Mo­bile push

Blue But­ton fo­cus of gov­ern­ment IT strat­egy

Modern Healthcare - - THE WEEK IN HEALTHCARE - Joseph Conn

Pres­i­dent Barack Obama aims to put the Blue But­ton tech­nol­ogy for ac­cess­ing med­i­cal records in the palm of your hand via a smart­phone or tablet as part of sev­eral ini­tia­tives to ex­pand the gov­ern­ment’s pres­ence on mo­bile de­vices.

Obama also is­sued a memo to depart­ment and agency heads in­sist­ing that each of them come up with two mo­bile ap­pli­ca­tions us­ing their gov­ern­ment data within the next 12 months.

And the ad­min­is­tra­tion re­leased a 12-month IT strat­egy that called on en­trepreneurs and the gov­ern­ment to “bet­ter lever­age the rich wealth of fed­eral data to pour into ap­pli­ca­tions and ser­vices.”

As part of that ef­fort, Fed­eral Chief Tech­nol­ogy Of­fi­cer Todd Park an­nounced a tech­nol­o­gist fel­low­ship pro­gram that aims to bring pri­vate sec­tor tech wiz­ards to Washington to pair them up with gov­ern­ment “in­no­va­tors” on six-month “tours of duty.” Park tweeted last week that 600 peo­ple had reg­is­tered to ap­ply.

The pri­vate-sec­tor whiz kids— the first batch of 15 are ex­pected to ar­rive in July—will work over the next six months on tech­nol­ogy in­no­va­tion projects in five tar­get ar­eas, two of which have health­care im­pli­ca­tions.

One is a se­ries of “open data ini­tia­tives” aimed at stim­u­lat­ing “a ris­ing tide of in­no­va­tion that uti­lizes gov­ern­ment data to cre­ate tools that help Amer­i­cans bet­ter nav­i­gate their world.” Listed among Park’s tar­gets is a tool to help cit­i­zens find health­care providers, the pro­gram’s web­site notes.

The White House’s “Blue But­ton for Amer­ica” pro­gram seeks to ex­tend the use of a sys­tem de­vel­oped by the Vet­er­ans Af­fairs Depart­ment into wide­spread use out­side the VA. Park’s fel­lows are ex­pected to use Blue But­ton to “de­velop apps and cre­ate aware­ness of tools that help in­di­vid­u­als get ac­cess to their per­sonal health records—cur­rent med­i­ca­tions and drug al­ler­gies, claims and treat­ment data, and lab re­ports—that can im­prove their health and health­care,” ac­cord­ing to de­scrip­tion of the pro­gram on a White House Web page.

Ac­cord­ing to Peter Levin, se­nior ad­viser to the sec­re­tary and chief tech­nol­ogy of­fi­cer at the VA, the Blue But­ton con­cept came out of a brain­storm­ing ses­sion hosted by the New York-based Markle Foun­da­tion in 2010. Blue But­ton soft­ware al­lows pa­tients to make copies of their med­i­cal records in the ASCII “plain text” char­ac­ter cod­ing scheme or as PDFS. It has proven to be wildly pop­u­lar, ac­cord­ing to VA data. Thus far, 500,000 vet­er­ans have down­loaded 1.6 mil­lion copies of their records us­ing Blue But­ton, Levin said.

He and the VA are Park’s in­ter­a­gency leads in the fed­eral push to ex­pand Blue But­ton. The VA has its own mo­bile Blue But­ton ap­pli- cation un­der de­vel­op­ment, Levin said.

Dr. Wil­liam Bria, a pul­mo­nolo­gist, sees vet­er­ans bring in their records from Blue But­ton downloads at the VA out­pa­tient treat­ment fa­cil­ity where he works in ad­di­tion to his reg­u­lar du­ties as chief med­i­cal in­for­ma­tion of­fi­cer for the Tampa, Fla.based Shriners Hos­pi­tals for Chil­dren sys­tem. Bria is chair­man of the As­so­ci­a­tion of Med­i­cal Di­rec­tors of In­for­ma­tion Sys­tems, a pro­fes­sional as­so­ci­a­tion for physi­cian in­for­mati­cists.

“There is no ques­tion, it’s a sig­nif­i­cant help,” he said. “For the pa­tient, it’s see­ing the in­for­ma­tion and start­ing to par­tic­i­pate. Even if you’ve had a nice con­ver­sa­tion, when you get home, there it is in black and white. There’s no con­fu­sion, and they al­low you to part­ner on the trends that mat­ter.”

Bria also is a booster—and per­sonal user—of mo­bile health ap­pli­ca­tions. One mo­bile app Bria uses makes “best-guess es­ti­mates” of the calo­ries in the food he’s about to eat—or, on sec­ond thought—not eat. “With the cam­era on your phone, you take a picture of your food, and it says, ‘Oh, Bill, that looks like a ham­burger with cheese. This is like 500 calo­ries! You re­ally want to do this now, be­cause you’ve al­ready had 500 calo­ries to­day?’”

“The mo­bile apps, I think, are a rev­o­lu­tion,” Bria said. “While a lot of other things in the past have been the pa­ter­nal­is­tic or the ma­ter­nal­is­tic prac­tice of medicine, where the doc­tor tells you what to do, it lets you take charge.”

Dr. Lyle Berkowitz, an in­ternist and med­i­cal di­rec­tor of clin­i­cal in­for­ma­tion sys­tems for the North­west­ern Me­mo­rial Physi­cians Group in Chicago, said he has sev­eral sug­ges­tions for HHS to cre­ate mo­bile ap­pli­ca­tions in com­pli­ance with Obama’s march­ing or­ders.

One would be a mul­ti­fac­eted “data trans­parency” ap­pli­ca­tion that would help pa­tients “un­der­stand the costs of var­i­ous items, what we know about qual­ity for hos­pi­tals and physi­cians, and even find­ing a physi­cian and hospi­tal which take their in­sur­ance,” Berkowitz said.

Berkowitz also sug­gested HHS mo­bile apps could al­low physi­cians to sub­mit drug re­ac­tions and prob­lems to reg­u­la­tors; find ICD-9 and ICD-10 di­ag­nos­tic and pro­ce­dure codes; look up reg­u­la­tory in­for­ma­tion; and sub­mit ques­tions to fed­eral agen­cies.


Fel­lows from Park’s pro­gram will be en­listed to de­velop apps that give in­di­vid­u­als ac­cess to their health records.

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