ONC Presents Personal Health Records Roundtable: Report from Washington, DC

Day in Washington, DC at PHR Roundtable
This post was blogged during the meeting, and may be reviewed and corrected in the next few days. Please see links to the videos at the end of this post.

PHR Roundtable, Washington, DC
PHR Roundtable, Washington, DC

Washington, DC, (December 3, 2010)–The meeting is getting started today with introduction by Joy Pritts, Chief Privacy Officer, HHS/Office of National Coordinator (ONC)  for Health IT, and welcoming remarks by the National Coordinator David Blumenthal, MD. Dr. Blumenthal is speaking about the process of innovation spurred by HITECH, and not directed by ONC. “The patient and consumer come first” is one of the guiding principles for ONC according to Blumenthal, and the consumer’s faith in the privacy and security of their patient information is critical to the HITECH initiatives. Part of the reason for this privacy and security hearing is to encourage innovation and transparency, one of the over 200 open meetings held already by ONC.

Pritts also notes that the Health IT initiatives are focused on patients as the center of healthcare. Now we’re on to role of “Meaningful Use,” providing patients with electronic version of their health records. HITECH Act requires that ONC study privacy and security with regard to those records, in addition to the current requirements. Pritts asks  how are we going to strike right balance of innovation and maintain the use of that information for intended purposes.

First panel will provide some historical perspective and is focused on origins, development, and security practices. Tim McKay, Kaiser Permanente, provides brief on Kaiser’s use of electronic health records and personal health records which began in ’90s as regional Kaiser initiatives, and took on national scope in late 90s. Currently Kaiser has roled out EHR and PHRs. Is this patient portal or PHR? And the answer is “yes.”

Lori Nichols, Director, HInet, is director of Whatcom Health Information Network in Whatcom County, Washington state. Per their Web site, HInet is an inclusive, secure, community-wide, healthcare intranet in Whatcom County. Using various broadband technologies, it connects hospital, payors, physician offices, and community health services.  It also provides connection to the Internet.”

George Steinberg, MD, president and ceo of ActiveHealth Management, a company started with venture capital and now owned as separate company by Aetna. Started as decision support for physicians, and grew to consumer tool. Consumer PHR contains decision support to respond to consumer entering data dynamically.

Colin Evans, CEO of Dossia, a PHR company describes how the firm was founded for employers for use by their employees for safety and care coordination. Use by employees ranges from 10% to 80% based on whether company is offering incentives or not. Evans claims that data is owned by consumers. In some cases there are conflicts between HIPAA regulations and FTC regulations with regard to online protected health information.

George Scriban, Sr. Program Manager, Microsoft HealthVault, speaks about consumer interaction with healthcare as something that goes much beyond interaction with clinicians. HealthVault is cloud-based location for fragments of health information gathered from full-range of entities, improving the boxes of a patient’s information located throughout the house and clinical offices. HealthVault is not a PHR, but a personal health information platform, per Sriban, one of Microsoft’s constant refrains.

McKay of Kaiser Permanente is starting a large initiative to expand Identity Services, to maintain their information even if they leave Kaiser plans.

ONC moderator Kathy Kenyon asks “Do patients ever pay for a PHR?” of those represented. Panel answer is no.

Panel moves on to revenue sources and sustainability of consumers are paying.
Dossia: Support by employers.
Kaiser: From consumer dues. Savings comes from cost savings in employer time saved. In 2006, about 20% of Kaiser patient population used PHR, and risen to 60% in 2010. Patients viewing their patient information alone raises safety of patients.
HInet: no charge for consumers, currently grant-funded, but there will be a  charge for Smartphone use. Employers and payers are noticeably absent from financial support, and this is due in large part because consumers don’t want insurance companies and employers to view their personal health information.
Microsoft: HealthVault is a free service, that is part of the larger health services unit with services offered commercially, the revenue source.
ActiveHealth: Paying customers are the employers, with PHR one of services offered. ActiveHealth is offered to 8 million Aetna members and close to 2 million non-Aetna users, with another 700,ooo non-Aetna users expected to be announced shortly. Non-Aetna users are based on offering to employers (need to confirm who these non-Aetna users are).

Additional discussion on opportunity of health plan or employer viewing health information on PHRs. Dossia says no to employers. HInet users can see who has and has not accessed their share plan PHR  since the last time the consumer viewed their PHR.

Lack of physician support and interoperability of electronic health records appears to be a limiting factor to actual use of PHRs.

