National Indian Health Board
American Indian/Alaska Native National REC
(AI/AN National REC)

Fact Sheet with Questions & Answers

National Goal for Adoption and Use of  Certified Electronic Health Records

Adopt use of certified electronic health records (EHRs) and successfully meet the Meaningful Use standards for use of certified EHRs.  Integrate improved workflow processes into facility/provider clinical practices through demonstration of meaningful use of an EHR that results in “Improved Quality of Patient Care and Outcomes.”

National Indian Health Board

In April 2010, the National Indian Health Board (NIHB) received approval for a cooperative agreement award from the Office of the National Coordinator for Health IT (ONC) to establish the NIHB American Indian/Alaska Native National REC (NIHB AI/AN National REC).  The terms of this award include a four year scope of work and only two years of funding.  NIHB will need the teamwork assistance of the Indian Health Service (IHS), Tribes and Tribal Organizations, and urban Indian organizations to make this project a success. 

The NIHB AI/AN National REC must work with Providers in IHS, Tribal and Urban Indian (I/T/U) health facilities to gain access to $14.1 million in REC direct support funds.  The $14.1 million must be earned by meeting three ONC-mandated milestones:
Milestone 1 - Secure signed agreements from up to 3,000 providers in the Indian Health System to work with the AI/AN National REC = $4.7 million.
Milestone 2 - Verify implementation of certified EHR software among those 3,000 providers = $4.7 million.
Milestone 3 - Verify the meaningful use of certified EHRs among those 3,000 providers = $4.7 million.

The direct support funds earned by the NIHB AI/AN National REC will be used to support EHR adoption and Meaningful Use support activities in I/T/U facilities.  The NIHB AI/AN National REC support activities will be provided mostly by Area sub-recipient awardees that have capacity and experience. 

NIHB will only receive $750,000 per year in core funds to establish the REC staff infrastructure, manage the REC’s national operations plan and maintain the ONC-mandated reporting system during the first two years of the cooperative agreement.

NIHB AI/AN National REC Goal 

The NIHB AI/AN National REC goal is to ensure that providers throughout the Indian Health System receive resources to support EHR adoption and use health information technology to achieve Meaningful Use of certified EHRs.

NIHB AI/AN National REC Objectives

  • Provide resources to support EHR vendor selection and, to the extent possible, technical resources to support the adoption and use of certified EHRs.
  • Provide outreach and education resources to providers in the Indian Health System to assist with their goal of achieving Meaningful Use of certified EHRs.
  • Support health IT workforce development initiatives through partnerships with the Tribal education organizations/institutions and the Indian Health Service.

How Do Area Health Board or Other Tribal Organizations Prepare for Sub-Recipient Award Process?

  • Produce a working list of I/T/U facilities in designated service area and identify types of facilities (e.g. hospital or health center).
  • Develop a working profile of Providers in I/T/U facilities in designated service area – e.g. number of Providers in each facility.
  • Develop a comprehensive EHR Adoption Status Report for I/T/U facilities in designated service area.
  • Develop a viable EHR Adoption Plan and Meaningful Use Support Strategy for I/T/U facilities in designated service area based on local resource capabilities.

QUESTIONS & ANSWERS

How do Providers in Tribal healthcare facilities receive REC services to support adoption of certified EHRs including training for facility staff?

The NIHB AI/AN National REC will issue a REC Provider Agreement Form.  Tribal health care facilities are requested to complete form entries for all Providers in the facility. Provider Agreement Form “sign-ups” approved by ONC will result in the allocation of direct support funds to our REC.  In turn, our REC will distribute these direct support funds through REC Sub-Recipient Awards to Tribal Organizations to support local certified EHR adoption and Meaningful Use support activities. 

What are REC Sub-Recipient Awards and how does a Tribal Health Organization obtain an award?

