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.
Iowa City VA Health Care System, Comprehensive Access and Delivery Research and Evaluation (CADRE) Center, Iowa City, IA, United States. dawn.klein@va.gov.
Dawn M
http://orcid.org/0000-0002-7122-0823
DM
Klein
Gemmae M
http://orcid.org/0000-0001-6055-4177
GM
Fix
Timothy P
http://orcid.org/0000-0002-6888-0927
TP
Hogan
Steven R
http://orcid.org/0000-0002-4624-4364
SR
Simon
Kim M
http://orcid.org/0000-0002-0966-5602
KM
Nazi
Carolyn L
http://orcid.org/0000-0002-8219-8676
CL
Turvey
D000368:Aged; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration; D057286:Electronic Health Records / Q000458:organization & administration; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D020407:Internet; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration; D014481:United States; D014493:United States Department of Veterans Affairs
care coordination; consumer health information technology; eHealth; health care providers; health record, personal; information sharing; meaningful use; qualitative research