New Forms, New Audiences, New Challenges–Second Panel
Wil Yu, Special Assistant of Innovation and Research, ONC, is moderating panel on PHR’s new forms, audiences, and challenges. Stephen Downs, Asst. Vice President, Robert Woods Johnson Foundation, is responsible for Project Health Design, a 4 1/2 year old program to reinvent PHRs; Open Notes, where patients can view their physician’s notes; and Blue Button.  Downs offered three themes: separating apps from data, expanding definition of healthcare–ODL, observations of daily living, and sharing data.

Darcy Gruttadaro, Director, NAMI Child & Adolescent Action Center. NAMI is National Alliance on Mental Illness. Since launch of its social networking site in April 2010, NAMI has gained 1,300 users for social networking site, modeled somewhat after facebook. Realizes there are a lot more security issues than she initially realized. NAMI social networking site: http://www.strengthofus.org

Description of NAMI’s social networking site:
“StrengthofUs is an online community designed to empower young adults through resource sharing and peer support and to build connections for those navigating the unique challenges and opportunities in the transition-age years.  StrengthofUs provides opportunities for you to connect with your peers and offer support, encouragement and advice and share your real world experiences, personal stories, creativity, resources and ultimately, a little bit of your wonderful and unique self. It is a user-generated and user-driven community; so basically it’s whatever you make it. Everything here has been developed and created by and for young adults with you specifically in mind…because we think you’re worth it! We hope every time you visit, you find hope, encouragement, support and most of all, the strength to live your dreams and goals.”

John Moore, of Chilamrk Research, says the terms EHR and PHR create an artificial barrier. “People could care less” about PHR as file cabinet. Unified or collaborative health records need to be actionable Moore said. Moore made a great segue to Gail Nunlee-Bland, MD, interim chief of Endocrinology and Director of Diabetes Treatment Center, Howard University, referencing his Chilmark post “Smashing Myths & Assumptions: PHR for Urban Diabetes Care.” That post is certainly worth reading, and Nunlee-Bland mentioned that 85% of their inner-city patients have access to computer and Internet, which is not what the “general knowledge” says. While Howard’s PHR users are concerned about privacy, only about 5% of their potential users, have opted not to use it because of privacy issues.

Douglas Trauner, CEO, of TheCarrot.com, asked what do we need to do for overcoming healthcare, privacy and security issues. TheCarrott.com’s web site describes  itself: “TheCarrot.com provides easy-to-use tools for tracking your life for a variety of topics including health, nutrition, fitness, and medicines—all within a familiar calendar format. Through this free, anonymous service, you gain a comprehensive view of your health that helps you identify areas of improvement and goal-setting.”

There’s a lot of discussion about sharing information among consumer/patient users. Panelists offer range of views about how much consumers are concerned about privacy and security. There’s a great deal of discussion about trust, including Downs’ tale of a teenager being quite willing to share lots of personal information with their 80 friends, but not their parents.

Privacy and Security of Identifiable Health Information in PHRs and Related Technologies: Expectations and Concerns – Panel Three
Joy Pritts is moderating the first afternoon panel session. Tresa Undem, VP, Lake Research Partners, said consumers are generally unaware of PHRs, based on a year-old study when only 7% reported using a PHR. Lee Tien, from West-coast based Electronic Frontier Foundation, specializes in privacy laws, not healthcare privacy. New reports from recent FTC survey shows how little public knows about privacy issues. Josh Lemieux, director of Personal Health Technology, Markle Foundation, based on six surveys, said public likes the idea of personal health records, and also say they want privacy practices.

Robert Gellman, reported on privacy issues and concerns about data leakage based on long experience, starting with working on the Hill. Strong need to define of what we’re trying to do: http://www.bobgellman.com/

Key data research resources for this panel:
Conducted by Lake Research Partners

Consumer surveys of privacy and personal health records

Tien says there is a basic ignorance among consumers and patients of actual privacy policies and implications. Based on work by Microsoft privacy expert, Tien cited the change of attitude or reality of public and private areas.  It used to be that privacy was the default reality for people and it was hard to get known publicly. Currently, public knowledge of details about people is the default reality, while maintaining privacy is a challenge.

Perspectives on Privacy and Security Requirements for PHRs and Related Technologies — Panel 4
Moderator is Leslie Francis, Distinguished Professor of Law and Philosophy at University of Utah.

Adam Greene, JD, Senior Health IT & Privacy Specialist, HHS Office of Civil Rights explained that HIPAA jurisdiction does not follow the data. OCR oversees three kinds of covered entities plus direct jurisdiction of business associates. Greene asked and answered:  Are PHRs covered by HIPAA? Sometimes–yes when furnished by covered entity or provided on behalf of covered entity.

