CMS Blue Button on FHIR: Empowering Patients

Mark Scrimshire CMS Blue Button Innovator, Office of Enterprise Data and Analytics

Carly MedoschCMS Blue Button Program Analyst, Office of Enterprise Data and Analytics

May 2016Cinderblocks3

●CMS Blue Button Innovator

●Health Data and Cloud Technologist

●Co-Founder & CTO – Medyear

●Chief Instigator – HealthCa.mp

●Blogger – blog.ekivemark.com

●Twitter – @ekivemark

Introductions: Mark

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Disclaimer

The views expressed in this presentation are my own and should not be construed as an official position of the US Department of Health and Human Services or The Centers for Medicare & Medicaid Services.

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●CMS/OEDA Blue Button Program Analyst

●Project Management Professional (PMP)

●Program and Project Manager (FAC-P/PM)

●Contracting Officer’s Representative (FAC-COR)

●Chronic illness patient/advocate

Introductions: Carly

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A Brief History of Blue Button

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Blue Button Unleashes Personal Data

3.3M2010

2016

Total UsersVA, CMS, DoD

DoD

CM

S

VA

0.45 1.41 1.44

But people don’t want their data for it’s own sake…

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Blue Button in Use

1.4M CMS users

20–30kDownloads/Month

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

• Hospital• Physician• Prescription drugs

Federally InspiredBlue Button Community• VA• DoD (TRICARE)• CMS

2x textdownloads

Beneficiaries can download up to 3 years of claims data

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●Health information challenging to use in current PDF or plain text format

●Beneficiary has to return to MyMedicare.gov to get at least 6 months of data each time new information is available

●Apps like iBlueButton have entered the market to automate this process by screen scraping and borrowing beneficiary userids and passwords weakening security

●Health care industry has moved to structured data formats (BlueButton+ / CCDA)

●Enhanced Blue Button service can be a powerful tool to support the drive to improve quality of care

● Interoperability is finally taking hold in health care

Why Should Blue Button Change?

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Blue Button supports several White House initiatives:● The President’s Precision Medicine Initiative

● The President’s Cancer Moonshot Task Force

Why Should Blue Button Change?

“that ensures consumers have access to their own health data—and to the applications and services that can safely and accurately analyze it”

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“Enhanced Data Sharing: Data sharing can break down barriers between institutions, including those in the public and private sectors,

to enable maximum knowledge gained and patients helped. The cancer initiative will encourage data sharing and support the development of

new tools to leverage knowledge about genomic abnormalities, as well as the response to treatment and long-term outcomes.”

Sources:https://www.whitehouse.gov/the-press-office/2015/01/30/fact-sheet-president-obama-s-precision-medicine-initiativehttps://www.whitehouse.gov/the-press-office/2016/02/01/fact-sheet-investing-national-cancer-moonshot

How Could We Improve Blue Button?

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Blue Button 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”

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An Enhanced BlueButton has a Critical Role in Value and Quality-Based Health

Personal Applications Personal Health Record

Care Coordination

V?

Research

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Putting Patientsat the center

Why Blue Button on FHIR*?

*Fast Health Interoperability Resources14

“I control who I share my data with”“I download my data”

Sample

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Patients take ownership of their data

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• A Familiar and Proven Authorization Process

• Used billions of times each day

Research team registers with CMS

Research institution obtains unique access ID

Research team embeds ID in data

collection app

Research team recruits Medicare

user

Medicare user uses data collection app

Blue Button on FHIR API

requires Medicare user to authenticate

Medicare user gives app data access

permission via API

Blue Button on FHIR API issues

user access key to data collection app

Data collection app uses ID and key to

automate data collection for user

Behind the Scenes: Consumer Consent and Data Donation

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4 5 6

7 8 9

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Blue Button on FHIR will create a robust data API service that enables beneficiaries to connect their health data with the applications and services they trust.

●For beneficiaries More easily using their health data for better health

Structuring Blue Button data will unleash innovation

International standard improves interoperability

●Directly supporting key administration initiatives Supports several White House initiatives

Reduces agency FOIA requests

Supports PCOR investment objectives

Enhanced Blue Button Outcomes

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●Blue Button on FHIR Front-end OAuth Server/Client: https://github.com/TransparentHealth/hhs_oauth_server

https://github.com/TransparentHealth/hhs_oauth_client

●POET https://github.com/HHSIDEALab/BlueButtonFHIR_API

https://github.com/HHSIDEALab/poet

●HL7 FHIR http://www.hl7.org/implement/standards/fhir/http.html

●HL7 WIKI http://hl7-fhir.github.io/index.html

●HAPI Server: https://github.com/jamesagnew/hapi-fhir

Follow Our Progress, Join Us, and Contribute

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●Mark Scrimshire Blue Button Innovator

Mark.Scrimshire@cms.hhs.gov

●Carly Medosch Outreach

Carly.Medosch@cms.hhs.gov

Contact Info

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Find Out More

http://go.cms.gov/bluebutton

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