President’s budget has $25M to fund new Indian Health Service EHR

If the Trump administration has its way, more than 2 million American Indians and Alaska Natives could benefit from a new electronic health record system.

The President’s Fiscal Year 2020 budget request for the Indian Health Service, an agency in the Department of Health and Human Services, includes an initial $25 million EHR investment.

“In FY 2020, the budget invests $25 million to begin transition to a new and modernized electronic health record system,” according to HHS. “This funding will lay the groundwork to improve the quality of care, reduce the cost of care, promote interoperability, simplify IT service management, increase the security of patient data, enhance cybersecurity and update infrastructure across rural locations to enable a successful electronic health record transformation.”

However, Rear Adm. Michael Weahkee, IHS principal deputy director, testified last month before the Senate Committee on Indian Affairs that the agency is not yet certain what form the modernization of its EHR system will take.

“In collaboration with the HHS Office of the Chief Technology Officer, we are completing a Health Information Technology Modernization Research Project to inform IHS regarding options to replace or modernize our existing HIT infrastructure,” Weahkee told lawmakers.

Signage displaying Indian Health Service

Currently, IHS leverages the Resource and Patient Management System (RPMS), which was developed in close partnership with the Department of Veterans Affairs, to manage its clinical, financial and administrative information.

“The model for the RPMS EHR is the Veterans Health Administration (VHA) electronic medical record,” according to IHS. “The EHR utilizes a technical infrastructure originally developed for the VHA that displays various clinical functions in a graphical user interface (GUI) format. A private corporation, Medsphere Systems, under contract to IHS, owns the framework technology for RPMS EHR, called VueCentric.”

The problem is that RPMS is dependent on the VA’s legacy EHR, the Veterans Health Information Systems and Technology Architecture (VistA), which is being replaced by the agency with a new Cerner Millennium system. Although the VA EHR modernization effort will take a decade to complete, IHS says it has accelerated efforts to re-evaluate its health IT needs and options in light of VistA’s replacement.

Also See: Lawmakers voice concerns about VA’s plans for Cerner EHR

The agency’s Health Information Technology Modernization Research Project, which is being conducted under a contract funded by HHS and awarded to Emerging Sun, with subcontractors Pistis and the Regenstrief Institute, will seek to address—among other issues—how RPMS can transition from its current dependence on VistA.

In February, IHS—the only HHS agency whose primary function is direct healthcare delivery—released its Strategic Plan FY 2019-2023, which includes as an objective to modernize HIT systems to support data driven decisions.

Among the agency’s strategies in support of this objective is to evaluate its EHR needs and the ability to “create seamless data linkages” as well as “align with universal patient record systems to link off-reservation care systems that serve American Indians and Alaska Natives.”

According to IHS, the Health Information Technology Modernization Research Project, which started in October 2018 and will end in September 2019, will provide recommendations for how the agency can streamline its HIT infrastructure, applications and capabilities.

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