Geographies Blue Button Conversation 2010-10-28
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Status of Notes: DRAFT
Date: October 28, 2010
Time: 4:00pm-5:00pm EDT
Attendees:
Date: October 28, 2010
Time: 4:00pm-5:00pm EDT
Attendees:
Actions
# |
Date |
Action |
Status |
Owner |
Due Date |
1 |
Arien Malec
- Markle Foundation
- Adam Bosworth
- Lets get the data moving/fungible
- Todd?
- Every personal health record could press a big blue button which you could download from
- Support from Aneesh Chopra, Peter Levith, VA
- Adam Bosworth
- Priority Project for the VA
- My Healthy Vet
- Consumer offerings to Veterans who used VA Care
- View into their records
- Blue Button and download their data
- Data format
- Defined a sample
- Round on Attendance:
- Brett Peterson Visionshare
- John Odden CGC
- Paul Saxman Google
- Epic - Janet Campbell, Peter DeVault
- Microsoft - Sean Nolan
- Meena -- ??
- MedCommons -- ??
- Bob Barker - NextGen
- Dave Carlson - NoMoreClip
Peter Levin
- CTO of the VA
- Great government collaboration
- White House
- ONC
- DoD
- VA
- Not prescriptive
- Easily readable by human people
- Downloads = goal 100,000
- VA - 80,000
- HHS / DoD
- Started with a PDF (not initial intention)
- Markle Foundation Consortium
- 50 commercial organizations
- First Mobile App for the Blue Button by one of their vendors
- Delighted to see people from outside use this in new and creative ways
- Why he is excited
- Think its awesome to effectively do a ?? match with this ASCII flat files
- Bring into NHIN Direct send file
- Patient focused transport
- Electronic
- Clever and smart ways to insert into the NHIN network
- Purpose of Peter Levith's involvement
- Think its awesome to effectively do a ?? match with this ASCII flat files
Arien Malec
- What is a simple way to bring Blue Button data into Direct Project messages
- Whats the best way?
Peter Levith
- Curveball:
- His boss is calling him right now
- Stepped away for a second
- Won't be acoustically disturbing the call
Arien Malec
- Two ways to proceed
- Stuff Blue Button in a RFC message
- Stuff Blue Button in an XDM message
- Anyone who can do a Direct message should be able to unpack that file
- Two questions:
- 1: How do you identify that it is blue button data?
Fred Trotter
- Another question: How do you bring this into the XDM functionality?
Janet Campbell
- It is Blue Button Data, but it is text- what do we do about that?
Arien Malec
- From the VA perspective
- Has headers, values and sections
- Not super-structured or not unstructured
Paul Saxman
- What is the goal?
Fred Trotter
- Asked question
Peter Levith
- Go deep and long into this Google question
- Not going into it
- Pre-processor is okay
- Go forward with the assumption that we are going to vigilant if not dogmatic that we will leave the file the way that it is
- Good policy and technical reasons
Peter DeVault
- Reference terminologies may impact the value of the message
David Carlson
- Agrees with that
- Asked for clarification regarding the CCR
Peter Levin
- Pretty agnostic about it, pretty uninformed about it
- If that is the community's preference, then knock yourself out
- With respect to the Blue Button
- Comes from Standards world
- Will not be happening on this specific project
David Tao
- Announced his presence in the call
Arien Malec
- Peter to clarify = doesn't matter about the format, if you have IDC or STOMAT code, it would be good to include?
Peter Levin
- Minor impendiment to do it that way
- Looking at My Healthy Vet connecting to the Vista core
- Some way violates the way that veterans/citizens to input their own data
- If there was code that could achieve it, then it would be good
- From a VA perspective, will not be happening
- Question about the data
- They have the data in Vista
- Not addressing this in Blue Button
- Recognize that this relates to the project
- Limits the potential clinical validity
- The idea is that you are entering data in a clinical entry in a physician visit
- You would normally not see that data anyways
Janet Campbell
- I think that is key
- Good question: who we are sending to, why and where?
