Draft Indian Health Service Strategic Plan Fiscal Year 2018-2022, 35012-35016 [2018-15740]
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94. Sandra Williams, Dresher, Pennsylvania,
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[FR Doc. 2018–15739 Filed 7–23–18; 8:45 am]
BILLING CODE 4165–15–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Indian Health Service
Draft Indian Health Service Strategic
Plan Fiscal Year 2018–2022
Indian Health Service, IHS.
Request for comments; notice of
Tribal Consultation and Urban Indian
Confer.
AGENCY:
ACTION:
The Indian Health Service
(IHS) is developing an Agency-wide
Strategic Plan to guide the work and
strengthen partnerships with Tribes and
Urban Indian Organizations. The IHS is
SUMMARY:
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Federal Register / Vol. 83, No. 142 / Tuesday, July 24, 2018 / Notices
seeking public comment on its Draft IHS
Strategic Plan fiscal year (FY) 2018–
2022 (Draft IHS Strategic Plan FY 2018–
2022). Additionally, notice is given that
the IHS will conduct a Tribal
Consultation and Urban Indian Confer
regarding the Draft IHS Strategic Plan
FY 2018–2022. In addition to the virtual
town hall sessions, the IHS will seek
other opportunities to solicit input from
Tribal and Urban Indian programs on
the Draft IHS Strategic Plan FY 2018–
2022 during the comment period. For
IHS Strategic Plan events during the
comment period, please check the IHS
Event Calendar at: https://www.ihs.gov/
ihscalendar/.
DATES: Comments due by August 23,
2018.
The IHS virtual town hall sessions:
1. Urban Indian Confer on August 3
2018, from 2:00 p.m.–3:30 p.m. (Eastern
Time).
2. Tribal Consultation on August 6,
2018, from 2:00 p.m.–3:30 p.m. (Eastern
Time).
ADDRESSES: Written comments on the
Draft IHS Strategic Plan FY 2018–2022
may be provided by email, or by United
States (U.S.) postal mail.
E-mail addresses are as follows:
For Tribes: consultation@ihs.gov.
For Urban Indian Organizations:
urbanconfer@ihs.gov.
For IHS Employees and the General
Public: IHSStrategicPlan@ihs.gov.
Please use ‘‘DRAFT IHS STRATEGIC
PLAN FY 2018–2022’’ as the subject
line.
U.S. Postal Mail: RADM Michael D.
Weahkee, MBA, MHSA, Acting Director,
ATTN: Draft IHS Strategic Plan FY
2018–2022, Indian Health Service, 5600
Fishers Lane, Mailstop: 08E86,
Rockville, Maryland 20857.
FOR FURTHER INFORMATION CONTACT:
CAPT Francis Frazier, Director, Office of
Public Health Support, IHS, 5600
Fishers Lane, Mail Stop: 09E10D,
Rockville, Maryland 20857. Telephone
(301) 443–0222 (This is not a toll-free
number).
The IHS
participated in a strategic planning
process informed by feedback received
from Tribes, Urban Indian
Organizations, and staff, as described in
more detail below, to develop the Draft
IHS Strategic Plan FY 2018–2022 for
consideration. The IHS is committed to
improving health care delivery services
and enhancing critical public health
services to strengthen the health status
of American Indian and Alaska Native
people throughout the health system.
The Draft IHS Strategic Plan FY 2018–
2022 includes a revised IHS Mission
statement, a new IHS Vision statement,
jstallworth on DSKBBY8HB2PROD with NOTICES
SUPPLEMENTARY INFORMATION:
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and articulates how the IHS will achieve
its mission through three strategic goals.
The three strategic goals are: (1) To
ensure that comprehensive, culturally
acceptable personal and public health
services are available and accessible to
American Indian and Alaska Native
people; (2) To promote excellence and
quality through innovation of the Indian
health system into an optimally
performing organization; and (3) To
strengthen IHS program management
and operations. Each goal is supported
by objectives and strategies. To review
the current IHS Mission statement and
priorities, please visit: https://
www.ihs.gov/aboutihs/overview/.
The strategic planning Consultation
and Confer process is an opportunity for
the IHS to further refine and strengthen
the Draft IHS Strategic Plan FY 2018–
2022. The IHS appreciates the
invaluable feedback received to date on
the Draft IHS Strategic Plan FY 2018–
2022 and seeks to ensure all Agency
stakeholders have the opportunity to
comment. As we build on the current
Draft IHS Strategic Plan FY 2018–2022,
we look forward to receiving your
comments by August 23, 2018.
The Urban Indian Confer on August 3,
2018, and the Tribal Consultation on
August 6, 2018, will be held
telephonically and by webinar. A letter
will be sent to Urban Indian
Organization Leaders and Tribal Leaders
to notify them about details associated
with conference call and webinar
schedules and call-in information.
To develop the Draft IHS Strategic
Plan FY 2018–2022, the IHS used a
process similar to the U.S. Department
of Health and Human Services (HHS)
Strategic Plan FY 2018–2022, including
use of goals; objectives and strategies;
environmental scans; Strengths,
Weaknesses, Opportunities, and Threats
(SWOT) analysis; and workgroup
participation. The environmental scan
reviewed several IHS Areas,
Headquarters Offices, and other
available documents, and the SWOT
exercise was conducted with IHS staff.
Informed by these documents and
analysis, the IHS developed an initial
framework for review and comment by
Tribes, Urban Indian Organizations, and
IHS staff. The IHS first initiated Tribal
Consultation and Urban Indian Confer
on the IHS Strategic Plan initial
framework on September 15, 2017, and
formed an IHS Federal-Tribal Strategic
Planning Workgroup (workgroup) to
review all comments and recommend a
list of final goals and objectives for IHS
leadership review and approval.
During the initial framework
comment period (September 15, 2017–
October 31, 2017), the IHS held
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listening sessions, presented at Tribal
meetings, and held conference calls
with Tribal and Urban Indian
Organization leaders. The workgroup
membership included IHS staff at the
Area, Service Unit, and Headquarters
levels (including a representative from
the IHS Office of Urban Indian Health
Programs); Tribal leaders or their
designees. The workgroup reviewed the
comments received from 150 Tribes,
Tribal Organizations, Urban Indian
Organizations and IHS staff on the
initial framework and suggested
strategies during six meetings over a 3month period, resulting in final
recommendations on the IHS Mission,
Vision, Goals, Objectives, and
Strategies. These recommendations are
the basis of the Draft IHS Strategic Plan
FY 2018–2022.
Since initiating Tribal Consultation
and Urban Indian Confer on the IHS
Strategic Plan initial framework, the IHS
has issued four letters to Tribal Leaders
and Urban Indian Organization Leaders
to update Tribes and Urban Indian
Organizations on progress. Additionally,
the IHS issued several communications
stating that comments on the Draft IHS
Strategic Plan FY 2018–2022 will be
accepted throughout the strategic
planning process. The IHS strategic
planning Web site includes more
information about the IHS strategic plan
timeline, as well as links to the Tribal
Leader letters, Urban Indian
Organization Leader letters, and
workgroup activities.
