This is a presentation I gave to the CMS Enterprise Data Services Group about the CMS Blue Button on FHIR API Initiative and how the FHIR API offers powerful new solutions for CMS for data interoperability.

1. What the CMS Blue Button® on FHIR®
Data API Can Do for CMS
Mark Scrimshire
CMS Blue Button Innovator
Office of Enterprise Data & Analytics
June 2016

2. Blue Button in Use
1.4MCMS 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
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3. “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
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4. What is FHIR?
Fast Health Interoperability Resources
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5. 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
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Explanation
of Benefits

6. ● Permission process is familiar to beneficiaries
● Growing tools marketplace
● Data is structured with internationally accepted meaning
Making Consent and Data Donation
Simple for the Beneficiary and Researcher
Prototype:
Post-Authentication
Application
Permission Screen
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7. ● Beneficiaries explicitly give permission to share their data.
● This is a new option for data collection. All current research data
acquisition options are still available.
● There is no cost for downloading an individual beneficiary’s data
once a data collection app has been developed and registered.
CMS Blue Button on FHIR Data API
is a New Channel for Research Data Collection
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8. ● 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
Code-a-thons
 April 1–2, Washington DC
 Sept 15–16, Baltimore (Proposed)
 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: Part B
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:
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9. ● Patient profile
● Explanation of Benefit profile:
 Part A in-patient claims
 Part B professional claims
 Part D pharmacy claims
● Typical content of a FHIR EOB/Claim record:
 Provider
 Diagnosis code
 Costs and charges
What Data Will Be Published
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10. FHIR Service
● Upgrades the current Blue Button to make it more useful to
beneficiaries
● Demonstrates API leadership by example to the industry
● Blue Button is a flexible tiered architecture
Why Blue Button on FHIR is important to CMS
FHIR ServiceCCW
BlueButton Front-endSLS
Auth
Configurable Resource Mapping
FutureIntegrations
DataCollection/DataPublishing
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11. ● FHIR can publish AND consume data
● FHIR profiles represent internationally and industry standard data
formats
● FHIR REST API can be used to handle simple searches
● REST API with OAuth2 scopes allows controlled access to data
● REST API can be easily integrated with other platforms and
workflow
Why FHIR is a CMS Game Changer
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12. Working with FHIR
http://fhir.bbonfhir.com/fhir-p/
http://hl7-fhir.github.io
http://fhirtest.uhn.ca
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13. ● What the research community can do now
 Visit for more information:
 http://go.cms.gov/bluebutton
 Attend FHIR Code-a-thon
 Sept 15–16, Baltimore, MD (Proposed)
 http://healthca.mp/onfhir/
 Learn more about FHIR
 http://hl7-fhir.github.io
 Participate in pilot
Next Steps
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14. ● Blue Button text to JSON converter:
 https://github.com/ekivemark/python-bluebutton
● Blue Button on FHIR
 https://github.com/TransparentHealth/hhs_oauth_server
 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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15. ● Mark Scrimshire
 CMS Blue Button Innovator
 Mark.Scrimshire@cms.hhs.gov
● Karl Davis
o Entrepreneurs-in-Residence:
 Karl.Davis@cms.hhs.gov
● Lori Pettebone-Maatta
 Program Manager
 Lori.Maatta@cms.hhs.gov
● Carly Medosch
 Outreach
 Carly.Medosch@cms.hhs.gov
Contact Info
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