The Indian Health Service (IHS) was mandated to improve its data systems for management purposes and took action to better manage its information systems. The Resource and Patient Management System (RPMS) is capable of data integration throughout the IHS and provides the framework for a uniform national data system and automated management information system. Information systems coordination is provided through the Information Systems Advisory Council (ISAC), Professional Specialty Groups (PSG), Data Management Taskforce (DMT), and Area Information Systems Coordinators (ISC) to address the diverse information systems issues. The tribal consultation process on information systems is carried out through full tribal participation in the ISAC, PSG'S, DMT and interaction with the Area ISC'S. A goal adopted by the IHS was to integrate existing and new systems into a single database structure. This report presents the activities conducted, activities to be completed, and funds needed to complete the implementation of an automated management information system as required by Public Law 100-713, Section 602. The report specifies the extent of management involved to improve financial management, including the ability to generate data on cost, and the degree to which service unit directors and tribal health personnel have been involved in the planning and design of the management information systems, and its planned implementation.The standard cost accounting system approach has been assessed for applicability to IHS facilities and found to have a questionable cost/benefit ratio. Computer systems with security software have been deployed in the hospitals and health centers for the installation of core clinical software. Eighty-nine percent (89%) of the hospitals and health centers have installed computer systems and a majority of these are implementing the RPMS core clinical software package. The IHS activities which have been undertaken to establish the AMIS are: (1) the establishment of RMS planning and management, and coordination of information systems development; (2) the establishment of a patient care information system core package of software; (3) the installation process of the initial hardware systems and core clinical software at the point of patient care; and (4) the initiation of consultation with tribes and key management for planning and design of information systems. The IHS followed three basic principles in undertaking the activities to implement the RPMS: (1) established an overall framework and purpose for guiding data collection; (2) utilized automation for program efficiency and effectiveness; and (3) conducted a systematic approach for information integration. There are five requirement to implement RPMS into Indian Health Service area: (1) Hospitals and Clinics Technical Support; (2) Information System Development and Technical Support; (3) Appropriate Computer Systems; (4) National Database; and (5) Telecommunications Network. The cost structure for assessing, coordinating, and phasing existing data into an integrated data system closely matched the IHS resource structure, thus allowing for coordination of growth and internal capacity development. The IHS is progressing from a collection of system-specific information systems concentrated at Area Offices and the national data center to an integrated information system based at the point of patient care. By the end of FY 89, computer systems with Patient Registration software will have been installed at 89% of the IHS and tribal hospitals and health centers that account for 90% of the patient workload. A majority of IHS health care facilities are implementing an IHS-core clinical package consisting of an automated Patient Registration, Outpatient Pharmacy, Maternal & Child Health Immunization, Dental, Ambulatory Patient Care, and Contract Health System.The Indian Health Service initiated a pilot program to test the feasibility of expanding the program to all IHS hospitals. The sites selected for pilot testing were the Clinton, OK, Albuquerque, NM, and Parker, AZ, hospitals. The study has been initiated and will be completed within 9 months. The test sites have begun to collect data. This data will be submitted to Chicago for processing and the first reports are expected in mid-summer (1990).In the next 5 years. $71,000,000 is estimated to be needed to complete implementation by the IHS and $18,000,000 will be needed on a recurring basis to maintain, keep current, and meet the changing information needs of the system. Tribal facilities outside the scope of IHS will require an estimated $8,600,000 in funding over five years and $3,400,000 on a recurring basis to support the projected implemented systems.
Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-91).
Markowitz J. The establishment of an automated management information system for the Indian Health Service. Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-91). 1989