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Healthcare 

Heal Thyself!
Are You Prepared for the 

Consumer-driven Revolution?
Mark Scrimshire
@ekivemark
R LES
HHS
Entrepreneur

-in-Residence
Medyear CTO &

Co-Founder
HealthCa.mp
Chief Instigator
Ski Instructor
Big Data & Cloud

Technologist
Health & Social
Data Ninja
@ekivemark
@ekivemark
Disclaimer
The views expressed in this presentation are my
own personal views and should not be construed as
an official position of the US Department of Health
and Human Services or the Centers for Medicare
and Medicaid Services.
3
HealthCare is complicated
... because the

patient is
usually excluded
@ekivemark
YOU
One Common Factor…
Consumerism
Technology Data Policy
Regulatory
Economic
Five Transformational Changes in Health
@ekivemark
A Tipping Point is
coming…
Consumer Industry
Retail
PHR
Devices
Genome
EHR
@ekivemark
will be
the hubY U
@ekivemark
“The new health care infrastructure must be
built on independent and autonomous
patients, not on systems that surround and
subordinate patients.
Once it is, the systems will be vastly
improved, and far more profitable for all.”
Doc Searls - Cluetrain Manifesto
@ekivemark
@ekivemark
Consumers
are still kept in the dark
Joachim @ daysoff.wordpress.com
@ekivemark
http://healthca.mp
$
A decision without
Information…
@ekivemark
"Patient Engagement
is the
Blockbuster Drug
of the Century"
@LeonardKish
@ekivemark
A tough economy
drove rapid adoption
of High Deductible
Health Plans
Consumer-Directed
81%
72%
2014
2015
@ekivemark
17.4%
Health Affairs Magazine
HealthCare percentage of GDP in 2013
$2.9T
@ekivemark
CBO.gov
Medicare shifts to
Value-based Pay
$585B@ekivemark
Sensors are
becoming
commodities @ekivemark
Observations of
Daily Living
ODL
http://healthca.mp
@ekivemark
@ekivemarkhttp://healthca.mp
Blue Button
Unleashes Personal Data
http://healthca.mp
2010
@ekivemark
…but it left the patient doing the heavy lifting
An Essential First Step
@ekivemark
@ekivemark
https://leicalady.files.wordpress.com/2010/08/annie-­‐admiring-­‐paintingsmall.jpeg
People don’t want
their data 

for it’s own sake…
@ekivemark
Our Health data 

should be 

a valuable tool

we put to good use
http://commons.wikimedia.org/wiki/File:Toolbox_(6788494881).jpg
@ekivemark
JSON and the Argonauts: 

A New Approach
FHIR
Fast Healthcare Interoperability Resources
Project Argonaut
• Open source
• Industry Heavyweight adoption
• Public/Private partnership
REST API
Lightweight web services
Read AND write
OAuth
Traceability
Popular Authorization protocol
Familiar to users
Layered Authorization
BlueButton Structured Data:
JSON
XML @ekivemark
Innovators are already creating
Personal Health Hubs
and a SMART api ecosystem…
@ekivemark
<XML>BlueButton	
  
CCDA</XML>
FHIR. “Resources” are:
• Granular concepts
• Managed in isolation, or
aggregated into complex
documents
• Designed for the web
• Simple XML or JSON
structures
• HTTPS-based RESTful
protocol
• Predictable URLs
• Using open internet
standards for data
representation
• Authorization via OAuth
BBonFHIR: One Platform – Two Services
OAuth 2.0:
• Defeats the
password anti-
pattern
• Creates a
consistent, flexible
identity and policy
architecture
• Suited to web
applications, web
services, devices
and desktop clients
communicating with
Cloud APIs.
{“json”:”format”}
<xml>format</xml>
BLUEBUTTON 

ON FHIR
@ekivemark
Follow our progress, join us and contribute
• Structured File Formats:
• ( https://github.com/ekivemark/claims )
• BlueButton Text to JSON Converter:
• ( https://github.com/ekivemark/python-bluebutton )
• Developer Code of Honor:
• ( http://2.healthca.mp/1GjOUsY )
• HL7 - FHIR
• ( http://www.hl7.org/implement/standards/fhir/http.html )
• Developer.HealthCa.mp
• Washington DC: May 30, 2015
• http://healthca.mp/dev
@ekivemark
There are big opportunities
54,000,000Medicare Beneficiaries (2014 est.)
@ekivemark
Are you ready for the
Personal Health Hub?
Y U
@ekivemark
Big Data, Little Data and Data Flows all
represent Opportunities in the new paradigm
@ekivemark
@ekivemark
Mark Scrimshire
HHS Entrepreneur-in-Residence
(CMS)
@ekivemark
http://ekivemark.com
mark.scrimshire@cms.hhs.gov
703.623.2789
Find out more about

#BlueButton on FHIR}{ @

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