The IHS values all feedback and input
regarding the Draft IHS Strategic Plan
FY 2018–2022 and invites Tribes, Tribal
Leaders, and/or their designees to
Consult and Urban Indian Organization
Leaders to Confer on the Draft IHS
Strategic Plan FY 2018–2022. Tribal
Consultation will be conducted with
elected or appointed leaders of Tribal
Governments and their designated
representatives. Those wishing to
participate in the Tribal Consultation as
a designee must have a copy of a letter
signed by an elected or appointed Tribal
official or their designee that authorizes
them to serve as the representative of
the Tribe. Urban Indian Confer will be
conducted with recognized
representatives from Urban Indian
Organizations, as defined by 25 U.S.C.
1603(29). Representatives from other
Tribal Organizations and Native nonprofit organizations are welcome as
observers. Those wishing to be
recognized representatives from Urban
Indian Organizations should provide
documentation that their organization
meets the definition at 25 U.S.C.
1603(29) and that the selected
participant has the official capacity to
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Federal Register / Vol. 83, No. 142 / Tuesday, July 24, 2018 / Notices
represent the organization. This
documentation should be submitted by
e-mail no later than 3 days in advance
of the Tribal Consultation and Urban
Indian Confer session to the address that
follows: IHSStrategicPlan@ihs.gov.
The text of the Draft IHS Strategic
Plan FY 2018–2022 is available at the
IHS Web site at: https://www.ihs.gov/
strategicplan/and below.
jstallworth on DSKBBY8HB2PROD with NOTICES
Indian Health Service (IHS)
Draft IHS Strategic Plan Fiscal Year 2018–
2022
The Indian Health Service (IHS) provides
a wide range of clinical, public health,
community and facilities infrastructure
services to approximately 2.2 million
American Indians and Alaska Natives (AI/
AN) from 573 federally recognized Tribes in
37 States. Comprehensive primary health
care and disease prevention services are
provided through a network of hospitals,
clinics, and health stations on or near Indian
reservations. These facilities are
predominately located in rural and primary
care settings and are managed by IHS, Tribes,
and Tribal Organizations. In addition, IHS
contracts with Urban Indian Organizations
for health care services provided in urban
centers. The Draft IHS Strategic Plan FY
2018–2022 includes the Mission statement, a
new Vision statement and articulates how the
IHS will achieve its mission through three
strategic goals. Each goal is supported by
objectives and strategies.
Mission: To raise the physical, mental,
social, and spiritual health of American
Indians and Alaska Natives to the highest
level.
Vision: Healthy communities and quality
health care systems through strong
partnerships and culturally relevant
practices.
Goal 1: To ensure that comprehensive,
culturally acceptable personal and public
health services are available and accessible to
American Indian and Alaska Native people.
Goal Explanation: The Indian Health
Service (IHS) provides comprehensive
primary health care and public health
services, which are critical to improving the
health of AI/AN people. The Indian health
system delivers care through health care
services provided in IHS, Tribal, and Urban
(I/T/U) health facilities (e.g., hospitals,
clinics) and by supporting the purchase of
essential health care services not available in
IHS and Tribal health care facilities, known
as the Purchased/Referred Care (PRC)
program. Additional services include
environmental health improvements as well
as traditional healing to complement the
medical, dental, pharmacy, laboratory,
behavioral health and other primary care
medical programs. Expanding access to these
services in AI/AN communities is essential to
improving the health status of the AI/AN
population. This goal includes securing the
needed workforce, strengthening
collaboration with a range of public and
private, Tribal, and Urban Indian providers
and expanding access to quality health care
services to promote the health needs of AI/
AN communities.
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Objective 1.1: Recruit, develop, and retain
a dedicated, competent, and caring
workforce.
Objective Explanation: Consistent, skilled,
and well-trained leadership is essential to
recruiting and retaining well-qualified health
care professionals and administrative
professionals. Attracting, developing, and
retaining the needed staff will require
streamlining hiring practices and other
resources that optimize health care outcomes.
Within the Indian health system, staff
development through orientation, job
experience, mentoring, and short and longterm training and education opportunities are
essential for maintaining and expanding
quality services and maintaining
accreditation of facilities. Also, continuing
education and training opportunities are
necessary to increase employees’ skill sets
and knowledge to keep pace in rapidly
evolving areas of medical science, prevention
science, improvement science, and
information technology, as well as to increase
opportunities for employee career
advancement and/or to maintain necessary
professional credentialing and accreditation.
Strategies—The following strategies
support this objective:
Health Care Recruitment and Retention:
1. Improve and innovate a process that
increases recruitment and retention of
talented, motivated, desirable, and competent
workers, including through partnerships with
Tribal communities and others.
2. Continue and expand the utilization of
the IHS and Health Resources and Services
Administration’s National Health Service
Corps scholarship and loan repayment
programs, as authorized by the law, to
increase health care providers at I/T/U
facilities.
3. Support IHS sponsorship of fellowship
slots in certain specialized leadership
programs for recruitment of future physician
leaders.
4. Evaluate new organizational structure
options and reporting relationships to
improve oversight of the Indian Health
Professions program.
5. Expand the use of paraprofessionals and
mid-level practitioners to increase the
workforce and provide needed services.
6. Develop training programs in
partnership with health professional schools
and training hospitals and expand
opportunities to educate and mentor Native
youth interested in obtaining health science
degrees.
7. Enhance and streamline IHS Human
Resources infrastructure to hire wellqualified personnel.
Staff Capacity Building:
8. Strengthen the workforce to improve
access to, and quality of, services.
9. Improve leadership skills, adopt a
consistent leadership model, and develop
mentoring programs.
10. Improve continuity processes and
knowledge sharing of critical employee,
administrative, and operational functions
through written communications and
documentation within IHS.
11. Improve workplace organizational
climate with staff development addressing
teamwork, communication, and equity.
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12. Strengthen employee performance and
responsiveness to the Agency, Tribes, and
patients by improving employee orientation
and opportunities for training and education,
including, customer service skills.
Objective 1.2: Build, strengthen, and
sustain collaborative relationships.
Objective Explanation: Collaboration
fostered through an environment that values
partnership is vital to expanding the types of
services to improve population health
outcomes that can be achieved within the
health care delivery system. These
relationships include those between Tribes,
Urban Indian programs, communities, other
government agencies, not-for-profits,
universities/schools, foundations, private
industry, as well as internal cooperation
within the Agency and collaborative project
management.
Strategies—The following strategies
support this objective:
Enhancing Collaboration:
1. Collaborate with Tribes in the
development of community-based health
programs, including health promotion and
disease prevention programs and
interventions that will increase access to
quality health programs.
