CMS BlueButton On FHIR for Researchers - Presentation to NIH and PCORI Researchers
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Transcript of CMS BlueButton On FHIR for Researchers - Presentation to NIH and PCORI Researchers
Donate My Data:What Blue Button on FHIR
Can Do for Research
Mark ScrimshireCMS, Office of Enterprise Data & AnalyticsJanuary 2016
● 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
A Brief History of Blue Button
3
Blue Button Unleashes Personal Data
1.2MMedicare
Users
Blue Button in Use
1.2M CMS users
20–30kDownloads/Month
Private sector applications already ingest, optimize, and visualize data from Blue Button text files
• Hospital• Physician• Prescription drugs
Federally InspiredBlueButton Community• VA• DoD (TRICARE)• CMS
2x textdownloads
Beneficiaries can download up to 3 years of claims data
4
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, services and research programs they trust”
Blue Button on FHIR Vision
6
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,
workflow, conformance, and financial.CMS Blue Button uses a limited subset of
these profiles based on the data we publish
8
Explanation of Benefits
Consent*Patient
*Recorded in FHIR ContractResource
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
Under Construction
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
● 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
● 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
● 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: 2333444555200Provider: No Information AvailableProvider Billing Address: Service Start Date: 01/05/2014Service End Date: 01/05/2014Amount Charged: * Not Available *Medicare Approved: * Not Available *Provider Paid: * Not Available *You May be Billed: * Not Available *Claim Type: PartBDiagnosis Code 1: 2163--------------------------------Claim Lines for Claim Number: 2333444555200--------------------------------Line number: 1Date of Service From: 01/05/2014Date of Service To: 01/05/2014Procedure Code/Description: 99213 - Established Patient Office Or Other Outpatient Visit, Typically 15 MinutesModifier 1/Description: Modifier 2/Description: Modifier 3/Description: Modifier 4/Description: Quantity Billed/Units: 1Submitted Amount/Charges: * Not Available *Allowed Amount: * Not Available *Non-Covered: * Not Available *Place of Service/Description: 22 - Outpatient HospitalType of Service/Description: 1 - Medical CareRendering Provider No: PARTBPROVRendering Provider NPI:
Current Blue Button Claims
Information Layout
● What the research community can do now Subscribe for updates – contact [email protected]
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
● 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
● Mark Scrimshire Entrepreneurs-in-Residence:
● Carly Medosch Outreach
Contact Info