@ekivemark

BlueButton on FHIRBlueButton Data-as-a-Service is a prototype design that will add functionality to the current MyMedicare.gov BlueButton Service.

Mark Scrimshire (HHS Entrepreneur-in-Residence) Gajen Sunthara (Presidential Innovation Fellow)

Centers for Medicare and Medicaid Services Office of Enterprise Data Analytics (OEDA) April, 2015

OEDA

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@ekivemark

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

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@ekivemark

BlueButton

DirectProject

Patient Centric

QuantifiedSelf

Mark Scrimshire

Data Donation

@ekivemark

Improving beneficiaries’ access to their data

• BlueButton has enabled 1M+ Medicare Beneficiaries to download their health data.

• BlueButton on FHIR aims to create a robust data API service enabling Beneficiaries to connect their health data with the applications and services they trust.

For beneficiaries this means: • More easily using their health data for better health For CMS this means: • Directly supporting the Presidential Precision Medicine Initiative:… 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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@ekivemark

BlueButton has been an essential first step

kickstarting innovation across healthcare

@ekivemark

“THERE IS NO SUBSTITUTE FOR HARD WORK” … Until someone builds an App for that.

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- Thomas Edison

Putting our health data to use is still too hard

@ekivemark

https://leicalady.files.wordpress.com/2010/08/annie-­‐admiring-­‐paintingsmall.jpeg

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

@ekivemark

Our Health data should be a valuable toolwe put to good use

http://commons.wikimedia.org/wiki/File:Toolbox_(6788494881).jpg

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@ekivemark

OAuth-enabled data APIs brings operational and security benefits

• More robust web applications(Screen  Scraping  anti-­‐pattern)

• Visibility to real utilization metrics(Who  is  using  the  data)

• Avoiding users sharing passwords (the  password  anti-­‐pattern)

@ekivemark

Which style of API?

Direct-based Push• Beneficiary Direct-Email

Address and Preference Management

• Backend Data Update Triggers

• SMTP+S/MIME email platform

• Identify Direct-compliant HISP

• Implement Accredited Trust Bundles from DirectTrust/NATE

FHIR-­‐based  Pull• Registered Application

Directory • API and Developer

Access Managed via api.data.gov

• Use Existing Beneficiary Authentication

• Web Services triggered on NGD updates

• Build Beneficiary Application Access Management

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@ekivemark

<XML>BlueButton  CCDA</XML>

FHIR. “Resources” are: • Granular clinical concepts • Managed in isolation, or

aggregated into complex documents

• Designed for the web • Based on simple XML or JSON

structures • HTTP-based RESTful protocol

with predictable URLs • Using open internet standards

for data representation • Uses OAuth for authorization

BLUEBUTTON ON FHIR

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OAuth 2.0: • Defeats the password

anti-pattern • Creates a consistent,

flexible identity and policy architecture

• Suited to web applications, web services, devices and desktop clients communicating with Cloud APIs.

BBonFHIR:  One  PlaXorm  –  Two  Services

{“json”:”format”} <xml>format</xml>

@ekivemark

On the Internet “Simple” Wins• FHIR

– Fast Healthcare Interoperability Resources – Project Argonaut

• Open source • 25 Industry Heavyweights • Public/Private partnerships

• REST API – Lightweight architecture for web services

• Eg.  https://bb.cms.gov/api/1.0/beneficiary/….. – Read and write options (GET / POST)

• OAuth – Improving security through traceability – A popular Authorization  protocol – Familiar to users of top web sites – Provides layers of Authorization control

• BlueButton Structured Data Formats – JSON – XML

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@ekivemark

Clarifying the Scope of BlueButton on FHIR

• No new data is being released • Beneficiaries will still be in control of who they release their

BlueButton data to and can revoke access at any time • Currently released BlueButton data will be reformatted to make it

easier for applications to ingest and process • BBonFHIR will simplify the process of enabling beneficiaries to

connect their data to the applications and services they trust • BBonFHIR and OAuth will provide a framework for fine grained

control over who is accessing Beneficiary information

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@ekivemark

Experiment with a FHIR Server REST API

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http://fhirtest.uhn.ca

@ekivemark

Follow our progress, join us and contribute

• Structured File Formats: – ( https://github.com/ekivemark/claims )

• BlueButton Text to JSON Converter: – ( https://github.com/ekivemark/python-bluebutton )

• Developer Code of Honor: – ( http://2.healthca.mp/1GjOUsY )

• HL7 - FHIR – ( http://www.hl7.org/implement/standards/fhir/http.html )

• Developer.HealthCa.mp – Washington DC: May 30, 2015 – http://developer.healthca.mp

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@ekivemark

Mark Scrimshire HHS Entrepreneur-in-Residence (CMS)

@ekivemark http://ekivemark.com

mark.scrimshire@cms.hhs.gov 410-786-5049

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