Tech giants, insurers, health stakeholders to test drive new claims data initiative

CARIN, a nonprofit dedicated to consumer-directed exchange of health information, has unveiled its Blue Button HL7 FHIR API model and draft guidance implementation guides.
By Laura Lovett
11:56 am

Twenty stakeholders including health and technology giants such as, Apple, Google, Anthem, Microsoft and Humana have announced their plans to test drive a new health record interoperability initiative, which specifically helps connect claims data. 

CARIN, a nonprofit dedicated to consumer-directed exchange of health information, has unveiled its Blue Button HL7 FHIR API model and draft implementation guides — the private sector’s answer to CMS’ Blue Button 2.0, a program aiming to help beneficiaries get digital access to their claims data. 

CARIN released its implementation draft yesterday at the White House Blue Button Developer Conference. The guidance spells out 240 different claims elements that will be mapped onto HL7 FHIR.

“We envision a future where any consumer can choose any application to retrieve both their complete health record and their complete coverage information from any provider or health plan in the country,” the organization wrote in the new draft guidance. “Specifically, we are promoting the ability for consumers and their authorized caregivers to gain digital access to their health information via non-proprietary application programming interfaces or APIs.”

The guidance also spelled out some of the reasoning behind the initiatives. 

“Allowing third-party applications to access payer data can directly impact the triple aim of health care to provide the right service to the right member at the right time," it reads. "Members will undoubtedly engage at higher rates because they self-select the applications they find most appropriate to their unique circumstance. In addition, consumer data exchange is bi-directional. A consumer right to access their health data can include an opt-in provision allowing sharing of their historical health information with their health plan.”

While this draft implementation guide serves as a starting point, the ultimate goal is to move the API into production in 2020. 


Health record interoperability has been a hot topic in the healthcare space for nearly a decade

In 2009, President Barack Obama kicked off a program to incentivize providers that went to electronic records. While the adoption rate of EHRs by American providers skyrocketed during this time period — from only 9% of hospitals having the systems to 80% in 2013 — in the rush to create these systems, hospitals went to different EHR vendors, and those vendors didn't take the time to come to a consensus about storing and sharing data in standardized ways.

Now some are looking at claims data as an alternative avenue for helping both patients and clinicians link up medical histories. 


This interest from the private sector has been a long time coming. At last year’s Blue Button 2.0 Developer Conference, a similar coalition of technology giants took the stage in an unscheduled session. This included Amazon, Google, IBM, Microsoft, Oracle and Salesforce, all of whom pledged to remove interoperability barriers. 


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