title: Blue Button use by patients to access and share health record information using the Department of Veterans Affairs' online patient portal.
abstract: 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.
  
  
  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.
authors.affiliation: Iowa City VA Health Care System, Comprehensive Access and Delivery Research and Evaluation (CADRE) Center, Iowa City, Iowa, USA Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Turvey
authors.affiliation: Iowa City VA Health Care System, Comprehensive Access and Delivery Research and Evaluation (CADRE) Center, Iowa City, Iowa, USA Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
authors.forename: Dawn
authors.initials: D
authors.lastname: Klein
authors.affiliation: Edith Nourse Rogers Memorial Veterans Hospital, Center for Healthcare Organization and Implementation Research (CHOIR), A VA HSR&D Center of Innovation, Bedford, Massachusetts, USA Department of Health Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA.
authors.forename: Gemmae
authors.initials: G
authors.lastname: Fix
authors.affiliation: Edith Nourse Rogers Memorial Veterans Hospital, Center for Healthcare Organization and Implementation Research (CHOIR), A VA HSR&D Center of Innovation, Bedford, Massachusetts, USA Edith Nourse Rogers Memorial Veterans Hospital, eHealth Quality Enhancement Research Initiative, National eHealth QUERI Coordinating Center, Bedford, Massachusetts, USA Division of Health Informatics and Implementation Science, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Hogan
authors.affiliation: Portland VA Medical Center, Health Services Research & Development, Portland, Oregon, USA Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Woods
authors.affiliation: Veterans Affairs Boston Healthcare System, Section of General Internal Medicine, Boston, Massachusetts, USA Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Simon
authors.affiliation: Iowa City VA Health Care System, Comprehensive Access and Delivery Research and Evaluation (CADRE) Center, Iowa City, Iowa, USA Department of Epidemiology, The University of Iowa College of Public Health, Iowa City, Iowa, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Charlton
authors.affiliation: Iowa City VA Health Care System, Comprehensive Access and Delivery Research and Evaluation (CADRE) Center, Iowa City, Iowa, USA Department of Internal Medicine, The University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Vaughan-Sarrazin
authors.affiliation: Veterans Affairs Palo Alto Health Care System, Center for Innovation to Implementation, Menlo Park, California, USA Division of General Medical Disciplines, Stanford University, Stanford, California, USA.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Zulman
authors.affiliation: Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
authors.forename: Lilian
authors.initials: L
authors.lastname: Dindo
authors.affiliation: Iowa City VA Health Care System, Comprehensive Access and Delivery Research and Evaluation (CADRE) Center, Iowa City, Iowa, USA University of Missouri Sinclair School of Nursing, Columbia, Missouri, USA.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Wakefield
authors.affiliation: Veterans and Consumers Health Informatics Office, Office of Informatics & Analytics, Veterans Health Administration, Washington, DC, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Graham
authors.affiliation: Veterans and Consumers Health Informatics Office, Office of Informatics & Analytics, Veterans Health Administration, Washington, DC, USA.