2. Develop a community feedback system/
program where community members can
provide suggestions regarding services
required and received.
3. Support cross collaboration and
partnerships among I/T/U stakeholders.
Service Expansion:
4. Promote collaborations between IHS,
other Federal agencies, Tribes, and Tribal
Organizations to expand services, streamline
functions and funding, and advance health
care goals and initiatives.
5. Work with community partners to
develop new programs responsive to local
needs.
Objective 1.3: Increase access to quality
health care services.
Objective Explanation: Expanded access to
health care services, including individual
and community health services, requires
using many approaches and is critical to
improving the health of AI/AN people and
reducing the leading causes of death risk
factors. Among the needs identified are
increased prevention, specialty care,
innovative use of health care providers,
traditional medicine, long-term and aftercare
services (which may require advancing
holistic and culturally centered population
health models), and expanded facilities and
locations. To assess the success of these
efforts, measures are needed to evaluate
provider productivity, patient satisfaction,
and align improvements in support
operations (e.g., human resources,
contracting, technology) to optimize access to
quality health care services.
Strategies—The following strategies
support this objective:
Health Care Service Access Expansion:
1. Develop and support a system to
increase access to preventive care services
and quality health care in Indian Country.
2. Develop and expand programs in
locations where AI/AN people have no
access to quality health care services.
3. Overcome or mitigate challenges and
enhance partnerships across programs and
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agencies by identifying, prioritizing, and
reducing access limitations to health care for
local AI/AN stakeholders.
4. Increase access to quality community,
direct/specialty, long-term care and support
services, and referred health care services
and identify barriers to care for Tribal
communities.
5. Leverage technologies such as
telemedicine and asynchronous electronic
consultation systems to include a more
diverse array of specialties and to expand,
standardize, and increase access to health
care through telemedicine.
6. Improve team effectiveness in the care
setting to optimize patient flow and
efficiency of care delivery.
7. Reduce health disparities in the AI/AN
population.
8. Provide evidence-based specialty and
preventive care that reduces the incidence of
the leading causes of death for the AI/AN
population.
9. Incorporate Traditional cultural
practices in existing health and wellness
programs, as appropriate.
10. Improve the ability to account for
complexity of care for each patient to gauge
provider productivity more accurately.
11. Hold staff and management
accountable to outcomes and customer
service through satisfaction surveys.
Facilities and Locations:
12. In consultation with Tribes, modernize
health care facilities to expand access to
quality health care services.
13. In consultation with Tribes, review and
incorporate a resource allocation structure to
ensure equity among Tribes.
14. Develop and execute a coordinated
plan (including health care, environmental
engineering, environmental health, and
health facilities engineering services) to
effectively and efficiently execute response,
recovery, and mitigation to disasters and
public health emergencies.
Goal 2: To promote excellence and quality
through innovation of the Indian health
system into an optimally performing
organization.
Goal Explanation: In pursuit of high
reliability health care services 1 and care that
is free from harm, the IHS has implemented
several innovations in health care delivery to
advance the population health needs of AI/
AN communities. In many cases, innovations
are developed to meet health care needs at
the local level and subsequently adopted
across the Indian health system, as
appropriate. IHS will continue to promote
excellence and quality through innovation by
building upon existing quality initiatives and
integrating appropriate clinical and public
health best practices. Recent IHS efforts have
been aimed at strengthening the underlying
quality foundation of federally operated
facilities, standardizing processes, and
sharing health care best practices with other
1 High reliability health care means consistent
excellence in quality and safety for every patient,
every time. High reliability in health care improves:
organizational effectiveness, efficiency, culture,
customer satisfaction, compliance, and
documentation. For more information about High
Reliability Organizations, please see: https://
psnet.ahrq.gov/primers/primer/31/high-reliability.
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Federal, State, Tribal, and Urban Indian
programs.
Objective 2.1: Create quality improvement
capability at all levels of the organization.
Objective Explanation: Ensure quality
improvement is operational in all direct care,
public health, administrative, and
management services throughout the system.
Quality improvement will be achieved at all
levels of the organization including
Headquarters, Area Offices, and Service
Units and will be made available to Tribes,
Tribal Organizations, and Urban Indian
Organizations, as requested. Creating quality
improvement capability at all levels will
require training, resources, commitment, and
consistency to assure that every employee
shares a role in continuous quality
improvement in all IHS operations and
services. This objective will build upon
current efforts of the 2016–2017 IHS Quality
Framework 2 to strengthen quality
improvement related to data, training, and
standards of care.
Strategies—The following strategies
support this objective:
Quality Data:
1. Improve the quality of data collected
regarding health care services and program
outcomes.
2. Develop and integrate quality standards
and metrics into governance, management,
and operations.
3. Standardize quality metrics across the
IHS and use results to share information on
best practices, performance trends, and
identification of emerging needs.
Continuous Quality Improvement:
4. Provide training, coaching, and
mentoring to ensure continuous quality
improvement and accountability of staff at all
levels of the organization.
5. Evaluate training efforts and staff
implementation of improvements, as
appropriate.
Standards of Care:
6. Develop and provide standards of care
to improve quality and efficiency of health
services across IHS.
7. Adopt the Model of Improvement in all
clinical, public health, and administrative
activities in the Indian health system.
8. Adopt patient-centered models of care,
including patient centered medical home
recognition and care integration.
Objective 2.2: Provide care to better meet
the health care needs of Indian communities.
Objective Explanation: Key to improving
health outcomes and sustaining population
health is culturally responsive health care
that is patient-centered and community
supported. IHS will implement culturally
appropriate and effective clinical and public
health tools, as appropriate, to improve and
better meet the health care needs of AI/AN
communities. This objective reinforces
current efforts addressing culturally
appropriate care and support dissemination
of best practices.
Strategies—The following strategies
support this objective:
2 The IHS Quality Framework 2016–2017 is
available at: https://www.ihs.gov/newsroom/
includes/themes/newihstheme/display_objects/
documents/IHS_2016-2017_
QualityFramework.PDF.
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Culturally Appropriate Care:
1. Strengthen culturally competent
organizational efforts and reinforce
implementation of culturally appropriate and
effective care models and programs.
2. Promote and evaluate excellence and
quality of care through innovative, culturally
appropriate programs.
3. Promote the total health integration
within a continuum of care that integrates
acute, primary, behavioral, and preventive
health care.
4. Explore environmental and social
determinants of health and trauma-informed
care in health care delivery. Expand best
practices across the IHS.
5. Continue to develop and implement
trauma-informed care models and programs.
Sharing Best Practices:
6. Work collaboratively within IHS, and
among other Federal, State, Tribal programs,
and Urban Indian programs to improve
health care by sharing best practices.
Goal 3: To Strengthen IHS program
management and operations.
Goal Explanation: This goal addresses
issues of management, accountability,
communication, and modernized information
systems. IHS is committed to the principles
of improved internal and external
communication, and sound management.
