Stream: implementers
Topic: Blue Button on FHIR
Abbie Watson (Feb 11 2017 at 20:58):
Does anybody have experience with Blue Button on FHIR? Is there an example of a Blue Button document that we can download? A profile perhaps? Which FHIR Resources are included?
James Agnew (Feb 11 2017 at 20:59):
There's this: https://github.com/HHSIDEAlab/bluebutton-server
Abbie Watson (Feb 11 2017 at 21:11):
Huh. Interesting. Reading through the code, it seems like the project is mostly concerned with setting up a FHIR server for the BlueButton folks, rather than elucidating the BlueButton format for the FHIR folks. But, still... useful utility. Thank you!
Grahame Grieve (Feb 12 2017 at 10:17):
@Mark Scrimshire might comment on this
Mark Scrimshire (Feb 12 2017 at 22:13):
At CMS we are taking the FHIR ExplanationOfBenefit Resource and using it to publish a beneficiary's claims information. This includes: Part A, B and D data - Hospital, Professional and Prescription Drugs respectively.
We have worked with the FM Workgroup to define the EOB Resource.
What should also be noted is that our BlueButton Front-end ( http://www.github.com/TransparentHealth/hhs_oauth_server/ ) can be configured to expose any standard FHIR resource that is then filtered by the user identity. ie. A beneficiary will only be able to retrieve their own claims information.
Abbie Watson (Feb 13 2017 at 01:29):
So it sounds like you're only serving up ExplanationOfBenefit, Claim, and maybe ClaimResponse?
According to HealthIT.gov (https://www.healthit.gov/patients-families/blue-button/about-blue-button), the BlueButton initiative includes things such as:
- Check to make sure the information, such as your medication list, is accurate and complete
- Keep track of when your child had his/her last vaccination
But you're not serving up a FHIR Immunizatoin or FHIR MedicatoinStatement resource, correct? Just the FHIR Claim resource, referencing those resources. Or will people be able to drill-down into the other resources?
Abbie Watson (Feb 13 2017 at 01:44):
I guess what I'm trying to figure out is this....
So, like, Epic has published which FHIR resources they support at https://open.epic.com/Interface/FHIR. Cool. Based on this, I went and implemented the following schemas:
AllergyIntolerance
Binary
Condition
Coverage
DiagnosticReport
DocumentReference
FamilyMemberHistory
Immunization
Medication
MedicationOrder
MedicationStatement
Observation
Patient
Procedure
ProcedureRequest
Schedule
Slot
And Cerner has published the resources it supports at http://fhir.cerner.com/dstu2/
Cerner
AllergyIntolerance
Appointment
Binary
CarePlan
Condition
Contract
Device
DiagnosticReport
DocumentReference
Encounter
Goal
Immunization
MedicationOrder
MedicationStatement
Observation
Patient
Person
Procedure
RelatedPerson
Of these, there are only 10 resources that are supported by both Epic AND Cerner:
AllergyIntolerance
Binary
Condition
DiagnosticReport
Immunization
MedicationOrder
MedicationStatement
Observation
Patient
Procedure
Now then... what does BlueButton support? According to HealthIT.gov, it seems they at least support:
Immunization
MedicationOrder
MedicationStatement
But they also talk about "Have your medical history available in case of emergency, when traveling, seeking a second opinion, or switching health insurance companies". So, what does that mean? Conditions? Procedures? CarePlans? Diagnostic Reports?
I'd be all for getting my clients accessing CMS claims data via an OAuth connector. I just need some specifics of which resources, exactly, to expect. Or does CMS support all 100+ FHIR resources?
Abbie Watson (Feb 13 2017 at 01:45):
Sorry about the formatting of the last post. Zulip's maybe not the best medium for more complex questions or think pieces.
Lauren Wolejsza (Feb 13 2017 at 12:39):
@Gang Chen - This may help with the PDF generation. Our app is utilizing Blue Button, correct?
Mark Scrimshire (Feb 13 2017 at 14:54):
Abigail,
We have limited information that we can publish. The EOB is designed as a patient-facing document. Consequently we will primarily be publishing:
- Patient
- ExplanationOfBenefit
We are currently finalizing the data mapping and should be able to publish profiles and sample data later this year.
We are working on a synthetic dataset that we can load in to a sandbox environment for developer access for testing purposes.
- Mark
Paul Knapp (Feb 14 2017 at 18:26):
One would just provide the ExplanationOfBenefit (EOB) not the Claim or ClaimResponse as all of the relevant information is in the EOB.
Last updated: Apr 12 2022 at 19:14 UTC