authors.forename: Kim
authors.initials: K
authors.lastname: Nazi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003197:Computer Literacy; D003625:Data Collection; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D055991:Health Records, Personal; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D033283:Patient Access to Records / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D014481:United States; D014493:United States Department of Veterans Affairs; D014584:User-Computer Interface; D014728:Veterans; D055815:Young Adult
keywords: Care Coordination; Health Record, Personal; Veterans
references.citation: J Am Med Inform Assoc. 2006 Mar-Apr;13(2):121-6
references.pmid: 16357345
references.citation: Arch Intern Med. 2011 Mar 28;171(6):568-74
references.pmid: 21444847
references.citation: Ann Intern Med. 2012 Oct 2;157(7):461-70
references.pmid: 23027317
references.citation: J Am Med Inform Assoc. 2011 Dec;18 Suppl 1:i13-7
references.pmid: 21984604
references.citation: AMIA Annu Symp Proc. 2006;:764-8
references.pmid: 17238444
references.citation: Ann Intern Med. 2011 Dec 20;155(12):805-10
references.pmid: 22184687
references.citation: J Am Med Inform Assoc. 2010 May-Jun;17(3):341-4
references.pmid: 20442154
references.citation: N Engl J Med. 2008 Mar 6;358(10):1064-71
references.pmid: 18322289
references.citation: Am J Health Syst Pharm. 2013 May 1;70(9):804-13
references.pmid: 23592363
references.citation: Am J Manag Care. 2011 Apr;17(4):e104-20
references.pmid: 21774099
references.citation: Inform Prim Care. 2012;20(3):151-69
references.pmid: 23710840
references.citation: J Med Internet Res. 2013 Feb 26;15(2):e43
references.pmid: 23470453
references.citation: J Hosp Med. 2013 Jul;8(7):414-7
references.pmid: 23813756
references.citation: J Am Med Inform Assoc. 2010 Mar-Apr;17(2):203-11
references.pmid: 20190065
references.citation: Health Aff (Millwood). 2009 Sep-Oct;28(5):1475-84
references.pmid: 19738266
references.citation: J Med Internet Res. 2012 Nov 05;14(6):e150
references.pmid: 23128775
references.citation: J Am Med Inform Assoc. 2009 Jul-Aug;16(4):550-60
references.pmid: 19390112
references.citation: J Med Internet Res. 2013 Apr 04;15(4):e70
references.pmid: 23557596
references.citation: J Med Internet Res. 2010 Dec 18;12(4):e73
references.pmid: 21169163
references.citation: Health Aff (Millwood). 2005 Sep-Oct;24(5):1170-9
references.pmid: 16162560
references.citation: JAMA. 2005 Feb 2;293(5):565-71
references.pmid: 15687311
references.citation: Comput Inform Nurs. 2012 Jul;30(7):354-62
references.pmid: 22525046
references.citation: Health Aff (Millwood). 2005 Jul-Dec;Suppl Web Exclusives:W5-509-25
references.pmid: 16269444
references.citation: J Am Med Inform Assoc. 2006 Jan-Feb;13(1):91-5
references.pmid: 16221943
references.citation: Arch Intern Med. 2004 Apr 12;164(7):793-800
references.pmid: 15078650
references.citation: Milbank Q. 2004;82(3):457-81, table of contents
references.pmid: 15330973
references.citation: J Med Syst. 2012 Jun;36(3):1043-52
references.pmid: 20703633
references.citation: BMC Med Inform Decis Mak. 2012 Apr 13;12:32
references.pmid: 22500560
references.citation: Telemed J E Health. 2012 Mar;18(2):109-14
references.pmid: 22304439
references.citation: J Adv Nurs. 2013 Mar;69(3):685-96
references.pmid: 22681669
references.citation: JAMA. 2007 Feb 28;297(8):831-41
references.pmid: 17327525
references.citation: Fam Pract. 2013 Aug;30(4):363-4
references.pmid: 23887635
references.citation: JMIR Res Protoc. 2014 Mar 27;3(1):e18
references.pmid: 24675395
references.citation: Ann Intern Med. 2010 Jul 20;153(2):121-5
references.pmid: 20643992
references.citation: Am J Manag Care. 2004 Sep;10(9):593-8
references.pmid: 15515991
references.citation: Med Care. 2013 Mar;51(3 Suppl 1):S52-6
references.pmid: 23407012
references.citation: Health Aff (Millwood). 2006 Nov-Dec;25(6):1629-36
references.pmid: 17102188
references.citation: JAMA. 1999 Jun 2;281(21):2045-9
references.pmid: 10359396
references.citation: J Am Med Inform Assoc. 2008 Jan-Feb;15(1):1-7
references.pmid: 17947615
references.citation: Health Aff (Millwood). 2010 Apr;29(4):607-13
references.pmid: 20368589
references.citation: J Am Med Inform Assoc. 2011 Jul-Aug;18(4):515-22
references.pmid: 21672914