The NIHB AI/AN National REC will provide Sub-Recipient Awards to qualifying Tribal Organizations to cover designated service areas to support certified EHR adoption and achieve Meaningful Use.  The Sub-Awardees must meet ONC-mandated award requirements and demonstrate the organizational capacity to deliver REC services. ONC-mandated requirements for Sub-Recipient Award Proposals include the following:

  1. Scope of Work – Describe in outcome terms, the specific services/tasks to be performed by the sub-recipient contractor. Describe how they relate to the accomplishment of program objectives. Contract deliverables and dates must be clearly defined.
  2. Method of Accountability – Describe how services/tasks identified in scope of work will be monitored and reported on by the sub-recipient contractor.  Identify who will be responsible for supervising the contract and who will be responsible for submitting progress reports.
  3. Itemized Budget and Justification – Provide an itemized budget to support identified contract services/tasks and appropriate justification for sub-recipient contract funds.

Can Providers or Tribal healthcare facilities directly receive funds to support certified EHR adoption including training for facility staff?

The NIHB AI/AN National REC cannot provide direct support funds to individual facilities or providers.  REC direct support funds will be made available for use through the following REC direct support funds strategies:

  • Area Sub-Recipient Awards
  • National RPMS  Certified EHR Adoption and Meaningful Use Support Strategy
  • National Commercial Off-the-Shelf (COTS)  EHR Adoption and Meaningful Use Support Strategy

Is NIHB supporting RPMS  EHR sites?

Yes, each Area receiving a Sub-Recipient Award will support adoption of certified RPMS  EHR and Commercial Off-the-Shelf (COTS)  certified EHR and achieving Meaningful Use of  certified EHRs for facilities in their Area.

The NIHB AI/AN National REC will also provide direct support funds for a National RPMS certified EHR Adoption and Meaningful Use Support Strategy for facilities located in areas that do not receive Sub-Recipient Awards. This certified EHR adoption strategy will include the services of Clinical Consultants (Nurse, Pharmacy and Lab) experienced in RPMS EHR adoption.  The Clinical Consultants will provide technical training and assistance to facility staff subject to the availability of federal cooperative agreement funds.  

Is NIHB supporting non-RPMS  EHR sites?

Yes, each Area receiving a Sub Recipient Award will support adoption of certified RPMS  EHR and Commercial Off-the-Shelf (COTS)  EHRs and achieving Meaningful Use of  EHRs for facilities in their Area.

The AI/AN REC will also provide direct support funds for a National Commercial Off-the-
Shelf (COTS) EHR Adoption Strategy and Meaningful Use Support Strategy for facilities located in areas that do not receive Sub-Recipient Awards. This EHR adoption strategy will include vendor selection support services and Meaningful Use training and technical assistance services.  Vendor costs associated with technical training and assistance for certified COTS EHR adoption will be the responsibility of the facility.    

Are federal IHS facilities allowed to sign up with the NIHB REC?

Yes, the NIHB AI/AN National REC is ready to begin enrollment of IHS Facility Providers.   The Agreement, which has been approved by the NIHB AI /AN National REC, the IHS Office of General Counsel, and the ONC, is available NOW. Enrollment is easy.  Only one Agreement form needs to be completed for each facility.

Do federal IHS facilities HAVE to sign up with the NIHB REC?

IHS management will issue a letter to Federal IHS facilities to encourage every Facility to sign-up as soon as possible with the NIHB AI/AN National REC. 

Are tribal health facilities allowed to sign up with the NIHB REC?

Yes, the NIHB AI/AN National REC will be ready to begin enrolling Tribal facilities during December 2010.  We will be announcing the Provider Agreement Form to sign-up Providers in Tribal healthcare facilities very soon.

Do tribal health facilities HAVE to sign up with the NIHB REC?

Tribal healthcare facilities have the option to sign up to work with the NIHB AI/AN Native REC or with their local State REC.  The AI/AN REC does not charge a fee for its services while many State RECs are assessing fees to Providers for their services. Most State RECs will not be knowledgeable about RPMS for those tribal facilities that have a certified RPMS EHR.  We also strongly recommend that Tribal facilities fully evaluate the type and level of certified COTS  EHR technical training and assistance services that will be provided by a State REC prior to signing their agreement.  And, of course, we hope that Tribal facilities will decide to support the NIHB AI/AN National REC and help the Indian Health System prove again how quickly our system adopts the highest quality standards of care, including EHR and Meaningful Use

Are urban Indian health facilities allowed to sign up with the NIHB REC?

