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Blue Button: Driving a Patient-Centered Revolution in Health Care

Sep 13, 2011, 7:47 AM, Posted by Steve Downs

Editor's note: This post originally appeared 9/13/2011 at the Huffington Post.

A lot can happen in a year.

Last October, I wrote about a promising new offering for people looking to take control of their own health and health care decisions. Known as "blue button," this simple (but rather revolutionary) technology offers individuals the ability to download their own health information with just the click of a mouse. They can then use and share this information however they may choose -- with doctors, care providers, or even third-party applications designed to help them track and make sense of their own personal data.

Born out of a collaborative working group convened by the Markle Foundation, the blue button was beta-tested and then implemented by the Department of Veterans Affairs, the Department of Defense, and the Centers for Medicare & Medicaid Services (CMS). The immediate demand from their patients and beneficiaries was inspiring.

Recognizing the disruptive potential of the blue button idea, we at the Robert Wood Johnson Foundation took an interest in it at an early stage of its growth. One of our aims is to help individuals understand, identify and receive high quality care. As such, exploring and supporting the development of technologies that enable people to make informed decisions is one way we hope to realize our vision of placing patients at the center of their care. Health data download capabilities modeled after the blue button approach can really move the ball forward in that regard. People can review their health records or claims information, educate themselves about conditions, procedures, medications, or test results found in their records, and share their information with family, friends and their health care providers. They can also point out errors they find and make sure that they are corrected.

I concluded my last post on the blue button idea by observing that the federal government had taken a strong step forward to give people access to their own health information, and that it was time for more in the private sector to do the same.

Not even a year later, I'm thrilled to look back and see that progress is being made -- in terms of both demand and implementation. Well over 400,000 veterans, members of the military, and Medicare beneficiaries have downloaded their data using the Department of Veterans Affairs', the Department of Defense's, and CMS' Blue Button, showing just how desired this functionality is by individuals. Equally inspiring is how much the private sector has taken up the challenge to make the health data they hold available to their patients and beneficiaries. Aetna, United Health Care, Walgreens and PatientsLikeMe are just a few of the major care providers, insurers and patient groups that have either implemented or committed to offering their consumers a blue button download capability.

Broader use of the blue button approach also offers opportunity to mobile app and software developers working in the burgeoning consumer e-health field. As the blue button download capability becomes more widespread, we expect to see more and more apps designed to take the data individuals can download and turn it into useful information and valuable tools used to manage one's health like reminders to get preventive services or refill a prescription, or a list of the lowest price outlets to order medications. To encourage these innovations, several organizations (including RWJF) have sponsored "developer challenges," and we expect more to be announced.

It's clear that we're in the middle of a health care quality revolution. But to improve outcomes on a broad scale, we need to empower individuals to become active participants in their care. Download capabilities like blue button can help do that, which is why we at RWJF are continuing to encourage their spread. Today, I am excited to announce the launch of bluebuttondata.org, a web site that is a one-stop-shop for anyone (individuals, providers, insurers, health care organizations, patient groups, mobile app/software developers) who is interested in finding out how they can join the revolution.

I encourage you to help us harness the early momentum blue button has made and turn it into a full-fledged movement. Spread the word. Or better yet, visit the site and commit to transforming health care as we know it. 

Building Bridges in the City by the Bay - The 2011 Health 2.0 Conference

Aug 29, 2011, 4:13 AM, Posted by Steve Downs

We have a few questions for you.

Every day there are people who are finding new ways and developing new technologies to observe or collect information about themselves that has the power to improve health.

For example, Pioneer’s Project HealthDesign researchers are exploring practical ways for people to collect their own ODLs (observations of daily living) and integrate them into the clinical setting – empowering individuals to be at the center of their own care.

The pioneers at Open mHealth are equally committed to involving individuals in their own health and health care as they create an open learning ecosystem and share innovative technologies to improve everyone’s health.

In another cutting-edge movement, self-trackers who seek “self knowledge through numbers” are gaining insights into their own health and health-related behaviors everyday. The number of tools, apps and devices to help them are increasing exponentially, and it seems as if we’ve only scratched the surface of what people are starting to do by collecting and sharing their health-related data.

Today’s reality is that individuals have the opportunity to have the power of their own health information literally in the palms of their hands. We can point to when our blood pressure was high during the day, how our diet impacted our energy levels or sleep, what movements or behaviors caused a flare-up in back pain.

But how many will choose to track this information? Can self-tracking become mainstream in the next two years? What about five, 10 or 20 years? And if it does, then what do we do?

How do we make sure that information is put to its best use, both for us personally and the population as a whole? As patients, what do we want our doctors to do with our self-generated data? What do our doctors want us to track, and how? How do they integrate it into our diagnoses and treatment plans?

These are some of the questions we’ll be asking this coming week, September 25-28, at the 2011 Health 2.0 Conference in San Francisco. We’re excited to be a sponsor of this event and we’ve brought a diverse group of grantees and friends with us.

We’ve been involved in the broader Health 2.0 space for some time now. Through our investments in programs like Project HealthDesign, Open mHealth and support of groups like Quantified Self, we’ve been trying to bridge the worlds of technologies and health, and the experiences of patients and clinicians.

Over the course of the conference and beyond, we’ll be asking guests to help us tackle several questions that we think are critical if this movement is to reach its full potential—and we’d like your ideas too.

So tell us what you think. Help us answer these questions. Please add your comments below. You can also message us privately at pioneerblog@rwjf.org.

  1. What do you think are the most important challenges to be addressed in order to get more people collecting their own health data and information?
  2. What do you think are the most important hurdles to be overcome for patients to bring this information to their doctors and for it to inform clinical care? 
  3. Of all the things that one can track, what is the one piece of patient-generated data that has the most potential value to both personal health and clinical care?

As we look for opportunities to advance the thoughtful exploration of these practices, your responses will guide us. We value your input and look forward to hearing what you have to say.