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https://github.com/jmandel/bluebutton-push-workflow

BlueButton+ Push: Simplifying Patient Workflows
https://github.com/jmandel/bluebutton-push-workflow

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BlueButton+ Push: Simplifying Patient Workflows

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README 

        
# This work has been supplanted!

# [https://github.com/blue-button/blue-button-plus-pull](https://github.com/blue-button/blue-button-plus-pull)



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# BlueButton+ Push: Simplifying Patient Workflows



## Background: Today's Workflow



It's been exciting to see the BlueButton+ Push implementation guide come

together, and gratifying to see trust bundles being used to bootstrap circles

of trust within the BlueButton+ Direct community.  Now that so much

infrastructure is in place, it's time to think carefully about the

**patient-facing workflows** that we'll need in order to connect apps to data

**simply and safely**.



### Example:  Getting BP readings to a "BP Grapher" app

So what happens when a patient discovers a new app ("BP Grapher") and would like

to connect it to her health data via BlueButton+ Push?  It's a pretty good guess

that the process will look something like this:



* Patient visits https://bp-grapher.com and registers for an account.

* BP Grapher presents the patient with a screen something like:



![Current BB+ Push Workflow](mockup/01-current-workflow.png)



In other words: to connect the app, the patient needs to know the portal URL 

for each of her data providers; she needs to log in, locate the BB Connection

feature (which will differ from portal to portal), and type or copy/paste

the appropriate (app-specific) Direct address in the authorization form.



This process requires **many steps**, is **error prone**, and in the end provides

**no explicit notification** to the app that a connection has been established. 



It's a start -- but we can do better!



## Proposal: Simpler Redirection-Based Workflow

We can streamline this process to make it more consistent and easier for

patients.  The following is a **strawman proposal** for how a streamlined system

might work -- it's designed to **provoke comments and feedback**!  (Also, please

note that BIDMC and SFGH are used purely for illustrative purposes in this

mockup scenario.)



### Step 1: Choose a Provider



![Proposed Workflow Step 1: Choose a Provider](mockup/02-improved-workflow.png)



If BP Grapher can learn about which data holders support BlueButton+ Push,

it can present the patient with a simple "find my provider" search box. 

(How this happens is out of scope for this proposal -- but centralized

infrastructure could be helpful, perhaps taking advantage of the existing

BlueButton+ Trust Bundle distribution mechanism.)



When a patient identifies a provider to connect with, she just clicks 

"Connect to [Provider]".  Behind the scenes, she's redirected to a special

URL within the provider's portal.  She sees...



### Step 2: Create a BB+ Connection



![Proposed Workflow Step 2: Create a BB+ Connection](mockup/03-improved-workflow.png)



In this example, the patient is redirected to an authorization screen within

her provider's portal.  (Note: she's probably presented with a login screen

first; after she logs in, she sees the screen above.)  



Very simply, the provider shows the patient a pre-filled authorization form.

The patient sees the proposed Direct e-mail endpoint address, as well as basic

information about the app itself. (Where this app-specific information

comes from is out of scope -- but again, the Trust Bundle infrastructure could

be a good starting point.) 



She chooses `Create` or `Reject`, and is redirected back to the BP Grapher app,

which learns about her decision.  



### Step 3: Done!  (Or connect to more providers as needed.)



![Proposed Workflow Step 2: Create a BB+ Connection](mockup/04-improved-workflow.png)



At this point, the patient is back at BP Grapher's site.  She can begin to see

her blood pressure data as soon as the provider sends it over to the app.  And

she can connect to additional providers as needed.



## Technical Details: How It Works

To support this redirection-based workflow, **each BlueButton+ data holder needs

to expose a single HTTP endpoint at a published URL.**



For this example, we'll call that URL `/create-bb-connection`.  



#### The endpoint takes three parameters:



 * `sendMailTo`: Direct address to which a connection is being requested

 * `redirectTo`: HTTPS URL to return the patient to after a connection is created/rejected

 * `state`:  (optional) app-supplied string that will be returned to the app along with the patient's decision



#### The job of this endpoint is to:



1.  Ensure the patient is logged in

2.  Present the patient with a pre-filled authorization form asking to create a connection to the address found in `sendMailTo`

3.  Present the patient with any addtional information that could help in making an informed authorization decision

4.  Record the patient's `create` vs. `reject` decision, establishing a persisting BlueButton+ connection in the event of `create`.

5.  Redirect the patient back to the app via the HTTPS URL found in `redirectTo`, appending two parameters:



 * `state`: copy of the app-supplied state from the first step

 * `decision`: either `create` or `reject`, according to the patient's decision