Assuring the availability and ongoing
development of a comprehensive information
technology (IT) system is essential to
improving access to integrated clinical,
administrative, and financial data to support
individual patient care, and decision-making.
Objective 3.1: Improve communication
within the organization with Tribes and other
stakeholders, and with the general public.
Objective Explanation: This objective
addresses the critical need to improve
communication throughout the IHS, with
employees and patients, with Tribes, with
Urban Indian Organizations, with the many
organizations working with IHS and with the
general public. Most important is to assist
Tribes, Urban programs, and IHS in better
understanding Tribal and Urban Indian
needs and IHS program needs, to encourage
full participation in information exchange,
and to engage Tribes and Urban programs in
partnership and coalition building. This
includes defining and characterizing
community needs and health program needs,
modifying health programs as needed, and
monitoring the effectiveness of programs and
program modifications.
Strategies—The following strategies
support this objective:
Communication Improvements:
1. Improve communication and
transparency among all employees,
managers, and senior leadership.
2. Develop and define proactive
communications plans for internal and
external stakeholders.
3. Enhance health-related outreach and
education activities to patients and families.
4. Design social media platforms that will
ensure wide dissemination of information to
interested and affected individuals and
organizations.
Strengthened Partnership:
5. Assure quality reporting relationships
between service units, Area offices, and
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Federal Register / Vol. 83, No. 142 / Tuesday, July 24, 2018 / Notices
headquarters are clearly defined and
implemented.
6. Effectively collaborate with other IHS
offices (e.g., the Loan Repayment Program)
and HHS Staff and Operating Divisions
where missions, goals, and authorities
overlap.
Objective 3.2: Secure and effectively
manage the assets and resources.
Objective Explanation: This objective
supports the delivery of health care through
improved management of all types of assets
and non-workforce resources. To elevate the
health status of the AI/AN population and
increase access to medical care, IHS must
continue to help ensure patients understand
their health care options and improve
business process and efficiencies to the
health care system. IHS will also increase the
effectiveness of operations and reporting,
while providing more assistance and
infrastructure support to Areas and facilities.
Strategies—The following strategies
support this objective:
Infrastructure, Capacity, and
Sustainability:
1. Enhance transparency of the IHS
management and accountability
infrastructure to properly manage and secure
assets.
2. Ensure that Federal, State, Tribal,
territorial, and local Tribal health programs
have the necessary infrastructure to
effectively provide essential public health
services.
3. Provide technical assistance to
strengthen the capacity of service units and
Area Offices to enhance effective
management and oversight.
4. Apply economic principles and methods
to assure ongoing security and sustainability
of Federal, Tribal and Urban Indian facilities.
Improved Business Process:
5. Routinely review management
operations to effectively improve key
business management practices.
6. Optimize business functions to ensure
IHS is engaged in discussions on value-based
purchasing.
7. Develop policies, use tools, and apply
models that ensure efficient use of assets and
resources.
8. Strengthen management and operations
through effective oversight.
9. Develop standardized management
strategies for grants, contracts, and other
funding opportunities to promote innovation
and excellence in operations and outcomes.
Patient Education and Resources:
10. Strengthen patients’ awareness of their
health care options, including Medicaid and
Medicare enrollment, which may increase
access to health care and optimize third party
reimbursements.
Objective 3.3: Modernize information
technology and information systems to
support data driven decisions.
Objective Explanation: This objective is to
assure the availability and ongoing
improvement of a comprehensive
information technology (IT) system that
meets the needs of providers, patients, and
I/T/Us, including using technology to
provide improved, timely access to care and
to reduce the need for transit. This objective
recognizes that qualified and capable IT staff
VerDate Sep<11>2014
13:59 Jul 23, 2018
Jkt 244001
and leadership are fundamental in achieving
the strategies listed below and further
reinforces the workforce objectives outlined
elsewhere in the plan. An improved Indian
health IT network increases access to
integrated clinical, administrative, and
financial data to support individual patient
care, decision-making, and advocacy. The
need for data will require the development of
a system integrated with Tribal and Urban
Indian programs that will address the current
and projected clinical, administrative, and
fiscal data needs. Timely fiscal data
dissemination to all Federal partners when
developing budgets is necessary to accurately
address health care needs of Indian
communities. Data quality (i.e., accuracy,
reliability, and validity) and quality patient
care will continue to play a highly visible
role both within and outside the IHS. Data
quality is only partially dependent upon
technology. Improved data quality also
reflects other sustained initiatives, such as
accuracy of data entry, legibility of
handwriting, appropriate and timely data
exports, and accuracy of coding.
Strategies—The following strategies
support this objective:
Health Information Technology (HIT):
1. Evaluate electronic health record needs
of the IHS and the ability for the health
information systems to meet those needs,
create seamless data linkages, and meet data
access needs for Tribes and Tribal program
health information systems.
2. Develop a consistent, robust, stable,
secure, state-of-the-art HIT system to support
clinicians workflow, improve data collection,
and provide regular and ongoing data
analysis.
3. Modernize the HIT system for IHS
Resource and Patient Management System
(RPMS) or commercial off-the-shelf packages.
4. Align with universal patient record
systems to link off-reservation care systems
that serve AI/AN.
5. Enhance and expand technology such as
the IHS telecom to provide access for
consultative care, stabilization of care,
decreased transportation, and timeliness of
care at any IHS-funded health program.
Data Process:
6. Provide available data to inform decision
making for internal and external
stakeholders.
7. Act upon performance data and
standardize data and reporting requirements.
8. Assure system of data sharing to solidify
partnerships with Tribal Epidemiology
Centers and other Tribal programs.
9. Establish capability for data federation 3
so that data analytics/business intelligence
may be applied to disparate data stored in a
single, general-purpose database that can
hold many types of data and distribute that
data to users anywhere on the network.
Note: This draft plan is developed for
public consideration, it is intended to
improve the management and administration
of the IHS and strategic direction of the
Agency over the next 5 years, and it is not
3 Data federation provides an organization with
the ability to aggregate data from disparate sources
in a virtual database so it can be used for business
intelligence or other analysis.
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intended to create any right, benefit, or legal
responsibility, substantive or procedural,
enforceable at law by a party against the
United States, its agencies, or any person.
The IHS will publish an additional
Federal Register Notice with the final
IHS Strategic Plan FY 2018–2022 after
all comments are received and
considered.
Dated: July 16, 2018.
Michael D. Weahkee,
RADM, Assistant Surgeon General, U.S.
Public Health Service, Acting Director, Indian
Health Service.
[FR Doc. 2018–15740 Filed 7–23–18; 8:45 am]
BILLING CODE 4165–16–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
National Cancer Institute; Notice of
Closed Meetings
Pursuant to section 10(d) of the
Federal Advisory Committee Act, as
amended, notice is hereby given of the
following meetings.
