The Indian Health Service

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products and a qualifying guideline. 15

ICD-10 does not provide reimbursement, it is a coding system that is used for billing and reimbursement based on the codes used.

A.2c Patient Access

The IHS, FEHB and TRICARE will all likely adopt some sort of web portal that will allow patient access to their information and that of their families that they may have access to. This is a growing trend in the industry due to the use of HER products. HIEs will not likely give patients access to their data and thus will not impact patient access. Meaningful use will have a direct impact on patient as through meaningful use HER products will be purchased that will be used in part to give patients access to their health information. ICD-10 will not have direct any real direct impact on patient access to data.

A.3 NHIN

The Office of the National Coordinator for Health Information Technology has been responsible for the development of the NwHIN, which is the Nationwide Health Information Network. NwHIN is an initiative for the exchange of healthcare information. It is a web service designed to exchange protected healthcare related data securely. The primary goal in establishing a governance mechanism for NwHIN is to establish a consistent baseline for electronic exchange. One of the main purposes of NwHIN is to bring together HIEs, RHIOs, government, pharmacies, labs, and providers into a nationwide HIE. This will have an impact on TRICARE, IHS, FEHB as well as a potential to impact all service providers one day. 16

HIEs will directly support the NwHIN by exchanging data with them. Meaningful Use will support it through the use of HER products that capture data that will in turn be sent to an HIE and/or the NwHIN. ICD-10 will not directly support the NwHIN as it is a coding system primarily for payment. 17

B.1 Roles Performed

The IHS is responsible for providing health care and services to Alaska Natives and American Indians. It administers health services to Native Americans and Alaska Natives at 33 different hospitals, 59 health centers, as well as 50 health clinics. Various health projects supplement these facilities with a multitude of referral and health services. 18

FEHB’s main role is to provide a system of benefit programs for civilian government employees. There are many different plans available of which the three most broad are fee-for-service, HMOs or health management organizations, high-deductible health plans, PPOs or preferred provider organizations, As well as some other consumer driven plans. 19

TRICARE is the healthcare program for the US DOD. The Department of Defense uses TRICARE to provide civilian health benefits for some members of the military reserve, retired military, their dependants, and active personnel that are stateside. 20

The role of an HIE is to provide the capability to electronically move clinical data among multiple health care information systems all the while maintaining the integrity of the information being transferred.

Meaningful Use has the role of defining guidelines for Health IT professions to develop and deploy HER or Electronic Health Record systems.

ICD-10 is a medical classification list by the World Health Organization. Its role is in providing a list of diseases, symptoms and sign, and other factors that are then coded for billing and reimbursements.

B2. Impact on Workforce

Each of the Federal Government Programs such as IHS, FEBH and TRICARE have an impact on the Health Information Workforce by employing healthcare professionals in a multitude of positions in all facets of their organizations. HIEs and Meaningful Use both employ various professionals in the Health Information Workforce to achieve their goals. ICD-10 coding professionals are employed by various organizations for their reimbursements.