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@ekivemark
BlueButton on FHIR

BlueButton Data-as-a-Service is a prototype design that will add functionality
to the curre...
@ekivemark
Disclaimer
The views expressed in this presentation are my
own personal views and should not be construed
as an...
@ekivemark
BlueButton
DirectProject
Patient Centric
QuantifiedSelf
Mark Scrimshire
Data Donation
@ekivemark
Improving beneficiaries’ access to their data
• BlueButton has enabled 1M+ Medicare Beneficiaries to
download t...
@ekivemark
BlueButton has been an essential first step
kickstarting innovation 

across healthcare
@ekivemark
“THERE IS NO SUBSTITUTE
FOR HARD WORK” … Until someone builds an App for that.
6
- Thomas Edison
Putting our he...
@ekivemark
https://leicalady.files.wordpress.com/2010/08/annie-­‐admiring-­‐paintingsmall.jpeg
7
But People don’t
want the...
@ekivemark
Our Health data 

should be 

a valuable tool

we put to good use
http://commons.wikimedia.org/wiki/File:Toolbo...
@ekivemark
OAuth-enabled data APIs 

brings operational 

and security benefits
• More robust 

web applications

(Screen	...
@ekivemark
Which style of API?
Direct-based Push
• Beneficiary Direct-Email
Address and Preference
Management
• Backend Da...
@ekivemark
<XML>BlueButton	
  
CCDA</XML>
FHIR. “Resources” are:
• Granular clinical concepts
• Managed in isolation, or
a...
@ekivemark
On the Internet “Simple” Wins
• FHIR
– Fast Healthcare Interoperability Resources
– Project Argonaut
• Open sou...
@ekivemark
Clarifying the Scope of BlueButton on FHIR
• No new data is being released
• Beneficiaries will still be in con...
@ekivemark
Experiment with a FHIR Server REST API
14
http://fhirtest.uhn.ca
@ekivemark
Follow our progress, join us and contribute
• Structured File Formats:
– ( https://github.com/ekivemark/claims ...
@ekivemark
Mark Scrimshire
HHS Entrepreneur-in-Residence
(CMS)
@ekivemark
http://ekivemark.com
mark.scrimshire@cms.hhs.gov...
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BlueButton on FHIR @HXRconf

Slides from my presentation at HxRefactored 2015 in Boston. This is an overview of the work I am doing as HHS Entrepreneur-in-Residence to Improve Beneficiaries' access to their health information at CMS (MyMedicare.gov). How we plan to use the HL7 FHIR protocol to build a data service that enables beneficiaries to connect their CMS health information to the applications and services that they trust.

