NATE Blue Button for Consumers

//NATE Blue Button for Consumers
NATE Blue Button for Consumers 2018-04-03T10:13:22+00:00


National Association for Trusted Exchange (NATE)
Washington, DC 20001 USA

The National Association for Trusted Exchange (NATE) is a not-for-profit membership association focused on enabling trusted exchange among organizations and individuals with differing regulatory environments and exchange preferences. NATE brings the expertise of its membership and other stakeholders together to find common solutions that optimize the appropriate exchange of health information for greater gains in technology adoption and improvement of patient outcomes. Consistent with NATE’s mission to address the legal, policy and technical barriers that inhibit health information exchange between data holders and healthcare consumers, NATE leads and participates in a number of ongoing and emerging projects focused on exchange via multiple modes of transport, including Direct secure messaging and APIs. Working with a broad set of stakeholders through multiple task forces, crowdsourcing and a call for public comment, NATE was proud to make available the first release of NATE’s Blue Button for Consumers (NBB4C) Trust Bundle beginning in 2015.  NATE is working to extend the utility of its trust community beyond Direct secure messaging to include other consumer-centric technologies, such as those that leverage APIs or other modes of exchange. Stakeholders interested in participating in the next phase of NATE’s work in consumer mediated exchange should consider NATE membership or subscribe to News from NATE.

Primary Contact:

Aaron Seib
[email protected]

Alternate Contact:

Rim Cothren
[email protected]

NATE Blue Button for Consumers (NBB4C) Trust Bundle

The flagship NATE Blue Button for Consumers (NBB4C) Trust Bundle contains trust anchors of consumer-facing applications (CFAs) that utilize Direct to securely move data from one application to another. The NBB4C Trust Bundle helps relying parties to identify CFAs that meet or exceed criteria considered to be the most important characteristics of a trustworthy steward of consumer health information, while still enabling patients to benefit from the value of having access to their health information.

Participation in the NBB4C Trust Bundle facilitates secure exchange of health information from provider-controlled applications to consumer-controlled applications such as personal health records (PHRs) using Direct secure messaging protocols. Provider organizations that wish to send messages to consumers using one of these recognized applications should load this bundle into their trust stores. In most cases, CFAs that are onboarded to the NBB4C have loaded publicly recognized trust bundles of provider facing applications and Direct Secure messaging should be enabled.

CFAs are welcome to submit an onboarding application and supplementary documentation online by using the NATE Bundles Administrator.  Go to to upload the completed form and supporting documentation.  New applicants will be required to create a profile to upload their documents and certificates, and must complete requisite testing by first adding their test trust anchor to the NBB4C staging bundle.  See How to Use the NBA for more instruction on how to apply and onboard.  Currently, NATE invoices qualified CFAs an administrative fee of $4,000 before being added to the production NBB4C trust bundle.

NBB4C Staging

The NBB4C Staging Bundle is a non-production bundle that is used by candidate consumer-facing applications to conduct the testing required by the NBB4C onboarding process.

This bundle is also used by NATE and the consumer-facing applications in the NBB4C to give demonstrations, such as those offered as part of the HIMSS Interoperability Showcase.

Demonstration Trust Bundle

The Demonstration Trust Bundle is a non-production bundle used by provider-facing applications such as electronic medical records systems when participating with NATE in demonstrations such as the HIMSS Interoperability Showcase.

Helpful Links

Go to NBA to Download NBB4C Trust Bundle
Download the NBB4C Onboarding Application
NBB4C Policies and Procedures
NBB4C Presentation
How to Use the NBA

NATE Blue Button for Consumers (NBB4C)

The following customer-facing organizations have completed the NBB4C onboarding process:

Organization List of Trust Anchors Issuer Name Expiry Date Trust Anchors Serial Number
Carebox Healthcare Solutions Inc. 02/03/2025  DC EA B5 92 D3

2B FE E5

GetRealHealth IPHR-Direct-CA.cer Instant PHR Direct CA 12/31/2039  3A 7F FE 8A 79

CA 37 8E 47 A2

4D AC F6 C9 09


Humetrix  02/22/2033  6C 9C 98 D8 E5

5D 2A 6D

iShare Medical isharemedicalrecords_com_anchor.cer iShare Medical Direct Intermediate CA  01/14/2025  72 8B E4 E2 D2

35 04 FB 44 BB

6D 7E D2 1B AB


Medical Informatics Engineering (MIE) NoMoreClipboard.der  12/09/2023  0
MedYear root.der Medyear Direct root  02/26/2025  FF 45 CC 18 92

02 55 65

Microsoft Microsoft HealthVault Direct CA.cer Microsoft HealthVault Direct CA  12/31/2039  -3 66 B9 3A 93

9B 6B D6 5B 57

EA B9 E2 05 19

A8 3

Omedix root.der Root for 01/16/2084  77 BF 19 C7 8A

12 8D