The meetings will be closed to the
public in accordance with the
provisions set forth in sections
552b(c)(4) and 552b(c)(6), Title 5 U.S.C.,
as amended. The grant applications and
the discussions could disclose
confidential trade secrets or commercial
property such as patentable material,
and personal information concerning
individuals associated with grant
applications, the disclosure of which
would constitute a clearly unwarranted
invasion of personal privacy.
Name of Committee: National Cancer
Institute Special Emphasis Panel; NCI
Program Project I (P01).
Date: September 17–18, 2018.
Time: 3:00 p.m. to 5:00 p.m.
Agenda: To review and evaluate grant
applications.
Place: Bethesda North Marriott Hotel &
Conference Center, 5701 Marinelli Road,
North Bethesda, MD 20852.
Contact Person: Mukesh Kumar, Ph.D.,
Scientific Review Officer, Research Program
Review Branch, Division of Extramural
Activities, National Cancer Institute, NIH,
9609 Medical Center Drive, Room 7W618,
Bethesda, MD 20892–9750, 240–276–6611,
mukesh.kumar3@nih.gov.
Name of Committee: National Cancer
Institute Special Emphasis Panel; NCI SPORE
I (P50) Review.
Date: September 25, 2018.
Time: 8:00 a.m. to 2:00 p.m.
Agenda: To review and evaluate grant
applications.
Place: Gaithersburg Marriott
Washingtonian Center, 9751 Washington
Boulevard, Gaithersburg, MD 20878.
E:\FR\FM\24JYN1.SGM
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[Federal Register Volume 83, Number 142 (Tuesday, July 24, 2018)]
[Notices]
[Pages 35012-35016]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-15740]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Draft Indian Health Service Strategic Plan Fiscal Year 2018-2022
AGENCY: Indian Health Service, IHS.
ACTION: Request for comments; notice of Tribal Consultation and Urban
Indian Confer.
-----------------------------------------------------------------------
SUMMARY: The Indian Health Service (IHS) is developing an Agency-wide
Strategic Plan to guide the work and strengthen partnerships with
Tribes and Urban Indian Organizations. The IHS is
[[Page 35013]]
seeking public comment on its Draft IHS Strategic Plan fiscal year (FY)
2018-2022 (Draft IHS Strategic Plan FY 2018-2022). Additionally, notice
is given that the IHS will conduct a Tribal Consultation and Urban
Indian Confer regarding the Draft IHS Strategic Plan FY 2018-2022. In
addition to the virtual town hall sessions, the IHS will seek other
opportunities to solicit input from Tribal and Urban Indian programs on
the Draft IHS Strategic Plan FY 2018-2022 during the comment period.
For IHS Strategic Plan events during the comment period, please check
the IHS Event Calendar at: https://www.ihs.gov/ihscalendar/.
DATES: Comments due by August 23, 2018.
The IHS virtual town hall sessions:
1. Urban Indian Confer on August 3 2018, from 2:00 p.m.-3:30 p.m.
(Eastern Time).
2. Tribal Consultation on August 6, 2018, from 2:00 p.m.-3:30 p.m.
(Eastern Time).
ADDRESSES: Written comments on the Draft IHS Strategic Plan FY 2018-
2022 may be provided by email, or by United States (U.S.) postal mail.
E-mail addresses are as follows:
For Tribes: [email protected].
For Urban Indian Organizations: [email protected].
For IHS Employees and the General Public: [email protected].
Please use ``DRAFT IHS STRATEGIC PLAN FY 2018-2022'' as the subject
line.
U.S. Postal Mail: RADM Michael D. Weahkee, MBA, MHSA, Acting
Director, ATTN: Draft IHS Strategic Plan FY 2018-2022, Indian Health
Service, 5600 Fishers Lane, Mailstop: 08E86, Rockville, Maryland 20857.
FOR FURTHER INFORMATION CONTACT: CAPT Francis Frazier, Director, Office
of Public Health Support, IHS, 5600 Fishers Lane, Mail Stop: 09E10D,
Rockville, Maryland 20857. Telephone (301) 443-0222 (This is not a
toll[dash]free number).
SUPPLEMENTARY INFORMATION: The IHS participated in a strategic planning
process informed by feedback received from Tribes, Urban Indian
Organizations, and staff, as described in more detail below, to develop
the Draft IHS Strategic Plan FY 2018-2022 for consideration. The IHS is
committed to improving health care delivery services and enhancing
critical public health services to strengthen the health status of
American Indian and Alaska Native people throughout the health system.
The Draft IHS Strategic Plan FY 2018-2022 includes a revised IHS
Mission statement, a new IHS Vision statement, and articulates how the
IHS will achieve its mission through three strategic goals. The three
strategic goals are: (1) To ensure that comprehensive, culturally
acceptable personal and public health services are available and
accessible to American Indian and Alaska Native people; (2) To promote
excellence and quality through innovation of the Indian health system
into an optimally performing organization; and (3) To strengthen IHS
program management and operations. Each goal is supported by objectives
and strategies. To review the current IHS Mission statement and
priorities, please visit: https://www.ihs.gov/aboutihs/overview/.
The strategic planning Consultation and Confer process is an
opportunity for the IHS to further refine and strengthen the Draft IHS
Strategic Plan FY 2018-2022. The IHS appreciates the invaluable
feedback received to date on the Draft IHS Strategic Plan FY 2018-2022
and seeks to ensure all Agency stakeholders have the opportunity to
comment. As we build on the current Draft IHS Strategic Plan FY 2018-
2022, we look forward to receiving your comments by August 23, 2018.
The Urban Indian Confer on August 3, 2018, and the Tribal
Consultation on August 6, 2018, will be held telephonically and by
webinar. A letter will be sent to Urban Indian Organization Leaders and
Tribal Leaders to notify them about details associated with conference
call and webinar schedules and call-in information.
To develop the Draft IHS Strategic Plan FY 2018-2022, the IHS used
a process similar to the U.S. Department of Health and Human Services
(HHS) Strategic Plan FY 2018-2022, including use of goals; objectives
and strategies; environmental scans; Strengths, Weaknesses,
Opportunities, and Threats (SWOT) analysis; and workgroup
participation. The environmental scan reviewed several IHS Areas,
Headquarters Offices, and other available documents, and the SWOT
exercise was conducted with IHS staff. Informed by these documents and
analysis, the IHS developed an initial framework for review and comment
by Tribes, Urban Indian Organizations, and IHS staff. The IHS first
initiated Tribal Consultation and Urban Indian Confer on the IHS
Strategic Plan initial framework on September 15, 2017, and formed an
IHS Federal-Tribal Strategic Planning Workgroup (workgroup) to review
all comments and recommend a list of final goals and objectives for IHS
leadership review and approval.
