HomeHealthcareIndian Well being Service IT Exec Describes Plans for EHR Transition

Indian Well being Service IT Exec Describes Plans for EHR Transition

Indian Well being Service IT Exec Describes Plans for EHR Transition

Jeanette Kompkoff serves because the director of the Division of Well being Data Know-how Modernization and Operations (DHITMO) on the Indian Well being Service (IHS). In a current interview, carried out by way of e-mail, with Healthcare Innovation, she detailed IHS’ not too long ago introduced plans to transition from a home-grown EHR to Oracle Cerner. 

The IHS, an company within the U.S. Division of Well being & Human Companies, offers well being companies for about 2.8 million American Indians and Alaska Natives who belong to 574 federally acknowledged tribes in 37 states. 

DHITMO, which was established to supervise the Well being IT Modernization Program, sits inside the IHS Workplace of Data Know-how. Because the DHITMO director, Kompkoff offers oversight and administration of the enterprise digital well being document (EHR) system and its upkeep. She additionally manages the acquisition exercise for quite a few well being IT companies and merchandise that complement the EHR funding and oversees a crew of greater than 80 federal and contract IT personnel who help this system’s efforts. 
Kompkoff joined the IHS in 1988 and brings practically 35 years of well being IT implementation experience to the IHS Well being IT Modernization Program. Throughout this time, she created infrastructure necessities, led a number of software program growth tasks, managed multimillion-dollar IT contracts, and led nationwide groups to implement and handle giant and sophisticated IT investments, together with the IT modernization effort.
Healthcare Innovation: Are you able to clarify among the the reason why the IHS is working to switch the Useful resource and Affected person Administration System (RPMS) with a business enterprise well being IT suite?

Kompkoff: Implementation of recent expertise is important for IHS to reinforce the person expertise for sufferers and suppliers, centralize the system for speedy, responsive help from expertise specialists nationwide, and bolster catastrophe restoration and continuity of care. This modernization goals to reduce system disruptions and streamline entry to affected person knowledge throughout amenities, granting sufferers larger management over their care and offering suppliers with a complete care overview. By transitioning from the RPMS to a business enterprise well being IT suite, IHS is addressing these important wants, laying the groundwork for improved well being care supply and operational effectivity.

In listening periods that mentioned findings of the 2018 evaluation of the present state of the company well being IT system, 60 p.c of the Tribal and City Indian Group (UIO) companions have been in settlement that full substitute of RPMS is probably the most acceptable and life like modernization answer. In a complete examine carried out by the U.S. Division of Well being and Human Companies (HHS) between 2018 and 2019, deficiencies within the RPMS expertise used throughout IHS, Tribal and City medical amenities got here to mild, leading to a powerful suggestion to switch the system. Highlighted by two important experiences from the HHS Workplace of Inspector Normal, these shortcomings known as for rapid motion. Compounding the difficulty, the approaching substitute of the U.S. Division of Veterans Affairs’ VistA system, upon which the IHS has dependencies, underscores the urgency for IHS to transition to a business enterprise well being IT suite, making certain the continued supply of top-tier well being companies. 

HCI: May you give a timeline of what has been performed to date when it comes to planning and fascinating with stakeholders — and what the following steps are? For example, has an RFP course of began? 
Kompkoff: Throughout the Well being IT Modernization Program, the IHS seeks methods to actively share updates with, take heed to, and procure inputs from companions to construct the enterprise EHR answer. IHS needs a partnership within the journey to construct the enterprise EHR answer utilizing governance frameworks that promote collaboration.   
One of many central rules of the IHS Well being IT Modernization is to construct and function the enterprise EHR answer with our companions, not for them. The Enterprise Collaboration Group will function a discussion board for companions to supply enter concerning the configurations and workflows that the enterprise EHR answer offers. Further alternatives for enter might be out there by focus teams, with preliminary matters targeted on interoperability, implementation, knowledge administration and analytics.
HCI: What sort of appropriations have there been to date for this mission? Is there a projected total price and timeline?  
The IHS Well being IT Modernization Program is a complete, multi-year initiative geared toward updating well being IT techniques throughout IHS, Tribal, and City Indian well being care applications, following a transparent timeline from analysis and planning levels in 2018 to 2021, to purchasing and constructing in 2022 to 2024, and eventually coaching, creating, and working from 2025 onwards. Financially, the mission has a Life Cycle-Price Estimate starting from $4.5 to $6.2 billion to be expended all through a 10-year interval, accounting for the required infrastructure to help an enterprise EHR answer. The Fiscal Yr 2024 President’s Finances Request features a request for $913 million for the initiative, with an extra $1.1 billion per yr to be requested for FY2025 by FY2029, totaling $5.5 billion over 5 years to supply steady funding to help the deliberate length. Every funds request is topic to annual congressional approval.  
HCI: The Navy Well being System and VA are within the means of upgrading to a brand new enterprise system from Oracle Cerner. Are there interoperability benefits for IHS to be on the identical system because the army and VA?