Loretta Garrison, JD, Senior Attorney, Bureau of Consumer Protection, FTC uses unfairness and deceptive prongs to protect consumers. Bureau is claims driven. On December 1, 2010, FTC issued Privacy Report and recommended a privacy framework for consumers, businesses, and policymakers.
Here’s the link on press release.
Here’s link to actual report titled “Protecting Consumer Privacy in an Era of Rapid Change: A Proposed Framework for Businesses and Policymakers.” And it’s a preliminary FTC staff report.

Joanne McNabb, Chief, California Office of Privacy Protection, is “chief cajoler” and not a regulator.

Greene spoke about how HIPAA requirements are not really a check list but dependent upon the particular circumstances and business processes. Greene also wanted to disabuse people of the notion that they have 60 days to report a breach event of Protected Health Information (PHI). In fact, they are required to notify HHS of a breach on 500 individuals or more as quickly as possible, no later than 60 days.

FTC does not have specific rules about breach notification, except in case of PHRs, based on HITECH.

McNabb spoke of prohibition of marketing from data in PHRs, and also be careful about using mobile devices to move PHI. California’s Privacy office Web site is http://www.privacyprotection.ca.gov/

Garrison said we heard alot about trust today and trustworthiness. Per Ponemon report on security, that there was not enough support for healthcare privacy and issues in hospitals. Security is not a check list; it’s an ongoing process according to Garrison. Garrison also expressed concern about location of PHI on the 18 of 20 PHRs that had gone out of business since John Moore had studied them.

Second subpanel section
New group of panelists consists of three lawyers and law professors.

Robert Hudock, JD, Counsel, EpsteinBeckerGreen sees keysecurity issue is integrity. Sees smart phones as more secure than computers. Suggests that we let mobile devices and security evolve, and don’t restrict it while still developing. Hudock’s biggest privacy issue is for the average person being able to protect the confidentiality of  family’s information.

Frank Pasquale, JD, Schering-Plough Professor in Healthcare Regulation and Enforcement, Seton Hall Law School, lauded Markle Foundation’s emphasis on identification of versioning. There are many issues around research. He really worries when data is collected from various sources, and the digital self created from those sources. Pasquale identified several technological solutions and books.

Nicholas Terry, Chester A. Myers Professor of Law, Saint Louis University School of Law, asked what we mean by security. Data scraping is one of the issues of great concern to him. Trust is big at moment, but Terry said he doesn’t know what trust means.

Session ended with brief period with public comments.

Morning Session:
Morning session video
Afternoon Session:
Afternoon session video
*Please note: Apple QuickTime is required to view the video. To download and install QuickTime, visit www.apple.com/quicktime/download

For PHR Roundtable information on ONC site, click here.

Personal Health Records ONC Roundtable: Dec 3 Webcast

Roundtable: Personal Health Records
Understanding the Evolving Landscape
December 3, 2010:
Now available without pre-registration!
See post reporting on roundtable on e-Healthcare Marketing.
Morning Session:
8:30 a.m. to 12:15 p.m. (EST)

Afternoon Session

1:15 p.m. to 5:00 p.m. (EST)
Physician at laptop
December 3, 2010 

Please note that due to an overwhelming response to the PHR Roundtable, pre-registration for in-person attendance has reached its capacity. However, you may still participate in the Roundtable via webcast.  See information on webcast below.
Content excerpted from ONC site on 12/2/2010.  

The Office of National Coordinator for Health Information Technology (ONC) will host a free day-long public Roundtable on “Personal Health Records — Understanding the Evolving Landscape.” The Roundtable is designed to inform ONC’s Congressionally mandated report on privacy and security requirements for non-Covered Entities (non-CEs), with a focus on personal health records (PHRs) and related service providers (Section 13424 of the HITECH Act).The Roundtable will include four panels of prominent researchers, legal scholars, and representatives of consumer, patient, and industry organizations. It will address the current state and evolving nature of PHRs and related technologies (including mobile technologies and social networking), consumer and industry expectations and attitudes toward privacy and security practices, and the pros and cons of different approaches to the requirements that should apply to non-CE PHRs and related technologies.

Public comment is open now through Friday, December 10.

Friday, December 3, 2010
(Must have pre-registered to attend in-person.)

FTC Conference Center
601 New Jersey Avenue, NW
Washington, DC 20001
Where to Eat | Where to Stay | Travel DirectionsMEETING MATERIALS:

Morning Session
8:30 a.m. to 12:15 p.m. (EST)

The PHR Roundtable agenda includes time for public comments from 4:20 to 4:50 p.m. (EST). To provide comments by phone during this time, call toll-free: 1-866-363-9013 and enter the conference ID number: 28762819. An operator will assist you. 

