Blue Button Mash Up Challenge

About the Challenge

Background

The Office of the National Coordinator for Health Information Technology (ONC) and the Department of Veterans Affairs are working to empower individuals to be partners in their health through health information technology (health IT). There are three primary strategies (the “three As”) to meet this goal: 1) increase consumer and patient Access to health information; 2) catalyze market innovation to allow consumers to take Action toward better health using health information; and 3) shift consumer and provider Attitudes in support of consumer engagement in health.

In September 2011 ONC launched a Pledge Program (www.healthIT.gov/pledge) to catalyze public and private organizations to make it easier for individuals to access their personal health information online, and to encourage consumers to use that information to improve their health. Today, more than 375 organizations participate in the Pledge Program. Through the Pledge Program and other initiatives, especially the “Meaningful Use” incentive program for health care provider adoption of electronic health records (EHRs), online access by individuals to their own health information is becoming increasingly common. 

One of the ways individuals access their health data is through Blue Button®. A patient can click on the Blue Button® on a website or mobile device and download their health data from a personal health record (PHR) or from their doctor’s, hospital’s or clinical laboratory’s patient portal. Blue Button® data helps patients better understand their medical histories and treatments, ask more informed questions and better control their health. Blue Button® data helps physicians rapidly understand the health status of a new patient and quickly assess recent treatment received by an established patient. VA launched the Blue Button® in mid-2010; today it is used by nearly a half million Veterans, a quarter million Medicare beneficiaries and nearly 75,000 Service Members and their families. The Blue Button® appears on the patient portals of more than one third of America’s hospitals and nearly one third of practicing physicians. It has been or is being implemented by more than 200 major health plans including Aetna, United Health Care and Blue Cross. 

Giving patients access to information about them related to the care they receive from doctors and other healthcare providers is in itself valuable, but it is also important to enable patients to use that information to make informed decisions. To do so, individuals will benefit from additional contextual information to help them ask and answer the following types of questions:

• How might your activity level be impacting your insomnia?
• How does your cholesterol compare to that of others of your age and gender? (Such comparison can be a powerful motivator!)
• If you need to lose weight, what are some resources for doing so in your community?
• If you are taking a certain medication, is there somewhere else you could buy it more cost effectively

Individuals should be able to access and use their basic health information together with other information to take action: to better understand their current health status, use decision support software to choose treatments, anticipate and consider the costs of different options, and target and modify the everyday behaviors that have the greatest impact on their health. Inspired by the well-known “three-part aim” for improvement of the health care system, this challenge requires participants to help individuals to take action based on combining their health information with additional information that puts it into a more meaningful context. The three-part aim consists of the following goals as indicated on the Center for Medicare & Medicaid Services (CMS) Innovations Center website (http://innovations.cms.gov/):

• Better health care by improving all aspects of patient care, including Safety, Effectiveness, Patient-Centeredness, Timeliness, Efficiency, and Equity (the domains of quality in patient care as defined by the Institute of Medicine).
• Better health by encouraging healthier lifestyles in the entire population, including increased physical activity, better nutrition, avoidance of behavioral risks, and wider use of preventative care.
• Lower costs through improvement by promoting preventative medicine, improved coordination of health care services, and by reducing waste and inefficiencies. These efforts will reduce the national cost of health care and lower out-of-pocket expenses for all Medicare, Medicaid, and CHIP beneficiaries.

Challenge Description

This challenge builds on a prior Blue Button® challenge to make personal health information more usable and meaningful for the individual consumer or patient.  The challenge is broken into two parts:

1. App Development: Entrants must submit an app that makes the best use of Blue Button® downloaded personal health data and combines it with other types of data. Apps must mash up Blue Button® data with data inspired by the structure of the three part aim. Apps must use data representing at least two of the three part aim categories below. 
2. Reach: The app must be able to garner high patient engagement rates. Entrants are encouraged to demonstrate a partnership with a personal health information data holding organization (such as a provider, payor, or Personal Health Record vendor—see healthit.gov/pledge for a definition of a data holding organization) to achieve wide distribution among patients. 

Applying the Three Part Aim: To participate in the challenge, entrants must mash up Blue Button® data – data about a patient which the patient can download directly using a health plan’s, doctor’s or hospital’s Blue Button®  function – with information from two or more of the three part aim categories. Below are examples of types of contextual data that would qualify for purposes of this contest. Entrants can use data sets from the categories below or similar data sets:

Components of the Three Part Aim:

Part 1 of the Three-Part Aim: Better care interactions with the healthcare system

• Assist individuals in choosing high quality care that is relevant to their individual needs by including ratings for physician comparisons, hospital comparisons, or other care quality data.
• Assist individuals in identifying providers, practices, and hospitals that are health information technology enabled by using information from CMS related to Meaningful Use or other sources.
• Support individuals in understanding their current state of health by combining clinical data and medical claims data to create a comprehensive list of the individual’s medical conditions.
• Support individuals in understanding their current medication regimen by aggregating clinical data from doctors/hospitals, prescription claims data, and downloaded clinical data to create a single comprehensive list of medications.

