ONC posts tech guide for Blue Button Plus

By Mary Mosquera
09:43 AM

The Office of the National Coordinator for Health IT has made available technical descriptions and guidance for its more automated version of the Blue Button feature aimed at giving patients easier access and use of their health information.

ONC announced in a Jan. 16 webinar an initial draft implementation guide for Blue Button Plus (+), a rebranding of its Automated Blue Button Initiative, so vendors and others can begin to incorporate the feature in their health IT system updates.

Blue Button+ will help providers meet requirements for meaningful use stage 2 because it incorporates in their certified electronic health records (EHRs) the function for view, download and transmit information for patients, said Lygeia Ricciardi, acting director of ONC’s Office of Consumer Health.

“But it goes beyond that, most notably by automating the information update functions for them,” she said at the webinar sponsored by the National eHealth Collaborative.

Any provider, developer or others may access the technical guides to accelerate a growing ecosystem of tools to help patients participate in and manage their care, especially through easier, secure access to their health information, Ricciardi said. The health IT tools also enhance communications between patients and their physicians and improve care coordination.

Blue Button+ is being advanced through ONC’s Standards & Implementation Framework community. The full draft implementation guide will be launched by the end of this month, said Pierce Graham-Jones, Innovator in Residence at the Health and Human Services Department, and a member of the S&I community working on the project.

The draft implementation guidance includes how to transmit data to patients in structured format, how to transmit data to patients using Direct secure messaging protocol, and a privacy and security piece.

“We’re working with our first big data holders and their vendors to follow this guidance and implement this into their EHRs by the time of the HIMSS13 conference in early March. You’ll see more from them and ONC at HIMSS13,” he said.

[See also: ONC selects designs to make EHRs more consumer-friendly]

Blue Button, which was started in the Veterans Affairs Department, has been an unstructured ASCII text document, a simple download mechanism. Because of its potential, official ownership of Blue Button has moved from VA to the Health and Human Services Department, which is going “to try to take it nationwide and build functions and features in the Blue Button Plus to make it really appealing,” Ricciardi said. 

Blue Button + focuses on two use cases as models “for how we want to evolve the brand to give meaningful data access to consumers,” Graham-Jones said.

One is a push model to transmit the consumer’s structured health data to a location of their choosing, and the other is pull, using a RESTful interface or web service to allow a consumer application to access the consumer’s data on their behalf.

The implementation guide for these two use cases has involved 68 organizations, including most major EHR vendors, payers, VA, ONC and the Centers for Medicare and Medicaid Services, he said.

ONC has identified standards for a patient clinical summary and advanced an automated information update through the push and pull models, according to Henry Wei, Presidential Innovation Fellow at VA. With automation, apps can receive this data without the process needed today.

“It’s a painstaking task of manually updating your services and pulling down your data and then pushing it to a location,” he said.

Blue Button+ will also be able to combine data streams from multiple sources, like insurers, physicians and pharmacies, “so you can pull all your health data together in a much more simple fashion,” Wei said.


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