What is the Blue Button?
“Blue Button” is shorthand for a movement toward an improved healthcare system in which patients and providers use information technology to collaborate and improve health. The Blue Button logo signifies that you—as an individual consumer or patient--can get easy, secure access to your own health information in a format you can use. To “Blue Button” is a verb, meaning, for a consumer, “download my health data so I can use it.” As Americans, we each have the legal right to access our own health information held by doctors, hospitals and others that provide health care services for us. But many of us don’t, either because we don’t know we can, or because we’re not sure what to do with it. Until recently, most medical information was stored in paper files, so it wasn’t very easy to access or use anyhow. But all that is changing.
As America’s health care system rapidly goes digital, health care providers, insurance companies and others are starting to give patients and consumers access to their health information electronically through the “Blue Button”. Blue Button information can be lifesaving in an emergency situation, can help prevent medication errors, and can improve care coordination so everyone who is caring for you is on the same page. As a result of Blue Button, many patients can now electronically access the vital health information they need to keep track of their medicines, chronic conditions, and laboratory results. They can securely access and download that information and share it with people they trust. Increasingly, they can also plug it into apps and tools that help them to better understand their health, prevent illness, and modify their own behaviors in healthy ways. Study after study shows that engaged patients recover more quickly, and stay healthy longer. Blue Button includes a vision for better health and health care and a specific “action” consumers can take—download your own health information and use it! Blue Button is also becoming a movement. Won’t you join us?
Why would I want to use the Blue Button?
Is the Blue Button available to everyone?
Many people in the United States still don’t have easy, electronic access to their health information, and many don’t know that the Federal government has taken a large step towards solving that problem. Today, Blue Button is available to people whose insurers, health care providers or other entities that maintain their health information (pharmacies, labs, etc.) offer a way to make that info easily available online. Today, veterans, members of the military and Medicare beneficiaries have access to the Blue Button. Other federal agencies and many companies in the private sector such as UnitedHealthCare1 and Aetna2 , are also offering Blue Button to their beneficiaries or members. We encourage all other organizations that maintain your health information to make it easier for patients to be able to easily and securely access their health information electronically.
Blue Button is already expanding in use – in December 2011, the U.S. Office of Personnel Management (OPM) asked all health insurance carriers in the Federal Employees Health Benefit Program (FEHBP) to offer the Blue Button functionality to their personal health record (PHRs) systems on their web site so that patients can see, download and keep their personal health data by clicking a Blue Button on a secure Internet site.3 There are more than 200 separate health insurers in the FEHBP that deliver benefit to more than eight million employees. Health care providers, pharmacies, and others are also using Blue Button in growing numbers.
2 - http://investor.aetna.com/phoenix.zhtml?c=110617&p=irol-newsArticle&ID=1606005&highlight=
3 - http://www.opm.gov/news/blue-button-added-to-health-insurance-carriers-…;
What is “Blue Button for America”?
How does the Blue Button work?
The Blue Button enables you to securely access your personal health data online by clicking on a “Blue Button” logo or icon. You may have access to your claims and personal health information that is maintained by your doctors, hospitals, health plans, and others, depending on the tools and data they are offering. Patients can securely access their health data and then choose to download that data to their computer, thumb drive or smartphone without using any special software, or share that data with individuals they trust - whether it’s their other physicians or family members.
What information will I get through Blue Button?
It depends. The data that you are able to get from your health plan and your health care provider (doctor, hospital, etc.) may be different.
Health plans may have both claims and personal health information in their databases. Adding Blue Button could provide you with secure, electronic access to information such as lab results, medication and problem lists, allergies, appointment information and wellness reminders, all of which could make managing your health easier.
Your health care providers are likely to have clinical information about your visits, including diagnostic test results, problem lists, medication lists, medication allergies, discharge summaries (if you have been hospitalized), procedures and treatments, which could be accessible to you through the Blue Button.
From the MyHealtheVet site, veterans can use the Blue Button to download: Demographic information (age, gender, ethnicity and otherwise); Emergency contacts; Lists of prescription medication; and Wellness reminders.4
Medicare beneficiaries can view and download their claims data in a more timely and user-friendly format than ever before through the improvement of the Medicare Blue Button. And that information will now cover three years, instead of only one, and will include claims information on services covered under Parts A and B, and medicines that were purchased under the Medicare prescription drug coverage (Part D). The Centers for Medicare and Medicaid Services (CMS) that administers the Medicare program plans to continue to expand the data available and improve the user experience over time. Greater access to their personal claim history will help to improve the quality of care provided to people with Medicare. http://www.healthdata.gov/blog/controlled-access-cms-data
The Blue Button eventually will be capable of downloading electronic health record data from:
- Laboratories;
- Major pharmacies; and
- Physicians' offices.
