On Tuesday, December 14, 2021, National Indian Health Board (NIHB) hosted the National Tribal Health IT Summit to bring together a wide range of subject matter experts and Tribal representatives to engage in critical topics surrounding health information technology (IT) modernization in Indian Country. The event, held virtually, had robust participation, with over 365 attendees from across the country.
The event opened with a welcome and introduction from NIHB Chairman William "Bill" Smith, Chief of the Valdez Native Tribe of Alaska. “We’re here today to discuss a path forward for Health IT modernization for Indian Country,” said Chief Smith. “We all know the critical importance of ensuring our health facilities have access to modern health IT systems. We also know that acquiring the up-to-date health IT systems we need has been a long and rocky road. This Summit will provide us an opportunity to have a Tribally-led and Tribally-focused forum in which to engage with this important topic and come together to develop a roadmap for moving forward.”
Elizabeth Fowler, Acting Deputy Director of the Indian Health Service (IHS), also provided opening remarks, focused on the department’s responsiveness to Tribal concerns and input. “We do appreciate the National Indian Health Board for holding this Summit, to get additional feedback and information on modernizing our health IT,” said Deputy Director Fowler. “Having an open dialogue is truly important as we move forward with this vital process.”
The Summit featured presentations from a variety of perspectives regarding health IT. Douglas Barton from event sponsor Leidos shared important considerations for health IT from an industry perspective. John Short from the Department of Veterans Affairs (VA) Office of Electronic Health Record Modernization discussed lessons learned from the VA’s experience modernizing its electronic health records system. Carolyn Crowder, President of Crown Consulting and Management Services, and A.C. Locklear, Policy Analyst for NIHB, presented a brief history of health IT modernization in Indian Country. Stewart Ferguson, Chief Information Officer for Alaska Native Health Consortium (ANHC), shared their experiences in modernizing health IT. Mr. Ferguson said, “Tribes need a voice in this system if it’s going to be successful,” when asked what has been learned from that experience as IHS’s health IT modernization project.
In the second half of the event, a roundtable discussion on funding explored funding needs, opportunities, and the work of the IHS Budget Formulation Workgroup. A subsequent roundtable featured representatives of several Tribes who have chosen different paths for health IT and have varied experiences with modernizing their electronic health record systems. The panelists shared their lessons learned and advice for other Tribes looking at health IT modernization.
Over the course of the six-hour Summit, several key themes emerged from the presentations, roundtables, and group discussions about significant factors in health IT modernization for Indian Country. The importance of planning and strategy regarding data sharing, security, and privacy came up repeatedly, as did the vital place of open, deliberate, and effective communication among all stakeholders. Presenters also highlighted the highly complex nature of any health IT modernization effort and the widely varying IT needs among Tribes, types of facilities, and state requirements.
Those with experience in modernizing their health IT emphasized the immense impact changing health IT has on every aspect of a healthcare organization. The one-time and ongoing costs are substantial, as are the staff time and training required. Refining and updating the system is an ongoing, never-ending process. On the other hand, successful health IT modernization can revolutionize healthcare, vastly improving patient experience and health outcomes. Presenters remarked that success depends on early planning and developing a thorough understanding of what the organization will need from its health IT system and electronic health records.
Tribal leaders, health IT experts, and healthcare professionals also reiterated the desire for expanded and improved cooperation and collaboration. Tribal organizations considering moving to a commercial off-the-shelf (COTS) health IT system discussed the possibilities of forming consortia to better negotiate and expand options with health IT companies. Tribes and Tribal organizations who have already switched to COTS systems discussed the potential benefits of forming collaboratives among those with the same system to better learn from each other and work together.
Tribal representatives with widely varying experiences with health IT expressed the desire for more collaboration with IHS, as the department works to fully replace the electronic health record system currently used by IHS facilities. Tribes want a greater voice at every step and level of project governance, as well as improved communication from the department. Some participants of the Summit stated they had not heard before that IHS was pursuing a full replacement of its health IT system.
Presenters also discussed the central role IHS’s Information Systems Advisory Committee (ISAC) plays in facilitating communication between IHS Office of Information Technology and Indian Country. “If you’re interested in [health IT] modernization, you really should participate in those calls, whether you’re on the ISAC or not,” said Melissa Gower, Senior Advisor and Policy Analyst for the Chickasaw Nation Department of Health. “We get really good updates, [and] there’s open discussion times where anyone can ask any question.” She mentioned her concern that out of the twelve seats on the committee representing the 12 IHS areas, seven are vacant, which weakens the effectiveness of the committee. The open seats on ISAC currently include representatives from the following areas: Albuquerque; Billings; Great Plains; Nashville; Navajo; Phoenix; and Tucson.
The National Tribal Health IT Summit was a great success, and the National Indian Health Board looks forward to our next steps in bringing health IT modernization to Indian Country.
For questions, please contact A.C. Locklear at alocklear@nihb.org.
ACCESS SUMMIT RECORDINGS
All Summit content, including presenter slides and session recordings, are now available. You may access the recordings by visiting NIHB's YouTube channel from the link below.