Blue Button: The Patient-Physician EHR Connection

At Every Point of Care

Bettina Experton, M.D. M.P.H.

The 2013 Physician-Computer Connection Symposium

What is Blue Button®? A Transformative National Policy for Patients to V/D/T their Online Health Records

and Adopted Nationwide for Use Today by ~100 million Americans

From Blue Button… to iBlueButton

From a 300 page Blue Button ASCII text claims record to…

A Mobile Longitudinal Health Record Available at Every Point of Care

From a Simple Text File to.... iBlueButton® The ONC Industry Innovation Blue Button Challenge Winner

Blue Button+ Meets MU-2 V/D/T Requirements http://bluebuttonplus.org/mu2.html

Requirements Specified in MU 2 VDT Specified for Blue Button+

Structure Consolidated CDA Consolidated CDA

Section & Fields MU2 Sections & Fields MU2 Sections & Fields

Transmit Direct Protocol (SMIME/SMTP) Direct Protocol (SMIME/SMTP)

Trust Anchors Manual Anchor Exchange Blue Button Trust Bundle

Certificate Discovery Via DNS or LDAP Via DNS or LDAP

Transmit Context - In message body and optional Request.txt

Download Yes Yes

Transmit: Send Once Yes Yes

Transmit: Send on Change - Automation & Triggers

iBlueButton®: a Registered Blue Button+ Trust Bundle Patient Application

https://secure.bluebuttontrust.org/

Name Website Domains Expires Status

Microsoft HealthVault healthvault.com direct.healthvault.

com 12/31/2039 Active

NoMoreClipboard nomoreclipboard.com

nomoreclipboard.com 12/9/2023 Active

ibluebutton ibluebutton.com ibluebutton.com direct.ibluebutton.com

2/23/2033 Active

EMR Private Payer Lab

iBlueButton Server

Direct Registry Service Push Notification Service

Download Service Direct Messaging Service

Blue Button+ goes mobile with iBlueButton For Anywhere, Automated V/D/T on the User’s Own Device

Push Notification

Immediate Record Access

File Decoding & Reformatting

iBlueButton Home Screen

App Direct Address

Mobile to Mobile Exchange of Blue Button and

other records at the Point of Care

The iBlueButton apps are based on Humetrix U.S. patent #5,995,965 and other pending patents. "Blue Button", the Blue Button logo, and the slogan "Download My Data" are registered Service Marks of the U.S. Department of Health and Human Services (HHS) an agency of the United States Government and are used by permission of HHS. © 2013 Copyright Humetrix.

Patient-Controlled Mobile HIE App POC Device to Device 2-way Data Exchange

HIE and Care Coordination Shortfalls: The Medicare Use Case

In 2011, only 31% of physicians can exchange records electronically

With the average Medicare beneficiary seeing 7 physicians per year, 2/10,000 odds that all of a given patient’s physicians could exchange medical records for that patient

Under 5% of SNFs, Rehabilitation or Long-term Care facilities have installed EMR systems

Given that 1/3 of Medicare patients are discharged from a hospital to one of these facilities, large gaps exist in making medical records available which are not addressed by conventional HIE strategies

“Advancing Interoperability and Health Information Exchange” By Leveraging the Blue Button Initiative (Question #9 RFI)

Response to ONC/CMS (April 22, 2013) Broad outreach communication campaign to Medicare

beneficiaries

Large scale healthcare provider outreach to let them know about the value of the 3- year longitudinal history provided by the Medicare Blue Button for transitions of care and drug reconciliation.

Register Medicare patients for Blue Button record access at the time of the Welcome to Medicare and/or at the Annual Wellness visits.

Upon admission & prior to hospital/ER discharge, register

Medicare beneficiaries for Medicare Blue Button record access at My Medicare.gov

“An eye opener to me…” “You’ve got to see this because it is that good”

“There are 38 Million on Medicare now who could be doing this and there are 38 million on Medicare who have not done this”.

Bipartisan Policy Center December 10, 2012

ONC Annual Meeting December 12, 2012

Dr. Mostashari shares his personal iBlueButton experience caring to his father

Consumer Partnership for e-Health (CPeH) of 150 consumer/patient groups advocate iBlueButton for use by Medicare beneficiaries, their family caregivers and healthcare providers . (Letter to CMS/ONC , April 22, 2013)

National Leader and Organizations Spread the Word

When iBlueButton Saved Beth’s Father’s Life

White House Patient Access Summit June 6 2013

www.ibluebutton.com

iBlue Button App Password Entry

TRICARE User Name & Password Entry

iBlue Button Portal Screen

New First Use Portal Credentials Entry

Auto-Download/Auto-Pull & View of Blue Button Record

Android Display of Medicare Blue Button Record

Auto-Download/Auto-Pull & View of Blue Button Record

17

MedlinePlus Drug Side Effects with

Patient Annotation

MedicationsDisplayed

Display of Medicare Blue Button Record Medication Reconciliation,

Look up and Annotation Functions

Medications Aggregated

from Multiple Records

Patient Medication Annotation

18

MedlinePlus Condition

Information

Conditions Displayed

My Conditions

Anemia

Chronic kidney disease

Depression

Hypertension

Fracture

Syncope

Coronary artery disease

Hypercholesterolemia

Candidiasis YES

Condition Information

Currently experiencing?

Cholesterol

Conditions Aggregated

from Multiple Records

Condition Annotation by

Patient

Display of Medicare Blue Button Record Problem List,

Condition Look up and Annotation Functions

iOS and Android Phone and Tablet Applications with

Device-to-Device Cross-Platform Data Exchange Capabilities

Device to Device

2-way proximity

data exchange

iBlueButton Professional Display of Patient-Noted Change in Condition

Provider Look up by iBlueButton Professional app

Display of All Providers (from last 3 yrs) with Specialties, and Contact Information

White House Patient Access Summit June 6 Launch of a Blue Button National Campaign:

Will Physicians Take the Lead?

Learn more and spread the word www.ibluebutton.com

#ibluebutton #bluebutton

The 2013 Physician-Computer Connection Symposium

bexperton@humetrix.com