[link to Ryan’s example]
Is Blue Button a specific technology?
No, but it used to be. Blue Button started as a simple-as-it-gets text (ASCII) file. But that was only the start. As more organizations adopted the Blue Button and more patients used it, it became apparent that there was a need for more – and more complex – ways of downloading and transmitting data.
Adding Portable Document Format (PDF) formatting for Blue Button downloads happened quickly. Organizations offering Blue Button were also encouraged to experiment with other formats, including the industry’s HL7-based Continuity of Care Document (CCD) and other XML-tagged formats – so long as the human-readable ASCII and .pdf formats remained available to users.
As of September 2012, Blue Button is no longer constrained to mean a text or PDF format– so long as consumers can view, download, and print their health data. In the near future, we expect consumer access to health data through the Blue Button will also include the ability for consumers to be able to also transmit their health data and have it available in both human and machine readable format. Importantly, however, organizations that provide the more basic "Blue Button" —through ASCII text or PDF files--are not discouraged from continuing as before. Rather, they are encouraged to build on and evolve the technical capability they have. The Button has become a recognized brand that signifies consumer access to and use of electronic health data. We hope that organizations will continue to build on and evolve the technical capability they have available for patients.
Can I sign up for Blue Button today?
It depends if your health care providers, health insurance company, or other organizations that manage your health records (e.g. pharmacy, lab, etc.) offer Blue Button. You may be able to get your health information from several sources and compile it for a more complete picture of your health. The best way to find out is to ask. Although Blue Button is in its early stages, it is expanding rapidly. If you are a Medicare beneficiary, a veteran or an active service member you can get secure, electronic access to your health records today by clicking the Blue Button icon within your Medicare, VA, or military health patient portal. More and more doctors, health insurance companies and hospitals are offering “patient portals” through which patients and their families can view and download their health records.
Even if your healthcare providers don’t offer Blue Button, they are required under the law to let you see and get a copy of your health records. Read about your rights in this document [PDF - 82 KB] which you can download and take to your provider. This video also explains your rights.
What kind of technology do I need to access the Blue Button?
Remember that unless you are a veteran, Medicare beneficiary or service member or your health plan, health care provider (doctor or hospital) or other entities where you seek care use Blue Button, it may not yet be available to you. When it becomes available, the Blue Button should allow you to download and/or print your own health information without using any special software. You shouldn’t need any special technology to take advantage of Blue Button’s ability to make it easier for you to view, download and share your personal health data with others you trust. However, you may want to consider using a personal health record to store and manage all your health information in one place. Increasingly, more health plans, health care providers, nursing homes, pharmacies, laboratories and other institutions that have your health information on file are offering you a portal or personal health record—a place for you to store and manage your health information online. You can also sign up to get one on your own.
Does my doctor have to use the Blue Button?
No. Your doctor is not required to offer Blue Button to you today. However, there are financial incentives available from the federal government to encourage health care providers to adopt electronic health records (EHRs) and to use these systems in a way that improves your care. In order to receive these payments, doctors must provide their patients with an electronic copy of their health records. Over time, these requirements will expand and your doctor will be required to provide you with a way to view, download and share your health records online. Under the Health Insurance Portability and Accountability Act (HIPAA), however, your doctor does have to give you access to your health records upon request, and to do so in an electronic format if it’s easy for him or her to do so.
Is there a cost to use the Blue Button?
There should not be a cost. Ask your health care provider or health plan if they offer a way for you to view, download and share your health information online.
If I don’t have access to Blue Button now, why should I care about this?
Even if you don’t have access to Blue Button right now you still have a legal right to see and get a copy of your health records. Having electronic access to your health records allows you to have the information you need at your fingertips to share with other doctors or in case of an emergency.
More and more healthcare providers and health insurance companies are adopting Blue Button, which means that yours may soon be offering it, as well. Although Blue Button is in its early stages, it is expanding rapidly. The best way to find out is to ask. Ask your health care provider or health insurance company when they plan to offer Blue Button or a way for you to view, download, and share your health records online.
Even if your healthcare providers don’t offer Blue Button, they may be required under the law to provide you with your health records electronically, if they have the capability to do so. Read about your rights in this document [PDF - 82 KB] which you can download and take to your provider. This video also explains your right.
What other options do I have to manage my care if I don’t use Blue Button?
What if I don’t want to use Blue Button?
How safe is the information in Blue Button?
Does Blue Button let other people get access to my health records?