Kompkoff: In November 2023, the Indian Well being Service introduced that Normal Dynamics Data Know-how, Inc. will construct, configure, and keep the enterprise digital well being document answer utilizing Oracle Cerner expertise. The enterprise EHR answer might be shared by each federal and non-federal companions and prioritizes Tribal sovereignty and our collective mission of bettering the well being standing of American Indian and Alaska Native folks. 

Whereas the VA and DoD efforts and the IHS Well being IT Modernization Program will each use Oracle Cerner expertise, each occasion of an EHR construct is completely different. The IHS enterprise EHR answer might be a special product than the VA and DOD merchandise and will probably be applied in a different way. IHS has had profitable implementations of comparable merchandise all through Indian Nation and we’ve got the benefit of gaining classes discovered from our federal, Tribal and City companions and can construct the system with our customers. Interoperability might be supported utilizing licensed expertise between VA, DOD and business companions.

HCI: What are some parts of the IT governance method that DHITMO is taking with this mission?
Kompkoff: IHS is proactively establishing a collaborative governance construction to information the event of an enterprise EHR answer. The Govt Steering Committee will handle federal features, making certain alignment with our objectives. The federally led Enterprise Collaboration Group, supported by IHS informatics, offers suggestions for the enterprise EHR answer’s design and configuration. This complete governance method, spearheaded by the DHITMO, underscores our dedication to a collaborative and efficient growth course of for the enterprise EHR answer. 
HCI: What do you foresee as probably the most difficult facet of the transition?
Kompkoff: The transition to an enterprise EHR answer is advanced. We anticipate probably the most difficult facet to be making certain a clean knowledge migration, aiming to forestall knowledge points reminiscent of knowledge loss, misinterpretation, or mis-mapping fields. To attenuate downtime and keep productiveness, we plan to conduct strong testing at amenities previous to go-live. To make sure websites have the right infrastructure, employees, and workflows earlier than implementing the answer, we’re actively incorporating suggestions from our companions throughout Indian Nation. Clear communication and powerful management are essential to navigate this transition, stopping misunderstandings and errors, making certain a profitable implementation that aligns with our mission, and serves our sufferers and suppliers effectively. 
HCI: Are there many points associated to knowledge migration from legacy techniques? 
Kompkoff: IHS is proactively addressing a number of points associated to knowledge migration from legacy techniques to make sure seamless entry to finish info for each sufferers and suppliers within the enterprise EHR answer. Key challenges embody stopping knowledge loss, avoiding misinterpretation of knowledge, and making certain correct mapping of information fields between the outdated and new techniques.
HCI: Are some clinics within the system already utilizing another kind of EHR fairly than RPMS?  And in that case, will they be allowed to remain on these fairly than switching to the brand new system?
Kompkoff: All federally acknowledged Tribal nations and City Indian applications that function their very own EHR can choose into the brand new system at any time or proceed to make use of a system of their alternative. If a Tribal or City program is at the moment utilizing RPMS, they might want to both undertake the IHS chosen enterprise EHR answer or pursue a special system of their alternative.  All IHS-operated amenities could have RPMS changed with the chosen IHS enterprise EHR answer.
HCI: I learn that the proposed structure includes establishing a brand new database – “4 Instructions Warehouse (4DW)” – in a federal cloud setting. Are you able to describe briefly what 4 Instructions will contain?

Kompkoff: 4 Instructions Warehouse is about to be a central repository in a federal cloud setting, with long-term storage options for complete RPMS knowledge archive and capabilities to include knowledge from a number of EHR options. It allows seamless entry to scientific knowledge for each sufferers and suppliers throughout numerous amenities, boosting visibility into affected person care wants. 

The system facilitates using legacy info with out the necessity for loading the complete historical past of affected person healthcare knowledge into the enterprise EHR, and it requires no upkeep of RPMS techniques. With strong safety controls and a complete knowledge analytics setting, 4DW ensures the safety of affected person knowledge on the IHS-managed platform, streamlining the transition to fashionable healthcare options whereas laying the groundwork for superior affected person care optimization. 

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