The US Department of Health and Human Services (HHS) and the Indian Health Service (IHS) have formalized an overarching plan to support improved clinical and nonclinical operations across IHS, Tribal, and Urban healthcare facilities through RPMS EHR & HIT modernization.
The IHS currently uses Resource and Patient Management System (RPMS) to manage clinical, financial, and administrative information in the Indian health system. IHS provides health services to about 2.5 million Native Americans and Alaska Natives. The system was developed in the mid-1980s 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. In 2017 when the VA announced a decision to replace VistA, IHS accelerated efforts to reevaluate its health IT (HIT) system. In November 2019, IHS released the HHS Health IT Modernization project final report. The report identifies key improvement opportunities and related work initiatives for implementing health IT (including RPMS). During the consultation process and based on the received responses from a data call from 1,381 HIT end users, results show that:
of users are either somewhat or very dissatisfied with how well RPMS helps them do their jobs.
of users think RPMS needs significant improvements.
of RPMS sites feel they are far from having the necessary hardware to complete their work.
of all users agree that now is the time for HIS to deploy a new HIT system.
Table A Source: HHS Health IT Modernization Project
The HHS' Office of the Chief Technology Officer research team also did a technical evaluation, which found the system will be completely unsupportable in ten years. In addition, they discovered there was little to no interoperability between most IHS facilities, meaning patients’ health records are not available to providers at different locations. Consequently, four go-forward approaches have been identified as options and are identified below:
Figure 1. HHS Health IT Modernization Project, Dec. 13, 2019
Lastly, the high-level timeline below was shared to reflect the multiyear effort.
While it has taken a substantial amount of time to get to this point and congressional funding is still required, IHS, Tribal, and Urban (I/T/U) healthcare facilities that have not yet switched to a different EHR solution should dig deeper into the roadmap to see how the timing and modernization efforts align with their own unique clinical and non-clinical operations priorities.
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