Engaging Patients with Blue Button+

Even in 2013, the vast majority of patients do not have online access to their own medical records and histories.

Almost all of the world’s information is right at our fingertips—flight information, traffic information, weather predictions, banking records, and stock market charts.

But data about our own bodies remains out of reach.

The federal government is working to give patients access to their data via the Blue Button+ initiative. Essentially, Blue Button+ gives patients online access to their own personal health records. Several federal agencies have implemented Blue Button+ (BB+) capabilities for their beneficiaries, including the Department of Defense, Health and Human Services, and Veterans Affairs.

In addition, payers United Healthcare and Aetna have announced that they will provide their members with electronic access to their health records via BB+. However, early reports indicate that there’s still some room for improvement.

Major EMR provider Cerner has announced its support of the BB+ initiative as well.

In 2012, the Office of the National Coordinator for Health IT (ONC) introduced the Automate Blue Button Standards and Interoperability Framework Initiative, and in 2013 the ONC released the BB+ Implementation guide. Ultimately, the ONC wants to expand BB+ to everyone in the country.

Here is a chart that shows the BB+ data flow:


Source: HHS.gov

Several innovative products have been developed on top of the BB+ framework, including iBlueButton, ID Blue Button, and InstantPHR.

SMART Platforms, Harvard Medical School, and Boston Children’s Hospital built a proof-of-concept BB+ app called Growth-tastic.

With Growth-tastic, parents can view charts of their child’s height, weight, and BMI trended over time.

Here is a screenshot taken from the Growth-tastic app:


Source: Growth-tastic

Third party developers are welcome (and encouraged) to develop applications on top of the BB+ framework. There are four steps to launching a BB+ application:

  1. Parse health data in a CCDA format
  2. Receive health data using either DIRECT
  3. Submit anchor to trust bundle
  4. Retrieve BB+ Provider Trust Bundle

There is also a BB+ REST API, which is available on github.


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