Bluebutton on FHIR from 35,000 feet
NATE/HIE Conference: Deer Valley, UT
This week has been a crazy travel week. I have been across the country talking BlueButton on FHIR at different events. The first leg was a trip to Deer Valley Utah to the National Association for Trusted Exchange (NATE) and Health Information Exchange User Group (HIE HUG) Conference.
At the conference there were some great discussions about what I will call “Traceability” for health record information. The question is how best to capture information about where health information came from and whether it was altered along the way. This will become increasingly important as Patients become more involved with their Health Information. They are set to become both creators (from wearable devices) and aggregators (assimilating information from their journey across the health care system). Traceability gives the recipients the ability to apply a level of confidence to the information they receive.
As Health Care evolves the Fast Health Interoperability Resource (FHIR) framework we need to consider how this traceability AND an individual’s privacy and sharing preferences are passed with different data profiles and in the structured document formats (CCDA) that flow across Health information Exchanges and other networks in health care.
Later in the Conference I presented two workshops that built on my “Baptism of FHIR” presentation. One workshop was an overview of FHIR and how we are looking at FHIR as part of the next generation of BlueButton for Medicare beneficiaries. Rather than build yet another API we are looking to leverage FHIR as a standard format and transport. The second workshop, presented with Aaron Seib, from NATE, looked at a proposed use case for a “Virtual Clipboard” and how this could be mapped to FHIR profiles to allow patient information to be gathered and communicated as part of any appointment setup where coverage and eligibility needs to be checked. This is an area of great interest to a number of Payer organizations.
You can see the deck from workshop on Slideshare here: http://2.healthca.mp/1PWF05x
ONC Consumer Summit: Washington, DC
I left the NATE/HIE Conference on Wednesday to take a late flight to get back to Washington DC for the ONC Consumer Summit. There I was privileged to share the stage with some of my predecessors who have worked inside the Federal Government on BlueButton. Claudia Williams, from the White House, chaired the panel with Erin Siminerio, from the ONC and prior Presidential Innovation Fellow Ryan Panchadsaram and Gajen Sunthara. It was a chance to reflect back on the great things that have been achieved in the past five years with BlueButton and to gaze forward at what the future looks like for BlueButton as it moves in to the world of Health APIs.
After Thursday’s ONC Summit I met with folks who are interested in the President’s Precision Medicine Initiative which has patient consent and privacy preferences front and center. This was followed with additional meetings to talk about Privacy Preferences. It seems that the stars are aligning to make some real progress in this area. This will ultimately help consumers gain better control over their health data and how it is shared.
HL7 FHIR Connectathon: Atlanta, GA
Friday meant a trip to Atlanta to join in Saturday’s HL7 FHIR Connectathon. The event was a packed house with over 100 participants. It was great to meet Grahame Grieve, the father of FHIR, James Agnew, the prime mover behind the java-based HAPI Server and Josh Mandel, the chief architect behind Project Argonaut and FHIR-based S/MART Apps. These guys are brilliant. Just a few minutes with them can be incredibly enlightening. One of the things that was impressive in the few short hours i was able to spend at the Connectathon is the diversity of people and organizations involved in FHIR. This is truly an international movement. Even within the USA FHIR is gathering not just interest, but action, from organizations across the health care spectrum. Payers were strongly represented, as well as EMR vendors, Health Information Exchanges and developers from organizations that support these sectors. Experimentation is going on but the core of FHIR is being developed rapidly for real world adoption.
FHIR is not perfect but it has a real ability to help address some of the challenges with the current practice of shipping large structured documents between entities. FHIR can be more granular, can be pulled on demand and can help to support privacy because less information needs to be disclosed than a comparable CCDA document.
Health 2.0 – Developer Challenge: San Francisco, CA
My short time at the Connectathon was packed with networking with people who are interested in the BlueButton on FHIR work being carried out at CMS. It would have been great to stay longer but I am writing this blog post from a plane at 35,000 feet heading to Santa Clara, CA to get to day 2 of the Health 2.0 Hackathon and then joining the Health 2.0 Conference until Wednesday.
At the Health 2.0 Hackathon, aka the Developer Challenge there is a track that is looking at FHIR resources. This is an opportunity to bring FHIR to the wider health care developer and entrepreneurial community. I am looking forward to working with friends and colleagues to continue fleshing out the BlueButton on FHIR prototype I have been working on. The code for the protoype BlueButton API front-end is available on github here: http://2.healthca.mp/1PWEYLc
The backend HAPI Server, built in Java, is also available on Github here: http://2.healthca.mp/1FUeBBA
This is a version that uses a back-end PostgreSQL Server to store the FHIR data.
Health 2.0 Fall Conference: Santa Clara, CA
I am also looking forward to connecting with people during Health 2.0. There has already been a request from a European country to learn more about the BlueButton API we are developing. They see it as useful for distributing health information to citizens.
All in all this has been (and continues to be) a crazy two weeks of travel but it has been incredibly worthwhile meeting so many thought leaders who are pushing to improve the state of Health Care for consumers and patients everywhere.
More to come: Watch out for a blizzard of blog posts
I will also give you this warning. When I am at conferences I often produce real time notes from sessions, warts and all 
and publish these to this blog. So watch out for a series of posts appearing from the Health 2.0 Conference over the course of the next week.
[category News, Health]
[tag health cloud, bluebutton]
Mark Scrimshire
IT and Health Data Ninja
Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://2.healthca.mp/1b61Q7M
email: mark@ekivemark.com
Stay up-to-date: Twitter @ekivemark
Disclosure:
I am currently HHS Entrepreneur-in-Residence working at CMS on an assignment to update BlueButton for Medicare Beneficiaries. This involves creating a Data API. Watch out for more about BlueButton on FHIR.
The views expressed on this blog are my own.
I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.
Medyear: Less Hassle, Better Care.
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