Senior Editor, Government Health IT
Developers in an ONC voluntary community are beginning to drill down into what will be required to automate the Blue Button feature to exchange patient health information at the consumer’s request under different scenarios.
The Blue Button enables patients to view and download their information in simple text format and is currently available to veterans, military service members and Medicare beneficiaries. A few private sector health organizations have begun to make it available to their members.
The ONC’s Standards & Interoperability Framework community has just created three panels to identify standards and tools to push personal data to a specific location, such as using Direct secure messaging protocols and the Consolidated Clinical Document Architecture (CDA), and allowing a third-party application to access personal health data on demand, in a pull transmission, according to Doug Fridsma, MD, director of ONC’s Office of Standards and Interoperability and acting chief scientist.
The standards and specifications would enable patients to not only download their health information to their personal computer, but also to privately and securely automate the sending of that data from their healthcare providers to their personal health records, email accounts, health-related applications, or other preferred holding place.
This will support the meaningful use stage 2 requirement that patients be able to view, download and transmit their health information to a personal health record or other location, he said at the Sept. 19 advisory Health IT Standards Committee meeting.
Developers are also considering the content of a Blue Button file so it can be both human-readable and machine readable, Fridsma said.
ONC wants to have an eco-system developed with applications to support patients in their ability to look at their information and do interesting things with their healthcare data.
“The idea is to move from ASCII text files, which are very important for patients just to get access to it, to things that are more standardized structures so that we can have the ability to share between systems and move from one-time download to where we can automate the system as part of the process of care, either making sure that we can push it in a way that makes sense or figure out ways we can pull it into a personal health record,” Fridsma said.
One of the principles of Blue Button is that it is always human readable, added Farzad Mostashari, MD, the national health IT coordinator.
“If we can make it be smart data that can be parsed and machine interpreted but have like an equivalent of an Adobe reader that can take that and put it into human readable format, then you’ve solved both problems,” he said at the meeting.
The S&I Framework also has an aggressive timeline to identify standards and services for the Health eDecisions project to advance the sharing of clinical decision support (CDS) interventions, Fridsma said.
Standards will make it easier for vendors to add clinical decision support capabilities into their electronic health records (EHRs) and for providers to use “for importing best practices and save yourself some time and try to do proven intervention, like reminders, orders and templates,” he said.
Developers are exploring what the standards and formats are going to be, and what’s the best way to operationalize this, Fridsma said.
One use case is to promote repositories or catalogues where providers can locate CDS content, download standards or share knowledge in an executable format and incorporate it into the provider’s EHR.
The community will propose an artifact sharing standard in October, conduct pilots, and by May submit it to a standards development organization for approval, Fridsma said.
In January, the community will consider standards for an electronic interface that enables a provider to send information or patient history to a service, which would then send back actionable clinical guidance.