Building Bridges Working With American Indian Alaska Native Health Care Providers To Integrate Reproductive Health Sti And Hiv Prevention Services PDF Download

Accurate and timely information is essential for understanding and improving the health of all Americans. This is especially important for the American Indians and Alaska Natives (AI/AN) residing in urban areas who receive their health services through a network of urban Indian health organizations (UIHOs). This community driven health care network is successful at addressing many of the health needs because it tailors health care delivery to the unique needs of the urban Indian population. As the nation engages in fervent debate about the future of health care, the need for data to inform the process for organizations that serve urban AI/AN is needed. But unlike the rest of the American health care system, the diversity across the urban Indian health landscape demands a thorough assessment and defined strategy to move toward Health Information Technology (HIT) that will meet the requirements outlined by health care reform. HIT is integral in quality improvement. Quality can be defined as delivering the right care, at the right time to meet the patient's needs. Effective and timely utilization of a patient's information combined with knowledge of the best treatment information available will be critical in improving quality of care to patients. In addition, HIT promises to provide significant improvements in: preventive care, chronic disease management, care coordination, non-visit-based care, or "e-care", knowledge-based medication management, to name a few. Improvement in these areas could make serious inroads in eliminating the health disparities for urban AI/AN. A major barrier to widespread implementation of these HIT models is the provider payment system. The current U.S. health care payment system pays predominantly for the volume of services rendered, such as office visits and procedures, and not for the quality of health care outcomes. And it's a payment system that effectively punishes providers for achieving efficiencies such as the elimination of avoidable readmissions and unnecessary in-person office visits. If the average medical practice today were to reduce its volume of reimbursed office visits in order to spend more time on unreimbursed care coordination, chronic care management, non-visit-based care, and medication management in order to improve patient health, care quality, and care efficiency, then the practice would not survive. HIT can provide valuable inroads to quality improvement related to patient care, but it also lends itself to a critical role in payment reform. HIT implemented specifically as an accelerator of health care delivery innovation and payment reform could transform U.S. health care as we know it.