A 'Blue Button' for Health Data

To promote cost-effective, quality care, healthcare movers and shakers are pointing to health information technology to help lead the way. Patients and their families will need to be included in this process as well—to help them get the information they need to make informed decisions about their health. So to make it easier, how about clicking a blue button on their computer screens—just when they need their data?

The idea for the blue button—basically, an easy-to-remember icon to download information—isn't as far-fetched as it sounds, according to Markle Foundation, a Washington, DC-based public-private collaborative, which just released a policy paper this week on the subject. In fact, the idea of a blue button was given some credence in a speech to military veterans last month by President Obama.

In his talk, the President said that for the first time ever, veterans will be able to go to the Department of Veterans Affairs website, "click a simple blue button, and download or print your personal health records so you have them when you need them, and can share them with your doctors outside of the VA." 

And, similar plans are in the works for www.MyMedicare.gov to offer it to Medicare beneficiaries, Markle noted. So why can't medical practices, hospitals, insurers, pharmacies, and laboratory services consider blue buttons as well for their websites as well?

According to Markle, the move toward the blue button idea is part of the evolution toward making patients' personal health records (PHR) easily part of their care. In one of its surveys, Markle found that at least 86% of those questioned said that they thought obtaining their PHRs could help them avoid duplicated tests, keep physicians informed, move more easily from physician to physician, review the accuracy of their medical records, and track personal health expenses.

Last year, the American Recovery and Reinvestment Act "set the expectation" that individuals will be able to get electronic copies of pertinent health information about themselves, the foundation noted. And, when compared to more sophisticated health IT functions, a blue button appeared to be a "relatively low-cost and low-burden means" for health care providers to comply with the law, it added.

However, at the current time, this simple capability is rarely offered. But, if it was implemented with sound privacy practices, the little blue button could make a big difference if it became a common feature of health IT, the foundation observed.

In its policy paper, Markle calls for the blue button to be routinely offered to consumers—provided that a set of recommended practices are in place. These practices would first inform individuals about their choice to download information and confirm that the individual wants to do it.

As Markle notes in its white paper: "Simplicity is one of the biggest strengths of the download button. [But] no matter how simple this concept, individuals need to be made aware of how it works."

Next, safeguards need to be put in place so that the right person—and the right machines—are accessing the information. Given that patient engagement is a federal health IT priority, a need exists for federal guidance on "acceptable thresholds" for identity proofing and authentication of individuals, the foundation said.

As the download capability becomes a common feature on patient portals and other personal health information services, structured health data is likely to become more "easily harvestable" by automated processes—whether acting as legitimate proxies or as impostors. Therefore, Markle suggested the following protections:

• Deploy separate pathways for download requests from individuals, and download requests via automated processes acting on the individual’s behalf.

• On human-accessible download pages, deploy an effective means to determine whether a real person is requesting the download.

• Keep a record of download events in immutable audit logs.

• Consider enabling individuals to set up automated notifications for each time their information is downloaded.

• Include source and time stamps for data entries in the information downloads.

So, will there be a bevy of blue buttons soon in our healthcare future? Markle and the Robert Wood Johnson Foundation are challenging Web developers to "stimulate innovations" that can help patients stay healthy and manage their care using sample patient data sets made available by the VA and CMS. The challenge, to be staged at the Health 2.0 Conference in San Francisco next month, will offer $2,500 to the winner.

So maybe getting our personal health information in a timely and secure fashion could soon become as easy as ordering on Amazon or even filing our taxes online—just with the press of a blue button.