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February 22, 2011

The dirty little secret about ‘Blue Button’

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Since last summer, various government agencies, notably the Department of Veterans Affairs, have been touting the Blue Button Initiative as an easy way of  sharing electronic data with patients. Just click the blue button in the patient EHR portal and download data into a personal health record or a printout. Sounds simple enough.

Late yesterday, my successor at a publication I was the primary writer of until late last year, cited the importance of the Blue Button, particularly when coupled with Microsoft’s HealthVault PHR platform. (If I turned in my story as late as 4:52 p.m. for that client, I would have been docked at least $150, but that’s neither here nor there.)

The fact that HealthVault and other “untethered” PHRs are non-starters when it comes to the public notwithstanding, Blue Button has a serious, perhaps fatal flaw. It outputs data in unstructured text form that’s not easily readable by an EHR. There’s no Continuity of Care Record, no Continuity of Care Document, no form of Clinical Document Architecture at all.

Just. Plain. Text.

One techie doctor I know calls this data essentially useless.

UPDATE 10 a.m. EST: The techie doctor I mentioned is Dr. Enoch Choi of Palo Alto Medical Foundation, per his comment below. He tweeted about this last month.

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    13 responses to "The dirty little secret about ‘Blue Button’"

    1. # Gerald Theis commented on February 22nd, 2011:

      Enter the “RED BUTTON”
      The launching of our patent pending ER health solution technology system will be unveiled during my presentation at the Wireless Technology Asia Summit in Singapore 3-24-3-25..
      First responders are “one tap away” from your vital medical data during a personal medical emergency or disaster event anywhere anytime. This proactive system will rewrite disaster preparedness planning.
      The interoperable webapp solution was designed to empower all citizens, not just a seagment of the population to save lives and avoid adverse events allowing ER physicians and first responders a knowledge-based assessment and evidence-based intervention at or BEFORE point of care!!

      2 minutes ago

    2. # Neil Versel commented on February 22nd, 2011:

      Gerald, that sounds like another untethered PHR that relies on the patient to keep everything up to date. Doctors won’t use it because they don’t trust patient-entered data and it doesn’t fit their workflow. I’ve not seen any evidence to the contrary for any PHR not directly linked to an institutional EMR. Period.

    3. # Enoch Choi, MD commented on February 22nd, 2011:

      You can use my name, I tweeted openly about this

    4. # Barbara Duck commented on February 22nd, 2011:

      The Blue Button for Medicare, same issue but at least it was made a bit more public-from December 2010. Middle ware or an API required for user friendly formats.

      http://ducknetweb.blogspot.com/2010/10/medicaregov-blue-button-download-for.html

      Having written code in VB years ago I still am driven to inquire about and inspect formats:)

    5. # Margalit Gur-Arie commented on February 25th, 2011:

      Folks, you’re going to have to start reading my stuff…. Just kidding, but I wrote about this back in September and it is actually worse: the CMS version and the VA version are totally incompatible. Collaboration anybody?
      More, here:
      http://onhealthtech.blogspot.com/2010/09/red-white-and-blue-buttons.html

    6. # Neil Versel commented on March 1st, 2011:

      Please do start reading Margalit’s blog. :)

    7. # Big health systems to promote connectivity | Meaningful HIT News pingbacked on April 4th, 2011:

      [...] be using for data sharing. If they pick something that’s unformatted text, à la Blue Button, this initiative might be doomed to failure. Related Articles:Podcast: Dr. Bill Yasnoff on regional [...]

    8. # Park defends plain-text format of ‘Blue Button’ | Meaningful HIT News pingbacked on May 1st, 2011:

      [...] back in February how I reported that the Blue Button Initiative that HHS, the VA and the Department of Defense had been touting was [...]

    9. # Park defends plain-text format of ‘Blue Button’ | Meaningful Use Technologies pingbacked on May 8th, 2011:

      [...] back in February how I reported that the Blue Button Initiative that HHS, the VA and the Department of Defense had been touting was [...]

    10. # Online Tool Aims to Ease Vets’ Job Search | | DOCUMENTSDOCUMENTS pingbacked on December 26th, 2011:

      [...] Through a MyHealtheVet online portal, they can download central information about their service, including deployment data, in-uniform knowledge and Military Occupational Specialty codes. They also will be means to upload this information to social-networking and pursuit sites. The portal formerly authorised vets to download their personal health records. This new information, as good as a health records, will be accessible in a Blue Button format, record designed to make it easy to share information (though that technology has a critics). [...]

    11. # Online Tool Aims to Ease Vets’ Job Search – IT Business Edge – How To Job Hunt pingbacked on December 26th, 2011:

      [...] Through the MyHealtheVet online portal, they can download official information about their service, including deployment data, in-uniform experience and Military Occupational Specialty codes. They also will be able to upload this information to social-networking and job sites. The portal previously allowed vets to download their personal health records. This new information, as well as the health records, will be available in the Blue Button format, technology designed to make it easy to share information (though that technology has its critics). [...]

    12. # Online Tool Aims to Ease Vets’ Job Search | | UTILITY DOCUMENTSUTILITY DOCUMENTS pingbacked on December 26th, 2011:

      [...] Through a MyHealtheVet online portal, they can download central information about their service, including deployment data, in-uniform knowledge and Military Occupational Specialty codes. They also will be means to upload this information to social-networking and pursuit sites. The portal formerly authorised vets to download their personal health records. This new information, as good as a health records, will be accessible in a Blue Button format, record designed to make it easy to share information (though that technology has a critics). [...]

    13. # Online Tool Aims to Ease Vets’ Job Search – IT Business Edge – How Do I Find Work? pingbacked on December 27th, 2011:

      [...] Through the MyHealtheVet online portal, they can download official information about their service, including deployment data, in-uniform experience and Military Occupational Specialty codes. They also will be able to upload this information to social-networking and job sites. The portal previously allowed vets to download their personal health records. This new information, as well as the health records, will be available in the Blue Button format, technology designed to make it easy to share information (though that technology has its critics). [...]

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