Improving Medicare Beneficiary Access to Health Information: Blue Button On FHIR

Enabling beneficiaries to connect their claims data with the applications, services and programs they trust.

Executive Summary

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; and 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 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.

A project supported by the: HHS Entrepreneur-in-Residence Program

Team Members

Mark Scrimshire
Karl Davis

Internal Team
Niall Brennan
Christine Cox
Lori Pettibone-Maata
Carly Medosch


September 2014: Entrepreneur-in-Residence Project begins

Project Sponsor

Niall Brennan, Chief Data Officer, Office of Enterprise Data and Analytics, Centers for Medicare and Medicaid Services

Additional Information