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More on Blue Button Plus and MU2

My last post, based on comments from Frost & Sullivan health IT analyst Nancy Fabozzi at last week’s Healthcare Unbound conference, has generated a bit of controversy. Fabozzi said that “Blue Button Plus is totally disruptive,” possibly eliminating the need for some providers to get full-fledged patient portals in order to meet Meaningful Use Stage 2 standards.

In the comments under that post, David Smith of HealthInsight.org, a health improvement consortium in three Western states, correctly pointed out that MU2 requires not just that providers give 50 percent of patients electronic access to their records, but also that 5 percent of patients actually view, download and/or transmit information back to their doctors or hospitals. I also got an e-mail from a GE Healthcare executive reminding me that of the view/download requirement as well as the fact that EHR technology had to be certified by an ONC-approved certification and testing body.

The viewing and downloading certainly can be accomplished with Blue Button Plus apps or widgets. In fact, ONC’s Lygeia Ricciardi has said Blue Button Plus could be part of the Stage 3 rules.

Transmitting would seem to necessitate a portal since HIPAA demands — and patients should expect — security when sending protected health information over the Internet. Standard e-mail doesn’t cut it, but e-mail following Direct Project protocols does. MU2 already sanctions Direct Project for health information exchange between healthcare entities. There is no reason why it can’t work for individuals as well, as Dr. Deborah Peel’s Patient Privacy Rights Foundation is trying to facilitate.

This might be a bit unwieldy, asking each patient to set up a Direct e-mail address, but remember, providers only need 5 percent to do so in Stage 2. I see it as perfectly feasible that some small physician practices could bypass the portal and just make do with freely available resources like Blue Button Plus — though Blue Button Plus app developers likely will charge fees — and open-source Direct standards.

UPDATE, July 18, 12:40 a.m. CDT:

HHS itself says Blue Button Plus meets MU2 standards.

From http://www.hhs.gov/digitalstrategy/open-data/introducing-blue-button-plus.html:

Blue Button Plus is a blueprint for the structured and secure transmission of personal health data. It meets and builds on the view, download, and transmit requirements in Meaningful Use Stage 2 for certified EHR technology in the following ways —

Structure: The recommended standard for clinical health data is the HL7 Consolidated Clinical Document Architecture or Consolidated CDA. The C-CDA is a XML-based standard that specifies the encoding, structure, and semantics of a clinical document. Blue Button Plus adopts the requirements for sections and fields from Meaningful Use Stage 2.

Transmit: In alignment with Meaningful Use Stage 2 standards, Blue Button Plus uses Direct protocols to securely transport health information from providers to third party applications. Direct uses SMTP, S/MIME, and X.509 certificates to achieve security, privacy, data integrity, and authentication of sender and receiver.

It sounds to me like compliance is just a matter of making sure that a Blue Button Plus app is certified as an EHR module.

July 17, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

RIP, Google Health, doomed to fail from the start

It’s official, Google is in fact walking away from Google Health, the way overhyped, way underused personal health record platform. In a posting on the Google Blog today, Aaron Brown, Google Health’s senior product manager, said the company would “retire” Google Health Jan. 1, 2012. (Data will be available to download until Jan. 1, 2013.)

Google also decided to wind down another experiment, Google PowerMeter.

From the post:

When we launched Google Health, our goal was to create a service that would give people access to their personal health and wellness information. We wanted to translate our successful consumer-centered approach from other domains to healthcare and have a real impact on the day-to-day health experiences of millions of our users.

Now, with a few years of experience, we’ve observed that Google Health is not having the broad impact that we hoped it would. There has been adoption among certain groups of users like tech-savvy patients and their caregivers, and more recently fitness and wellness enthusiasts. But we haven’t found a way to translate that limited usage into widespread adoption in the daily health routines of millions of people. That’s why we’ve made the difficult decision to discontinue the Google Health service.

In the end, while we weren’t able to create the impact we wanted with Google Health, we hope it has raised the visibility of the role of the empowered consumer in their own care. We continue to be strong believers in the role information plays in healthcare and in improving the way people manage their health, and we’re always working to improve our search quality for the millions of users who come to Google every day to get answers to their health and wellness queries.

Google said it soon will install functionality to help current PHR users migrate their data to other services following the Direct Project protocol, in the spirit of “data liberation.” That’s nice, but data really needs to connect with EHRs, or doctors and patients simply won’t use PHRs. Period.

I’m also going to take issue with Google referring to Google Health and Google PowerMeter as “trailblazers in their respective categories.” Google didn’t blaze any trails in PHRs. Dozens of other, smaller companies that have been working on the concept of PHRs for a decade or more are the real trailblazers.

The bottom line on Google Health? Google came into healthcare arrogantly believing it could save healthcare from itself and be all things to all people. (See also: WebMD, circa 2001.) It leaves with its tail between its legs.

Healthcare really does need disruptive outside forces, but it has to be a product people want to use. The iPad qualifies. Google Health never did, nor has any other untethered PHR to date.

 

 

 

June 24, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Post-HIMSS Health Wonk Review is heavy on health IT

The first Health Wonk Review since last week’s HIMSS conference is up, courtesy of Jared M. Rhoads of the Lucidicus Project. While I’m no fan of organization’s ideological bent (it seems to think CMS Administrator Don Berwick is more interested in socialism than in improving healthcare), I’m happy to say this roundup has more IT than normal.

For one thing, Rhoads mentions my post detailing my injury at HIMSS and the consumerism and EMR use that played into the care I received at a walk-in clinic in Orlando, Fla. I’m happy to report that I got the stitches out on Tuesday and the deep laceration is healing well. There’s a good chance that the resulting scar might kind of blend into my eyebrow, so I’m hoping it won’t be too conspicuous.

Four other IT-related items made it into this biweekly roundup of healthcare blogging and punditry, including Jane Sarasohn-Kahn’s discussion of remote health monitoring, based on a just-published white paper she wrote for the California HealthCare Foundation. You’ll also find posts about health insurance exchanges, the Direct Project to foster health information exchange and the recent “Developer Challenge” that Microsoft sponsored in the Boston area.

March 3, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.