Trump FY 2021 budget seeks $125M for new Indian Health Service EHR

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President Trump's Fiscal Year 2021 Budget includes an investment of $125 million in an “improved and modernized” electronic health record system for the Indian Health Service.

IHS, an agency of the Department of Health and Human Services, currently uses the Resource and Patient Management System (RPMS), which was developed in close partnership with the Department of Veterans Affairs. However, in 2017, the VA announced that it will phase out support of RPMS.

President Trump’s Fiscal Year 2020 budget request for IHS included an initial $25 million EHR investment to begin transitioning to a replacement for RPMS. The FY 2021 allocation continues this effort.

“Over the coming years, IHS must update its overall health information technology system with a modern, innovative and practical solution to improve health and healthcare across Indian Country,” contends HHS in its FY 2021 budget justification document. “A new system supports IHS’s ability to provide high-quality care, increase efficiency, ensure patient safety, protect from cybersecurity threats and participate in CMS demonstration projects.”

According to the HHS budget document, IHS “requires a secure, certified EHR system to improve healthcare delivery and quality, enhance access to care, reduce medical errors and provide high quality services.”

Writing recently in a Health Affairs blog, researchers from the Regenstrief Institute and Indiana University School of Medicine found that “years of inattention and underfunding have left the RPMS unusable by current technological standards, making it difficult to provide continuous, consistent care.”

Further, they point out that “until FY 2020, there was no budget line item for IHS health IT at all.”

Researchers concluded that the federal government has “an obligation” to provide $3 billion to IHS to replace the agency’s legacy EHR system. They say the cost estimate is consistent with the VA’s $10 billion EHR modernization over 10 years, given that IHS’ patient population—2.6 million American Indian and Alaska Native people—is equal to 27 percent of the VA patient population.

“Supporting the health IT needs within the IHS through appropriate funding and oversight of a health IT modernization program will be critical to achieving success,” the researchers contend. “An adequately sourced health IT program is an essential component to ensuring high-quality and safe care.”

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