Project Summary

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.

Project Team

Internal Entrepreneur
Niall Brennan, Chief Data Officer, OEDA, CMS

External Entrepreneur
Mark Scrimshire

Associate Entrepreneur
Karl Davis

CMS Internal Project Team (OEDA)
Christine Cox
Lori Pettibone-Maata
Carly Medosch

Project Details

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 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
  • Develop Pre-Oauth Entity Trust (POET) API for Developer validation and present to Health Industry Trust Administration bodies
  • Define integration touch points with existing web site and current Blue Button service
  • Plan Health Data Palooza events including a FHIR Code-a-thon (April 1-2), Un-Conference and Panel Sessions to showcase Blue Button On FHIR

January 2016 – March 2016

  • Build Blue Button On FHIR Prototype Service and import synthetic data
  • Test FHIR Explanation Of Benefit Profile at HL7 FHIR Connect-a-thon
  • HIMSS speaking engagement to showcase Blue Button On FHIR
  • Prepare prototype Blue Button On FHIR API for Health Data Palooza FHIR Code-a-thon

April 2016 – June 2016

  • Run FHIR Code-a-thon and present Blue Button On FHIR at Health Data Palooza
  • Build Test and Production FHIR platform
  • Test Pre-OATH Entity Trust API with Health Industry Trust Administrators

July 2016 – September 2016

  • Test Blue Button On FHIR integration to

October 2016 – December 2016

  • Beneficiary outreach
  • Prepare for pilot launch of Blue Button On FHIR Service.

Additional Information and Resources


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.