Mobile application iBlueButton just got a technical design boost as a multi- and cross-platform health information hub patients and providers can use to share health data at the point of care with the most popular mobile tools.

San Diego-based Humetrix has expanded the ways patients and physicians can exchange health records via its iBlueButton app using not only iPhones and iPads but also Android devices with secure Quick Response code to transfer the patient’s Blue Button record between systems.

The Office of the National Coordinator for Health IT awarded Humetrix first place in its Blue Button Mash-Up Challenge in October. iBlueButton builds on the feature developed by the Department of Veterans Affairs, which enables patients to download their health information in a simple ASCII text format to their computers or personal health records to share with providers, families or caregivers.

Government Health IT recently spoke with Humetrix CEO Bettina Experton, MD, about how iBlue Button can help patients fill in the gap in advancing health information exchange to coordinate and improve care.

Q: Farzad Mostashari, MD, the national health IT coordinator, has talked about the difference iBlueButton made in making his parents’ health information usable, but he didn’t fully understand it until he saw it in action. What is it about the design that makes people want to use it?

A: Blue Button at its start was about a minimal and easy format standard in a text file. The Medicare Blue Button is a text file, but it is not appealing to see. It’s a list of three years of claims of Medicare providers in a list format in addition to all sorts of codes. For instance, in lieu of showing you your provider name, specialty and contact information, you are given a provider name and an NPI code attached to it. Or you have a drug name and code that was filled at pharmacy.

We turn that Blue Button text file into a user-friendly actionable record. We decode all the codes so that now it is a formatted record where everything is in a user-friendly format. We go from a list of claims data to a list of problems and diagnoses. We pull all the claims for drugs and provide a table with all the medications in detail, the brand name, the chemical name, the manufacturer, where it was prescribed and filled. From the claims, we provide a prior history of the patient, with prior hospitalizations, dates, admission diagnoses, ER visits, office visits, imaging, labs and tests and preventive services.

We go from a raw claims listing with a bunch of codes that no one can understand to something really usable and organized, where everything is clear and on view for the patient to see.

Q: How will the iBlue Button app advance meaningful use stage 2 and patient engagement with their physicians?

A: To meet consumer engagement requirements for meaningful use stage 2, physicians have to give a means for the patient to access, view, download and transmit their health summary, which can be generated by a Blue Button record. We provide a view download transmit solution so the consumer at the point of care so they can use push technology and transmit his or her record to his physician on a smartphone or iPad device during an encounter.

When the record is pushed over, the physician has the same user-friendly display on one screen on his iPad of the Blue Button record re-formatted with all the codes translated. 

Physicians can use the Direct protocol to exchange records, and that means it can be a Blue Button record. The patient, who can have direct access to a Blue Button record through a mobile app, such as iBlueButton, can securely download that record onto a mobile device to review and then be in the position to present and transmit the information to a provider right there.

On the patient side, not only is the Blue Button re-formatted, but we add contextual data with it so the record is actionable. The patient can review the list of meds, for instance, through Medline Plus, to look for explanation of potential side effects and if selected can be pushed to the record viewed by his physician. And when the record is pushed to the physician’s iPad, a warning can come with the medication name to open the alert and determine if the patient has experienced potential side effects. We also do medication reconciliation with these apps.

The patient can mark if he or she is taking the medication, and when the patient is no longer taking the medication the physician can receive alerts.

Q What functionality have you now addied to iBlue Button?

A: iBlueButton is a mobile health information hub that the patient carries and can do device-to-device transmission at the point of care. But it’s a two way communication. The physician at the point of care can use the same app and push a health summary to the patient right there and push back some patient instructions, images and x-rays.

When you use iBlueButton, on the consumer side, you could accept a series of Blue Button enabled portals, such as MyMedicare.gov, MyHealtheVet, Aetna, Tricare Online and RelayHealth. By adding other Blue Button portals to the hub, consumers will be able to pick from upcoming Blue Button enabled portals by Aetna, some Blue plans and large health plans. I choose the portal or portals that apply to me. I can be a veteran and access my records from MyHealtheVet but also [may be covered by a] commercial plan, so I may have a use case to access more than one Blue Button portal through my iBlueButton. But there will also be the ability to access multiple accounts for a single app user, such as when caring for elderly parents.

None of what we do is on the Humetrix server. Everything — all of the code translation, reformatting — is all done on board the app. We don’t have to run a server and expose personal health information to privacy risk. It is all under the user’s control.

Q: Do you see meaningful use generating other new markets, the way BlueButton has?

Experton: Absolutely. This combination of national policy and mobile technology is revolutionizing health care. I think the consumer is driving that revolution. Meaningful use stage 1 was about establishing an EHR infrastructure; meaningful use stage 2 is about exchange.

One of the means of exchange is consumer-driven exchange, which can work hand-in-hand with patient engagement. It’s not just running an app to care about my health and record in the privacy of my home. It is to be an active partner in my health care, so I come prepared and I have access to meaningful information that is up to date, contextual information so I can understand what the diagnosis means, and I can activate whether I am or not taking a drug any more or when I have a side effect. You create this meaningful exchange between a patient and provider, which couldn’t take place before. 

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