Unethical Blue Button Contest

This contest is deeply problematic.

The blue button initiative was a good initiative because it allowed greater access. It made that possible by ensuring that access to patient data did not have to wait for the VA/DOD/Whatever to create a download that conformed to the still-forming XML standards that make true interoperability possible.

But now the VA is promoting the Blue Button format as something that should be integrated into other EHR systems. That is unacceptable.

Meaningful use requries that doctors allow patients access to their health record summaries using CCR or CCD. Both of those standards can easily be translated to printable reports that are very readable. Meaningful use -also- requires that patients be provided a summary in a printed form. The simplest way to do this is just to have onsite printing of the CCR or CCD reports.

Blue Button data format is not as readable as a summary printout, and is not as parseable as XML. It is the worst compromise between human and computer readability. No clinician should ever make a clinical decision based on the content of a Blue Button download. The data is simply not rich enough to transfer into another health record or PHR. Essentially that makes the blue-button data format standard an FYI-only use case.

The innovation of Blue Button is to not let standards compliance get in the way of access. For this reason the DOD and the VA use of the Blue Button format should be applauded! The Blue Button initiative was fully give-me-my-damn-data compliant! But promoting it as an alternative process to a process that supports fundamental data reuse and is -already- required by meaningful use is unethical.

I formally request that the VA withdraw this contest, or make it clear that a CCR/CCD/printable report download meets the requirements of the contest.

Either you are promoting the notion of patient access, which is wonderful, or you are promoting shitty health data standards, which is unethical.

Cross posted on the VA challenge forums here.

Here is the example of the file format in question.


4 thoughts on “Unethical Blue Button Contest

  1. Hi Fred good points about re-using data. I agree with the FYI information so patient have the information and know what’s on file and to develop as a platform, yes a bit iffy if you will and I agree with you in the fact that standard compliance should not interfere with patients having access. We might be moving along here just a little too ahead of ourselves if the CCR/CCD is overlooked or not included as we have folks at all levels of technology today.

  2. OK, Blue Button does not currently support CCR/CCD summaries. Good point.

    Short-sighted? Yes.

    Unethical? That’s a stretch.

    More importantly, what needs to happen to fix this rather than just rant about it?

    Blue-Button-Like capabilities in health care could be very helpful to patients and very disruptive of the current health care non-system that separates patients from their own data.

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