blue Button data that coincides with the HL7 Consolidated Clinical Document Architecture standard.
The HL7 standard will make it easier to share information with and among health providers and to develop applications and services that aggregate Blue Button data from multiple sources and present data in a simple format. Levin said the industry is moving in a direction "that adds value to the data, that mashes it, that aggregates it, and that shares it not just between patient and provider, but between institutions." Blue Button leadership calls this the Automate Blue Button initiative.
There are a growing number of Blue Button applications. The Office of the National Coordinator for Health IT's Blue Button Mash Up Challenge and The Advisory Board Company's Patient Engagement Blue Button Challenge are underway, with winners to be announced in October.
Humetrix is among the companies participating. Humetrix is working on version 3.5 of its iBlueButton app for iOS devices, and an Android version is planned. The health IT company's smartphone apps can download Blue Button data from sources such as the VA and Aetna and let patients share the data with their doctors via Bluetooth or Wi-Fi over an encrypted channel.
Blue Button data in its raw form includes coded numbers representing, for example, pharmaceuticals. The next version of Humetrix's iBlueButton will query public databases to translate those numbers into drug names and potential side effects. It will also let patients note if they're experiencing those side effects.
Given the sensitivity of healthcare data, privacy and security are being closely watched. Levin declined to discuss the specific security measures VA has in place to ensure the safety of data, saying only that the agency takes "exquisite care in maintaining the security and privacy of the health information" that it possesses.
Companies supporting Blue Button must make similar commitments due to laws such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH). Humetrix's iBlueButton app uses an encrypted channel for downloads and requires users to log in and validate any transfer of information from patient to provider. In addition, the app automatically logs off if it's been idle for too long.
Many of these pieces still need to be put into place before Blue Button can live up to its full potential. There are 17 million potential users at United Health Care alone, but only 12,000 have used Blue Button so far. United Health Care plans to launch an awareness campaign. Said Officer, "We've also got to shift patients to think they're responsible for their own health."
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