During the initial framework comment period (September 15, 2017-
October 31, 2017), the IHS held listening sessions, presented at Tribal
meetings, and held conference calls with Tribal and Urban Indian
Organization leaders. The workgroup membership included IHS staff at
the Area, Service Unit, and Headquarters levels (including a
representative from the IHS Office of Urban Indian Health Programs);
Tribal leaders or their designees. The workgroup reviewed the comments
received from 150 Tribes, Tribal Organizations, Urban Indian
Organizations and IHS staff on the initial framework and suggested
strategies during six meetings over a 3-month period, resulting in
final recommendations on the IHS Mission, Vision, Goals, Objectives,
and Strategies. These recommendations are the basis of the Draft IHS
Strategic Plan FY 2018-2022.
Since initiating Tribal Consultation and Urban Indian Confer on the
IHS Strategic Plan initial framework, the IHS has issued four letters
to Tribal Leaders and Urban Indian Organization Leaders to update
Tribes and Urban Indian Organizations on progress. Additionally, the
IHS issued several communications stating that comments on the Draft
IHS Strategic Plan FY 2018-2022 will be accepted throughout the
strategic planning process. The IHS strategic planning Web site
includes more information about the IHS strategic plan timeline, as
well as links to the Tribal Leader letters, Urban Indian Organization
Leader letters, and workgroup activities.
The IHS values all feedback and input regarding the Draft IHS
Strategic Plan FY 2018-2022 and invites Tribes, Tribal Leaders, and/or
their designees to Consult and Urban Indian Organization Leaders to
Confer on the Draft IHS Strategic Plan FY 2018-2022. Tribal
Consultation will be conducted with elected or appointed leaders of
Tribal Governments and their designated representatives. Those wishing
to participate in the Tribal Consultation as a designee must have a
copy of a letter signed by an elected or appointed Tribal official or
their designee that authorizes them to serve as the representative of
the Tribe. Urban Indian Confer will be conducted with recognized
representatives from Urban Indian Organizations, as defined by 25
U.S.C. 1603(29). Representatives from other Tribal Organizations and
Native non-profit organizations are welcome as observers. Those wishing
to be recognized representatives from Urban Indian Organizations should
provide documentation that their organization meets the definition at
25 U.S.C. 1603(29) and that the selected participant has the official
capacity to
[[Page 35014]]
represent the organization. This documentation should be submitted by
e-mail no later than 3 days in advance of the Tribal Consultation and
Urban Indian Confer session to the address that follows:
[email protected].
The text of the Draft IHS Strategic Plan FY 2018-2022 is available
at the IHS Web site at: https://www.ihs.gov/strategicplan/and below.
Indian Health Service (IHS)
Draft IHS Strategic Plan Fiscal Year 2018-2022
The Indian Health Service (IHS) provides a wide range of
clinical, public health, community and facilities infrastructure
services to approximately 2.2 million American Indians and Alaska
Natives (AI/AN) from 573 federally recognized Tribes in 37 States.
Comprehensive primary health care and disease prevention services
are provided through a network of hospitals, clinics, and health
stations on or near Indian reservations. These facilities are
predominately located in rural and primary care settings and are
managed by IHS, Tribes, and Tribal Organizations. In addition, IHS
contracts with Urban Indian Organizations for health care services
provided in urban centers. The Draft IHS Strategic Plan FY 2018-2022
includes the Mission statement, a new Vision statement and
articulates how the IHS will achieve its mission through three
strategic goals. Each goal is supported by objectives and
strategies.
Mission: To raise the physical, mental, social, and spiritual
health of American Indians and Alaska Natives to the highest level.
Vision: Healthy communities and quality health care systems
through strong partnerships and culturally relevant practices.
Goal 1: To ensure that comprehensive, culturally acceptable
personal and public health services are available and accessible to
American Indian and Alaska Native people.
Goal Explanation: The Indian Health Service (IHS) provides
comprehensive primary health care and public health services, which
are critical to improving the health of AI/AN people. The Indian
health system delivers care through health care services provided in
IHS, Tribal, and Urban (I/T/U) health facilities (e.g., hospitals,
clinics) and by supporting the purchase of essential health care
services not available in IHS and Tribal health care facilities,
known as the Purchased/Referred Care (PRC) program. Additional
services include environmental health improvements as well as
traditional healing to complement the medical, dental, pharmacy,
laboratory, behavioral health and other primary care medical
programs. Expanding access to these services in AI/AN communities is
essential to improving the health status of the AI/AN population.
This goal includes securing the needed workforce, strengthening
collaboration with a range of public and private, Tribal, and Urban
Indian providers and expanding access to quality health care
services to promote the health needs of AI/AN communities.
Objective 1.1: Recruit, develop, and retain a dedicated,
competent, and caring workforce.
Objective Explanation: Consistent, skilled, and well-trained
leadership is essential to recruiting and retaining well-qualified
health care professionals and administrative professionals.
Attracting, developing, and retaining the needed staff will require
streamlining hiring practices and other resources that optimize
health care outcomes. Within the Indian health system, staff
development through orientation, job experience, mentoring, and
short and long-term training and education opportunities are
essential for maintaining and expanding quality services and
maintaining accreditation of facilities. Also, continuing education
and training opportunities are necessary to increase employees'
skill sets and knowledge to keep pace in rapidly evolving areas of
medical science, prevention science, improvement science, and
information technology, as well as to increase opportunities for
employee career advancement and/or to maintain necessary
professional credentialing and accreditation.
Strategies--The following strategies support this objective:
Health Care Recruitment and Retention:
1. Improve and innovate a process that increases recruitment and
retention of talented, motivated, desirable, and competent workers,
including through partnerships with Tribal communities and others.
2. Continue and expand the utilization of the IHS and Health
Resources and Services Administration's National Health Service
Corps scholarship and loan repayment programs, as authorized by the
law, to increase health care providers at I/T/U facilities.
3. Support IHS sponsorship of fellowship slots in certain
specialized leadership programs for recruitment of future physician
leaders.
4. Evaluate new organizational structure options and reporting
relationships to improve oversight of the Indian Health Professions
program.
5. Expand the use of paraprofessionals and mid-level
practitioners to increase the workforce and provide needed services.
6. Develop training programs in partnership with health
professional schools and training hospitals and expand opportunities
to educate and mentor Native youth interested in obtaining health
science degrees.
7. Enhance and streamline IHS Human Resources infrastructure to
hire well-qualified personnel.
Staff Capacity Building:
8. Strengthen the workforce to improve access to, and quality
of, services.
9. Improve leadership skills, adopt a consistent leadership
model, and develop mentoring programs.
10. Improve continuity processes and knowledge sharing of
critical employee, administrative, and operational functions through
written communications and documentation within IHS.
11. Improve workplace organizational climate with staff
development addressing teamwork, communication, and equity.
12. Strengthen employee performance and responsiveness to the
Agency, Tribes, and patients by improving employee orientation and
opportunities for training and education, including, customer
service skills.
Objective 1.2: Build, strengthen, and sustain collaborative
relationships.
