Achieving Meaningful Use: IHS Resource and Patient Management System (RPMS) Interoperability with IIS

Background: 

Since 2006, the Indian Health Service (IHS) immunization data exchange initiative has worked with IHS, tribal and urban Indian health (ITU) sites to participate in immunization information systems (IIS) via ITU/IIS Health Level 7 (HL7) immunization interfaces.  In 2009, the Centers for Medicare and Medicaid Services (CMS) established interoperability measures of Electronic Health Record (EHR) meaningful use that can be demonstrated by submission of electronic immunization data to IIS. 

Setting:  ITU clinics utilizing the IHS RPMS can use the IHS interface software to demonstrate meaningful use through submission of test immunization messages in states with an IIS that can accept HL7 uploads.   

Population:  The IHS is responsible for providing federal health services to American Indians and Alaska Natives who belong to 562 federally recognized tribes in 34 states. As of 2009, roughly 30% of patients served by IHS facilities were enrolled in Medicaid, and most IHS Eligible Hospitals and Providers are expected to apply for Medicaid meaningful use incentives.

Project Description:  The IHS National Immunization and Information Technology Programs work closely with IIS personnel, software programmers and ITU facility staff to establish and maintain functional interfaces.

Results/Lessons Learned:  In 2010, there were 232 ITU facilities in 34 states, with 62 (27%) facilities exchanging immunization data with 12 IIS.  The 2009 IIS Annual Report  notes that 19 state IIS were able to upload an HL7 message in states with ITU facilities.  IHS must establish interfaces in additional states to enable provider facilities to meet meaningful use requirements but has found that interface testing protocols are not uniform, and considerations beyond technical interoperability can prevent true meaningful use of EHR.