Part 2 of the Three-Part Aim: Better care for oneself outside of the healthcare system

• Provide support to help an individual meet some of their personally stated health goals, (for example related to healthy eating, exercise, social support, or other virtual or geographically based resources).
• Provide an easily understood representation of an individual’s health status in comparisons to others of a similar demographic (age, gender, ethnicity, or otherwise), and make recommendations for actionable things an individual could do toward better health outcomes based on their comparative health data.
• Extrapolate how healthy behavior change can lead to positive health outcomes over time (for example show potential weight loss and reduced risk of cardiac illness from adding two 30 minute walks per week.

Part 3 of the Three-Part Aim: Reduced costs

• Provide information related to costs of relevant health care services (treatments, procedures, medication formularies, etc.) and/or financial savings likely to accrue from behavior changes.
• Create algorithms that exhibit cost savings to the individual and/or the health care system if the individual makes healthy living interventions, or different cost related choices in their health care.

Requirements for Participation

• Effectively integrate Blue Button® with information from two or more of the three part aim categories described above (special consideration will be given to apps and tools that incorporate data from all three components of the three-part aim).
• Integrate patient-centered design and usability concepts to drive high patient adoption and engagement rates.
• Mash up an individual’s Blue Button® downloaded data in innovative ways to contextualize the individual’s health data.
• Combine, correlate or otherwise mash up a consumer’s Blue Button data with data from other no-cost-to-consumer sources of data.
• Provide a one page dissemination plan or commercialization strategy describing how this app solution will be implemented for scalability, including details for marketing and promotion.
• Existing or modified apps should show an uptake in their initial user base demonstrating the potential for market penetration based on Blue Button® data contextualization capabilities.
• The app must be designed for the Web, a personal computer, a mobile handheld device, console, or any platform broadly accessible on the open Internet.

Timeline

• Submission Period for Entries Ends: September 5, 2012
• Evaluation Process for Entries Begins: September 5, 2012
• Evaluation Process for Entries Ends: September 12, 2012
• Winners notified: September 21, 2012
• Winners Announced: Health 2.0 San Francisco Fall Conference, October 7-11, 2012

Prizes

• Total: $75,000 in prizes
• First Place: $45,000 plus conference exhibition opportunity
• Second Place: $20,000
• Third Place: $10,000

Submission Requirements

In order for an entry to be eligible to win this Challenge, it must meet the following requirements:

1. General – Contestants must provide continuous access to the app, a detailed description of the app, instructions on how to install and operate the app, and system requirements required to run the app (collectively, “Submission”)
2. Acceptable platforms – The app must be designed for the Web, a personal computer, a mobile handheld device, console, or any platform broadly accessible on the open Internet.
3. Data used – The app must utilize 508 or W3C compliant EHR modules and associated data.
4. No ONC logo – The app must not use ONC’s logo or official seal in the Submission, and must not claim endorsement.
5. Functionality/Accuracy – A Submission may be disqualified if the software application fails to function as expressed in the description provided by the user, or if the software application provides inaccurate or incomplete information.
6. Security – Submissions must be free of malware. Contestant agrees that the ONC may conduct testing on the app to determine whether malware or other security threats may be present. ONC may disqualify the app if, in ONC’s judgment, the app may damage government or others’ equipment or operating environment.

Review Criteria

The ONC review panel will make selections based upon the following criteria:

• Data from the three part aim categories:
• Does the app help individuals achieve least two components of the three-part aim?
• Does the app help individuals achieve all three components of the three-part aim?
• Commercialization plan:
• • Thoughtful approach to commercializing the app.
  • Viability of the plan and potential for broad adoption of the app.
  • Viable plan for initial and ongoing technical and support capacity to meet anticipated app usage and future enhancement.
  • Special consideration for demonstration of plans in place (e.g. letter of intent, formalized agreement).
• Is the app simple and intuitive to use?
  • App is available on broadly-used platform
• App must garner high patient engagement rates
• • Uses Blue Button® downloads as the primary source of data about a consumer's health or health status
  • Is the app interactive with easily understood data mashups?
  • How useful are each of the chosen mashups to a wide audience?
  • Are specific actionable suggestions provided to the user based on meaningful mashups of Blue Button (consumer-specific) and other sources of data?