Afternoon Session
1:15 p.m. to 5:00 p.m. (EST)


ONC Seeks Public Comments on PHRs by Dec 10 Re: Security & Privacy

Office of the National Coordinator (ONC) for Health IT:
Public Comments Sought on Personal Health Records
by Dec 10, 2010
Emailed by ONC on Nov 1, 2010

In conjunction with ONC’s upcoming PHR Roundtable, ONC is seeking public comments on issues related to personal health records. The public comment period is open now through December 10. ONC would like the public’s input on the following topics:

  • Privacy and Security and Emerging Technologies
  • Consumer Expectations about Collection and Use of Health Information
  • Privacy and Security Requirements for Non-Covered Entities

Visit the ONC website to submit your comment by December 10:
This link goes to an ONC page with the content that’s posted below.

ONC Seeks Public Comments on PHRs
Excerpted from ONC site on 11/1/2010.

[Click here for ONC Public Comments Page on PHRs]
The Office of the National Coordinator for Health Information Technology is seeking public comments on issues related to personal health records. Please submit comments by visiting one or more of the following questions. Please note that your name and comment will be placed on the public record of this roundtable, including on the publicly accessible HHS/ONC website (links below).

Thank you for your submission. (Note: The links below will take you directly to the ONC blog pages for posting.) 1. Privacy and Security and Emerging Technologies
What privacy and security risks, concerns, and benefits arise from the current state and emerging business models of PHRs and related emerging technologies built around the collection and use of consumer health information, including mobile technologies and social networking?

2. Consumer Expectations about Collection and Use of Health Information
Are there commonly understood or recognized consumer expectations and attitudes about the collection and use of their health information when they participate in PHRs and related technologies? Is there empirical data that allows us reliably to measure any such consumer expectations?  What, if any, legal protections do consumers expect apply to their personal health information when they conduct online searches, respond to surveys or quizzes, seek medical advice online, participate in chat groups or health networks, or otherwise? How determinative should consumer expectations be in developing policies about privacy and security?

3. Privacy and Security Requirements for Non-Covered Entities
What are the pros and cons of applying different privacy and security requirements to non-covered entities, including PHRs, mobile technologies, and social networking?

4. Any Other Comments on PHRs and Non-Covered Entities
Do you have other comments or concerns regarding PHRs and other non-covered entities?

Event Details | Register for the Event by Webinar

See previous e-Healthcare Marketing post for Event Details. In-person participation is now closed due to capacity, but registration for the Webinar is available.

Strategy for Empowering Consumers with Health IT: ONC Wants Your Feedback

Strategy for Empowering Consumers
Monday, November 1st, 2010 | Posted by: Jodi G. Daniel JD MPH, Director of the Office of Policy and Planning, Office of National Coordinatator for Health IT and reposted here by e-Healthcare Marketing. 

For the past few months, ONC has been reviewing the government’s role in empowering consumers to better manage their health through information technology (IT). As we work toward a future of widespread electronic health record adoption and meaningful use, and as we continue to see rapid technology advancements in this industry, there is opportunity for consumers to take fuller advantage of the benefits of health IT.

Last week, we hosted a meeting with representatives from some of the leading consumer advocacy organizations in the country, including consumer protection agencies, disease advocacy groups, clinical innovation think tanks, and consumer health web designers. This particular meeting was focused on building a dialogue between the government, consumer organizations, and their members about the nation’s transition to electronic health records.  It further validated our belief that public input is critical to the process of focusing our work on areas where the federal government has an important role to play, and away from areas best left to others.

ONC is currently drafting a five-year Federal Health IT Strategic Plan, which is scheduled for publication in early 2011. In the plan, our proposed framework for consumer empowerment takes into consideration our existing activities. But it also provides a unique opportunity to set forward-looking direction and do more for consumers over the next five years. We hope you will assist us.

  • First, do you agree with the four objectives listed below?
  • Second, what specific activities would you like to see the federal government take on? See the bullet points below each objective for some starting ideas of possible activities.   

We will be unable to respond to every post but we will follow-up with another entry to reflect on the discussion.

