Indian Health Service tries 'insourcing' IT work

The 52-bed Northern Navajo Medical Center in Shiprock, N.M.'named for an 1,800-foot-tall soaring rock formation'has created three Web-ready data applications for hospitals run by the Indian Health Service of the Health and Human Services Department.

The center, an IHS hospital that serves American Indians on the Navajo reservation, wanted to improve service, speed record searches and save money by what CIO Tom Duran calls 'insourcing.'

It was more expedient to create the Web-enabled software at the point of care than at the agency level, he said.

Duran and two other IHS employees last year began developing what they dubbed the E-Series Web applications. The E stands for excellence.

The first app, E-Verify, took only 12 hours to build. 'We demonstrated it in 24 hours,' he said. E-Verify checks for insurance eligibility in 1.6 million IHS patient records. The Shiprock team now can search records with 'subsecond response time,' Duran said.

He used WebLink Developer from InterSystems Corp. of Cambridge, Mass., which comes with the Cache database software the center already had.

E-Post, the second app, posts remittance data received from insurance companies. A third, called E-Code, applies disease classification codes to health records.

Physicians, administrative workers, clinicians and nurses all access the E-Series apps via their Web browsers, Duran said.

Although Duran developed the apps specifically for the Shiprock center, 1,200 workers at IHS facilities throughout the country now use them.

The E-Series apps comply with the Health Insurance Portability and Accountability Act's privacy requirements, Duran said. If a patient asks who has looked at certain medical records, the apps show the audit trail within seconds, he said.

The Shiprock center runs E-Series under Linux from Red Hat Inc. of Raleigh, N.C., on a quad-processor Dell PowerEdge server with a 1T hard drive and 16G of RAM.

Savings are mostly anecdotal so far. Many vendors charge 25 cents to 30 cents per lookup on eligibility systems, Duran said, but 'we've done half a million inquiries thus far, so just imagine what we're saving and will continue to save.'

That means IHS can spend more on clinical services, said Duran, who also works as a pharmacist at the center, specializing in seizure management medications.

About the Author

Trudy Walsh is a senior writer for GCN.

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