Web apps improving Native American health care

As CIO at Shiprock Indian Health Services (, Tom Duran says his first priority is saving money on technology so that more funds can go to care for Native Americans.

That is the goal of the E-Series Web applications that Duran's organization, based in Shiprock, New Mexico, is developing. Duran said his department works with a budget that is 1% of the total Indian Health Services allocation from the federal government.

''Because we choose to move as much of our resources toward the clinical side of the house so we can provide clinical services, we have to do novel things to maximize our dollars,'' Duran said. ''We've developed software that doesn't require upgrading IT systems. We basically developed a Web front end that was platform-independent and processor-independent so that we could use old antiquated workstations in our health system that could run our E-Series without any problems whatsoever.''

The Web-based E-Series applications are designed to allow IHS clinics with Internet access to perform sophisticated queries of heterogeneous health care, government and insurance databases, the CIO explained. IHS will provide information such as a patient's health-care coverage, including Medicare, Medicaid and private insurance, which might help offset the cost of care and medicine and help the service to obtain reimbursement, he added.

To develop the E-Series on the Red Hat Linux operating environment, Duran's IT staff is using tools and database technology from the Cache ''post-relational'' database and tools from InterSystems Corp. (, Cambridge, Mass.

Mike Pike, IT specialist, application software at IHS, said he has been impressed with the reliability of Linux, which his unit has been running for more than a year with no down time. Combined with the database tools, development of the first E-Series apps moved along quite quickly, he said. ''Basically, when we developed the very first E-Series app, E-Verify, patient eligibility verification, it took about 12 hours,'' Pike said.

Pike recalled that on a Tuesday afternoon around 4 p.m., Duran asked him if he could quickly develop an application that would help the hospital to overcome a budget deficit. ''I stayed up all night in my hotel room at that time, actually got it finished about 6:30 in the morning and then we presented it later that day.''

The E-Series originally deployed for IHS in northern New Mexico is now being rolled out in other states, including Arizona and Oregon, Duran said. It is intended to be a nation-wide system to help provide Native Americans with medical care. As a Web-based application, IHS is relatively easy to do, even though most of the clinics have little or no IT staffing to handle software rollouts and updates.

''We basically made an application that is 100% Web-based that we can deploy in seconds anywhere in the country,'' Pike explained. ''You go to the Web address, [and you] instantly have access into the system and can pull data out.''

Future plans for E-Series include applications that will allow doctors and nurses to access patient records from hand-held devices, Duran said.

About the Author

Rich Seeley is Web Editor for Campus Technology.


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