Short Description

Real-world testing of the CARIN Consumer Directed Payer Data Exchange (CARIN IG For Blue Button®), which provides a set of resources that payers can display to consumers via a FHIR API, including Oral and Vision Profiles.


Long Description

The CARIN Alliance is an HL7 FHIR Accelerator program which brings implementers together to advance the use of HL7 FHIR standards in health care. The CARIN Alliance Health Plan Workgroup was organized to develop a FHIR-based API that could be sent to a consumer-facing application and was designed to answer the challenge for health plans to ‘meet or exceed’ the CMS Medicare Blue Button 2.0 capabilities. The CMS Medicare Blue Button 2.0 project provides over 53 million Medicare fee-for-service beneficiaries access to their electronic claims information.

The CARIN Consumer Directed Payer Data Exchange Implementation Guide (CARIN IG For Blue Button®)  was balloted in January for STU2 and comments are currently being addressed and resolved. Updates to the IG are being made to the continuous build once voted on and approved by the HL7 Financial Management Work Group.


The objectives of this track are: 

  • Test and gather feedback on the Draft Implementation Guide V2.0
  • Test the Oral and Vision Profiles
  • Utilize the Aegis Touchstone Testscripts to identify gaps or errors

Evolution of Patient Access to Claims Data Related to the CARIN IG for Blue Button®


Blue Button 2.0 API

  • The Blue Button 2.0 API is a FHIR R4, developer-friendly, standards-based API that enables Medicare 
    beneficiaries to connect their claims data to applications, services and research programs they trust.
  • The API offers the following FHIR resources on a beneficiary-by-beneficiary basis:
    • Explanation of Benefit
    • Patient
    • Coverage
  • To access their data, beneficiaries must download a 3rd party application, then authorize the app to 
    retrive their data. Beneficiaries can revoke access at any time via Medicare.gov or by contacting the 
    3rd party application.
  • The Blue Button 2.0 API conforms to the CARIN Blue Button IG STU1 (See below)
  • The team that develops the API and manages production app access is a part of the Data Analytics 
    and Strategy Group (DASG) under the Office of Enterprise Data and Analytics (OEDA) at CMS. 

If you would like to learn more about the Blue Button 2.0 API - a publicly available FHIR R4 API that provides coverage and claims data for Medicare beneficiaries. Please visit the track page here: CMS 2022 - 07 Blue Button 2.0 API Introduction and Workshop


Type

Test an Implementation Guide


Track Lead(s)

Amol Vyas

Mark Roberts


Track Lead Email(s)

amol.vyas@cambiahealth.com;  mark.roberts@leavittpartners.com


Specification Information

 CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®) (PSS, STU1, Draft STU2)


Call for participants

Payers and consumer-facing apps


Zulip stream

 https://chat.fhir.org/#narrow/stream/204607-CARIN-IG.20for.20Blue.20Button.C2.AE/topic/Connectathon.20Ongoing


Track Implementers Connection Call


Scheduled Testers Call

A recording of the call can be found here:

Thank you for joining today’s call. If you were not able to join a recording of the session can be found here: https://leavittpartners.zoom.us/rec/share/sMu2tp-u6-IuI9TZ7wTrFp3Ek0IA9X2dBfftTfQ7WqsTlWiNt4fPIwC3a5tTkb1D.ZhXck1spShNRfUN1   Passcode: PrUJ#0Y&

Please see below a list of all of the servers and clients, their contact information, and sandbox portal information. If you name or organization is not listed here, please let me know and I will add it to the list.

Server

CVS Health

Janice Hsieh HsiehJ@cvshealth.com

Developer Portal: https://developerportal.aetna.com/gettingstarted

CNSI

Ajay Tipnis Ajay.tipnis@cns-inc.com

Developer Portal: https://sandbox.mhbapp.com/ 

Please contact Ajay at ajay.tipnis@cns-inc.com to request the OAuth2 client-id/secret.

1upHealth

Doug Williams payer-patient-access@1up.health 

Developer Portal: https://1up.health/docs/start/cms-patient-access-rule-for-developers/getting-started-with-cms-r4-apis

InteropX

Ankita Srivastava ankita.srivastava@xyramsoft.com

Developer Portal: https://demo.interopx.com/ix-auth-server/#/home

Onyx Health

Eric Lui Eric.lui@onyxhealth.io

Developer Portal: https://developer.safhir.io/

Accenture - Craig McClendon craig.mcclendon@accenture.com 

Developer Portal: Available soon!

CMS Sandbox https://bluebutton.cms.gov/

Client                                                                                                                                                                              

1upHealth - Doug Williams payer-patient-access@1up.health 

Humetrix - Ron Jawanda rjawanda@humetrix.com

Hike Health - Rakesh Mathew rakesh@hike.health

AaNeel - Nishant Thakkar nishant.thakkar@aaneel.com

Brandon Raab - brandon.raab@northhighland.com

Ryan Weihler - rweihler@gmail.com

Health Data Clarity - Eric Lui Eric.lui@onyxhealth.io


Testing Scenario:

In advance of the Connectathon we would ask participants to attend the Implementers Connection Calls and have signed up for the track ahead of the deadline. It is critical to attend the calls and sign up by the deadline as we will be matching Clients and Servers to ensure that everyone has someone to test the below Scenario.

We also ask that in advance of the testing session all participants onboard with the free Aegis Touchstone Testscripts. The below Powerpoint will guide you through the onboarding process. If you run into any issues, please reach out directly to Aegis at Touchstone_Support@AEGIS.net

These Testscripts are critical to ensuring that all participants are following a similar pattern when implementing the CARIN IG for Blue Button.



Scenario: Sandbox user retrieves EOBs from the Sandbox server using the Client

  • Action: Sandbox user receives the access and refresh tokens from the Sandbox server and calls the EOB endpoint
  • Precondition: Sandbox user is logged into the Client
  • Success Criteria #1: The server returns resources that are compliant with CARIN BB Profiles, including Vision and Oral EoBs
  • Success Criteria #2: Server is compliant with SMART App Launch [Stand alone mode] framework
  • Success Criteria #3: Registered and run Aegis TestsScript
  • Bonus point #1: On expiration of the access token, the app uses the refresh token to get new access and refresh tokens
  • Bonus point #2: The Server exposes search criteria (link) for selecting the EOBs and the client uses search parameters to select and retrieve the EOBs.
  • Bonus point #3: For a Server supporting _include, the resource instance included in the search response should match the instance from a separate read/vread on that resource's reference.

TestScript(s): Aegis Touchstone


July 20th (All Times ET)

Time

Session

Session Type

Background

Speakers

10:00 AM

CARIN IG for Blue Button®

Scenario / Tooling Review

In this session we will review the CARIN IG for Blue Button updates made in the STU2 update and review the Aegis Touchstone Test Scripts available to guide your implementation of the Blue Button IG. This introduction will prepare you to understand what you will see in the testing sessions following it.

Mark Roberts, Amol Vyas, Corey Spears, Pat Taylor,
Ryan Moehrke

10:30 -11:30 AM

CARIN IG for Blue Button®

Testing Report Out

Implementers will demonstrate their products which are using the CARIN Consumer Directed Payer Data Exchange IG leveraging the Touchstone Test Scripts to show conformance to the specification. Hear in real time what challenges they face.

Mark Roberts and Implementers

11:30AM

CARIN IG for Blue Button®

Office Hours

Ask the CARIN experts about any questions you have.

Mark Roberts and Amol Vyas

12:00 PM

Lunch





Report Out