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BlueButton on FHIR @HXRconf

  1. 1. @ekivemark BlueButton on FHIR
 BlueButton Data-as-a-Service is a prototype design that will add functionality to the current MyMedicare.gov BlueButton Service. Mark Scrimshire (HHS Entrepreneur-in-Residence) Gajen Sunthara (Presidential Innovation Fellow)
 Centers for Medicare and Medicaid Services Office of Enterprise Data Analytics (OEDA) April, 2015 OEDA 1
  2. 2. @ekivemark Disclaimer The views expressed in this presentation are my own personal views and should not be construed as an official position of the US Department of Health and Human Services or the Centers for Medicare and Medicaid Services. 2
  3. 3. @ekivemark BlueButton DirectProject Patient Centric QuantifiedSelf Mark Scrimshire Data Donation
  4. 4. @ekivemark Improving beneficiaries’ access to their data • BlueButton has enabled 1M+ Medicare Beneficiaries to download their health data. • BlueButton on FHIR aims to create a robust data API service enabling Beneficiaries to connect their health data with the applications and services they trust. For beneficiaries this means: • More easily using their health data for better health For CMS this means: • Directly supporting the Presidential Precision Medicine Initiative: … that ensures consumers have access to their own health data – and to the applications and services that can safely and accurately analyze it … 4
  5. 5. @ekivemark BlueButton has been an essential first step kickstarting innovation 
 across healthcare
  6. 6. @ekivemark “THERE IS NO SUBSTITUTE FOR HARD WORK” … Until someone builds an App for that. 6 - Thomas Edison Putting our health data to use is still too hard
  7. 7. @ekivemark https://leicalady.files.wordpress.com/2010/08/annie-­‐admiring-­‐paintingsmall.jpeg 7 But People don’t want their data 
 for it’s own sake…
  8. 8. @ekivemark Our Health data 
 should be 
 a valuable tool
 we put to good use http://commons.wikimedia.org/wiki/File:Toolbox_(6788494881).jpg 8
  9. 9. @ekivemark OAuth-enabled data APIs 
 brings operational 
 and security benefits • More robust 
 web applications
 (Screen  Scraping  anti-­‐pattern) • Visibility to real 
 utilization metrics
 (Who  is  using  the  data) • Avoiding users sharing 
 passwords 
 (the  password  anti-­‐pattern)
  10. 10. @ekivemark Which style of API? Direct-based Push • Beneficiary Direct-Email Address and Preference Management • Backend Data Update Triggers • SMTP+S/MIME email platform • Identify Direct-compliant HISP • Implement Accredited Trust Bundles from DirectTrust/ NATE FHIR-­‐based  Pull • Registered Application Directory • API and Developer Access Managed via api.data.gov • Use Existing Beneficiary Authentication • Web Services triggered on NGD updates • Build Beneficiary Application Access Management 10
  11. 11. @ekivemark <XML>BlueButton   CCDA</XML> FHIR. “Resources” are: • Granular clinical concepts • Managed in isolation, or aggregated into complex documents • Designed for the web • Based on simple XML or JSON structures • HTTP-based RESTful protocol with predictable URLs • Using open internet standards for data representation • Uses OAuth for authorization BLUEBUTTON 
 ON FHIR 11 OAuth 2.0: • Defeats the password anti-pattern • Creates a consistent, flexible identity and policy architecture • Suited to web applications, web services, devices and desktop clients communicating with Cloud APIs. BBonFHIR:  One  PlaXorm  –  Two  Services {“json”:”format”} <xml>format</xml>
  12. 12. @ekivemark On the Internet “Simple” Wins • FHIR – Fast Healthcare Interoperability Resources – Project Argonaut • Open source • 25 Industry Heavyweights • Public/Private partnerships • REST API – Lightweight architecture for web services • Eg.  https://bb.cms.gov/api/1.0/beneficiary/….. – Read and write options (GET / POST) • OAuth – Improving security through traceability – A popular Authorization  protocol – Familiar to users of top web sites – Provides layers of Authorization control • BlueButton Structured Data Formats – JSON – XML 12
  13. 13. @ekivemark Clarifying the Scope of BlueButton on FHIR • No new data is being released • Beneficiaries will still be in control of who they release their BlueButton data to and can revoke access at any time • Currently released BlueButton data will be reformatted to make it easier for applications to ingest and process • BBonFHIR will simplify the process of enabling beneficiaries to connect their data to the applications and services they trust • BBonFHIR and OAuth will provide a framework for fine grained control over who is accessing Beneficiary information 13
  14. 14. @ekivemark Experiment with a FHIR Server REST API 14 http://fhirtest.uhn.ca
  15. 15. @ekivemark Follow our progress, join us and contribute • Structured File Formats: – ( https://github.com/ekivemark/claims ) • BlueButton Text to JSON Converter: – ( https://github.com/ekivemark/python-bluebutton ) • Developer Code of Honor: – ( http://2.healthca.mp/1GjOUsY ) • HL7 - FHIR – ( http://www.hl7.org/implement/standards/fhir/http.html ) • Developer.HealthCa.mp – Washington DC: May 30, 2015 – http://developer.healthca.mp 15
  16. 16. @ekivemark Mark Scrimshire HHS Entrepreneur-in-Residence (CMS) @ekivemark http://ekivemark.com mark.scrimshire@cms.hhs.gov 410-786-5049 16

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