Blue Button Initiative Presents Issues For EHR Compatibility

The Automated Blue Button Initiative (ABBI), backed by the Department of Veterans Affairs and increasingly adopted by smaller providers, has been lauded for giving patients easy access to their electronic health records (EHRs) and fostering collaborative treatment.  Veterans and others are able to download a summary of their treatment, allowing them to print and share their information, involve themselves in their care, and check for errors.

However, the initiative presents certain problems that have not yet been addressed by the Markle Foundation, which conceived the effort.  While use of the Blue Button aids providers in achieving governmental standards for meaningful use, the way the data is presented leads to issues with the everyday use of EHRs — providing physicians with an easy and interoperable way to take patient notes and transfer them to other providers when necessary.

When a patient downloads an ABBI file from her doctor’s web portal, she receives an unstructured, plain-text document with no XML tags, making it unreadable by computers.  While this file format is sufficient for a patient reviewing her own file, the output is read-only, making it useless for importing into existing EHR systems to track changes and produce dynamic content...