Claims (Blue Button) Synchronization with Health Cloud and Data Cloud

Prerequisites:

1. Enable access to Salesforce Healthcare Industry APIs. Refer to the guide section here
2. A connected application in the Salesforce with Client Credentials Flow enabled and following Custom OAuth Scopes. Refer to the guide section here user_bundle_write,user_condition_write,user_encounter_write,user_medicationrequest_write,user_practitioner_read,user_practitioner_write,user_procedure_write
3. A client application in the Payer system.
4. (optional) PatientSyncJob__C custom object in Salesforce to track job status, history, and watermark.Entity Name: PatientSyncJob

Data Cloud setup:

• Log in to your Salesforce DataCloud instance.
• Go to Setup and click Data Cloud Setup.
• Click on Ingestion API, and then click New.
• Name the ingestion API BlueButtonClaim.
• Click SAVE.
• Upload the schema and save it.
• Click on the app launcher, and select Data cloud.
• Click Data Streams and click NEW.
• Select the Ingestion API box and click on Next.
• Select the Ingestion API name from the dropdown (this is the source API name you created in the previous steps), and then select the object names and click Next.
• Select each object one by one:
  • For Category, select Profile.
  • For Primary Key, select id.
• After all the objects and their fields have been selected, click Next.
• On the next page, verify the details like the Data stream name and object, and then click Deploy.
• Follow this link for setting up a connected app.

Setup:

• Log in to Salesforce and navigate to the Setup page.
• Search for the ‘Integrations Setup’ page.
• Select the Patient Summary - Blue Button Integration application and click the Enable button.
• Enter the application display name, target business group, and environment for deployment, then click Next.
• Enter all necessary configurations that are prompted.
• To add any optional configuration, Click Add Additional parameters and enter the required details. Refer below table for configuration details.

• Enter the following properties if claim data ingestion has to be enabled. By default, claim data flag will be disabled and will not be inserted in data cloud.

• Click Proceed to deploy the application

Post-Deployment Steps:

Consumption of the Integration application

For consuming the blue button endpoints and consuming patient data, it is required to get consent that gives access to the patient’s clinical data that is present in the Explanation of Benefit(EOB) records returned by the Blue Button 2.0 API. The consumer needs to follow the following sequence of steps to get consent from each patient.

NOTE: https://sandbox.bluebutton.cms.gov has to be replaced with a production endpoint. i.e. https://bluebutton.cms.gov

Create a Connected App in Blue Button

1. Login to the blue button portal.
   1. https://bluebutton.cms.gov/home
2. Click on ADD AN APPLICATION Button. Enter following details
   1. Application Name : Name of your choice
   2. OAuth - Client Type: Confidential
   3. Authorization Grant Type* Authorization code
   4. Callback URLs / Redirect URIs: The callback URL, that will redirect the authorization information after patient consent is done.
   5. Does your application need to collect beneficiary demographic information: Yes
   6. Agree to the terms and conditions and save the application.
3. After completing the above step, it generates client_id/client_secret that will be used to generate the code.

Persisting the Consent
After the connected app is created from the patient portal, the patient must be redirected to the Blue Button OAuth flow to get the code. This code is a kind of OTP to generate the refresh token.
1. Make sure that in your app, the patient is redirected to the following URL:

             https://sandbox.bluebutton.cms.gov/v2/o/authorize/?response_type=code&client_id=CLIENT_ID&redirect_uri=REDIRECT_URL

1. After the patient successfully authorizes with their credentials, the patient is then redirected to the REDIRECT_URL, where code is sent as a query parameter.

            {
                "code": "IDzfq8os2EPZAYU67kfW8VkNUzmmBz",
                "state": "07MNrjGXGX6ZAjq3IL1AXcAxPSlpIU"
              }

2. Using this code, another request is sent that retrieves the refresh token, which is then saved in named credentials. This named credential reference will be saved against the patient.

            POST /v2/o/token/ HTTP/1.1
              Host: sandbox.bluebutton.cms.gov
              Content-Type: application/x-www-form-urlencoded
              client_id=<CLIENT_ID>&client_secret=<CLIENT_SECRET>&grant_type=authorization_code&code=<code>

3. The above request returns the following response upon successful authorization:

            {
                "access_token": "7PE2ocGbMCtDQpVuhNNEcic4tE8srO",
                "expires_in": 36000,
                "token_type": "Bearer",
                "scope": [
                    "patient/Coverage.read",
                    "patient/ExplanationOfBenefit.read",
                    "patient/Patient.read",
                    "profile"
                ],
                "refresh_token": "jPHU2o1cwndiYIGjEpIt7FOZu6PO2g",
                "expires_at": 1690248292.6342547
                }

   The received refresh_token can be saved in named credentials.

4. The generated refresh_token token can be used to generate the access_token and this access token can be used to trigger the Mulesoft endpoints.

             POST /v2/o/token/ HTTP/1.1
               Host: sandbox.bluebutton.cms.gov
               Content-Type: application/x-www-form-urlencoded
   
               client_id=<CLIENT_ID>&client_secret=<CLIENT_SECRET>&grant_type=refresh_token&refresh_token=<refresh_token>

5. Along with the generation of an access_token, the above request also returns the new refresh_token that must be updated in the named credentials.

Triggering Mulesoft Endpoints

• Using the generated access token, the Mulesoft endpoints can be triggered as mentioned in the API documentation.