Improving Medicare Beneficiary Access to Health Information: Blue Button On FHIR
The mission of the Blue Button On FHIR project is to enhance the current Medicare Blue Button service to provide a developer-friendly, standards-based data Application Programming Interface (API) that enables beneficiaries to connect their Medicare claims data to the applications, services and research programs they trust.
Niall Brennan, Chief Data Officer, OEDA, CMS
Associate Entrepreneur Karl Davis
CMS Internal Project Team (OEDA) Christine Cox Lori Pettibone-Maata Carly Medosch
Background and Problem
The current Blue Button service was established in 2010 and since then, has been used by more than one million beneficiaries to download their CMS information via the MyMedicare.gov portal.
The current Text and PDF downloadable files, while relatively easy to read, become challenging when:
Handling large amounts of data
Converting the content into reusable data for further analysis
In the new world of digital healthcare, there is a drive to use data for better health, for the beneficiary to share information with researchers to find new cures. This is driving the need for a solution that offers easier data interoperability without requiring the beneficiary to perform all the heavy-lifting to move and re-format data.
The Proposed Solution
The enhanced Blue Button solution that has been the focus of this project has designed a Data-as-a-Service API that will enable Medicare Beneficiaries to connect applications, services and research programs they trust to their Medicare claims information.
Connecting external data consumers is only part of the challenge. The data itself needs to be in a format that can be more easily consumed. To address this need the team has embraced the HL7 Fast Health Interoperability Resource (FHIR) framework. This is an internationally accepted Application Programming Interface and associated structured data formats that enable secure and reliable data exchange.
The project team is building an interface on top of the FHIR API to enable Medicare beneficiaries to connect their individual claims information to third party applications they trust. Once connected, the third party application can pull their data without requiring further effort from the beneficiary. However, the beneficiary can come to Medicare at anytime and revoke permission. Putting the beneficiary in control of who they trust is a crucial part of the new data API design.
The successful delivery of the new Blue Button API requires progress on multiple fronts. When the project is closer to launch there will be a need for outreach to Beneficiaries. Prior to that the project has been involved in speaking engagements and work with industry bodies to raise awareness, particularly with the developer community. This is necessary to ensure that the evolving APIs and data formats will meet the needs of Blue Button and that third party applications will be ready to offer beneficiaries the ability to connect their CMS information.
Timeline and Progress
December 2014 – March 2015
Information gathering and solution ideation
Research into HL7 FHIR framework
Development of a python-based utility to convert the current downloaded Medicare Blue Button text file to a json structured format
April 2015 – July 2015
Develop high-level design for BlueButton On FHIR
Create component-level trial applications as Proof of Concept for critical elements of the overall design
Submit proposal for Patient Centered Outcome Research (PCOR) Trust Fund grant funding
Conference speaking engagements to raise awareness
Implement Proof of Concept FHIR Server and Blue Button front-end application
August 2015 – October 2015
Identify data sources and data extract processes
Finalize grant funding for deployment phase of Blue Button project
Work with HL7 FHIR Financial Management Work Group to define Explanation Of Benefit structured data profile
November 2015 – December 2015
Obtain cost estimates for back-end FHIR Server deployment and data extract services
The HHS Entrepreneurs-in-Residence (EIR) program helps HHS teams identify, recruit and onboard external talent to tackle high-priority challenges in health and human services. EIRs bring skill sets to an internal project team that are difficult to find within government, to complete a high-impact project in about a year.