Indian Health Service Case Study

Background

The Indian Health Service (IHS) is an agency within the Department of Health and Human Services with responsibility for providing health services to American Indian and Alaska Native (AI/AN) people. The IHS manages over 100 healthcare facilities nationwide, including 24 hospitals, while self-governance tribes and urban Indian organizations operate another 22 hospitals and over 400 outpatient clinics. Most locations are integrated care settings, where multiple disciplines – medical, behavioral health, optometry, dental, others – provide care under one roof.

IHS and many tribal/urban facilities utilize an internally developed health information technology suite called the Resource and Patient Management System (RPMS) that includes a certified electronic health record (EHR) and more than 80 other applications supporting processes from patient registration through the billing cycle. RPMS had its origins over 40 years ago and is a distributed solution, with hundreds of independent databases installed at sites across the country. It is also highly configurable to adapt to local preferences. This means that organizations have had decades to evolve disparate workflows within just about every business process. Evident when introducing new capabilities, in collecting and aggregating data, and on-site review and assessment, these differences have been identified in findings from both Joint Commission reviews and CMS surveys, and are key considerations as the agency seeks to modernize its process and IT portfolio.