Blue Button logistics could make VA contest problematic

The U.S. Department of Veterans Affairs (VA) is offering a $50,000 prize to anyone who can develop a personal health record (PHR) that uses the government's Blue Button download method to import patient data from electronic health records. The purpose is to provide veterans cared for by non-VA doctors with the same ability to download their records as those who see physicians employed by the VA or go to VA hospitals.

To win the contest, the organization or inventor must arrange to have the PHR installed on the websites of 25,000 physicians.

"Moving health data can and should be safe, simple and inexpensive," said VA Chief Technology Office Peter L. Levin. "Blue Button technology is all of those things.  Doctors who use PHRs developed as part of this competition can give their patients the ability to keep and control their own health data. Blue Button's simple format can even support patient-authorized health data transfers to other doctors or hospitals."

It's not clear, however, how that transfer would work, or how Blue Button downloads of VistA data from VA providers would be combined with records from non-VA doctors if veterans see both.

The main problem is that the Blue Button downloads are in plain ASCII files that can't be parceled into discrete data fields. Some private-sector PHRs, such as Microsoft HealthVault, are capable of uploading Continuity of Care Documents--which do have discrete elements--from EHRs, and VistA can generate a CCD that is transmittable through the government's CONNECT software. Most PHRs, though, can bring in only portions of the full 32 CCD data elements, Mark Anderson, a health IT consultant based in Montgomery, Texas, tells FierceHealthIT.

An even bigger problem is getting physicians to implement the patient portals that may come with their EHRs so that the clinical data can be downloaded to a PHR. Many physicians, according to Anderson, use their EHRs only for e-prescribing or lab orders. "[M]any times, you find they're not using them at all," he says.  

To learn more:
- read the VA announcement
- see the Government Health IT article
- check out the Blue Button page on MyHealtheVet 

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