Objective Explanation: Collaboration fostered through an
environment that values partnership is vital to expanding the types
of services to improve population health outcomes that can be
achieved within the health care delivery system. These relationships
include those between Tribes, Urban Indian programs, communities,
other government agencies, not-for-profits, universities/schools,
foundations, private industry, as well as internal cooperation
within the Agency and collaborative project management.
Strategies--The following strategies support this objective:
Enhancing Collaboration:
1. Collaborate with Tribes in the development of community-based
health programs, including health promotion and disease prevention
programs and interventions that will increase access to quality
health programs.
2. Develop a community feedback system/program where community
members can provide suggestions regarding services required and
received.
3. Support cross collaboration and partnerships among I/T/U
stakeholders.
Service Expansion:
4. Promote collaborations between IHS, other Federal agencies,
Tribes, and Tribal Organizations to expand services, streamline
functions and funding, and advance health care goals and
initiatives.
5. Work with community partners to develop new programs
responsive to local needs.
Objective 1.3: Increase access to quality health care services.
Objective Explanation: Expanded access to health care services,
including individual and community health services, requires using
many approaches and is critical to improving the health of AI/AN
people and reducing the leading causes of death risk factors. Among
the needs identified are increased prevention, specialty care,
innovative use of health care providers, traditional medicine, long-
term and aftercare services (which may require advancing holistic
and culturally centered population health models), and expanded
facilities and locations. To assess the success of these efforts,
measures are needed to evaluate provider productivity, patient
satisfaction, and align improvements in support operations (e.g.,
human resources, contracting, technology) to optimize access to
quality health care services.
Strategies--The following strategies support this objective:
Health Care Service Access Expansion:
1. Develop and support a system to increase access to preventive
care services and quality health care in Indian Country.
2. Develop and expand programs in locations where AI/AN people
have no access to quality health care services.
3. Overcome or mitigate challenges and enhance partnerships
across programs and
[[Page 35015]]
agencies by identifying, prioritizing, and reducing access
limitations to health care for local AI/AN stakeholders.
4. Increase access to quality community, direct/specialty, long-
term care and support services, and referred health care services
and identify barriers to care for Tribal communities.
5. Leverage technologies such as telemedicine and asynchronous
electronic consultation systems to include a more diverse array of
specialties and to expand, standardize, and increase access to
health care through telemedicine.
6. Improve team effectiveness in the care setting to optimize
patient flow and efficiency of care delivery.
7. Reduce health disparities in the AI/AN population.
8. Provide evidence-based specialty and preventive care that
reduces the incidence of the leading causes of death for the AI/AN
population.
9. Incorporate Traditional cultural practices in existing health
and wellness programs, as appropriate.
10. Improve the ability to account for complexity of care for
each patient to gauge provider productivity more accurately.
11. Hold staff and management accountable to outcomes and
customer service through satisfaction surveys.
Facilities and Locations:
12. In consultation with Tribes, modernize health care
facilities to expand access to quality health care services.
13. In consultation with Tribes, review and incorporate a
resource allocation structure to ensure equity among Tribes.
14. Develop and execute a coordinated plan (including health
care, environmental engineering, environmental health, and health
facilities engineering services) to effectively and efficiently
execute response, recovery, and mitigation to disasters and public
health emergencies.
Goal 2: To promote excellence and quality through innovation of
the Indian health system into an optimally performing organization.
Goal Explanation: In pursuit of high reliability health care
services \1\ and care that is free from harm, the IHS has
implemented several innovations in health care delivery to advance
the population health needs of AI/AN communities. In many cases,
innovations are developed to meet health care needs at the local
level and subsequently adopted across the Indian health system, as
appropriate. IHS will continue to promote excellence and quality
through innovation by building upon existing quality initiatives and
integrating appropriate clinical and public health best practices.
Recent IHS efforts have been aimed at strengthening the underlying
quality foundation of federally operated facilities, standardizing
processes, and sharing health care best practices with other
Federal, State, Tribal, and Urban Indian programs.
---------------------------------------------------------------------------
\1\ High reliability health care means consistent excellence in
quality and safety for every patient, every time. High reliability
in health care improves: organizational effectiveness, efficiency,
culture, customer satisfaction, compliance, and documentation. For
more information about High Reliability Organizations, please see:
https://psnet.ahrq.gov/primers/primer/31/high-reliability.
---------------------------------------------------------------------------
Objective 2.1: Create quality improvement capability at all
levels of the organization.
Objective Explanation: Ensure quality improvement is operational
in all direct care, public health, administrative, and management
services throughout the system. Quality improvement will be achieved
at all levels of the organization including Headquarters, Area
Offices, and Service Units and will be made available to Tribes,
Tribal Organizations, and Urban Indian Organizations, as requested.
Creating quality improvement capability at all levels will require
training, resources, commitment, and consistency to assure that
every employee shares a role in continuous quality improvement in
all IHS operations and services. This objective will build upon
current efforts of the 2016-2017 IHS Quality Framework \2\ to
strengthen quality improvement related to data, training, and
standards of care.
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\2\ The IHS Quality Framework 2016-2017 is available at: https://www.ihs.gov/newsroom/includes/themes/newihstheme/display_objects/documents/IHS_2016-2017_QualityFramework.PDF.
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Strategies--The following strategies support this objective:
Quality Data:
1. Improve the quality of data collected regarding health care
services and program outcomes.
2. Develop and integrate quality standards and metrics into
governance, management, and operations.
3. Standardize quality metrics across the IHS and use results to
share information on best practices, performance trends, and
identification of emerging needs.
Continuous Quality Improvement:
4. Provide training, coaching, and mentoring to ensure
continuous quality improvement and accountability of staff at all
levels of the organization.
5. Evaluate training efforts and staff implementation of
improvements, as appropriate.
Standards of Care:
6. Develop and provide standards of care to improve quality and
efficiency of health services across IHS.
7. Adopt the Model of Improvement in all clinical, public
health, and administrative activities in the Indian health system.
8. Adopt patient-centered models of care, including patient
centered medical home recognition and care integration.
Objective 2.2: Provide care to better meet the health care needs
of Indian communities.
Objective Explanation: Key to improving health outcomes and
sustaining population health is culturally responsive health care
that is patient-centered and community supported. IHS will implement
culturally appropriate and effective clinical and public health
tools, as appropriate, to improve and better meet the health care
needs of AI/AN communities. This objective reinforces current
efforts addressing culturally appropriate care and support
dissemination of best practices.
Strategies--The following strategies support this objective:
Culturally Appropriate Care:
1. Strengthen culturally competent organizational efforts and
reinforce implementation of culturally appropriate and effective
care models and programs.
2. Promote and evaluate excellence and quality of care through
innovative, culturally appropriate programs.
3. Promote the total health integration within a continuum of
care that integrates acute, primary, behavioral, and preventive
health care.
