Electronic Health Records

Integration & Interoperability News

mHealth, Blue Button put HIE, PHR into patient pockets

By Jennifer Bresnick

When National Coordinator for Health IT Dr. Farzad Mostashari had a family medical emergency last Thanksgiving, he didn’t go to the local clinic and lament the lack of interoperability that prevented their EHR from pulling records half way across the country.  He had his father, who was suffering from an eye complaint, whip out his smart phone, connect to his Blue Button app, and show the doctor everything he needed to know about his medical history right on the screen.  mHealth saved the day, and Dr. Mostashari believes it will only be more and more common for patients to be able to take their personal health information out of their pockets and into their own hands.

Signing his father up for Blue Button, which allows a patient to download their health record from a participating provider, let Mostashari bypass the need for phone calls and faxes over the holiday weekend, when his father’s eye care office was closed.  “Within the next 12 months if people want to, they will be able to get the same data that your doctors would send to each other to have it come to you,” Mostashari predicts.

That may be good news for patients who are tired of stepping into a new provider’s office and having to fill out page after page of a medical history they expect to be accessible from anywhere, but it also raises questions for Mostashari’s office.  Can the ONC really keep pushing providers towards the expensive and difficult quest for EHR interoperability and health information exchange (HIE) if a patient can push a few buttons on an iPhone and achieve the same result?

One of the reasons to ensure that HIE is possible through the provider first is privacy and security.  Provider-based HIE is covered by the extensive rules of HIPAA, but once a patient downloads their own information to an app, the guidelines get murky. “When you take possession of [personal health information] and share it, stick it in an app, share it on the web, a social networking site, it’s not going to be protected beyond what’s in the privacy policy for the app or what’s the privacy policy for the social networking site. And you need to read that,” explains Deven McGraw, director of the Health Privacy Project at the Center for Democracy and Technology. “Be aware before you share.”

mHealth is a poorly regulated industry that is still inventing itself, and most people aren’t aware of just how much information can be collected through a cell phone application, especially since it’s easy to click through the terms of service and click “I accept” without combing through the fine print.  When sensitive health information is involved, consumers need to be wary about what they’re letting developers see behind the scenes.

The Blue Button project, available to Medicare beneficiaries, military veterans, and an increasing number of other providers, has been shown to help patients take control of their healthcare, and has real, applicable benefits in situations like Mostashari faced last year.  As it continues its evolution, and mHealth continues to captivate the attention of patients and providers alike, HIE may take a new direction, cutting out the middleman and putting patients in charge of their data in an innovative way.





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