This document provides an overview and status update of the RPMS EHR (Resource and Patient Management System Electronic Health Record) system implemented across Indian Health Service facilities. It discusses the goals of adopting an EHR, the components and functionality of the RPMS EHR, implementation milestones achieved to date, lessons learned from early adopter sites, and how the EHR can help improve patient care, documentation, and metrics. Over 75 facilities are currently using the RPMS EHR, with a goal of all IHS federal sites implementing it by the end of 2008.

1. Howard Hays, MD, MSPH David Taylor MHS, RPh, PA-C, RN, CDE, NCPS RPMS EHR Where Are We Now? IHS Combined Councils February 26, 2007

3. EHR Presentations Page www.ehr.ihs.gov

6. RPMS/EHR/User Relationships

7. RPMS/EHR/User Relationships

10. EHR Sites as of 02/21/07 22 Tribal Health Ctr/Stn 5 Tribal Hospital 30 Federal Health Ctr/Stn 21 Federal Hospital

16. Pharmacy Waiting (Site D)

17. Medication Errors (Site A) EHR

18. Medication Errors (Site E) EHR

19. GPRA Indicator - Flu Vaccine 65+ (Site A) EHR

20. GPRA Indicator – Prenatal HIV (Site A) EHR

21. GPRA Indicator – DV Screen Age 15-40 (Site A) EHR

22. Depression Screening (Site A)

23. GPRA Indicator – Tobacco Assessment (Site A) EHR

24. GPRA Indicator – Medication Education (Site A) EHR

25. EHR Preparation and Lessons Learned

26. EHR Planning & Implementation Elapsed time (in months) Please note that this is just a general timeline of how long it might take for your site to implement EHR. Every site will be different, and the amount of time it takes to implement EHR depends upon many factors, including size of the facility, services offered at the facility, current state of RPMS and packages installed and utilized. Decision to implement EHR Review EHR Website 0 Complete EHR Site Survey Begin EHR Site Tracking Record Hire CAC Establish EHR Implementation Team Attend Lessons Learned class RPMS current, CACHE Begin pharmacy drug file cleanup for Pharm 5/7 Begin procurement process for hardware Install PIMS Optimize “Point-of-Service” RPMS Packages Optimize PCC Error Reports Install Radiology 5.0, Lab 5.2 p18 Install Pharmacy 5/7 and EHR GUI Implement Paperless Refill Attend CAC training On-site Setup with Nat’l EHR Team EHR Super User training EHR Go-Live with Nat’l EHR Team Full rollout 1 2 3 5 8 10 6 11 12 24

30. RPMS Integrates Multiple Clinical Systems Laboratory Appointment System Patient Registration Dental Emergency Room PCC Patient Database Elder Care Public Health Nursing Pharmacy Behavioral Health System Women’s Health RCIS Immunization Radiology Case Management CHR Surgery EHR PCC Data Entry

31. EHR Includes Four (4) New Packages Myth: Does Not Replace RPMS TIU “ Notes” OE/RR “ Orders” (CPRS) Reminders Consults PCC Patient Database