Improving Beneficiary Access to their Health Information through an Enhanced Blue Button Service

Implementing the re-design of the CMS Blue Button to Increase Data Access and Empower Beneficiaries.
Agency
  • Centers for Medicare and Medicaid Services (CMS)
Start Date
  • 4/30/2016
Functionality
  • Use of Enhanced Publically-Funded Data Systems for Research

 

 

STATUS: Completed Project 

BACKGROUND

The current CMS Blue Button service was established in 2010 as a joint effort of CMS and the Veterans Administration and allows CMS beneficiaries to download their CMS information via MyMedicare.gov. CMS took part in a conceptual re‑design of Blue Button to be a “data‑as‑a‑service” platform. To accomplish this re‑design, CMS utilized the new Health Level Seven (HL7) Fast Healthcare Interoperability Resources (FHIR) standard.

PROJECT PURPOSE & GOALS

Utilizing the FHIR framework to ensure data is in a structured format that can be accepted by a wide range of applications; the Blue Button on FHIR (BBonFHIR) interface put Medicare beneficiaries in control of connecting their data to third‑party applications and services they trust. In this model, beneficiaries are empowered to select participation in research based on their preferences (e.g., enrolling in a genetic cancer research study because of a familial history of cancer). This dramatically simplified the acquisition of beneficiary claims data to support beneficiary participation in clinical research studies. The BBonFHIR Service API allowed researchers to selectively pull beneficiaries’ Medicare part A, B, and D claims data specific for specific research needs.

Project Objectives:

  • Develop the BBonFHIR service and publish the code on open source software.

  • Pilot the BBonFHIR service.

  • Publish a technical paper on CMS Blue Button Structure Data.

  • Launch full production of the BBonFHIR service.

  • Promote the availability of BBonFHIR to external sources.

PROJECT ACHIEVEMENTS & HIGHLIGHTS

  • The Blue Button API, Blue Button 2.0, launched and open source code was published to the Blue Button Repositories on GitHub. A working prototype of the service was implemented in August 2016. Since April 2016, a prototype API with dummy data has been available. This data was replaced in December 2017 with de-identified synthetic data that represents 30,000 beneficiaries with realistic claims information. A pilot Code-a-thon was hosted in April 2016, and a report was delivered to ASPE in August 2016 for public posting. The team also participated in HL7 FHIR Connectathons in 2016 and 2017. 

  • A CMS Blue Button API developer sandbox environment was created using the front-end development system and backend sandbox server in the HHS IDEALab cloud. This developer preview was announced to developers at the HL7 Connect-a-thon as part of a consumer mediated exchange track at the event. As of April 2018, 240 organizations had joined the Developer Sandbox.

  • The CMS Administrator announced the launch of Blue Button 2.0 during a keynote presentation at the March 2018 Healthcare Information and Management Systems Society (HIMSS) conference in March 2018. Organizations are now able to request access to the production API, which will allow Medicare beneficiaries to connect their claims data to the health applications they choose to trust.

PUBLICATIONS, PRESENTATIONS, AND OTHER PUBLICALLY AVAILABLE RESOURCES

Resources:

  • The CMS Blue Button API developer environment is open to all interested parties and can be accessed via the CMS webpage at https://bluebutton.cms.gov.

  • Open source codes published to the Blue Button repositories are available on GitHub (codes are updated on a continuous basis): https://github.com/CMSgov.

Presentations:

  • The project team presented “The Power of Consumer-Directed Data” at Health Datapalooza in Washington, D.C. in April 2017.

RELATED PROJECTS

Below is a list of ASPE-funded PCORTF projects that are related to this project

Improving Beneficiary Access to Health Information: A Plan to Enhance “Blue Button” – “Blue Button” is a service that allows patients to access their own health information in electronic form. The Centers for Medicare and Medicaid Services (CMS) established a Blue Button platform in 2010 to give Medicare beneficiaries access to their own health information: however, this initial service had limited functionality and scalability, making it difficult for beneficiaries to use and share their health information. This project aimed to engage a range of stakeholders to define functional requirements for Blue Button as well as develop a plan to improve Blue Button, including an implementation strategy and roadmap for a ‘Data-as-a-Service’ Platform.

Technologies for Donating Medicare Beneficiary Claims Data to Research Studies – This project aimed to provide a safe and secure mechanism for Medicare beneficiaries to donate least three years of their individual Medicare claims data to scientific research studies. This project allowed researchers to collect longitudinal patient information from Medicare and to link data sets with other relevant information for NIH-led research. In addition, this project leveraged current investments in federal data infrastructure to inform future infrastructure development—combining advances in Blue Button on FHIR (Blue Button 2.0) and S4S to enhance data collection by the All of Us initiative.