4. Explore environmental and social determinants of health and
trauma-informed care in health care delivery. Expand best practices
across the IHS.
5. Continue to develop and implement trauma-informed care models
and programs.
Sharing Best Practices:
6. Work collaboratively within IHS, and among other Federal,
State, Tribal programs, and Urban Indian programs to improve health
care by sharing best practices.
Goal 3: To Strengthen IHS program management and operations.
Goal Explanation: This goal addresses issues of management,
accountability, communication, and modernized information systems.
IHS is committed to the principles of improved internal and external
communication, and sound management. Assuring the availability and
ongoing development of a comprehensive information technology (IT)
system is essential to improving access to integrated clinical,
administrative, and financial data to support individual patient
care, and decision-making.
Objective 3.1: Improve communication within the organization
with Tribes and other stakeholders, and with the general public.
Objective Explanation: This objective addresses the critical
need to improve communication throughout the IHS, with employees and
patients, with Tribes, with Urban Indian Organizations, with the
many organizations working with IHS and with the general public.
Most important is to assist Tribes, Urban programs, and IHS in
better understanding Tribal and Urban Indian needs and IHS program
needs, to encourage full participation in information exchange, and
to engage Tribes and Urban programs in partnership and coalition
building. This includes defining and characterizing community needs
and health program needs, modifying health programs as needed, and
monitoring the effectiveness of programs and program modifications.
Strategies--The following strategies support this objective:
Communication Improvements:
1. Improve communication and transparency among all employees,
managers, and senior leadership.
2. Develop and define proactive communications plans for
internal and external stakeholders.
3. Enhance health-related outreach and education activities to
patients and families.
4. Design social media platforms that will ensure wide
dissemination of information to interested and affected individuals
and organizations.
Strengthened Partnership:
5. Assure quality reporting relationships between service units,
Area offices, and
[[Page 35016]]
headquarters are clearly defined and implemented.
6. Effectively collaborate with other IHS offices (e.g., the
Loan Repayment Program) and HHS Staff and Operating Divisions where
missions, goals, and authorities overlap.
Objective 3.2: Secure and effectively manage the assets and
resources.
Objective Explanation: This objective supports the delivery of
health care through improved management of all types of assets and
non-workforce resources. To elevate the health status of the AI/AN
population and increase access to medical care, IHS must continue to
help ensure patients understand their health care options and
improve business process and efficiencies to the health care system.
IHS will also increase the effectiveness of operations and
reporting, while providing more assistance and infrastructure
support to Areas and facilities.
Strategies--The following strategies support this objective:
Infrastructure, Capacity, and Sustainability:
1. Enhance transparency of the IHS management and accountability
infrastructure to properly manage and secure assets.
2. Ensure that Federal, State, Tribal, territorial, and local
Tribal health programs have the necessary infrastructure to
effectively provide essential public health services.
3. Provide technical assistance to strengthen the capacity of
service units and Area Offices to enhance effective management and
oversight.
4. Apply economic principles and methods to assure ongoing
security and sustainability of Federal, Tribal and Urban Indian
facilities.
Improved Business Process:
5. Routinely review management operations to effectively improve
key business management practices.
6. Optimize business functions to ensure IHS is engaged in
discussions on value-based purchasing.
7. Develop policies, use tools, and apply models that ensure
efficient use of assets and resources.
8. Strengthen management and operations through effective
oversight.
9. Develop standardized management strategies for grants,
contracts, and other funding opportunities to promote innovation and
excellence in operations and outcomes.
Patient Education and Resources:
10. Strengthen patients' awareness of their health care options,
including Medicaid and Medicare enrollment, which may increase
access to health care and optimize third party reimbursements.
Objective 3.3: Modernize information technology and information
systems to support data driven decisions.
Objective Explanation: This objective is to assure the
availability and ongoing improvement of a comprehensive information
technology (IT) system that meets the needs of providers, patients,
and I/T/Us, including using technology to provide improved, timely
access to care and to reduce the need for transit. This objective
recognizes that qualified and capable IT staff and leadership are
fundamental in achieving the strategies listed below and further
reinforces the workforce objectives outlined elsewhere in the plan.
An improved Indian health IT network increases access to integrated
clinical, administrative, and financial data to support individual
patient care, decision-making, and advocacy. The need for data will
require the development of a system integrated with Tribal and Urban
Indian programs that will address the current and projected
clinical, administrative, and fiscal data needs. Timely fiscal data
dissemination to all Federal partners when developing budgets is
necessary to accurately address health care needs of Indian
communities. Data quality (i.e., accuracy, reliability, and
validity) and quality patient care will continue to play a highly
visible role both within and outside the IHS. Data quality is only
partially dependent upon technology. Improved data quality also
reflects other sustained initiatives, such as accuracy of data
entry, legibility of handwriting, appropriate and timely data
exports, and accuracy of coding.
Strategies--The following strategies support this objective:
Health Information Technology (HIT):
1. Evaluate electronic health record needs of the IHS and the
ability for the health information systems to meet those needs,
create seamless data linkages, and meet data access needs for Tribes
and Tribal program health information systems.
2. Develop a consistent, robust, stable, secure, state-of-the-
art HIT system to support clinicians workflow, improve data
collection, and provide regular and ongoing data analysis.
3. Modernize the HIT system for IHS Resource and Patient
Management System (RPMS) or commercial off-the-shelf packages.
4. Align with universal patient record systems to link off-
reservation care systems that serve AI/AN.
5. Enhance and expand technology such as the IHS telecom to
provide access for consultative care, stabilization of care,
decreased transportation, and timeliness of care at any IHS-funded
health program.
Data Process:
6. Provide available data to inform decision making for internal
and external stakeholders.
7. Act upon performance data and standardize data and reporting
requirements.
8. Assure system of data sharing to solidify partnerships with
Tribal Epidemiology Centers and other Tribal programs.
9. Establish capability for data federation \3\ so that data
analytics/business intelligence may be applied to disparate data
stored in a single, general-purpose database that can hold many
types of data and distribute that data to users anywhere on the
network.
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\3\ Data federation provides an organization with the ability to
aggregate data from disparate sources in a virtual database so it
can be used for business intelligence or other analysis.
Note: This draft plan is developed for public consideration, it
is intended to improve the management and administration of the IHS
and strategic direction of the Agency over the next 5 years, and it
is not intended to create any right, benefit, or legal
responsibility, substantive or procedural, enforceable at law by a
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party against the United States, its agencies, or any person.
The IHS will publish an additional Federal Register Notice with the
final IHS Strategic Plan FY 2018-2022 after all comments are received
and considered.
Dated: July 16, 2018.
Michael D. Weahkee,
RADM, Assistant Surgeon General, U.S. Public Health Service, Acting
Director, Indian Health Service.
[FR Doc. 2018-15740 Filed 7-23-18; 8:45 am]
BILLING CODE 4165-16-P