Blue Button puts the information others hold about you in your hands. You decide how to use it. Using Blue Button does not give anyone else access to your health records unless you choose to share it. Healthcare providers, such as doctors and hospitals, are accountable for the privacy and security of patients’ health records by a law called “The Health Insurance Portability and Accountability Act (HIPAA).” Healthcare providers are required by HIPAA to set up physical, administrative and technical safeguards to protect your health records. This may include “access controls” like passwords and PIN numbers to help limit who has access to your information; “encryption” so your health information can’t be read or understood except by someone who is approved to view it; and an “audit trail” so there is a record of who has looked at your information and what changes were made to it and when.
Once you download your health records from your healthcare provider or health insurance company’s web site via Blue Button, it is your responsibility to protect that information.
How safe is it to log into Blue Button or use it to transmit my health records?
To ensure that your health records are kept private and secure, only you or someone who has your permission can access your health records through Blue Button. Since this requires that you log in to your healthcare provider’s or health insurance company’s web site or patient portal (a place for you to store and manage your health records online), you will likely be able to secure your health records with a username and password. The specific privacy and security safeguards associated with Blue Button vary depending on the organization that is offering it. Read the privacy policy on the site you are using for details.
To maximize the security of your information, we recommend that you use an encrypted “Direct” health email address. The Direct Project offers easy and secure messaging, enabling healthcare providers and hospitals to send your health records to you, including summaries of your recent visits, or reminders about preventive or follow-up care. Some Personal Health Records can provide you with a Direct Address that you can use to receive such messages. Direct Project messages are secure, which means that unlike email, they can be used by your healthcare provider to send your information securely to you and to other healthcare providers who are participating in your care. See if your healthcare provider and your personal health record provider support the Direct Project.
Once you download your health records, we recommend that you protect that information by either securing it with a password or encrypting it (translating it into a secret code).
My doctor’s office was asking me questions about medicines I had purchased at the local drug store. With the Blue Button will my doctor have all of my information even if I don’t explicitly give them the authority to use it?
If I am a “Meaningful User” of health IT does that count as Blue Button?
Yes. Stage 2 of Meaningful Use requires that patients be given the capability to view, download and transmit their health data electronically. These requirements are fully aligned with the Blue Button goals of empowering patients to be partners in their health and health care through access to and use of personal health information. The evolving and expanding vision for Blue Button further articulates the goal of giving patients both a “human readable” and “machine readable” version of their information, which can be accomplished as part of meeting the view, download, and transmit capability requirements.
Please refer to the official web site for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs for the complete list of meaningful use criteria.
Will using Blue Button satisfy the “patient and family” requirements of Meaningful use?
Maybe. Stage 2 of Meaningful Use requires that patients be given the capability to view, download and transmit their health data electronically. These requirements are fully aligned with the Blue Button goals of empowering patients to be partners in their health and health care through access to and use of personal health information. The Blue Button vision is evolving and expanding to encompass a variety of technical solutions beyond the traditional download of a text file, including view, download, and transmit capabilities. Along those lines, we strongly encourage every EHR technology developer to associate the download capability related to a human readable file with the increasingly popular “Blue Button” phrase and logo. Please be aware, however, that some vendors and providers may be using the term “Blue Button” consistent with the original, narrower technical set of requirements defined by the Veteran’s Administration (VA), so use of the term does not automatically signify compliance with the full Meaningful Use Stage 2 requirements related to patient and family engagement. We refer all questions about the specific requirements for meeting Meaningful Use to the official web site for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs.
How does the Blue Button relate to the ONC Pledge Program?
The ONC Pledge Program was launched in September 2011 to catalyze and support organizations at the vanguard of empowering individuals to be partners in their health and health care through health IT. Taking the pledge is voluntary, and does not represent any endorsement by the U.S. Department of Health and Human Services or any other part of the Federal government. Members of the Pledge Community benefit from participation in activities including in person meetings and webinars that provide networking, updates from the federal government, and opportunities to share and learn best practices from and with peers and potential partners. A wide variety of organizations participate in the Pledge Program, including “Data Holders” and “Non Data Holders,” who make pledges ranging from directly providing electronic consumer access to health data, to developing tools that make it useful, to promoting a public shift in awareness of and attitudes about consumer engagement in health.
To bring together two complimentary activities and in recognition of the evolution and growth of the Blue Button vision, we have changed the name of the “ONC Pledge Program” to the “ONC Blue Button Pledge Program”. The terms of the original pledge and the purpose of this community have remained largely the same. We welcome additional members to the community and the movement it supports. Although it is not necessary to join the ONC Blue Button Pledge Program to use the Blue Button term and logo, we encourage organizations to join us.
In addition, we are encouraging (but do not strictly require) existing Data Holder organizations in the Pledge community to take their existing pledge to the next level by providing a way for patients to view, download and share their health record in a format that is both machine and human readable through Blue Button. [See details of the Pledge terms at www.healthit.gov/pledge]