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Stephen J. Downs Headshot

Why I Want a Blue Button

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This morning my colleague, Dr. Carol Diamond of the Markle Foundation, appeared on the Today Show to talk about an initiative called "blue button."

As many have experienced, getting a copy of your medical records is rarely as simple as it sounds. The process often involves making multiple phone calls, having to fax in requests, paying photocopying charges and waiting - often as much as a few weeks. And at the end of the process all you have is a stack of paper - good for reading and for filing away, but not much else. But today, as more and more hospitals, pharmacies, and physician offices are adopting electronic medical records, the process should get better. Health care institutions in the vanguard of information technology and customer service are making it possible for their patients to review their records online. But not necessarily take them with them.

That's where the blue button idea comes in. It's a simple practice: when a patient logs in to her account, provide a highly visible, clickable button to download her records in digital form. As Dr. Diamond noted, the federal government has taken a leadership role in modeling this practice. The Department of Veterans Affairs started providing blue button downloads to all patients of the VA system back in August and the Center for Medicare and Medicaid Services has launched a similar blue button service for all Medicare beneficiaries. And their efforts have not gone unnoticed - more than 60,000 veterans have downloaded their medical data since the launch. The Markle Foundation has also worked with experts from consumer and patient groups, health care provider, privacy advocates and technology companies to develop a set of recommended blue button practices that ensure high levels of security and privacy.

So why does it matter? For starters, reviewing your medical records is a step towards better engagement in your health. You can learn more about your conditions, your lab results and the treatments you might be undergoing. You can use the records as a springboard to conversations with your doctor. But you can do that paper records. Why does digital matter? Two reasons: sharing and apps. Of course, when you get your paper records, you can always photocopy them and send them on to someone you'd like to review them. But we all know that it's so much easier to share digital information online. So when you want your uncle the doctor to help you interpret a result, or when you and your sibling want to discuss Dad's condition, it's easily done.

But the real power lies in the apps. We now live in a world where there really is an app for just about everything. There are 6,000 apps for the iPhone that focus on health and fitness. They help with day-to-day health-related tasks, like managing your diet, tracking your exercise, understanding your meds, or checking out your symptoms. But these apps are, by and large, ignorant of the details of your health that could make them smarter and offer you more value. Many of them, and many that will soon be invented, could be even better if they could draw upon the information contained in your medical records - to spot trends in your lab values and warn you when a trend is of concern; to correlate your moodiness with a new medication you're taking; or to remind you it's time order that prescription refill, to name a few.

And we've already seen that the data made available through blue button downloads will lead to new apps. Earlier this month, the Markle Foundation and the Robert Wood Johnson Foundation announced the results of the blue button Challenge, held as part of the Health 2.0 Developer Challenge. With only a modest prize, the challenge drew nine entries, including the winner, from Adobe Systems, which was a slick front-end for the VA's data, making it easy for people to read, share and discuss the information. It also included a set of tools and reminders related to medications. Another significant entry came from Microsoft, which built a way for blue button downloads to go straight into its HealthVault personal health record service, which provides access to more than 50 different apps. And this all happened over the course of a month. As blue button becomes much more widespread, we can expect to see more and more apps designed to take the data you can download and turn it into useful information and valuable tools you can use to manage your health.

The federal government has taken a strong step forward to give people access to their medical records. Now it's time for more in the private sector to do the same. I know I want a blue button on my doctor's Website. If you think this is a good idea - if you believe that people should be able to download their medical records, or if you would like your physician's office to make yours available, or if you have a totally different take on this question, please join the conversation on Twitter - send a tweet with your opinion and be sure to use the hashtag #bluebutton.