In the meaningful-use vanguard

The Indian Health Service wasn't the first healthcare system to have its have its electronic health-record system certified as capable of meeting meaningful-use criteria under the American Recovery and Reinvestment Act, but it is one of the largest.

The service, a part of HHS, calls its EHR the Resource and Patient Management System, or RPMS. The homegrown system, which is adapted from the Veterans Affairs Department's VistA system, serves 2 million people at 280 IHS care sites.

Dr. Theresa Cullen, a rear admiral in the U.S. Public Health Service and the chief technical officer at the IHS, says the service collects "a significant amount of money" from billings to Medicare and Medicaid as well as private insurance companies. As such, it has been working closely with the CMS and the ONC with an eye to meeting meaningful-use targets.

"I took the position about nine months ago that meaningful use was made for the Indian Healthcare Service," Cullen said. The service already uses RMPS to perform many of the functions required to meet meaningful-use targets, such as computerized physician order entry and public health reporting, so, "it was a natural fit for us," she said. "We were able to use the carrot of the incentives to move our whole healthcare IT agenda forward."

The IHS allocated $25 million of the $85 million in direct appropriations it received under the federal stimulus law for RMPS upgrades, including those needed to meet meaningful certification criteria, Cullen says. The "vast majority" of IHS facilities should qualify for EHR incentive payments under Medicaid, and the service is poised to have its hospitals meet the Medicare meaningful use requirements yet this year as well, she says.

"There is no reason to think that any of our hospitals won't qualify," she says. But it will be something of a rush to get the software throughout the system updated to certified versions.

"We’re right now going through the process of getting all the patches up," Cullen says. "They should get them in May and have six to eight weeks to deploy. Then they’ll have from July 1 to meet their meaningful use."

RPMS, which was certified by the not-for-profit Certification Commission for Health Information Technology in 2008, passed muster this year with InfoGuard, winner of a require competitive bid for testing and certification services, Cullen says.

Certification of RPMS also was "welcome and expected news" in Hawaii, where the University of Hawaii at Manoa is helping healthcare providers in Hawaii and the Pacific Islands meet the Stage I requirements for meaningful use under an agreement with the IHS to use its EHR there, according to Norman Okamura, a faculty specialist at the university's Social Science Research Institute.

"The fact that the RPMS is now certified is one box that can be checked off on the list for Stage I meaningful use," Okamura said in an e-mail.