Need Complete FHIR StructureDefinition for C4BB Patient with CMS Blue Button Extensions

[Deepak Rajendra]

Hello BCDA Community,

I'm working on a data analysis project where I need to flatten FHIR patient/coverage/eob resources from BCDA data and load them into PostgreSQL for analysis. I'm start with patient resource but encountering an issue with the available FHIR StructureDefinition (StructureDefinition-C4BB-Patient.json) and would appreciate guidance from the BCDA team.

Current Situation:

• I have Patient data from Blue Button 2.0 that includes both standard C4BB Patient elements and CMS-specific extensions
• The base StructureDefinition-C4BB-Patient.json (from CARIN IG) doesn't include CMS Blue Button-specific extensions like:
  • https://bluebutton.cms.gov/resources/variables/race
  • https://bluebutton.cms.gov/resources/variables/rfrnc_yr
  • https://bluebutton.cms.gov/resources/variables/bene_id

Use Case:

I'm building an ETL pipeline to:

1. Parse FHIR StructureDefinitions to generate flattened database schemas
2. Create PostgreSQL tables with proper column mappings
3. Load NDJSON data into relational format for data analysis
4. Support other FHIR resources (Coverage, ExplanationOfBenefit) once I get patient data uploaded to PostgreSQL

Question:

Is there a complete FHIR StructureDefinition available that:

• Inherits from the base C4BB Patient profile
• Includes all CMS Blue Button-specific extensions and identifier systems
• Provides a full snapshot that can be used for schema generation?

If such a profile exists, could you point me to where I can access it? If not, would the BCDA team be able to provide guidance on:

• The correct approach to extend the base C4BB Patient profile with CMS extensions
• Whether there are official CMS Blue Button StructureDefinitions for the extensions
• Best practices for handling CMS-specific extensions in FHIR-based ETL pipelines

Technical Context:

I'm using Python with FHIR client libraries and need a complete StructureDefinition that includes all elements (base + extensions) so I can generate accurate database schemas that capture all the data present in the Blue Button NDJSON files.

Any guidance would be greatly appreciated!

Thank you,

Deepak

[Deepak Rajendra]

Hello BCDA Team,

Following up on this request. I appreciate your help.

Regards,

Deepak

[Beneficiary Claims Data API (BCDA) Community]

Hi Deepak,

BCDA does not currently provide a FHIR Structure Definition that includes the CMS Blue Button extensions to the C4BB Implementation Guide. You may find the the BCDA Data Dictionary helpful in creating the table schemas. The BCDA Data Dictionary includes locations of the extension definitions like the URLs you provided.

We hope this helps, please let us know if you have any questions.
The BCDA Team