Data on Health and Well-being of American Indians, Alaska Natives, and Other Native Americans. Resource and Patient Management System (RPMS)

12/01/2006

Sponsor: U.S. Department of Health and Human Services (DHHS)/Indian Health Service (IHS)
Description: The Resource and Patient Management System (RPMS) is an IHS-wide system designed to provide detailed and comprehensive clinical and administrative information to providers and managers at all levels of the Indian health system in order to allow them to better manage individual patients, local facilities, regional and national programs. It has several components for reporting detailed information on patient characteristics, diagnoses, and specific services provided to those patients. RPMS is a decentralized automated information system of over 50 integrated software applications with separate, individual databases at local sites. RPMS software modules fall into three major categories: (1) administrative applications that perform patient registration, scheduling, billing, and linkage functions; (2) clinical applications that support various healthcare programs within IHS; and (3) infrastructure applications. It has the capability to produce special reports, by individual provider, clinic, outpatient versus inpatient services, in addition to other output generated from patient-level records. Taken together, the RPMS components collect, store, and then display an extensive abstract of clinical and administrative information gathered during patient contacts.

A smaller subset of this abstracted information is exported to the National Patient Information Reporting System (NPIRS), a national data warehouse designed to allow IHS to aggregate RPMS data from all their local sites to track clinical practice patterns and episodes of care, provide measures of quality of care and clinical outcomes, perform epidemiological studies, report on patient demographics and healthcare utilization patterns and provide data from which health care costs can be estimated. Data elements exported to NPIRS include certain patient demographics; encounter-based information such as the date, location of a visit (facility), provider, the Purpose(s) of Encounter using International Classification of Disease (ICD-9) codes, medications, and certain laboratory test data; and specific patient related clinical data such as health factors.

Relevant Policy Issues: Measurement of Health Status, Disease-specific Measurements, and Factors Contributing to Measured Health Disparities.
Data Type(s): Program enrollment data
Unit of Analysis: Individual
Identification of AI/AN/NA: In the reports that are requested from NPIRS, one can select only AI/AN individuals. The data also permit analyses of a variety of subpopulations, selected by geographic and other variables such as state, reservation, community, facility, tribal affiliation, gender, age group, etc. Tribes have the right to disapprove the release of data that would allow the identification of their tribe.
AI/AN/NA Population in Data Set: RPMS system is in use at essentially all Indian Health Service facilities and at many tribal and some urban program sites, and therefore these local databases should have more than sufficient observations to facilitate detailed analyses. Most data pertains to AI/AN patients, although some is about non-AI/AN who obtain care at IHS, tribal, or urban sites for various reasons. NPIRS contains data on all RPMS registered patients and their encounters, but only for a specified subset of their RPMS data. NPIRS also contains similar data from a handful of tribal and/or urban sites who export data to NPIRS in an appropriate format.
AI/AN/NA Subpopulations: Tribes have the right to approve data release with detailed subpopulation identifiers. Given tribal approval, one could examine the following subpopulations: American Indian alone, Alaska Native alone, or specific tribes and villages.
Geographic Scope: IHS and tribally operated health care facilities are located in 35 states, while a handful of other states host urban Indian health programs. Geographic areas are identified by state and community. Geographic analysis is available by state, or each individuals tribal affiliation (pending approval by tribe during data request).
Date or Frequency: Data are continually fed into the RPMS system as patients are served. At sites where data entry into RPMS is performed by clerks from paper encounter forms that providers complete, there can be delays in this data entry that range from days to months. Data from the local RPMS systems are periodically exported to NPIRS. The frequency of these exports from local sites can vary from daily at the largest sites to once a year from a few smaller sites.
Data Collection Methodology: Participating IHS facilities and providers implement the RPMS software system and input data into the system. Data are then linked into the broader IHS database which can be tapped for research purposes.
Participation: Optional, with incentives for programs (technical support provided)
Strengths: Data sets contain a large number of AI/AN/NA respondents. Data are collected on key policy issues including health. There are multiple years of data available. The RPMS data source is a very powerful tool for examining detailed health and utilization information for individuals using the IHS system over time. It contains comprehensive encounter data not otherwise collected through surveys and includes most IHS providers.
Limitations: RPMS can only report on patients who use IHS facilities and providers and therefore may have some gaps in the overall health experience and utilization of AI/AN patients.
Access Requirements and Use Restrictions: The data are not available to those outside the agency in raw form, but users can request special data analyses. NPIRS is almost entirely outsourced (provided by a contractor under a contract with IHS), so depending on the scope and complexity of the request the user may or may not have to pay any associated costs. Users can send data request forms to the Statistics Program at the Office of Program Support at the Indian Health Service (see address below).
Contact Information: Statistics Program
Office of Program Support
Office of Public Health
Indian Health Service
12300 Twinbrook Parkway, Suite 450
Rockville, Maryland 20852
Telephone: (301) 443-1180
Fax: (301) 443-4087

The RPMS help desk for technical support with the RPMS system has staff who may be able to direct researchers to documents on the website and provide general information about RPMS data. However, the primary purpose of this help desk is for those who are implementing the RPMS system in their facility. The help desk can be contacted by telephone at (505) 248-4371 or (888) 830-7280, or by email to support@ihs.gov.

Main Website, geared primarily towards those who are implementing the RPMS system: http://www.ihs.gov/Cio/RPMS/index.cfm?module=home&option=index.

 

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