• The IHS is the principal Federal healthcare provider for American Indians and Alaska Natives
• The IHS provides comprehensive health services to 1.7 million people
• The IHS has 144 Service Units composed of more than 500 direct health care facilities
• Health Facilities are both urban and rural

To assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indian and Alaska Native people

• RPMS is a decentralized automated information system
• There are approximately 60 integrated software applications available to each site
• The Patient Care Component (PCC) is the clinical data repository within RPMS. It collects and stores demographic and medical data for each patient in the system

INTEGRATED CASE MANAGEMENT

Software Application

• Is Proactive
• Is about Communication
• Places the patient and family in the center of the care team
• Improves the delivery of care, as well as the outcomes
• Results in fiscal benefits for both the patient and the health care facility
• Can be performed by a variety of health care providers:
  • Nurses
  • Dieticians
  • Physicians
  • Dentists
  • Social Workers
  • Nurse Practitioners
  • Pharmacists

• Provide a useful tool to a wide variety of providers at I/T/U sites to facilitate the proactive management of their patients' healthcare and ultimately improve the lives of the communities IHS serves
• Provide users with integrated decision support and patient management for single or multiple disease states and or care conditions
• Allow IHS providers to manage patients by retrieving any and all information from the RPMS database and bringing it together under one graphical user interface (GUI)
• Provide an integrated patient record that will minimize stovepipe management
• Provide a tool that will incorporate information specific to an individual's household and community

• Utilizes existing IHS data base - Resource Patient Management System (RPMS)
• iCare is a Graphical User Interface (GUI) application
• Integrated Patient Record
• Multiple, customized patients panels
• Notification Flags
• Diagnosis "Tags"
• Individual and Aggregated GPRA data

• Integrate with other disease/condition specific register management systems (i.e. HIV, CVD, Diabetes, Asthma, Women's Health, Immunizations etc)
• Household and Community Profiles
• Integrated Reminders
• Patient Generated notes/ data/ plans

Users define their own patient population based on the site's business practice

(image: screenshot of IHS iCare User Preferences page, "Define My Patients" tab)

Users choose the type and duration of flags they'd like displayed

(image: screenshot of IHS iCare User Preferences Page, "Flag Setup" tab)

Users choose their own "start up" screen

(image: screenshot of IHS iCare User Preferences Page, "Startup View" tab)

An Individual User's Panel List

(image: screenshot of IHS iCare - Gebremariam, Cindy P-Demo Hospital, "Panel List" tab)

iCare provides users with the ability to create multiple, predefined and easy-to-define patient panels. Panels are customizable and unique to the individual user.

(image: screenshot of IHS iCare - Hi risk older women - Panel definitions page)

A Panel's Patient List

(image: screenshot of IHS iCare - Demo Panel - Panel View page)

iCare utilizes logic written for other clinical applications to "tag" individuals with pre-defined diagnoses and conditions

(image: screenshot of IHS iCare - Demo Panel - Panel View page, "Patient List" tab)

iCare displays patient "flags" related to

• Abnormal labs
• Hospitalizations
• ER visits
• Unanticipated ER returns

(image: screenshot of IHS iCare - GPRA Test - Panel View page, "Flags" tab)

User's select which GPRA measures they'd like to view and then check to see if the measure is met for any individual patient on the panel.

(image: screenshot of IHS iCare - Demo Panel - Panel View page, "GPRA" tab)

iCare uses "official" GPRA report logic on user-defined populations that are not currently available in the Clinical Reporting System (CRS)

(image: screenshot of IHS iCare - Demo Panel - Panel View page, "GPRA Aggregated" tab)

Modifications made to individual panels affect that panel only

Users have the Freedom to choose Which columns they'd Like displayed and in What order.
Each panel can Have a different design

(image: screenshots of IHS iCare - Demo Panel - Panel Definition, "Patient List" and "Layout" tabs)

iCare allows users to "share" their panels with others

"Shared" access is either Read or Read/Write and can be permanent or temporary

(image: screenshot of IHS iCare - Demo Panel - Panel View page, "Patient List" and "Sharing" tabs)

iCare pulls all available patient data and displays it in one view so the "whole picture" is appreciated

(image: screenshot of IHS iCare - Demo, Alice Janene page, "Cover Sheet" tab)

(image: screenshot of IHS iCare - Demo, Alice Janene page, "Problem List" tab)

iCare will generate nationally-defined general prevention and disease/condition specific healthcare reminders that are integrated to display most stringent criteria applicable to the patient's chronic condition(s)

(image: screenshot of IHS iCare - Demo, Carol page, "Reminders" tab)

A variety of Health Summaries can be displayed from within the patient record

(image: screenshot of IHS iCare - Demo, Alice Janene page, "Health Summary" tab)

• Beta testing to begin in CY 2006
• Deployment early 2007
• Development of next phase in process