The Indian Health Service’s electronic health record (EHR) system is the oldest critical information system currently in use in the Federal government, and a top agency official on Tuesday shared details of IHS’s “transformational” effort to modernize that system over the next few years.
Chief Medical Information Officer (CMIO) Howard Hays explained that IHS – a smaller agency within the Department of Health and Human Services – has operated electronic systems supporting healthcare since the late ’60s. The agency launched its current EHR system in 1984.
“We are still using the same technology that we launched in 1984,” Hayes said during an Aug. 20 webinar hosted by Federal News Network.
“So, we are actively and busily moving away from that to instead of being a developer of a homegrown electronic medical record system, which we share a lot of that with the [Department of Veterans Affairs (VA)], and as you know, they’re also doing a modernization effort,” Hays said. “We are in the early stages of moving away to a commercially available electronic healthcare record system.”
IHS provides Federal health services to 2.6 million Native Americans and Alaska Natives belonging to 574 Federally recognized tribes in 37 states.
IHS awarded General Dynamics Information Technology (GDIT) a $2.5 billion indefinite delivery, indefinite-quantity contract last fall to modernize its EHR system.
Under the 10-year contract, GDIT will replace the agency’s decades-old record and patient system, which is used for health system tasks from intake and patient registration to insurance billing.
The updated system is a new cloud-based enterprise solution from Oracle Health – the same contractor that the VA is using for its Electronic Health Records Modernization (EHRM) program.
“We’re in the early parts of [the project],” Hays said. “Our priority in the near term is getting the necessary staffing in place so that we can then begin the enterprise system build after the first of the year, and that’s going to be a major project over a course of maybe nine-plus months, to build the enterprise instance of the cloud-hosted electronic medical record system.”
“We’re also identifying the first pilot sites that will be implemented, probably in 2026, to do the initial rollout and basically test everything,” he continued. “We’ll do testing before we actually expose the patients to our new EHR, but there will be a lot of work.”
Hays explained that IHS is taking a “very deliberate and intentional approach” to its EHR modernization. As IHS is taking on work to build the system now, he said he envisions it will complete the implementation at the pilot sites “probably in three years.”
After the pilot sites, he said IHS will roll out the new system to “cohorts” – or small groups of sites – and repeat that process until the implementation is complete.
“So, the priorities for this year, it’s getting the people ready and just having our feet under us to begin this rather intensive work in 2025 to build this system that we’ve acquired,” Hays said.
“The main thing besides the functional improvements that will be brought by a more robust EHR that we’re able to provide now is that visibility into the total patient health status,” he added. “We’re going to be really seeing the beginnings of that in the next two or three years.”
