Use of the Blue Button Online Tool for Sharing Health Information: Qualitative Interviews With Patients and Providers.

BACKGROUND: Information sharing between providers is critical for care coordination, especially in health systems such as the United States Department of Veterans Affairs (VA), where many patients also receive care from other health care organizations. Patients can facilitate this sharing by using the Blue Button, an online tool that promotes patients' ability to view, print, and download their health records. OBJECTIVE: The aim of this study was to characterize (1) patients' use of Blue Button, an online information-sharing tool in VA's patient portal, My HealtheVet, (2) information-sharing practices between VA and non-VA providers, and (3) how providers and patients use a printed Blue Button report during a clinical visit. METHODS: Semistructured qualitative interviews were conducted with 34 VA patients, 10 VA providers, and 9 non-VA providers. Interviews focused on patients' use of Blue Button, information-sharing practices between VA and non-VA providers, and how patients and providers use a printed Blue Button report during a clinical visit. Qualitative themes were identified through iterative rounds of coding starting with an a priori schema based on technology adoption theory. RESULTS: Information sharing between VA and non-VA providers relied primarily on the patient. Patients most commonly used Blue Button to access and share VA laboratory results. Providers recognized the need for improved information sharing, valued the Blue Button printout, and expressed interest in a way to share information electronically across settings. CONCLUSIONS: Consumer-oriented technologies such as Blue Button can facilitate patients sharing health information with providers in other health care systems; however, more education is needed to inform patients of this use to facilitate care coordination. Additional research is needed to explore how personal health record documents, such as Blue Button reports, can be easily shared and incorporated into the clinical workflow of providers.

Blue Button use by patients to access and share health record information using the Department of Veterans Affairs' online patient portal.

OBJECTIVE: The Blue Button feature of online patient portals promotes patient engagement by allowing patients to easily download their personal health information. This study examines the adoption and use of the Blue Button feature in the Department of Veterans Affairs' (VA) personal health record portal, My HealtheVet. MATERIALS AND METHODS: An online survey presented to a 4% random sample of My HealtheVet users between March and May 2012. Questions were designed to determine characteristics associated with Blue Button use, perceived value of use, and how Veterans with non-VA providers use the Blue Button to share information with their non-VA providers. RESULTS: Of the survey participants (N=18 398), 33% were current Blue Button users. The most highly endorsed benefit was that it helped patients understand their health history better because all the information was in one place (73%). Twenty-one percent of Blue Button users with a non-VA provider shared their VA health information, and 87% reported that the non-VA provider found the information somewhat or very helpful. Veterans' self-rated computer ability was the strongest factor contributing to both Blue Button use and to sharing information with non-VA providers. When comparing Blue Button users and non-users, barriers to adoption were low awareness of the feature and difficulty using the Blue Button. CONCLUSIONS: This study contributes to the understanding of early Blue Button adoption and use of this feature for patient-initiated sharing of health information. Educational efforts are needed to raise awareness of the Blue Button and to address usability issues that hinder adoption.

Personal Health Record: uma revisão sobre os modelos e experimentos atuais / Personal Health Record: a review of the current models and experiments / Personal Health Record: una revisión de los modelos actuales y los experimento

Objetivo: Realizar uma revisão integrativa da literatura para verificar que modelos de personal health record (PHR) eletrônico estão sendo desenvolvidos e que aspectos influenciam na sua adoção por meio da análise dos experimentos realizados. Métodos: Uma busca nas bases de dados PubMed e LILACS foi realizada inicialmente para selecionar artigos publicados entre 2010 e 2012. Resultados: Foram recuperados 319 artigos originais publicados entre abril de 2010 e maio de 2012. A aplicação dos critérios de exclusão resultou em 36 artigos para leitura completa e foram validados 29 artigos. Foram identificados 14 modelos de PHR e três aplicativos. Os estudos foram categorizados em relação ao objetivo em termos de desenvolvimento e usabilidade, compartilhamento, impacto, atitudes dos consumidores e barreiras. Um conjunto básico de funcionalidades, conteúdo e interação com o usuário que influenciam positivamente na sua adoção foi identificado. Conclusão: O PHR ainda está em fase de desenvolvimento e outras questões devem ser propostas e avaliadas.

Objective: To perform a review in order to ascertain the kinds of electronic Personal Health Record (PHR) that are being developed and the aspects that influence their adoption by the analysis of experiments. Methods: A research in the PubMed and LILACS databases for original papers published between 2010 and 2012 was performed. Results: A total of 319 original papers were published between April 2010 and May 2012 which, were retrieved initially. These were analyzed using the inclusion and exclusion criteria, thus yielding to a total of 36 studies for further analysis and 29 studies validated. We identified 14 PHR models and three personal health application. The studies were categorized regarding the goal in terms of usability and development, sharing, impact consumer attitudes as well as barriers. We identified a basic set of features, content and user interaction that positively influence the adoption. Conclusion: The PHR is still under development and other issues must be proposed and evaluated.

Objetivo: Realizar una revisión integradora de la literatura, para verificar qué modelos de personal health record (PHR) electrónicos se estan desarrollando y que aspectos influyen en su adopción por medio del análisis de los experimentos realizados.Métodos: Fue realizada inicialmente una búsqueda en la base de datos PubMed y LILACS, para seleccionar artículos entre 2010 y 2012. Resultados: Se recuperaron 319 artículos originales publicados entre abril del 2010 y mayo del 2012. La aplicación de los métodos de exclusión dio lugar a 36 artículos de lectura completa de los cuales fueron avaliados 29 artículos. Se identificaron 14 modelos de PHR y tres aplicativos. Los estudios se clasificaron en relación al objetivo, en términos de desarrollo y usabilidad, compartir, impacto, actitudes de los consumidores y barreras. Fue identificado un conjunto básico de funcionalidades, contenido e interacción con el usuario que influencian positivamente en su adopción. Conclusión: El PHR aún está en fase de desarrollo y otras cuestiones deven ser propuestas y evaluadas.