Arien Malec
- Set of partners of the VA who are ready to accept Blue Button data on a download/upload purpose
- If they also have Direct Project connectivity
- Core Use-Case: Skipping the download/upload, and be able to direct push it
- Assumption: the patient has a direct address (under his/her control)
- Subordinate Use-Case: Patient has a doctor address, and wants to push to a community provider who is not the VA
Peter Levin
- Both make sense - will not likely be happening in Blue Button in the near future
- Sometimes is a challenge
- Understands that download/upload is tough
- Sophisticated users would not want to do this
- Your use-cases make sense, but the best right now:
- Create the download capability
- VA can't import its own Blue Button
- Benefit: For the first time we are pushing the data our in a liquid/accessible form to patients
- Resource Allocation challenge:
- Do I modernize it to offer more value-added/sophisticated interface use-models
- Or do I focus drilling into the Vista to make it more functional
- Blue button has sided with the latter to push more data out
Peter DeVault
- May not make sense in this case of Direct Project then
Arien Malec
- Those general use-cases regarding the doctors
- Ex (made up) Google patient or epic patient pushing out files
- We are already addressing in the Direct Project
Peter Levith
- Just because I am not giving you structured data, doesn't mean you might not get it
- Most of the records might even be structured
- So many people are happy to get on their computers what they have today, maybe they haven't thought about it clinical utility
- They are just pushing the data around, but they do not want force the structuring
Arien Malec
- Direct patients records to be pushing to a doctor in a structured format
Peter Levin
- Web enabled service or local installed app
- If you want to send this to your Dr.
- Click this Button to allow us to read your Blue Button download
- We will then send this
David Tao
- A lot emphasis was given to Blue Button
- You are from the VA, how about if a lot of other providers start offering Blue Button
- If every Blue Button has no ASCii standard to it, then it would be very unproductive
- Could be structured format from the get-go - not right now
- Maybe if everyone used a similar format, then hundreds of conversions would not be necessary
- If every Blue Button has no ASCii standard to it, then it would be very unproductive
- What do we do to prevent this in the long-term?
Peter Levin
- Short term = no one knows
- Long term = be useful to get used to it
- Let them create the Blue Button standard
- Formatting = unstructured/poorly = unlikely to change as of now
- Just going to continue to concatenating from Vista onto the documents generated
- Almost certainly going to look different
- Kaiser
- Blue Cross
- Strength/Weakness of the idea
- If one of theirs dominates, then that is okay
- The community has underestimated how hard it is to write those parsers
- The person most vocal against them, tried writing it and found out it was okay
- 3-4 conversions are okay
Fred Trotter
- If we could have a MIME type and an extension
- Depending on how you download it
- Something that it will download Blue Button
Adrien?
- Direct Project to make it easy for patients to put the PHR into their account
- Computer going to the VA and downloading the Blue Button
- Significant point of discussion in Markle Foundation conversation
- Need to address simple use case- typical user trying to fetch such a file
Arien Malec
- Then we would know the path, and structured messages could be sent
- Without downloading
- Peter is saying that getting data into the file is the priority over skipping the downloading
Adrien
- Entering my Healthy Vet password, and from that point on I would expect the file will be drawn from the HISP
Peter Levin
- Uoff - can't tell you when, but high on his list is the automated authentication
- Soon they will be having the conversation
- Its on their roadmap - putting their value on it
- Recognize that they have similar goals, just prioritized in different levels
Arien Malec
- Focus more on the patient controlled health records/ systems
- Focus on the u-off
Peter Levin
- Interim Step
- Writing the Direct Project pre-processor
- In your VA pilot
- Writing the Direct Project pre-processor
- There will be a Blue Button to CCR
John Odden
- Raised concern about the hundred of blue buttons that could show up
- Raised concern about the parsers that will have to be written
- Stay away from doctors using it
Janet Campbell
- We are not talking about a service system
Arien Malec
- Could be from PHR to VA to Uoff
Janet Campbell
- The only thing that is missing
Peter DeVault
- Blue button is getting backing from government because it is reasonable
- Need a way to map all of the blue buttons
- Need to develop a standardized way to do it
David Tao
- Could be a CCR/CCD if the patient could read it
- They really don't care about it
Arien Malec
- Many portals already have that functionality
David Tao
- So the Blue Button concept could live on even if that functionality exists
- If they actually care about the format/standard, then they mave create competing standards
- No one wants that
- Is there an example somewhere?
Arien Malec
- va.gov/bluebutton
- Long ASCii document with headers, sections, pairs
- Competing data can be parsed out
- Structured values will be tough, structured interoperable format will be tougher
- Textual description of the drug
Peter DeVault
- Don't know where the prescription is coming from necessarily
John Odden
- Most easily accessible?
- How can we do that with the Direct Project?
- Some how or another, the issue of how patients interact with the Direct Project vendors keeps getting pushed further into the future
Will Ross
- We do not have any patients asking to participant
- Still talking to the community health partners who have the patient facing activities
- Hopeful that they did find the partner in the local IDN
- Wants to ask those type of questions
- IDN has a tethered PHR
Janet Campbell
- Do not need consent right?
Arien Malec
- Confirmed Janet's quesiton
- Agreed with Adrien about getting structured patient data rather than focusing on the Blue Button
Fred Trotter
- Suggested anyone feel free to e-mail him about it
- He is working on exploring this
John Odden
- This is what we need to do to safely send to patients
- Major question of Blue Button
Arien Malec
- Indicated that is his major goal - discovering the use-cases where we can center efforts on patients