Blue Button® API: Creating a Data-Driven Ecosystem to Benefit Medicare Beneficiaries

Mark ScrimshireOctober 1, 2017

The Power of Beneficiary-Directed Data

HIMSS 2017

• HealthAPT/CMS Blue Button Innovator

• Health Data and Cloud Technologist

• Twitter: @ekivemark

Demo Support from Alan Viars

• HHS EIR Alumni

• CEO, Videntity

• Founder, TransparentHealth

Introduction: Mark Scrimshire

2

Total Users

VA, CMS, DoD3

A Brief History of Blue Button

Blue Button

Unleashes

Personal

Data

®

®

4

CMS Blue Button API Vision

“Build a developer-friendly, standards-based

data API that enables beneficiaries

to connect their data to the

applications, services,

and research programs

they trust”

5

Blue Button API Can Play a Critical Role in Value and Quality-Based Care

Personal Applications Personal Health Record

Care Coordination

Putting patientsat the center

Research

6

The Blue Button API Enables a New Era and a New Route for Research Data Collection

• Medicare beneficiaries will be able to register with research applications via the CMS Blue Button API

• Beneficiary consent creates opportunity to share personal health data electronically with research studies

• Benefits to researchers:– Avoid a data use agreement

– No payment to CMS to collect data

– More timely data • Weekly—Part A / B

• Monthly—Part D

7

Blue Button API using FHIR

“I control who I share my data with”

“I download my data”

Bi-directional

8

• FHIR extension to Chronic Condition Warehouse (CCW)

• 38M+ Medicare beneficiaries

• Three years of Blue Button claims information (6+ billion records)

• Jointly-developed FHIR “ExplanationOfBenefit” STU3 resource

• Integration with MyMedicare.gov

• Built on CMS Cloud Services

Lighting the FHIR at CMS

9

Building a Tiered Blue Button Platform

FHIR API

Access Rules

FHIR Resource

Definitions

FHIR Database

(HAPI-based)

Patient

Access

Blue Button

OAuth Server

Developer

Access

Portal/Customer

Authentication

PHRAllofUs

…

</> {API}

CMS Efforts:• FHIR OAuth2.0 Permissions• OAuth2.0 Patient Crosswalk• OAuth2.0 Patient Masking• FHIR ExplanationOfBenefit• CCW to FHIR ETL

Community

of Trust

JWT

(Future Option)

10

Where are we?• HHS DevCloud sandbox is loaded with dummy beneficiary claims data for testing

purposes

• Invites to sign up for the developer preview in the DevCloud sandbox are now available on go.cms.gov/bluebutton

• Next step is to load synthetic data in the DevCloud sandbox to enable developers to create mashups

Seeking developer feedback on:• Registration process

• Oauth2.0 application activation

• Oauth2.0 authorization process

• Compliance with FHIR specification given Blue Button API patient-directed use case

Interested? Visit go.cms.gov/bluebutton to sign up

Blue Button API Status

11

https://dev.bluebutton.cms.fhirservice.net/bluebutton/fhir/v1/

Blue Button Dev Sandbox

https://dev.bluebutton.cms.fhirservice.net/bluebutton/fhir/v1/Patient?_format=json

{"resourceType":"Patient","id":"421118","meta":{

"versionId":"1","lastUpdated":"2016-03-22T16:38:17.578-04:00"},

"identifier":[{

"system":"CCW_BENE_CRNT_VW.BENE_ID","value":"0"}],

"name":[{"family":["00013D2EFD8E45D1"],"given":["f5"]}

],"birthDate":"1923-05-01",""address":[{

"line":["220 S Almond Court"],"city":"Manchester", "state":"MI",

"postalCode":"48158"}]}

CMS FHIR Patient Profile

12

®

13

{"resourceType":"ExplanationOfBenefit","id":"421383","meta":{"versionId":"1",

"lastUpdated":"2016-03-22T16:38:17.578-04:00"},"identifier":[{"system":"CCW_PDE_FACT.PDE_ID",

"value":"233324492503674"}],"provider":{"reference":"Practitioner/421386"},"prescription":{"reference":"MedicationOrder/421384"},"patient":{"reference":"Patient/421118"},"coverage":{"coverage":{"reference":"Coverage/421134"}},"item":[{"sequence":1,

"type":{"system":"http://hl7.org/fhir/v3/ActCode","code":"RXDINV"},

"servicedDate":"2008-12-05","adjudication":[{"category":{"system":"CMS Adjudications",

"code":"Patient Pay Amount"},"amount":{"value":10,"system":"USD"}},{"category":{"system":"CMS Adjudications",

"code":"Total Prescription Cost"},"amount":{"value":350,"system":"USD"}

}]}]

}

CMS Blue Button Claim Profile

14

Get to Know the FHIR REST API

https://{server}/path/Patient

https://{server}/path/ExplanationOfBenefit?_format=json

?_format=json|xml

&{Search_parameters}

15

CMS Blue Button API: The Summary

• Building on industry and web standards

• Providing a blueprint for patient access to their data

• Designing solutions with the health care community

• Utilizing open source solutions

• Using FHIR positions CMS Blue Button API at the center of health information exchange interoperability

16

• Visit our web page and subscribe for updates: http://go.cms.gov/bluebutton

• Join the BBAPI Developer Google Group:

• https://groups.google.com/forum/#!forum/developer-group-for-cms-blue-button-api

• Learn more about HL7 FHIR: http://hl7-fhir.github.io

Learn More About Blue Button API

subscribe

17

• Mark Scrimshire

• HealthAPT/CMS Blue Button Innovator

• Mark.Scrimshire@cms.hhs.gov

• Alan Viars

• HealthAPT Blue Button Developer

• Alan.Viars@cms.hhs.gov

Contact Info

Learn more about Blue Button API using FHIRhttp://go.cms.gov/bluebutton

• Karl Davis

• Associate Entrepreneur-in-Residence

• Karl.Davis@cms.hhs.gov

• Lori Pettebone-Koraganie

• Program Manager, Blue Button API

• Lori.Maatta@cms.hhs.gov

• Carly Medosch

• Outreach, Blue Button API

• Carly.Medosch@cms.hhs.gov