BIDMC does all 3 but its efforts over the past year have focused on universal viewing of records for providers and patients. (Next year will be the year of statewide pushing of structured data).
On July 5, UnitedHealthcare announced that its 26 million patients (of which 20 million already access personal health records at www.myuhc.com) will have access to view/download
their health data using the Blue Button approach - a PDF or text file containing information from various sources, such as claims data, health screenings and self-entry.
From the press release
"UnitedHealthcare’s support of the Blue Button initiative first began in September 2011, and in March 2012 the Blue Button went live on one website for 500,000 people enrolled in Health Plan of Nevada benefit plans. As UnitedHealthcare rapidly expands the use of the Blue Button, more than 12 million employer-sponsored plan participants will have access by the end of the year and by mid-2013 nearly all 26 million UnitedHealthcare enrollees will be able to access their PHR with the click of the Blue Button.
The Department of Veterans Affairs launched the Blue Button in 2010 to allow simple exchange of a patient’s personal health data in a standard, consistent format. Initially designed for use by veterans, the idea has taken off in the private sector and has been supported by at least one major care provider overseas. Veteran Affairs and Health and Human Services have encouraged the health industry to adopt the Blue Button, and UnitedHealthcare is pleased to do so."
It's clear to me that PHRs are finally approaching the tipping point where patients will expect to have their data available for viewing and download. Clinicians have not universally supported that notion but Meaningful Use 2014 edition is likely to require it as part of attestation. I recently visited my own primary care physician and he provided me a full summary of the visit, including labs, within a few days of the visit, apologizing for the delay.
With United's adoption of a PHR that includes viewing/download capability, it's fair to say that the technology has now gone viral and is unstoppable. My daughter (and her generation) will not experience the silos of data that my generation grew up with. We're making progress.