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Donate My Data:
What Blue Button on FHIR
Can Do for Research
Mark Scrimshire
CMS, Office of Enterprise Data & Analytics
Ja...
● A brief history of Blue Button
● What are Blue Button and FHIR?
● What is CMS Blue Button on FHIR?
● Blue Button on FHIR...
A Brief History of Blue Button
3
Blue Button
Unleashes
Personal
Data
Blue Button in Use
1.2MCMS users
20–30k
Downloads/Month
Private sector applications
already ingest, optimize,
and visualiz...
How Could We Improve Blue Button?
5
“Build a developer-friendly, standards-based data API that
enables beneficiaries to connect their data to the applications...
What is FHIR?
Fast Health Interoperability Resources
7
What is CMS Blue Button on FHIR?
There are many FHIR structured profiles
covering infrastructure, clinical, identification...
1. Patient focused
2. Self-contained
3. Include reference Identifiers
4. Include patient profile subset
5. Contains a clai...
Research team
registers with CMS
Research
institution obtains
unique access ID
Research team
embeds ID in data
collection ...
● Permission process familiar to smartphone and social media users
● Growing tools marketplace
● Data is structured with i...
● Beneficiary Consent opens the door for:
 No cost access to their claims information
● Benefits to Researchers:
 Avoid ...
● Active development in 2016
 FHIR service for 38M FFS
Beneficiaries
 Data sourced from CMS Chronic
Condition Data Wareh...
● What the research community can do now
 Subscribe for updates – contact Carly.Medosch@cms.hhs.gov
 Attend Code-a-thon
...
● BlueButton Text to JSON Converter:
 https://github.com/ekivemark/python-bluebutton
● BlueButton on FHIR
 https://githu...
● Mark Scrimshire
 Entrepreneurs-in-Residence:
 Mark.Scrimshire@cms.hhs.gov
 Karl.Davis@cms.hhs.gov
● Carly Medosch
 O...
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CMS BlueButton On FHIR for Researchers - Presentation to NIH and PCORI Researchers

This is a presentation given to researchers from PCORI and NIH (Precision Medicine Initiative) about the potential benefits to researchers that comes from letting CMS Medicare Beneficiaries share their Claims information with a research study using the Proposed CMS BlueButton data formats built on the HL7 Fast Health Interoperability Resources Specification.

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CMS BlueButton On FHIR for Researchers - Presentation to NIH and PCORI Researchers

  1. 1. Donate My Data: What Blue Button on FHIR Can Do for Research Mark Scrimshire CMS, Office of Enterprise Data & Analytics January 2016
  2. 2. ● A brief history of Blue Button ● What are Blue Button and FHIR? ● What is CMS Blue Button on FHIR? ● Blue Button on FHIR: Consumer consent and data donation ● CMS plans for Blue Button on FHIR ● How researchers can get involved Agenda 2
  3. 3. A Brief History of Blue Button 3 Blue Button Unleashes Personal Data
  4. 4. Blue Button in Use 1.2MCMS users 20–30k Downloads/Month Private sector applications already ingest, optimize, and visualize data from Blue Button text files • Hospital • Physician • Prescription drugs Federally Inspired BlueButton Community • VA • DoD (TRICARE) • CMS 2xtext downloads Beneficiaries can download up to 3 years of claims data 4
  5. 5. How Could We Improve Blue Button? 5
  6. 6. “Build a developer-friendly, standards-based data API that enables beneficiaries to connect their data to the applications, services and research programs they trust” Blue Button on FHIR Vision 6
  7. 7. What is FHIR? Fast Health Interoperability Resources 7
  8. 8. What is CMS Blue Button on FHIR? There are many FHIR structured profiles covering infrastructure, clinical, identification, workflow, conformance, and financial. CMS Blue Button uses a limited subset of these profiles based on the data we publish 8 Explanation of Benefits *Recorded in FHIR Contract Resource
  9. 9. 1. Patient focused 2. Self-contained 3. Include reference Identifiers 4. Include patient profile subset 5. Contains a claim header & lines 6. One Claim per EOB 7. Each EOB has a GUID Creating the HL7 EOB 5 4 3 2 1 6 7
  10. 10. Research team registers with CMS Research institution obtains unique access ID Research team embeds ID in data collection app Medicare user agrees to join research study 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 Consumer Consent and Data Donation 1 2 3 4 5 6 7 8 9
  11. 11. ● Permission process familiar to smartphone and social media users ● Growing tools marketplace ● Data is structured with internationally accepted meaning Benefits of a Standard API Prototype: Post-Authentication Application Permission Screen
  12. 12. ● Beneficiary Consent opens the door for:  No cost access to their claims information ● Benefits to Researchers:  Avoid the Data Use Agreement  No payment to CMS  Refreshed Data  Weekly – Part A / B  Monthly – Part D The BlueButton API enables a new era and a new route for Research Data Collection
  13. 13. ● Active development in 2016  FHIR service for 38M FFS Beneficiaries  Data sourced from CMS Chronic Condition Data Warehouse (CCW) ● Use HL7 FHIR Explanation of Benefits ● Reformat of Current Blue Button File  Three years of claims data history in FHIR format  Mapping data to FHIR profiles ● Making Prototype API available at Health DataPalooza Code-a-Thon  April 1–2, Washington DC  Get more info & register: http://healthca.mp/onfhir/ CMS’ Plans for Blue Button on FHIR Claim Number: 2333444555200 Provider: No Information Available Provider Billing Address: Service Start Date: 01/05/2014 Service End Date: 01/05/2014 Amount Charged: * Not Available * Medicare Approved: * Not Available * Provider Paid: * Not Available * You May be Billed: * Not Available * Claim Type: PartB Diagnosis Code 1: 2163 -------------------------------- Claim Lines for Claim Number: 2333444555200 -------------------------------- Line number: 1 Date of Service From: 01/05/2014 Date of Service To: 01/05/2014 Procedure Code/Description: 99213 - Established Patient Office Or Other Outpatient Visit, Typically 15 Minutes Modifier 1/Description: Modifier 2/Description: Modifier 3/Description: Modifier 4/Description: Quantity Billed/Units: 1 Submitted Amount/Charges: * Not Available * Allowed Amount: * Not Available * Non-Covered: * Not Available * Place of Service/Description: 22 - Outpatient Hospital Type of Service/Description: 1 - Medical Care Rendering Provider No: PARTBPROV Rendering Provider NPI:
  14. 14. ● What the research community can do now  Subscribe for updates – contact Carly.Medosch@cms.hhs.gov  Attend Code-a-thon  April 1–2, Washington DC  http://healthca.mp/onfhir/  Learn more about FHIR  http://hl7-fhir.github.io  Participate in pilot (Anticipated Spring/Fall) Next Steps 14
  15. 15. ● BlueButton Text to JSON Converter:  https://github.com/ekivemark/python-bluebutton ● BlueButton on FHIR  https://github.com/ekivemark/BlueButtonFHIR_API  https://github.com/ekivemark/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
  16. 16. ● Mark Scrimshire  Entrepreneurs-in-Residence:  Mark.Scrimshire@cms.hhs.gov  Karl.Davis@cms.hhs.gov ● Carly Medosch  Outreach  Carly.Medosch@cms.hhs.gov Contact Info

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