The Goal: Empower Consumers to Better Manage Their Health through Health IT

  • Objective A. Engage consumers in federal health IT policy and programs: In order for federal health IT policy and programs to be successful, consumers must both understand the impact of those policies and programs and have direct involvement in shaping them. Ideas for possible activities:
    • Fund a communication campaign to engage with consumers about the benefits of health IT
    • Host consumer listening sessions designed to get consumers’ input on programs and policies
    • Solicit consumer input to Federal Advisory Committees and into rulemaking processes
  • Objective B. Accelerate consumer access to electronic health information: Consumers will be better able to manage their health when they have timely and electronic access to their own health information. Ideas for possible activities:
    • Develop tools like the “Blue Button,” an application that enables veterans to download their health information online from My HealtheVet
    • Require electronic access of consumer health information by patients and address privacy protections for this information through federal regulations and policies
    • Create meaningful use incentives for physicians to share health information with patients
  • Objective C. Foster innovation in consumer health IT: Innovative tools will make electronic health information more useful to consumers and make managing their healthcare more convenient. Ideas for possible activities:
    • Fund research into innovative technologies
    • Launch pilots (such as the Beacon Community Program) that show ways to improve outcomes through the use of consumer health IT
    • Set up “technology test beds” that could define needs for new technologies in the clinical setting
  • Objective D. Drive consumer-provider electronic communications: Consumers can become more active participants in their health and care if providers encourage electronic communications and tools, such as secure e-mail and remote monitoring. Idea for possible activity:
    • Develop quality improvement initiatives that encourage providers to help empower consumers through their use of health IT

Please post your comments directly on ONC Health IT Buzz blog.

Registration Open for PHR Roundtable by ONC: Dec 3, 2010 in Washington, DC

Registration Open for Personal Health Records Roundtable: Dec 3, 2010   

Register for the Event 

Online registration is now open for the Roundtable on “Personal Health Records – Understanding the Evolving Landscape.” This free day-long public Roundtable, hosted by the Office of the National Coordinator for Health Information Technology (ONC), will be held on Friday, December 3 at the FTC Conference Center in Washington D.C. Register to attend in person or via webcast by visiting http://healthit.hhs.gov/PHRroundtable.

Personal Health Records — Understanding the Evolving Landscape
Friday, December 3, 2010; 8:30 a.m. to 4:30 p.m.
(registration check-in opens at 7:30 a.m.)Where:
FTC Conference Center
601 New Jersey Avenue, NW, Washington, DC 20001
or via webcastRegister at http://healthit.hhs.gov/blog/phr-roundtable . 

For agenda and details of the panels, see previous post on e-Healthcare Marketing.

Privacy & Security ‘Tiger Team’ Seeks Comments on Provider-Entity Authentication: Due Oct 29

Privacy & Security “Tiger Team” Seeks Comments on Provider-Entity Authentication
Please comment by October 29, 2010

Tuesday, October 19th, 2010 | Posted by: Deven McGraw and Paul Egerman and reposted here by e-Healthcare Marketing.

The Privacy & Security Tiger Team is currently considering policy recommendations to ensure that authentication “trust” rules are in place for information exchange between provider-entities (or organizations).  We are currently evaluating these trust rules at the organizational level, and as such, our scope here does not include authentication of individual users of electronic health record (EHR) systems.  For purposes of this discussion, authentication is the verification that a provider entity (such as a hospital or physician practice) seeking access to electronic protected health information is the one claimed, and the level of assurance is the degree of confidence in the results of an authentication attempt. 

We hope that we can have a robust discussion on this blog that provides valuable input on this topic.  All comments are welcome, but we particularly encourage you to consider the following questions:

  1. What strength of provider-entity authentication (level of assurance) might be recommended to ensure trust in health information exchange (regardless of what technology may be used to meet the strength requirement)?
  2. Which provider-entities can receive digital credentials, and what are the requirements to receive those credentials?
  3. What is the process for issuing digital credentials (e.g., certificates), including evaluating whether initial conditions are met and re-evaluation on a periodic basis?
  4. Who has the authority to issue digital credentials?
  5. Should ONC select an established technology standard for digital credentials and should EHR certification include criteria that tests capabilities to communicate using that standard for entity-level credentials?
  6. What type of transactions must be authenticated, and is it expected that all transactions will have a common level of assurance?

Please comment by October 29, 2010, and identify which question(s) you are responding to.

Thank you,
Deven McGraw and Paul Egerman
Privacy & Security Tiger Team Co-Chairs

Please comment directly on ONC Health IT Buzz blog by clicking on this link.

