A Life-Saving Blue Button 50+ Million Americans Need to Know About and Have in Their Hands at All Times
August 14, 2017
By Bettina Experton, MD, MPH, CEO of Humetrix

It was a lovely summer weekend at home in Southern California, relaxing with friends, when one of my friend’s phone rang with the dreadful news no one wants to get - letting him know that a loved one fell seriously ill and was in the emergency room in need of surgery, and thousands of miles away. As a proxy to his 65+ family member, he was quickly on the phone with her and the ED physician going over her medical history, the various chronic conditions she suffers from and everything the hospital physician needed to know to quickly and best address the acute and life-threatening situation she was experiencing. Her internist and primary care provider could of course not be reached on the weekend, and the distressed patient with severe pain wasn’t in the position to thoroughly tell her doctor her medical history - but her phone could! As a Medicare patient, her family member had told her about the iBlueButton app to best manage her healthcare, which she had been using since on Medicare, letting also her family member and medical proxy use it to help her in such an emergency or to discuss her medical options when having new medical issues.

The iBlueButton app automatically transforms the undecipherable medical claim information coming from her Medicare Blue Button online account, decoding her Medicare Blue Button claim based information to give in an organized fashion everything her doctor needed to know: list of diagnoses, including these conditions which rendered the needed surgery even more urgent, all the doctors she had seen with their contact information, medications she took, list of past imaging studies, etc... But the lifesaving utility of this tool to allow patients and their family caregivers to have their critical health information at their fingertips didn’t stop there! As the patient was being then prepared for surgery, she was given an antibiotic for which she suffered a severe rash, an allergy she was rapidly treated for before heading for surgery, and which she then recorded in her iBlueButton health summary. Recovering from surgery and getting ready to be discharged home a few days later, she was however prescribed the very same antibiotic she was allergic to while in the hospital! Thanks to her vigilance and having all the information she needed right there in her hands, she avoided a more serious allergic reaction by not taking that antibiotic again! Last, when visiting last week her new primary care physician, as her previous internist had just retired, her doctor let her know that even if her large multi-specialty clinic was just a few miles away from the prestigious hospital where she had surgery, she had not yet received a hospital discharge summary to let her know about the treatment she had in the hospital. The patient then pulled her iBlueButton app, giving all the specific details on the surgery, the list of tests she had, the names and contact information of all the doctors who treated her in the hospital, medications prescribed, etc...! The physician couldn’t believe the extent of the information her patient was sharing with her – right from her phone, and let her know that the clinic had thousands of Medicare patients for whom they typically have no information when they are discharged from the hospital or have been seen in another clinic.

Today, between 200,000 to 400,000 Americans die every year from preventable medical errors, and one third of these are due to a lack of information at the point of care, leading to delayed treatment, diagnostic or therapeutic errors, costly redundant tests and procedures, and preventable hospitalizations. Most of these preventable and life threatening medical errors affect the elderly who are more likely to be on multiple medications (one third of preventable Medicare hospital re-admissions are caused by medication errors) and suffer from multiple chronic conditions which are too often unknown or partially known, given that on average a Medicare beneficiary sees seven different physicians in a given year, who for most them don’t have access to their patients outside medical records (when only one third of physicians exchange their patients’ medical records).

The iBlueButton won in October 2012 the ONC Industry Innovation (i2) Blue Button Mash Up Challenge by transforming Medicare Blue Button claim data into a usable and actionable longitudinal record, a literally life-saving tool for Medicare patients and/or their family caregivers to have. In December 2012, two months after giving the ONC i2 award to iBlueButton, Dr. Farzad Mostashari, then ONC Director, recognized its extraordinary value for Medicare patients, and called for all Medicare beneficiaries to be able to use the app just as he did for his own Dad.  Unfortunately, almost five years later in 2017, this message has still not reached the 50+ million Americans on Medicare.

As interoperability across provider systems will remain difficult for years to come, giving patients their medical histories, generated from these valuable Blue Button enabled Federal and State medical claim data sets, is a public health imperative. In its latest report, Improving Diagnosis in Health Care, the National Academy of Medicine, states that medical errors are the third cause of death in America, causing 10% of all deaths, and that the majority of Americans will be victim to at least one “meaningful” diagnostic error in their lifetimes. One of the key recommendations included in the report is that patients must be an integral and informed part of their own caregiving team, and have access to their electronic health records to facilitate patient engagement in the diagnostic process and patient review of their health records for accuracy.

By providing access to medical records – and making the information actionable – mobile Blue Button tools such as iBlueButton can literally save lives. Especially among Medicare and Medicaid beneficiaries, who often must seek care from disparate healthcare providers, tools that can ensure continuity of care are key to ensure patient safety and cost-effective healthcare.

With new leadership at HHS, CMS and the ONC, now is the time to capitalize on the pioneering Blue Button initiative in letting patients and providers know that lifesaving applications exist today for them to use so that millions of Americans can receive safer and more cost-effective care.

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