This page is part of the CARIN Blue Button Implementation Guide (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions 
Use Case
Consumer-directed health insurance data exchange Consumer-directed exchange occurs when a consumer or an authorized caregiver invokes their HIPAA Individual Right of Access (45 CFR 164.524) and requests their digital health information from a HIPAA covered entity (CE) via an application or other third-party data steward.
Use Case: Consumer Access to their Claims Data
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Actors:
- Consumer (aka Beneficiary, Patient, or Authorized Caregiver)
- Consumer App- A digital third-party application selected by and primarily for the Consumer with a consumer-facing user interface
- Patient Portal / Identity Provider
- Health Plan API (aka Health Plan, Commercial Payer, Covered Entity)
Normal Flow:
- Consumer downloads or accesses the application of their choice
- Consumer authorizes the application to access their digital claims data (thereby invoking their Individual Right of Access under HIPAA) via the SMART on FHIR authorization flow
- Application connects to a FHIR API to download their digital claims data and requests the health plan send the data to the application
- Application displays or otherwise uses digital claims data to the benefit of the Consumer