ONC’s Yu Blogs on Innovation Communities in Health Technology

Innovation Communities in Health Technology
Tuesday, October 5th, 2010 | Posted by: Wil Yu, Special Assistant Innovations, ONC Office of the Chief Scientist  on Health IT Buzz Blog and republished here by e-Healthcare Marketing.
As the Department of Health and Human Services (HHS) carries out its mission toward a goal of nationwide achievement of meaningful use, I am mindful that we are also working toward a greater vision of improved individual and population health outcomes – a vision of a high performance learning health care system that leverages health information and technology, while protecting privacy and confidentiality, and encourages an infrastructure for robust care delivery and technology innovation.   Over the coming weeks, a number of events are being held in support of health care and technology innovation. These events are just a glimpse of the excitement and passion I am seeing take place across country, as multiple, disparate and powerful forces in the environment converge in support of improving and transforming health care.  

Through my role in leading innovation programs and initiatives at ONC, I’m extremely pleased to see the steady growth of innovation communities – an essential requirement to creating sustained pathways for health technology innovation, especially in emerging fields such as data analytics and remote care management. These communities will hopefully bring together a diverse set of perspectives and backgrounds – beyond solely technologists – to include the full spectrum of stakeholders required for honest and practical discussion on the challenges of developing and adopting health technology. 

In the spirit of community building around health technology innovation, ONC has launched several high-profile programs and initiatives. The Beacon Communities program will help to demonstrate the potential of advanced health IT to help achieve measurable improvement in the quality and efficiency of health services at a population level. SHARP – Strategic Health IT Advanced Research Projects – is an applied research program focused on achieving breakthrough advances to address well-documented problems that have impeded adoption of health IT. At a department level (HHS) and under the leadership of Todd Park, Chief Technology Officer of HHS, we are taking action to improve health by making available a broad range of data sources under the Community Health Data Initiative (CHDI). These programs, along with a host of other initiatives (clinical decision support, personal health records, mHealth, and other areas) all seek to drive community building and will help to support private sector technology development. 

Sustained health IT innovation will inevitably lead to improved clinical outcomes and system efficiencies. While improving the health of the nation, innovation has the potential to lead to improved quality of life and increased patient engagement in care delivery. It represents the promise of breakthroughs in medical research. Importantly, it has the potential to create new markets, jobs, and entrepreneurial opportunities. I believe that no matter what stakeholder lens you view health innovation through, drawing from a diverse community to calibrate the focus will allow for a clearer vision of the future and pathway to success.

Wil Yu, Special Assistant, Innovations (wil.yu@hhs.gov)
ONC, Office of the Chief Scientist
Go to the ONC Health IT Buzz Blog to post comments directly on the original post on ONC site.

ONC’s FACA Meeting Calendar for Sept 2010

ONC logoSept 2010 FACA Meeting Calendar
Emailed by ONC on Sept 10, 2010

Please be sure the following Federal Advisory Committee (FACA) meetings are on your calendars!

See the ONC Website, http://healthit.hhs.gov/FACAs, for information on how to participate via phone or web, or how to find the location of the public hearings (indicated with an asterisk *) which will be held at hotels in the Washington DC metro area.  

HIT Policy Committee Meetings 
Information Exchange Workgroup, Sept 13, 11 am to 2 pm/EDT

HIT Policy Committee*, Sept 14, 10 am to 3 pm/EDT
Crystal Gateway Marriott, Arlington, VA

Meaningful Use WG*, Sept 22, 8:30 am to 4 pm/EDT
Park Hyatt Washington, Washington, DC

Enrollment WG, Sept 24, 11 am to 2 pm/EDT

Privacy & Security Tiger Team, Sept 24, 3 pm to 5 pm/EDT

Governance WG*, Sept 28, 9 am to 5 pm/EDT
Washington Marriott Wardman Park Hotel, Washington, DC

Quality Measures WG, Sept 29, 2 pm to 5 pm/EDT

Information Exchange WG*, Sept 30, 9 am to 4 pm/EDT
Location to be determined.

HIT Standards Committee Meetings
Implementation WG, Sept 15, 12 pm to 2 pm/EDT

HIT Standards Committee*, Sept 21, 9 am to 3 pm/EDT
Washington Marriott Wardman Park Hotel, Washington, DC  

Vocabulary Task Force, Sept 23, 10 am to 11:30 am/EDT  

Clinical Operations WG, Sept 23, 12 pm to 1:30 pm/EDT

Push Blue Button for Personal Health Information: Markle Foundation

Health IT Investments Should Enable People to Download Their Own Information …at the click of a blue button
Press Release from Markle Foundation on August 31, 2010
PDF Version

Blue Button

Blue Button

Markle Connecting for Health Collaboration Agrees on ‘How To’ Policies

Veterans, Medicare beneficiaries near ‘blue button’ access

Markle collaboration includes support from 48 organizations; recommends specific privacy practices

NEW YORK (Aug. 31, 2010)
Representing a wide array of providers, consumers, technology companies, insurers, and privacy advocates—48 organizations today declared their support for a specific set of privacy and security practices for the “blue button.”

