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User-Driven Mobile Health Information Exchange

Apps such as iBlueButton enable patients to directly access and share their Blue Button and other health encounter records at the point of care.

Farzad Mostashari, MD, national coordinator for health information technology, has always been a believer in the power of patient engagement to improve quality, coordination, cost-effectiveness and efficiency of care.

Today, he is an even bigger believer. On Thanksgiving, Mostashari helped his visiting parents register to use the Medicare Blue Button program, which enables any Medicare beneficiary to get easy access to three years' worth of their medical claims data.

Not fully satisfied with the result - a raw claims text file - Mostashari then used his iPhone to visit the App Store and download iBlueButton, which had recently won the ONC's Blue Button Mashup Challenge. The free iBlueButton app from Humetrix converted his father's lengthy claims file into a user-friendly list of diagnoses, visits, procedures, imaging and providers with detailed contact information - as well as other information his parents could understand and share with a provider.

"When I saw my Dad's information (in iBlueButton), it changed everything," Mostashari recounted at the ONC's annual meeting in December.1 "I realized this is true patient engagement."

The very next morning, Mostashari discovered just how useful that information could be when his father woke up with pain in the eye where he had cataract surgery. Even though his father's ophthalmologist's office was closed for the holiday and was 500 miles away, Mostashari was able to use iBlueButton to find a nearby ophthalmologist and convey everything the physician needed to know about his father's medical history.

"Think about the difference," Mostashari  said, "not just in our life and our experience and our enjoyment of Thanksgiving but for healthcare costs. For him to be able to walk into that office and say, here you go. This is my history. This is the procedure I had. This is the diagnosis. This is my doctor. This is who I am. That's real. That's meaningful."

Blue Button Program Development
The government's Blue Button program was developed in 2010 by the U.S. Department of Veterans Affairs and the Centers for Medicare and Medicaid Services to give Veterans and Medicare beneficiaries ready access to their personal health information (PHI). The goals were to help consumers have easy access to view, download and share their medical records and to partner more effectively with their healthcare providers.

Using the Blue Button to give patients access to their PHI is just the first step. Most patients still need to have the ability to access and share their health information at a time of need, i.e., when visiting a healthcare provider. People need mobile applications like iBlueButton for information access on their mobile device. The iBlueButton application does this, promoting shared decision-making and partnership between patients and clinicians.

Mobile apps with this functionality also offer providers a cost-effective method to meet a Meaningful Use Stage 2 requirement -- for their patients to be able to view, download and transmit information about their health summaries. This is easier with the use of mobile applications such as iBlueButton that enable patients to directly access, download and share their Blue Button and other health encounter records at the point of care.

With more than 50% of Americans using smartphones and 62% of physicians owning and using tablets professionally, it is finally becoming practical to transmit health records at the point of care from a patient mobile device to a physician device, establishing a new mode of health information exchange (HIE) that could soon become ubiquitous. 2, 3

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User-Driven Mobile Information Exchange
With iBlueButton, a consumer electronically "pushes" their medical record to a physician's iPad or iPad mini at the point of care and vice versa, avoiding the lack of coordination and communication that typically occurs during care transitions. In essence, this interaction becomes a different kind of HIE, a user-driven mobile information exchange. The exchange of information is driven and controlled by individual record holders with the use of their mobile devices, regardless of provider-to-provider HIE capabilities.

As payment models shift to quality-based models moving forward, ACOs, patient-centered medical homes, providers and payors will only be successful if they can meaningfully engage consumers in their own healthcare.

Practical, anytime-anywhere patient engagement and patient-driven HIE will first and foremost reduce medical errors and improve patient safety. But at the same time, applications such as iBlueButton will have a major impact on healthcare costs as they help reduce the number of adverse drug reactions, redundant tests and procedures and preventable hospital readmissions.

Those are the real bottom-line benefits of a truly user-driven and ubiquitous HIE.

References

1. Farzad Mostashari, MD, ScM, National Coordinator, ONC, HHS , Keynote speaker at the ONC Annual Meeting, December 12, 2012. http://www.tvworldwide.com/events/hhs/121212/default.cfm?id=15242&type=flv&test=0&live=0

2. Nielsen. May 7, 2012. America's New Mobile Majority: A Look at Smartphone Owners in the U.S. Retrieved Jan. 7, 2013, from http://blog.nielsen.com/nielsenwire/online_mobile/who-owns-smartphones-in-the-us/

3. News Release. Manhattan Research. New Study Reveals Physician's Device and Digital Media Adoption Rapidly Evolving. May 10, 2012. Online at http://manhattanresearch.com/News-and-Events/Press-Releases/physician-digital-media-adoption

Bettina Experton is the founder, president and CEO of Humetrix, which has developed award-winning mobile device-based solutions that have been deployed worldwide.


Articles Archives
 

It is so great to see that patients are catching onto the idea of patient engagement and taking interest in their own health in this way.

The next step, however, needs to be with the providers already having all of that information. One, central, patient index, sharing the information between all hospitals in the country (and further?). That way, if someone ends up in the ER and is not able to access their iBlueButton app, the physician can still see their history and knows how to best treat them. That would be the best case scenario for each patient.

Patients having access to their own information is wonderful and so helpful. But physicians having the access to that data without the patient having to physically bring it to them, that is what's coming next.

Alere Accountable Care Solutions is currently offering these solutions to physicians across the country.

Amy Corrado,  Community ManagerApril 11, 2013
Waltham, MA



Another step in the right direction for healthcare in the U.S. Hopefully as more and more patients and providers see the absolute value of this application, the word will spread and its use will increase. Mobile healthcare apps seem to be a hot IT topic currently; and the Blue Button is a front runner, it seems.

Lisa Graese,  Instructor,  Spokane Community College April 10, 2013
Spokane, WA



I see absolute postive outcomes with the patient that has access to smart phones and tablets. What thought has been given to the patients that do not.

Denise Rigsby,  Instructor,  Medtech CollegeApril 10, 2013
Fort Wayne , IN




     

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