HHS IHS Health IT Modernization of Electronic Health Records focuses on patient needs

by Mitchell Thornbrugh, Acting Chief Information Officer

Tribal Self-Governance Advisory Committee open forum questions and answers session

Last fall, the Indian Health Service Office of Information Technology and
the Department of Health and Human Services
Office of the Chief Technology officer
, launched a Health Information Technology Modernization Research Project.
Since it began, the project delivery team has gained valuable insight into
the current Resource and Patient Management System electronic health record
system.

The IHS currently uses RPMS to manage clinical, financial, and
administrative information in the Indian health system. The system was
developed in close partnership with the Veterans Health Administration and
has been somewhat dependent on the development of the VA health IT system,
known as VistA. When the
VA announced a decision to replace VistA
, IHS accelerated efforts to re-evaluate its health IT system.

The goal of the project is to identify and understand the perspectives and
challenges to help inform and provide alternatives for achieving
modernization of health information technologies related to electronic
health records. The project team is comprised of subject matter experts
informed by tribal leadership. We are evaluating the RPMS EHR system
through multiple approaches, including quantitative, qualitative, and
literature review methods. This work is designed to identify and evaluate
health IT solutions in order to provide guidance on alternatives and next
steps in the modernization initiative.

Preliminary findings demonstrate that the IHS health IT system involves a
complex ecosystem of human interactions, workflows, and systems of practice
in a clinical environment unique to the 400 sites that constitute the
Indian health system. IHS personnel have a high interest in team-based
care, as well as a commitment to community-oriented primary care and the
patient-centered medical home
. IHS patients require access to their health information, the ability to
share these records with their providers, and the tools to understand how
this information can be used enable patients and their families to
participate in their own healthcare.

PROJECT ACCOMPLISHMENTS & HIGHLIGHTS

****

The IHS is committed to seeking input from tribes, tribal organizations,
and urban Indian organizations as decisions are made about implementation
of the health IT modernization strategy. The IHS will continue to keep
consultation and confer openly on this topic to receive input throughout
the various stages of the project.

Since October 2018 the project team has:

completed 15 site visits across the Indian health system;

participated in numerous conferences and meetings across Indian Country;

participated in one-on-one interviews and listening sessions with tribal
communities;

conducted the pilot for Healthcare Information and Management Systems
Society, Electronic Medical Record Adoption Model and Outpatient Electronic
Medical Record Adoption Model assessments at seven IHS sites;

established a technical advisory committee with several key participants
from academia, government, and healthcare industry, and

established a legacy assessment team fully engaged, actively
understanding RPMS architecture, including a platform walk-through

IHS and HHS staff kick-off the Health Information Technology modernization research project.

WHAT TO LOOK FOR NEXT

From the start, the IHS Health IT Modernization Project has focused on the
needs of IHS patients and caregivers. At this time, multiple working groups
are collaborating their research into a final assessment. An assessment of
alternatives will then directly evaluate different modernization strategies
and approaches. Subsequently, a multi-stakeholder technical advisory
committee will make final recommendations to inform key decision makers. A
community of practices group is currently working to identify and align
existing IHS health IT efforts to establish a model for personal and
professional career development in IHS health IT.

As we look towards the development of a next-level health information
system, the focus is on the development of clinical systems that reduce the
fragmentation patients experience in their health care. Advanced software
with thoughtful user interfaces and automation can reduce clinician
administrative burden, highlight “the patient’s story,” and provide
clinical decision support that helps inform, instruct, and educate health
workers on the latest guidelines and treatments.

Ultimately, American Indian and Alaska Native communities deserve the
finest health information technology system available to improve their
quality of health care, be informed about current medical trends, and to
embrace best practices.

The IHS Health IT Modernization Project has the opportunity to make
medicine more human, more patient-centered, and more community-focused. We
are embracing that opportunity!

Related content:

IHS updates Congress on progress in improving services and strengthening systems based on GAO recommendations

IHS and HHS Launch a Health Information Technology Modernization Research Project

IHS looking towards future for Health IT

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