Alaska Native People Shaping Healthcare

Objectives

To find out what everyone is doing with Electronic Medical Records (EMR)

To find out what Regional CEO’s direction is with EMR

Alaska Native People Became Owners of their Healthcare System

Self Governance Alaska is the only state tribes have

assumed all contractible services from IHS

SCF 2009 Corporate Objectives

Reduce the rate of Domestic Violence, Child Abuse and Neglect.

Reduce the rate of preventable cancers and improve the management of cancer.

Reduce the incidence of suicide. Reduce the rate of obesity. Reduce the rate of substance abuse. Reduce the rate of and improve the management

of diabetes. Improve oral health. Reduce the rate of and improve the management

of cardiovascular disease.

EMR Data

Decrease in ER/Urgent Care over 40% Decrease specialty care by about 50% Decrease in primary care visits by 20% Decrease in admissions and days by 30% Segment need and behavior

EMR Data

Monitor health outcomes, customer and staff satisfaction

Monitor costs - 5% of user population generates over 30% of total costs

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

50,000F

eb-0

0

Jun

-00

Oct

-00

Feb

-01

Jun

-01

Oct

-01

Feb

-02

Jun

-02

Oct

-02

Feb

-03

Jun

-03

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-03

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-04

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-04

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-05

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-05

Oct

-05

Feb

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-06

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-07

Jun

-07

Oct

-07

Feb

-08

Num

ber E

mpa

nele

d .

Family Medicine Pediatrics Valley Total

Primary Care Provider Empanelment ProjectPatient Enrollment

50

70

90

110

130

150

170

190

210

May

-00

Aug

-00

No

v-00

Feb

-01

May

-01

Aug

-01

No

v-01

Feb

-02

May

-02

Aug

-02

No

v-02

Feb

-03

May

-03

Aug

-03

No

v-03

Feb

-04

May

-04

Aug

-04

No

v-04

Feb

-05

May

-05

Aug

-05

No

v-05

Feb

-06

May

-06

Aug

-06

No

v-06

Feb

-07

May

-07

Aug

-07

No

v-07

Feb

-08

Vis

it C

ount

per

1,0

00 P

atie

nts

.

FMC Peds

PCP Patient Visits To PCP per 1000

Anchorage Area Patients Visits to ER/Urgent Care Per 1000

200

400

600

800

1000

1200

1400

1600

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

Year

Num

ber

of V

isits

Day per 1000 Night per 1000

Better

Native ownership begins

Excludes Newborns and Delivery Moms and Length of Stay must be more than 1 day

Anchorage Area Patients Admits per 1000

40

50

60

70

80

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

Year

Num

ber

of A

dmits

Admts per 1000

Better

Native ownership begins

Excludes Newborns and Delivery Moms. Denominator PCP patients includes non-village patients with visit during past two years. Includes LOS >1 day only to adjust for introduction of “Observation Hospitalization”.

2

3

4

5

6

7

8

9

10

Ma

r-0

0

Jun

-00

Se

p-0

0

De

c-0

0

Ma

r-0

1

Jun

-01

Se

p-0

1

De

c-0

1

Ma

r-0

2

Jun

-02

Se

p-0

2

De

c-0

2

Ma

r-0

3

Jun

-03

Se

p-0

3

De

c-0

3

Ma

r-0

4

Jun

-04

Se

p-0

4

De

c-0

4

Ma

r-0

5

Jun

-05

Se

p-0

5

De

c-0

5

Ma

r-0

6

Jun

-06

Se

p-0

6

De

c-0

6

Ma

r-0

7

Jun

-07

Se

p-0

7

De

c-0

7

Ma

r-0

8

Ad

mits

pe

r 1

00

0

Admits per 1000 PCP

Timely A1C

0%

20%

40%

60%

80%Se

p-03

Nov-

03

Jan-

04

Mar-0

4

May-

04

Jul-0

4

Sep-

04

Nov-

04

Jan-

05

Mar-0

5

May-

05

Jul-0

5

Sep-

05

Nov-

05

0

10

20

30

40

2003 2004 2005

%

C-Section HEDIS 10%ile

BETTER

HIV Care

0

20

40

60

80

100

%

Consistent Med UseViral Load <75Q 6 Mo Visits or Viral Load

`BETTER

Customer Satisfaction

Discussion topics

Isolated data systems do not allow for adjustment to differences in user groups

Costs associated with redundant workCosts of care transfers between programs Inability to quantify impact of mobile

population and is use across the state

Opportunities

Funds allocated for EMR at the Indian Health Service Director Level

Collaborative ways for Alaska Native health organizations to connect systems

Next Steps

Meet again on this topicWhen?Where?

Thank You!