Data at the Point of Care
As part of the MyHealthEData initiative, the CMS announced a new pilot program called Data at the Point of Care. This initiative will deliver Medicare’s Blue Button data to clinicians to provide a more complete patient history. Clinicians will be able to access their patients’ information within their clinical workflow, which enables the delivery of high-quality care. This initiative will utilize the Blue Button FHIR APIs and requires that the data be accessed within the existing clinical workflow. Incorporating this data into the clinical workflow requires an EHR integration either through a SMART on FHIR application or through enhancements to the EHR.
This pilot will provide fee-for-service providers FHIR-formatted bulk data files of their active patients. Data is shared for treatment purposes as defined under HIPAA. A healthcare provider will assert to CMS that the provider has a treatment-related purpose for accessing patient information by submitting an attribution roster. CMS is currently piloting the implementation of the Attribution Guide, which is part of the Bulk FHIR specification.
While this pilot initiative is similar to the CMS Beneficiary Claims Data API (BCDA) program, there are some differences. The BCDA provides FHIR-formatted bulk data files to an Accountable Care Organization (ACO) only for all of the beneficiaries assigned to the ACO. The Data at the Point of Care Pilot provides FHIR-formatted bulk data files to fee-for-service providers for their active patients, regardless of the patient’s ACO affiliation.
CMS Manage Your Health is located here.
And information on CMS Blue Button 2.0 is found here.
The CMS announcement on Data at the Point of Care can be found here.
The Google Group for the Data at the Point of Care Pilot is located here.
More information on the Beneficiary Claims Data API program can be found here.
Cloud Interoperability Commitment
Microsoft, Amazon, Google, IBM, Oracle, and Salesforce reaffirmed their commitment to healthcare interoperability. These organizations are contributing and actively participating in FHIR’s standard-development, testing, and use. The open-source tools highlighted include Google’s FHIR protocol buffers and Apigee Health APIx, Microsoft’s FHIR Server for Azure, Cerner’s FHIR integration for Apache Spark, a serverless reference architecture for FHIR APIs on AWS, Salesforce/Mulesoft’s Catalyst Accelerator for Healthcare templates, and IBM’s Apache Spark service. These technology companies are supporting an API-first strategy for healthcare interoperability.
In the 2019 Medicare Call Letter, found here, CMS encouraged plans to “meet or exceed the capabilities of Medicare Blue Button 2.0”, and forewarned of future rulemaking that would make this a requirement. The CARIN Alliance organized a group of health plans, providers, and others to develop the data format needed for commercial payers to meet this obligation. This data format is called the Common Payer Consumer Data Set (CPCDS) or Payer Blue Button.
The CARIN Alliance released the CARIN Blue Button data model and draft the implementation guide, which includes more than 240 claim data elements that have been agreed upon by multiple regional and national health plans. The FHIR Resources of the CARIN Blue Button will assist health plans in meeting the requirements of the CMS Interoperability and Patient Access proposed rule. The CARIN Alliance announcement can be found here.
At the Blue Button Developer Conference, Humana’s Heather Cox announced the organizations that have committed to testing this data format in 2019 so it can move into production in 2020.
The following organizations committed to this testing coalition: