Enabling Consumer-Directed Health Data at CMS

IS HE?

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WH

Mark Scrimshire CMS BlueButton Innovator

http://ekivemark.com mark.scrimshire@newwave.io

703.623.2789

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DisclaimerThe views expressed in this presentation are my own personal views and should not be construed as an official position of:

• US Department of Health and Human Services or

• The Centers for Medicare & Medicaid Services.

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20–30kDownloads/Month

• Hospital • Physician • Prescription drugs

Federally Inspired Blue Button Community • VA • DoD (TRICARE) • CMS

2x textdownloadsBeneficiaries can download

up to 3 years of claims data

Private sector applications already ingest, optimize, and visualize data from Blue Button text files

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Unique Medicare Members since 2010

There are big opportunities…

54,000,000Medicare Beneficiaries (2014 est.)

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29,000,000MyMedicare Portal Users

An Essential First Step

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…but it left the patient to do the heavy lifting

BlueButton Vision

“Build a Developer-friendly, Standards-based data APIthat enables beneficiaries to connect their data to the applications, services and research programs they trust”

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Why create an API when the Industryhas done that?

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CMS Blue Button on FHIR

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Fast Health Interoperability Resources

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Making a contribution to the FHIR Community

CMS SyntheticPublic Use Files

(SYN-PUF)

FHIRPatient

ExplanationOfBenefit11K Patient Profiles 1.1M EOB Profiles

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80 Participants12 Teams

@ekivemarkA busy 2 days

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And the Winners were: @POC

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Un-conference

Code-a-thon

Health

Tech Policy

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CMS FHIR Patient Profilehttps://api.bbonfhir.com/api/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":["1625 N GEORGE MASON DR, 344, ARLINGTON, VA", “222053683”] } ]}

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CMS Blue Button Claim Profilehttps://api.bbonfhir.com/api/v1/ExplanationOfBenefit?_format=json{"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"} }] }]}

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Get to know the FHIR Rest API

https://api.bbonfhir.com/api/v1/Patienthttps://api.bbonfhir.com/api/v1/ExplanationOfBenefit

?_format=json|xml&{Search_parameters}

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Patients take ownership of their data

I Authorize

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Join inhttps://github.com/HHSIDEAlab/BlueButtonFHIR_API

https://github.com/HHSIDEAlab/bluebutton-text-to-fhir

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Keep Up To Date

http://go.cms.gov/bluebutton

Mark Scrimshire CMS BlueButton Innovator

@ekivemark http://ekivemark.com

mark.scrimshire@newwave.io 703.623.2789