In the meaningful-use vanguard

The Indian Health Service wasn't the first healthcare system to have its have its electronic health-record system certified as capable of meeting meaningful-use criteria under the American Recovery and Reinvestment Act, but it is one of the largest.

The service, a part of HHS, calls its EHR the Resource and Patient Management System, or RPMS. The homegrown system, which is adapted from the Veterans Affairs Department's VistA system, serves 2 million people at 280 IHS care sites.

Dr. Theresa Cullen, a rear admiral in the U.S. Public Health Service and the chief technical officer at the IHS, says the service collects "a significant amount of money" from billings to Medicare and Medicaid as well as private insurance companies. As such, it has been working closely with the CMS and the ONC with an eye to meeting meaningful-use targets.

"I took the position about nine months ago that meaningful use was made for the Indian Healthcare Service," Cullen said. The service already uses RMPS to perform many of the functions required to meet meaningful-use targets, such as computerized physician order entry and public health reporting, so, "it was a natural fit for us," she said. "We were able to use the carrot of the incentives to move our whole healthcare IT agenda forward."