The public-private collaborative group envisions the blue button as a common offering among secure websites for patients and beneficiaries by medical practices, hospitals, insurers, pharmacies, laboratories, and information services.

“By clicking the blue button, you could get your own health information electronically—things like summaries of doctor visits, medications you are currently taking, or test results. Being able to have your own electronic copies and share them as you need to with your doctors is a first step in truly enabling people to engage in their health care,” said Carol Diamond, MD, MPH, managing director at Markle.

“This capability is not common today, but we have the opportunity to make it a basic expectation—especially now that billions of public dollars will be flowing to help subsidize health information technology,” Diamond said.

The paper is being released as Medicare and the U.S. Veterans Administration (VA) prepare to implement a blue button this fall that will, for the first time, allow beneficiaries to electronically download their claims or medical information in a common format from the My Medicare.gov and My HealtheVet secure websites.

President Obama announced the blue button for veterans in an August 3 address. “For the first time ever, veterans will be able to go to the VA website, click a simple blue button and download or print your personal health records so you have them when you need them, and can share them with your doctors outside of the VA,” the President said.

The Markle collaboration’s recommendations are timely because the American Recovery and Reinvestment Act requires that individuals be able to receive electronic copies of their records from providers’ electronic health record systems. In addition, new federal economic stimulus rules require health care providers and hospitals to deliver electronic copies of things like lists of medications, after-visit summaries, and lab results if they choose to participate in federal subsidies for using health information technology.

The Markle policy recommendations reflect consensus on one means by which this can be accomplished today, securely and efficiently. The group details privacy policies and practices for implementing the download capability with sound authentication and security safeguards and suggests practices to help individuals make informed choices about downloading their information. For example, it recommends specific language to remind individuals not to download or store their personal health information on shared computers.

Christine Bechtel, vice president of the National Partnership for Women & Families, and a member of the federal Health IT Policy Committee, supported the Markle policy paper.

“People see a lot of different health care providers over time, so giving them a convenient option to securely assemble their health information from multiple sources will help them better manage and coordinate their own care,” Bechtel said. “This capability is one of the simplest and most direct ways of helping patients and families see the benefits of the federal health IT investments that they, as taxpayers, have helped fund.”

The proposed privacy policies build on the Markle Common Framework for Networked Personal Health Information, a set of recommended practices for individual access to information and privacy. The framework, first released in 2006, is widely supported by a range of technology companies, insurers, provider groups, and consumer and privacy advocates.

“We recommend specific privacy policies to help individuals make informed choices about downloading their personal health information, and to emphasize sound authentication and security practices,” said Josh Lemieux, director of personal health technology at Markle. “By supporting this set of policies, a wide range of leaders commit to practices that encourage individual access to information in a way that respects privacy and security.”

The following organizations declared their support for the policy paper,

—The simple, but rarely offered, ability for people to download their health records should be a priority in the nationwide push to upgrade health information technology, according to a policy paper released today by the Markle Foundation. Markle Connecting for Health Policies in Practice: The Download Capability:

AARP • Allscripts Healthcare Solutions • American Academy of Family Physicians • American College of Cardiology • American College of Emergency Physicians • American Medical Association • Anakam Inc. • Axolotl • BlueCross BlueShield Association • Center for Connected Health • The Children’s Partnership • Center for Democracy and Technology • Center for Medical Consumers • Children’s Health Fund • Chilmark Research • Computer Sciences Corporation • Consumers Union • Dossia

Consortium • DrFirst • Google • Initiate, an IBM Company • The Institute for Family Health • Intel Corporation • Intuit Health • Keas, Inc. • LifeMasters-StayWell Health Management • Markle Foundation • McKesson Technology Solutions/RelayHealth • MedCommons • Medical Group Management Association • MedicAlert Foundation • Meditech • Microsoft Corporation • National Coalition for Cancer Survivorship • National Committee for Quality Assurance • National Partnership for Women & Families • National Quality Forum • NaviNet • Pacific Business Group on Health • PatientsLikeMe • Prematics, Inc. • Press Ganey • PricewaterhouseCoopers LLP • RTI International • Vanderbilt Center for Better Health • Visiting Nurse Service of New York • Wal-Mart Stores, Inc. • Wellport


Markle Foundation works to improve health and national security through the use of information and technology. Markle collaborates with innovators and thought leaders from the public and private sectors whose expertise lies in the areas of information technology, privacy, civil liberties, health, and national security. Learn more about Markle at www.markle.org .


