Electronic Health Records

Integration & Interoperability News

Blue Button Aids in Health Data Exchange with Patients

By Kyle Murphy, PhD

- As government officials and industry stakeholders debate the best pathway forward for enabling true interoperability, healthcare providers and payers have made progress toward enabling patients to use health data exchange tools to access their health data.

According to a survey of providers, health plans, vendors, and clearinghouses by the Workgroup for Electronic Data Interchange (WEDI) in 2014, the advisory group to the Department of Health & Human Services found gains in industry awareness and adoption of Blue Button, a suite of services for exporting patient healthcare records.

“Based on the survey results, industry stakeholders are slowly building awareness about the Blue Button Initiative. It appears that usage and adoption of personal health records continues to grow among industry stakeholders,” WEDI Chair Jean Narcisi stated in a recent letter to HHS.

Key observations focused on six areas, with the first centering on the role of integrated EHR and medical device in populating personal health records. Government respondents saw the greatest gains between 2013 and 2014 in their use of integrated EHRs to populate PHRs from 60 to 100 percent. The use of medical devices to populate PHR data rose from zero to 25 percent over the same period of time.

At first glance, the WEDI survey reported a decrease in Blue Button awareness. However, the group claims that the greater participation of behavioral health providers and those ineligible for meaningful use is responsible for the skewing of figures from 32 to 49 percent of no awareness.

Downloading and printing health information (87.1%) outpaced secure messaging (58.1%), request for changes of PHR information (45.2%), and sending health information to third-party organizations (25.8%). The top formats supported by respondents’ PHR technology were PDF (78.6%), followed by HL7 Consolidated Clinical Data Architecture (CCDA) (55.8%), TXT (42.3%), and explanation of benefit (EOB) (13.5%).

A positive takeaway for proponents of patient access to health data is the offering of PHR technology by respondents to patients. As many as 80 percent of those surveyed reported offering a PHR to all their patients rather than a subset. The data most commonly available to patients are medications (79.0%), lab values/results (74.2%), and provider name and contact information (71.0%).

As for priorities with regard to providing patients with a better overall experience through the PHR, rankings held relatively study year over year:

Patient health data privacy and security remains a major concern for respondents especially as consumer engagement grows importance. Respondents saw a decrease in opt-out capabilities and an increase in opt-in capabilities between 2013 and 2014 — 50 to 22 percent and 69 to 89 percent, respectively.

As providers, health plans, vendors, and clearinghouses work to expand patient access to health data, DIRECT plays a role of varying usefulness:

Health plan and provider respondents both showed an increase in use of DIRECT for transmitting data, while government and technology developer respondents showed a decrease in use of DIRECT. All respondent groups showed a decrease in use of DIRECT with Secure Blue Button Trust with an overall decrease from 15 percent in 2013 to 8 percent in 2014.

Lastly, determining how to deliver Blue Button and PHR services to patients continues to evolve. Although email, text messaging, and direct mail are still the popular forms for disseminating health data to patients, respondents are looking into mobile services and third-party applications to enable data exchange.

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