Subscribe to the Free Print Edition!
Celebrating 25 Years

GCN Home > 07/16/07 issue

Technique: Holistic approach to data

Indian Health Service system delivers integrated look at patient information

By Trudy Walsh

The Indian Health Service is “the little engine that could,” said Dr. Theresa Cullen, the agency’s chief information officer.

With the job of operating a comprehensive health service delivery system for about 1.9 million of the nation’s estimated 3.3 million American Indians and Alaska natives, the service has a high provider turnover rate, Cullen said. And the population it serves has the highest disease burden of any group in the United States. Diabetes and obesity, for example, were epidemic in the American Indian community years before they became prevalent in the rest of the country. “So we needed to figure out a way to provide more efficient and effective health care delivery,” Cullen said.

About six weeks ago, the service launched a population management graphical user interface called iCare that gives health care providers an integrated view of patient data from IHS’ Resource and Patient Management System (RPMS).

“Providers have a zillion pieces of information,” Cullen said. The iCare system lets doctors and health care providers search and parse patient data by categories such as community, age, gender and number of doctor visits.

The system lets users tag patients in a database with one or more diagnoses, such as diabetes or asthma. By using a query management tool called Q-Man, users can perform Boolean-like string queries, requesting data on, for example, diabetics who had three doctor visits last year.

Using iCare, a health professional can call up patient data on everyone who lives in, for instance, the native village of Akhiok, Alaska, and compare the data with that from another village. “You can see how they are doing and if there’s a difference between the villages,” Cullen said. If there is a difference — if one village has higher asthma rates than another — providers can investigate the causes and take action.

Cullen credits Dr. Paul Nutting, a former researcher at IHS, with how the service takes a community-based approach to health care. Nutting helped the service implement the concept of community-oriented primary care (COPC). For example, a COPC approach helps the service look at not just the number of obese children but also if there’s an accessible community swimming pool and running track nearby.

This integrated approach to health care helps IHS “get away from this concept that your disease defines who you are,” Cullen said. A diabetic may have other diagnoses, such as cardiovascular disease, that have to be taken into consideration. Integrating all this data helps the service deliver better care.

More news on related topics: Communications / Networks, Data Management, State & Local



GCN Popup