Markle Connecting for Health is a public-private collaborative with representatives from more than one hundred organizations across the spectrum of health care and information technology specialists. Its purpose is to catalyze the widespread changes necessary to realize the full benefits of health information technology while protecting patient privacy and the security of personal health information. Markle Connecting for Health tackles the key challenges to creating a networked health information environment that enables secure and private information sharing when and where it is needed to improve health and health care. Learn more about Markle Connecting for Health at www.connectingforhealth.org .

President Obama Talks about the Blue Button Initiative (VIDEO)

See Department of Veteran Affairs for Blue Button Initiative.

See Centers for Medicare and Medicaid Services about Blue Button Initiative.

ONC Site Map Updated in Conjunction with New Health IT Unified Theme

“Connecting America for Better Health” – ONC for HIT
Web Site Map for Office of the National Coordinator for Health IT
On August 27, 2010, the Office of National Coordinator (ONC) for Health IT announced a new “unified identity for Health IT”  which includes a “new theme and visual identity” for the ONC Web site and ONC and can be seen at the top of ONC Web pages.

The site map below for  ONC’s Web site is pulled primarily from the left navigation bar on the ONC site with some additional links to key areas. [Please send any corrections or comments to e-Healthcare Marketing. This is an update to a previous site map posted on February 16, 2010 on e-Healthcare Marketing, including new workgroups.]

While the visible structure of the Web site remains mainly the same, the home page and much of the underlying architecture appears to have been updated to simplify access to users, highlight new and important content, and simplify the addition of new information anticipated to come soon, such as announcements of the  Authorized Testing and Certification Bodies (ATCB) and Certified EHRs and EHR Modules.

The new theme and identity ”really captures the spirit of these combined efforts to boost national adoption of electronic health records and ensure success. The insignia will also help people easily identify and connect with official HITECH information, resources, programs, and partners,” wrote Communucations Director Peter Garrett on the Health IT Buzz blog on August 27, 2010. Now to the site map.

DERIVED SITE MAP FOR  http://healthit.hhs.gov

          Meaningful Use
          Certification Program
          Privacy and Security
          HITECH Programs
          On the Frontlines of Health Information Technology
               NEJM Articles: Dr. Blumenthal
                                             Dr. Benjamin
          Federal Advisory Committees

Top Banner Links
          Get email updates from ONC
          Follow ONC on Twitter

HITECH & FUNDING Opportunities
          Contract Opportunities
          Learn about HITECH
          HIT Extension Program — Regional Extension Centers Program
          Beacon Community Program

     State Health Information Exchange Cooperative Agreement Program
     Health Information Technology Extension Program
     Strategic Health IT Advanced Research Projects (SHARP) Program
     Community College Consortia to Educate HIT Professionals Program
     Curriculum Development Centers Program
     Program of Assistance for University-Based Training
     Competency Examination Program
     Beacon Community Program

                  (Meeting Calendar At-A-Glance)

HIT Policy Committee Meetings
          Meeting Webcast & Participation
Upcoming Meetings
Past Meetings
HIT Policy Committee Recommendations
HIT Policy Committee Workgroups
          Meaningful Use
          Information Exchange
          Nationwide Health Information Network (NHIN)
          Strategic Planning
          Privacy & Security Policy
          Privacy & Security Tiger Team
          Quality Measures

Health IT Standards Committee Meetings
          Meeting Webcast & Participation
Upcoming Meetings
Past Meetings
HIT Standards Committee Recommendations
HIT Standards Committee Workgroups
          Clinical Operations
          Clinical Quality
          Privacy & Security
          Vocabulary Task Force

           Meaningful Use
           Privacy and Security
           Standards and Certification
          State-Level Health Initiatives 
          Nationwide Health Information Network
          Federal Health Architecture
          Clinical Decision Support & the CDS Collaboratory
                 FACA Meeting Calendar
          Fact Sheets
          Federal Health IT Programs
          Technical Expert Workshops

         News Releases (2007 – Present)
         FACA Meeting Calendar
         Fact Sheets
         Federal Health IT Programs
         Technical Expert Workshops

          Coordinator’s Corner: Updates from Dr. Blumenthal
          Budget & Performance
          Contact ONC and Job Openings
#                             #                     #

For a review of the new look and feel of the ONC site, see an earlier post on e-Healthcare Marketing.