25 March 2014

Get ready for Blue Button!

Soon, every patient can click a virtual “blue button” to access, download, transmit—and sometimes even enter data into—his or her personal health record. As a health care provider, are you ready for the broader implications this change will bring?

It all began in August 2010 when U.S. President Barack Obama announced that, for the first time ever, veterans would be able to click a blue button on the Veterans Administration (VA) website to download or print their personal health records, or to share them with physicians outside the VA.

The program was so successful it quickly expanded to the MyMedicare.gov website; health benefit plans for all 8 million federal employees; and private insurers, such as UnitedHealth Group with its 26 million beneficiaries. And in February, five major pharmacy chains signed on to roll the program out to more than 20,000 stories nationwide (Brewin, 2013; Brewin, 2014). As adoption has spread from the public to the private sector, some have called Blue Button+ the “VA’s gift to the country” (Brewin, 2013).

Blue Button+ is now the blueprint for building an “ecosystem” of secure, online portals through which patients access, via websites and mobile apps, their personal health information (Sinai, 2014; Blue Button+, 2013). The U.S. government requires that all certified EHR providers, as part of Stage 2 of the EHR-Meaningful Use program, allow patients to securely view, download, and transmit personal data (Graham-Jones & Panchadsaram, 2013). Blue Button+ supports and expands this functionality. (Note: Some websites or apps using Blue Button+ standards do not explicitly communicate this to the consumer, but the functionality is there, even if there is not a literal—or virtual—blue-colored button.)

Although precise uses of Blue Button+ vary according to each institution’s policies, the program, in general, allows patients to:
  • Access health records to determine dates of shots or procedures.
  • Check accuracy of records, monitor changes, and stay aware of health status.
  • Share information with health care providers or others they trust, e.g., when traveling, seeking a second opinion, moving, switching insurance, or in an emergency.
  • Use apps to better manage and coordinate health care to achieve health goals.
  • Self-enter health metrics, such as weight, blood pressure, and heart rate, directly into their personal records (ONC, n.d.; Chopra, 2010).

Patients probably welcome this autonomy and control but, as a health care provider, you need to reflect on the broader implications. To help you do that, the next three posts in this series will explore emerging opportunities to:
  • Optimize patient health via this new ecosystem of health care apps and tele health tools.
  • Take advantage of patient access to health information to improve continuity of care and reduce costs.
  • Reimagine nursing’s unique role to maximize the contributions of these newly empowered patients.

On that last point, consider nursing’s role in treating human responses, promoting optimal health, and advocating for individuals, families, and communities (ANA, 2014). It is precisely in this realm—in this domain—that these digital, information-access tools empower patients. The professional nurse can serve as a coach-mentor in identifying appropriate health goals and tailored methods for reaching those goals, including apps and other emerging tools. In addition, the nurse has a powerful role to play in teaching patients how to collect and use data to advocate on their own behalf for best outcomes.

Digitally empowered patients will not use their newfound health-record access to diagnose medical conditions, order consults or procedures, or prescribe medication, as these functions are, rightly, the domain of the physician. But as nurses, are we preparing ourselves for an expanded role in this brave, new digital world? Our patients and the new health care system desperately need us to do that.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

References:
American Nurses Assocation. (2014) What is nursing? Retrieved from http://www.nursingworld.org/EspeciallyForYou/What-is-Nursing

Blue Button+. (2013, February 4). Evolution of Blue Button. Retrieved from Blue Button + implementation Guide: http://bluebuttonplus.org/history.html

Brewin, B. (2013, October 1). True blue: VA’s gift to the country. Retrieved from http://www.govexec.com/magazine/nextgov/2013/10/true-blue-vas-gift-country/70994/

Brewin, B. (2014, February 10). Five major drug chains to adopt Blue Button prescription standards. Retrieved from http://www.nextgov.com/health/2014/02/five-major-drug-chains-adopt-blue-button-prescription-standards/78566/

Chopra, A. (2010, October 7). ‘Blue Button’ provides access to downloadable personal health data. Retrieved from http://www.whitehouse.gov/blog/2010/10/07/blue-button-provides-access-downloadable-personal-health-data

Graham-Jones, P., & Panchadsaram, R. (2013, February 5). Introducing Blue Button+. Retrieved from http://healthdata.gov/blog/introducing-blue-button

Office of the National Coordinator of Health Information Technology. (n.d.). Blue Button Connector: A way to help you find your health data. Retrieved from http://bluebuttonconnector.healthit.gov/

Sinai, N. (2014, February 7). Leading pharmacies and retailers join Blue Button initiative [Blog post]. Health IT Buzz. Retrieved from http://www.healthit.gov/buzz-blog/consumer/leading-pharmacies-retailers-join-blue-button-initiative/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+healthitbuzzblog+%28Health+IT+Buzz+Blog%29

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