I frequently write here about access to health information – necessary to just-in-time decision making, tracking status in meeting health goals, coordinating care among your health team – heavily weighted to individual action and team relationships. Effective communication within your finely honed health team is necessary, but not sufficient. You and your team still needs to access and share health information from all sources to coordinate your care. Much of health information sits in electronic tools: electronic medical records (EMR), personal health records (PHR), on the web, in smart phone applications (apps), and medical devices. We can share this information in emails and in the EMR, PHR and apps. Unfortunately, the tools often don’t link. They exist in different languages, requiring expensive translators (interfaces). In industry jargon, they lack interoperability. Often tools within one provider – a hospital, health care system, clinic needs these interfaces to work together. The problem is compounded when you see many clinicians in different systems, as I do. Multiple towers of Babel.
An example of good interoperability is among banks. You can go to any ATM and withdraw money and check your account balance anywhere in the world, instantly. No translators needed. Imagine that for health care? Finance is just as competitive as health care. What has the finance industry done that the health care industry hasn’t. They worked together to set standards (speak a common language) with little government involvement.
Apparently, for health care, government is necessary. Fortunately, our federal Department of Health and Human Services, has the Office of the National Coordinator for Health Information Technology (ONC) to sponsor collaborative forums for standards and interoperability. These initiatives directly impact our ability to access and share our health information. While our health team manages communication about an individual’s care, the ONC strives to facilitate communication across populations (all of us). Among their many activities:
CONNECT is an open source (the code is usable by anyone, not owned by a specific vendor) software gateway (door between IT systems) that allows health organizations to securely exchange health-related information using nationally recognized standards – whether across the street or across the country. One critical function is to identify patients so information can be linked and then record the communication between systems that occurs. Within your health team one of your caregivers could be taking care of many people. They need to be sure they are communicating about the right person and you want a record of that conversation. This gateway does the same for populations.
The Direct Project was created to specify a simple, secure (protected), scalable (used in many systems for lots of people), standards-based way for participants to send authenticated (the right person), encrypted (protected) health information directly to known, trusted recipients over the Internet. The Direct Project focuses on the technical standards and services necessary to securely push (electronically send) content from a sender to a receiver. This means that instead of you carrying paper or faxing information from clinician to clinician they can push the selected pieces of information electronically.
Automate the Blue Button Initiative (ABBI) allows patients to pull (retrieve) their health data in a human readable form and allows clinicians to push health data from one application to another. Blue Button is the symbol for a patient’s access to their own data. Blue Button+ is the ability to get records in a human-readable and machine-readable format; and to send them where they choose. This enables a consumer to do everything from printing a physical copy to sharing it with a third party application. What data?
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Demographic Information
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Emergency Contact Information
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Health Care Providers
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Health Insurance
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Treatment Facilities
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Medical Conditions and Personal Medical History
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Medications, Herbals, and Supplements
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Allergies and Adverse Reactions
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Lab and Test Results
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Immunizations
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Vitals and Readings
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Family Health History (Self and Relatives)
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Health Data (blood sugar, blood pressure, weight, etc.)
Some of the information above may seem difficult and overly technical. It’s important that you know your government is doing very good and necessary work here. You know health care is complicated. We can’t truly own our health care without this. Thank you ONC!
