How the future of health care lies behind a Blue Button

Wednesday - 4/2/2014, 4:00am EDT

Gaining secure, online access to your health information is as simple as the click of a button — a blue button, to be specific.

"Blue Button is all about empowering people with their health records, so that they can make better decisions around their own health," said Adam Dole, a Round 2 Presidential Innovation Fellow working on the Blue Button project at the Department of Health and Human Services.

An individual's health information is often stored in several places at once, everywhere from different doctors' offices to drug stores to health insurance companies.

Blue Button allows electronic access to all of those records, so that a patient can compile the records in one location or document and share them digitally.

"This is really about putting health data in the hands of people who own that data, who are then able to have access to their own health records to be able to make better decisions about their health care," said Lena Trudeau, associate commissioner for the Office of Strategic Innovations at the General Services Administration and director of the Presidential Innovation Fellows (PIF) program. "It's been an enormous success."

Dole said having access to personal health records is essential for patients to become more engaged in their health.

"If you do give people access to their records, they find more reason to take more ownership over their own health, and, actually, their self-efficacy or their capacity to change their health care outcomes increases."

Federal News Radio takes a closer look at the Blue Button Initiative as part of our special report, Solving Our Nation's Toughest Challenges: The Presidential Innovation Fellows.

Blue Button Round 1

The Blue Button initiative originated within the Department of Veterans Affairs, before the existence of the PIF program.

Adam Dole, Presidential Innovation Fellow

The VA developed Blue Button as a means for veterans to securely download their personal health information electronically. The Centers for Medicare and Medicaid Services quickly followed by allowing Medicare beneficiaries to download their health claims records.

Federal managers saw a great deal of potential to expand Blue Button to a greater segment of the American public, so they brought in a group of fellows during round 1 of PIF in a project deemed "Blue Button for America."

"It started out as a project for veterans, for whom access to health information is so critical," said Jennifer Pahlka, deputy chief technology officer in the White House Office of Science and Technology Policy. "But now it reaches so many more people and will be, I think, the standard in the United States pretty soon."

Machine-readable v. human-readable

The Round 1 fellows, Matthew McCall, Henry Wei and Ryan Panchadsaram, started the conversation with health insurance companies around making data easily accessible for consumers.

The fellows also wanted to create a more user-friendly, "human-readable" interface for the health data.

When downloaded, the data appeared in a text-only document that fellows said resembled a receipt and was "unwieldy because of the lack of presentation and hierarchy."

"It's not only a patient's right to have access to this data, but they should be demanding this data and demanding that it's in a certain format so they can actually use it," Dole said.

The fellows held a Health Design Challenge, asking for submissions on how to improve the medical record's visual layout. They received ideas from more than 230 designers, and the VA Center for Innovation is in the process of developing the winning layouts.

"I have to give a lot of credit to Round 1 fellows because I think they not only launched the challenge around making this data more available in a human-readable format, but really crowdsourced from some of the best talent in our country," Dole said.

The work of the fellows and agency partners also spurred private sector employees and entrepreneurs to develop a number of new applications, allowing users greater accessibility to their Blue Button data.

Smartphone applications remind patients to refill prescriptions, or set personalized health goals based on an individual's data.

A lack of technology, however, is not the issue, Dole said.

"The technology exists today both within health care but also within other industries and sectors to get data to flow in a more liquid way. The issue is really the culture of medicine and health care in our country," he said.

(Watch the video below to meet Adam Dole, Jacqueline Kazil and Derek Frempong - three of this year's Presidential Innovation Fellows. Story continues below video.)

Expanding the scope of Blue Button

The Round 2 fellows — Dole, Nayan Jain and Tom Black — took Blue Button another step forward, through the MyData Initiatives project.

The fellows continued talks with insurance companies initiated in Round 1, and they also began conversations with doctors' offices and other health care providers.

"When we talked to consumers, we learned that a lot of the records that they engaged with on a more regular basis, like their pharmacy records, or their lab records, or their state immunization records as it relates to their kids' vaccinations, were high-value touch points that were not [previously] being considered by Blue Button," Dole said.

He said his role in the Blue Button project is "externally focused," working frequently with private sector companies, labs and pharmacies to adapt and begin using Blue Button.

Companies ranging from large retail pharmacy chains and small start-ups have been receptive to the idea of interacting with their customer base through the use of Blue Button.

"We've now got Walgreens, Rite Aid, CVS, Kroger and Safeway as national retail pharmacy chains that not only are supporting Blue Button, but making their pharmacy records available to their patients," Dole said. "That has, I think, helped put Blue Button in context for people."

Through the work of the fellows and agency partners, 150 million Americans are able to use Blue Button to securely access their health data online.

The future of Blue Button

In Round 3 of the Presidential Innovation Fellows program, Blue Button will continue under the theme of data innovation.

Trudeau said it's uncommon for a project to fall under the PIF umbrella for three consecutive rounds.

A screenshot of the Blue Button Connector website.

"The PIF program is really meant to be a catalyst for these types of initiatives to get started," she said. "[But] I think we're going to continue support at least through the next round on Blue Button. There are a number of new aspects to that initiative that we want to take on that can be really catalyzed by having some PIF presence in that program."

The current fellows developed a new tool called the Blue Button Connector, which allows individuals to locate where their health information exists.

While Dole's term as an innovation fellow is coming to an end, he said he looks forward to what the Round 3 fellows will do with the Blue Button Connector, and what versions two and three of the Connector will look like.

"If they can continue the moment and take it in the direction that we know it can go, I have a lot of optimistic hope for the future of Blue Button," Dole said.


MORE FROM THE SPECIAL REPORT, SOLVING OUR NATION'S TOUGHEST CHALLENGES: THE PRESIDENTIAL INNOVATION FELLOWS

Inside the Presidential Innovation Fellows program: A Q&A with the White House

Saving lives ... one mobile app at a time

Data innovation, crowdsourcing on the horizon for Innovation Fellows program

Video: What is a Presidential Innovation Fellow?

Photos: Meet the Round 2 Presidential Innovation Fellows