Biological Telemetry

When Blue Button first went national last year, it included little more than the kind of data a patient would fill out on a clipboard while waiting for his or her appointment. At that point, it was nothing more than a simple convenience or memory aid — not insignificant if you happen to be juggling multiple appointments with multiple physicians, Levin said. “It was an extension of your health identity, your clinical identity. It helps keep track of the medicines you’ve been on and the medicines you taking and your appointments.”

VA has since added significantly more capability to the system, the most recent being the ability to download the latest laboratory results. VA expects to add radiological images and ultrasound images in the near future.

“This follows a well-modeled trajectory of new tech innovation,” Levin said. “We start small, start simple, make it available, make sure the users understand what it is. Then, in a very methodical way, we start adding capabilities and features to it. Veterans today have access to more data and better data than I do going to my private physician. This is a huge, huge thing. We’re starting to capture, in a coherent and comprehensive way, biological telemetry.”

One of the primary benefits of veterans being able to download both their VA and private physician data is that they will be easily able to transport their health records between the two.

“This is something they’re already doing today with paper — sometimes suitcases full of paper,” Levin said.

Blue Button will allow that transfer to occur digitally. Veterans will be able to e-mail their data or download their health records to a disc or flash drive and carry everything in their pockets.

As for the competition, looking at early proposals, Levin is very optimistic. “It looks like we asked the right questions, and that we structured it in a way that’s attractive to the private sector,” Levin said.

Provider-to-Provider Connections

Another goal of VA’s push for health technology innovation is to cut out the need for the middleman.

While a bidirectional connection between the veteran and his VA and private physicians is important, a direct connection between the two providers would allow for much better sharing of data. Such sharing has been made possible in several pilot sites across the country but has yet to be done on a national level.

“The way you structure data between two institutional providers would be richer and deeper,” Levin said. “We’re not restricting the data given to veterans, but there are technical terms, diagnoses, taxonomies, that would not be necessary to someone not steeped in the field, but which would be essential in the conversation two providers would have with one another.”

It also would improve the integrity of the data, Levin noted. Health data coming from a patient, especially one a physician does not really know, would be more suspect than data coming from another physician. With a direct provider-to-provider connection, the integrity question goes away.”

“This ability for providers to communicate is a profoundly important thing,” Levin said. “It’s one of the biggest impediments to health IT in general.”

Blue Button site: http://www.va.gov/bluebutton/

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