Electronic Health Reporter

Guest post by Bettina Experton, MD, MPH, president and CEO, Humetrix.

Mobile technology core to HIT implementation, a silent revolution which took place on September 23 this year when the HIPAA omnibus rule took effect, giving Americans the right to obtain electronic copies of their health records. But how can this new right be exercised at scale to transform healthcare nationwide? How do we help patients better coordinate their care and ensure their safety by getting their health records in their own hands?

The scalable computing device of choice in the hands of many is a smartphone, now owned by more than 50 percent of the population, and for many the only computing device they use daily to access information on the Internet. Clearly, electronic access to health records would be best provided on the very mobile device most of us carry at all times, especially when navigating a complex health care system with multiple  and dispersed providers.

Electronic copies of health records on CDs or flash drives are not only tools of the past, but also perpetuate the barriers and complexity most of us have to face when requesting copies of our records. Desktop and portal-only solutions are also not the optimum approach to consumer-directed health information exchange, since these cannot be available at the point of care where patients need to share their medical history in the most convenient and expedient way. Mobile is, therefore, central to health information exchange policies and new care delivery models built on patient-centered care, and should not be an afterthought or secondary implementation to dated patient portal systems.

Meaningful use requirements in Stage 2 for patient “View/Download & Transmit”(VDT) are now entering the critical phase of information flow between all actors, and for the first time, serving the patient as a required recipient and health information exchange actor of their own records. The complexity and cost of implementing patient portals to deliver VDT have many provider organizations calling for delay in MU-2 implementation. The limited use of patient portals by consumers also reinforces provider reluctance to invest in these additional IT resources.

Mobile tools in the hands of patients can provide a scalable and cost-effective solution for providers to meet MU-2 VDT requirements in a meaningful and practical way for everyone. Specifically, mobile applications which have implemented the Blue Button⁺ standards which directly tie in with MU-2 requirements for EMRs can offer the solution of choice for both patients and providers. The ONC award-winning iBlueButton apps are such a Blue Button enabled application and “mobile un-tethered PHR” which can aggregate records from multiple provider or payor sources and provide the longitudinal record HIE systems strive to achieve. The apps, which are available for anyone to download from iTunes or GooglePlay, are also part of a significant health information exchange pilot with patient use of PHRs conducted by the State of California and NATE.

iBlueButton can receive from MU-2 certified EMRs or consumer-serving HIEs summary health records in C-CDA format via the Direct transport protocol. Consumers using the app receive push notifications when a new or updated record is available for them to receive on their mobile device. No need to log into a patient portal and navigate a site to download a record, and print it to share it with a physician. With iBlueButton, users can fully capitalize on mobile technology for convenient download and device-based storage of their records, and can also easily exchange records with their physician at the point of care with secure device-to-device transfer.

Mobile technology provides the type of convenience and everywhere utility consumers expect and providers need. Mobile tools for health record access and exchange can ensure patient participation in their care and provider compliance with MU requirements for patient engagement and health information exchange.

From HIPAA to meaningful use, mobile solutions provide the operational means to deliver on these critical and revolutionary HIT policies to transform health care, because only mobile technology can ensure active consumer participation at scale.

As many as 200,000 preventable deaths occur every year in the USA. Many of these tragic events result from healthcare delivery failures and medical errors caused by a lack of information at the point of care and poor care coordination. These deaths of epidemic proportion need to be urgently addressed in moving to the operational phase of new policy-driven health information exchange, in placing health records and personal health information directly in the hands of consumers using mobile technology.

Now is the time to educate and inform the public about their new healthcare rights and the tools to exercise these rights, improve their healthcare and in some instances protect their lives, empowered by the very mobile devices they are using in every other aspect of their daily lives.