1. Blue Button:
The Patient-Physician EHR Connection
At Every Point of Care
Bettina Experton, M.D. M.P.H.
The 2013 Physician-Computer
Connection Symposium

2. What is Blue Button®?
A Transformative National Policy for Patients to V/D/T their Online Health Records
and Adopted Nationwide for Use Today by ~100 million Americans

3. From Blue Button… to iBlueButton
From a 300 page Blue Button
ASCII text claims record to…
A Mobile Longitudinal Health Record
Available at Every Point of Care
From a Simple Text File to.... iBlueButton®
The ONC Industry Innovation Blue Button Challenge Winner

4. Blue Button+ Meets MU-2 V/D/T Requirements
http://bluebuttonplus.org/mu2.html
Requirements Specified in MU 2 VDT Specified for Blue Button+
Structure Consolidated CDA Consolidated CDA
Section & Fields MU2 Sections & Fields MU2 Sections & Fields
Transmit Direct Protocol (SMIME/SMTP) Direct Protocol (SMIME/SMTP)
Trust Anchors Manual Anchor Exchange Blue Button Trust Bundle
Certificate Discovery Via DNS or LDAP Via DNS or LDAP
Transmit Context -
In message body and
optional Request.txt
Download Yes Yes
Transmit: Send Once Yes Yes
Transmit: Send on Change - Automation & Triggers

5. iBlueButton®: a Registered Blue Button+
Trust Bundle Patient Application
https://secure.bluebuttontrust.org/
Name Website Domains Expires Status
Microsoft
HealthVault
healthvault.com
direct.healthvault.
com
12/31/2039 Active
NoMoreClipboard
nomoreclipboard.
com
nomoreclipboard.
com
12/9/2023 Active
ibluebutton ibluebutton.com
ibluebutton.com
direct.ibluebutton
.com
2/23/2033 Active

6. EMR
Private
Payer
Lab
iBlueButton
Server
Direct Registry Service
Push Notification Service
Download Service
Direct Messaging Service
Blue Button+ goes mobile with iBlueButton
For Anywhere, Automated V/D/T on the User’s Own Device
Push
Notification
Immediate
Record Access
File Decoding &
Reformatting
iBlueButton
Home Screen
App Direct
Address

7. Mobile to Mobile Exchange
of Blue Button and
other records
at the Point of Care
The iBlueButton apps are based on Humetrix U.S. patent #5,995,965 and other pending patents. "Blue Button", the Blue Button logo, and the slogan "Download My Data" are registered Service Marks of the U.S.
Department of Health and Human Services (HHS) an agency of the United States Government and are used by permission of HHS. © 2013 Copyright Humetrix.
Patient-Controlled Mobile HIE App
POC Device to Device 2-way Data Exchange

9. HIE and Care Coordination Shortfalls:
The Medicare Use Case
 In 2011, only 31% of physicians can exchange records electronically
 With the average Medicare beneficiary seeing 7 physicians per year,
2/10,000 odds that all of a given patient’s physicians could
exchange medical records for that patient
 Under 5% of SNFs, Rehabilitation or Long-term Care facilities have
installed EMR systems
 Given that 1/3 of Medicare patients are discharged from a hospital to
one of these facilities, large gaps exist in making medical records
available which are not addressed by conventional HIE strategies

10. “Advancing Interoperability and Health Information Exchange”
By Leveraging the Blue Button Initiative (Question #9 RFI)
Response to ONC/CMS (April 22, 2013)
 Broad outreach communication campaign to Medicare
beneficiaries
 Large scale healthcare provider outreach to let them know
about the value of the 3- year longitudinal history provided by
the Medicare Blue Button for transitions of care and drug
reconciliation.
 Register Medicare patients for Blue Button record access at
the time of the Welcome to Medicare and/or at the Annual
Wellness visits.
 Upon admission & prior to hospital/ER discharge, register
Medicare beneficiaries for Medicare Blue Button record
access at My Medicare.gov

11. “An eye opener to me…”
“You’ve got to see this because it is
that good”
“There are 38 Million on Medicare
now who could be doing this and
there are 38 million on Medicare
who have not done this”.
Bipartisan Policy
Center
December 10, 2012
ONC Annual
Meeting
December 12, 2012
 Dr. Mostashari shares his personal iBlueButton experience caring to his father
 Consumer Partnership for e-Health (CPeH) of 150 consumer/patient groups
advocate iBlueButton for use by Medicare beneficiaries, their family caregivers
and healthcare providers . (Letter to CMS/ONC , April 22, 2013)
National Leader and Organizations Spread the Word

12. When iBlueButton Saved
Beth’s Father’s Life
White House Patient Access Summit June 6
2013

13. www.ibluebutton.com

14. iBlue Button
App Password Entry
TRICARE
User Name &
Password Entry
iBlue Button
Portal Screen
New First Use Portal Credentials Entry

15. Auto-Download/Auto-Pull & View
of Blue Button Record

16. Android Display of Medicare Blue Button Record
Auto-Download/Auto-Pull & View
of Blue Button Record

17. 17
MedlinePlus Drug
Side Effects with
Patient Annotation
Medications
Displayed
Display of Medicare Blue Button Record Medication Reconciliation,
Look up and Annotation Functions
Medications
Aggregated
from Multiple
Records
Patient Medication
Annotation

18. 18
MedlinePlus
Condition
Information
Conditions
Displayed
My Conditions
Anemia
Chronic kidney disease
Depression
Hypertension
Fracture
Syncope
Coronary artery disease
Hypercholesterolemia
Candidiasis
YES
Condition Information
Currently experiencing?
Cholesterol
Conditions
Aggregated
from Multiple
Records
Condition
Annotation by
Patient
Display of Medicare Blue Button Record Problem List,
Condition Look up and Annotation Functions

19. iOS and Android Phone and Tablet Applications with
Device-to-Device Cross-Platform Data Exchange Capabilities
Device to
Device
2-way
proximity
data
exchange
iBlueButton Professional Display of Patient-
Noted Change in Condition

20. Provider Look up by iBlueButton Professional app
Display of All Providers (from last 3 yrs)
with Specialties, and Contact Information

21. White House Patient Access Summit June 6
Launch of a Blue Button National Campaign:
Will Physicians Take the Lead?

22. Learn more and spread the word
www.ibluebutton.com
#ibluebutton
#bluebutton
The 2013 Physician-Computer
Connection Symposium
bexperton@humetrix.com