Senior Citizens May Soon Get Medicare Health Records
on Smartphones, Carry on Doc Visits
Within the next 12 months seniors in Medicare will be
able to get the same data on their smartphone their doctors send to each
other, one doctor says; check out website of Medicare Blue Button
Elizabeth Stawicki, Minnesota Public Radio
17, 2013 - It's one of those unhappy holiday surprises - a visiting
family member gets sick. That happened to Dr. Farzad Mostashari last
"My dad comes downstairs and he has acute pain in
his eye where he had cataract surgery. And I said, 'What's the matter,
what's the story?'" recalled Mostashari, who lives in Bethesda, Md. "And
he said, 'Well, I think they put the wrong lens in my eye, I'd gone back
to the doctor and...'" His father didn't remember exactly what had
happened at his last doctor's appointment and the office was closed
How could a local doctor in Maryland access his
dad's medical record in Boston? Through
Medicare Blue Button, a
computer program that allows patients to download their medical history
into a simple text file on their smartphones and personal computers.
Then third-party applications that you download help organize this
Mostashari certainly knew how to handle his dad's
problem. After all, he's the coordinator for health information
technology at the U.S. Department of Health and Human Services, and it's
his passion and profession to promote electronic health records.
And, he had signed his dad up for Blue Button,
which downloads three years of a patient's medical history, as well as
iBlueButton, a smartphone
app that translates and displays the information in a
simple-to-understand way. The file includes names, phone numbers and
addresses of physicians as well as diagnoses, lab tests, imaging
studies, and medications.
So when Mostashari took his father to a local
doctor, his dad was able to hand over his iPhone and say, "Here's my
Mostashari predicts that soon everyone will have
that kind of information at their fingertips: "Within the next 12 months
if people want to, they will be able to get the same data that your
doctors would send to each other to have it come to you."
The Blue Button service is available from the
for veterans as well as
Before a patient can download medical information
to a computer or a smartphone, the files must first be stored
electronically. And while electronic health record advocates note that
there has been a sharp increase in the number of hospitals and doctors
using EHRs, they acknowledge that a complete electronic system is a long
According to a 2012
CDC survey, while 72
percent of office-based physicians are using some sort of electronic
system in their practice, only 40 percent of practices meet the
definition of a basic system.
Power In The Hands Of The Patients?
The federal health law is designed to encourage
patients to be more involved in managing their own health. Making
medical records and test results accessible to smartphones is in line
with those policy goals.
The floodgates have opened for patients to use
technology to manage their own care particularly those that have
chronic, and expensive, diseases, said Jennifer Lundblad, CEO of
Stratis Health, a
nonprofit organization based in Minnesota, which aims to improve health
care by translating research into practice.
Lundblad said smartphones and health-related
applications can become powerful tools to help people monitor and
improve their health.
"Some parts of health care are so complex that we
need complex solutions," she said. "But some parts of health care can be
simplified and with the prevalence of smartphones, let's use the
smartphone tool that that patient already has."
But there are also risks that Lundblad and others
worry about, among them the possibility that a company storing the
health data could go out of business or that some patients may lose
smartphones containing their medical information.
But even its most recent report noted that "many
questions remain" about the applications. Among them: What information
should be included in application developer's privacy policies? What
might a model short privacy notice look like? Can a single system of
icons be developed to avoid consumer confusion?
Deven McGraw, director of the Health Privacy
Project at the Center for Democracy and Technology, notes that when
doctors and health plans store electronic medical information, that
information is covered by federal privacy and security rules. But those
rules don't extend to medical information on a smartphone.
"When you take possession of it and share it, stick
it in an app, share it on the web, a social networking site, it's not
to read that," McGraw said. "Be aware before you share."
McGraw provides some tips for consumers who want to
Determine if cellphone
app makers claim rights to patients' data for marketing purposes.
Look for very clear
statements about how the data is used. Language such as "from time to
time we will use your data...in order to improve the services we provide
for you" may warrant further investigation.
Look for who owns the
data, if the company will disclose it. Do you own your data? Or do you
merely have the right to use the service, but that is the extent of your
Look for commitments on
security of the data. Is the data stored on your phone or on a server?
What are your rights to
retrieve data if they cancel service? Are you permitted to have a copy
of the data? What is the app provider's right to use the data after
service is canceled? Ideally, McGraw said, companies should return all
your data and not have the right to subsequently use it.
You should use unusual
passwords that employ varied symbols and numbers.
If possible, you should
be able to remotely delete data from the device if it is stolen.
And Medicare Blue Button
has these security recommendations:
Download your data to a
secure location. You may want to download your information to a CD or
flash drive. Consider purchasing an encrypted flash drive for your
information. You may also encrypt or require a password to access a CD.
If you want to send
your information via email, you should encrypt the message.
Keep paper copies in a
safe and secure place that you can control.
Another problem with smartphone medical records -
not related to security - is that some physicians may not know whether
the records stored there are complete, said Scott Edelstein, co-chair of
Squire Sanders' Healthcare & Life Sciences Industry Group in Washington,
"There may be some data that the patient doesn't
want to keep on their smartphone," said Edelstein, who specializes in
mobile health applications. "Maybe there's very sensitive health
information. Maybe there's information that they don't want other
providers to know but it could be very important information for a
provider to know, for example, in the event of an emergency."
Edelstein said errors or omissions could be
But in the case of Dr. Farzad Mostashari's father,
the records on the phone had pointed to the problem: "He had dry eye;
that was the diagnosis."
Then, it was an easy treatment that salvaged the
This story is part of a collaboration that
MPR News, NPR
and Kaiser Health News.