Study Examines Veterans' Use of Blue Button Feature in MyHealtheVet

BACKGROUND:
A key component of healthcare coordination is efficient and accurate sharing of information. The U.S. Office of the National Coordinator for Health Information Technology (ONC) promotes the expansion and use of electronic health records (EHRs) to address gaps in communication and care coordination. The ONC has specified core objectives for the use of EHRs, which include providing patients "with the ability to view online, download, and transmit their health information within four business days of the information being available to their eligible provider." The Blue Button feature in VA's online combined personal health record and patient portal, My HealtheVet (MHV), allows patients to access EHR components, such as past and future appointments, lab results, and medications. This study aimed to characterize users of the MHV Blue Button, its perceived impact on Veterans' health, and its role in sharing healthcare information. Investigators identified a 4% random sample of MHV users (n=18,398) between March and May 2012, who answered survey questions designed to determine characteristics associated with Blue Button use, perceived value of use, and how Veterans with non-VA providers may use the Blue Button to share information with these providers.

FINDINGS:

• Among users of the Blue Button, the benefit most highly endorsed by Veterans (73%) was the value of having their health history in one place. In addition, 21% of users with a non-VA provider shared their VA health information, and of those, 87% reported 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.
• The majority of non-users of the Blue Button stated they were not aware of it. However, non-users who were aware of the Blue Button stated they did not use it because they did not know how (34%), they only use MHV for prescription renewal (26%), they preferred other methods to keep track of health information (11%), or they did not know where the Blue Button was located (10%).
• The odds of using the Blue Button increased 38% if the Veteran reported having a system for organizing his or her health information. Age was not associated with Blue Button use.
• Of the total sample, 33% (n=5,995) were current users and 63% (n=11,671) had never used Blue Button. A small minority (4%, n=728) had tried the Blue Button at least once, but no longer used it.

LIMITATIONS:

• Results are based on a voluntary online survey of MHV site visitors, thus survey completion rates may have biased the sample in unknown ways.
• Race and income were not assessed, so the impact of these important variables is unknown.
• Many outcomes were self-reported with no independent verification.

AUTHOR/FUNDING INFORMATION:
This study was funded through VA/HSR&D's eHealth Quality Enhancement Research Initiative (QUERI; RRP 11-407). Dr. Turvey and Ms. Klein are part of HSR&D's Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City, IA.

Turvey C, Klein D, Fix G, et al. Blue Button Use by Patients to Access and Share Health Record Information Using the Department of Veterans Affairs Online Patient Portal. Journal of the American Medical Informatics Association. July 2014;21(4):657-63.