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 application 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.