Yes, the NIHB AI/AN National REC is ready NOW to begin enrollment of Urban Indian Organization Facility Providers.  The Agreement, which has been approved by the NIHB AI /AN National REC, the IHS Office of General Counsel, and the ONC, is available NOW.  Enrollment is easy.  Only one Agreement form needs to be completed for each facility.

Do urban Indian health facilities HAVE to sign up with the NIHB REC?

Urban Indian health facilities have the option to sign up to work with the NIHB AI/AN Native REC or with their local State REC.  The AI/AN REC does not charge a fee for its services, while many State RECs are assessing fees to Providers for their services.  Most State RECs will not be knowledgeable about RPMS for those urban Indian organization facilities that have a certified RPMS EHR. We also strongly recommend that Urban Indian health facilities fully evaluate the type and level of certified COTS  EHR technical training and assistance services that will be provided by a State REC prior to signing their agreement.  And, of course, we hope that Urban Indian Organizations will decide to support the NIHB AI/AN National REC and help the Indian Health System prove again how quickly our system  adopts the highest quality standards of care, including EHR and Meaningful Use

What is the responsibility of the NIHB REC for MU Support activities?

The NIHB AI/AN National REC will provide funds to adopt Meaningful Use Support activities through locally planned and adopted efforts. These funds will be made available for use through the following REC direct support funds strategies:

  • Area Sub-Recipient Awards
  • National RPMS  EHR Adoption and Meaningful Use Support Strategy
  • National Commercial Off-the-Shelf (COTS)  EHR Adoption and Meaningful Use Strategy

What is REC providing that IHS Meaningful Use Team is not already providing?

The NIHB AI/AN National REC and the IHS Meaningful Use Team are collaborating to form an Indian Country Meaningful Use Initiative, to ensure a consistent approach and message, and to leverage all available resources for  I/T/U providers.  The National REC will supplement the IHS-funded efforts of the IHS Meaningful Use Support Team, and the IHS Meaningful Use Team will support the REC efforts in terms of knowledge-sharing, training materials, and expertise. Based on locally-determined priorities, REC  funds may be used to hire staff or support local Meaningful Use training services to work in tandem with the IHS MU Team.. Funds will be made available for use through the following REC direct support funds strategies:

  • Area Sub-Recipient Awards
  • National RPMS  EHR Adoption and Meaningful Use Support Strategy
  • National Commercial Off-the-Shelf (COTS)  EHR Adoption and Meaningful Use Strategy

Why would a non-RPMS site want to sign up with NIHB REC? With whom should the non-RPMS sites sign up as a REC?

It is incumbent upon each and every provider and facility to conduct their own “due diligence” process to determine which REC will best meet their needs.  While Indian Country sites - - on-RPMS sites (Tribal and urban Indian facilities using certified COTS EHR Software) and RPMS EHR - - are encouraged to sign up with the NIHB AI/AN National REC, they  have the choice of using a State REC.  Each provider/facility must fully evaluate the depth, type and level of certified EHR technical training and assistance services that will be provided by each REC and which is most suited to their EHR and needs

Each Area Tribal Organization receiving an NIHB AI/AN National REC Sub Recipient Award must support adoption of certified Commercial Off-the-Shelf (COTS) EHR and achieving Meaningful Use of certified COTS EHRs for the facilities in their Area.

The NIHB AI/AN National REC will also fund a National Commercial Off-the-Shelf (COTS)  EHR Adoption  and Meaningful Use Support Strategy  to support COTS Vendor Selection and Meaningful Use support activities in Tribal facilities planning to adopt certified COTS  EHR.

Will the NIHB AI/AN National REC help provide the best solution for each particular practice?

The NIHB AI/AN National REC will provide technical support for the certified EHR selection process. However, the individual I/T/U facilities must make their own decisions on whether to use the certified RPMS EHR or purchase a certified COTS EHR system.

 


If you have any further questions please feel free to contact us:

NIHB AI/AN National HITEC REC
Business hours of operation 9am- 530pm EST

Jason Heinecke
AI/AN National HITEC REC Director
Office: 202-507-4083
Email: jheinecke@nihb.org

Tom Kauley
AI/AN National HITEC REC Consultant
Email: tkauley@nihb.org

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