1. 1 Purpose of NDW Upgrade Improve our ability to provide a broad range of retrospective clinical and administrative information to managers at all levels of the Indian health system to allow them to better manage individual patients, local facilities, regional and national programs and to allow IHS management to provide legislatively required reports to the Administration and Congress.

2. 8/22/20082 NPIRS Technical Architecture

3. 3 The NDW Environment... Accepts registration and encounter-based patient data… …from sites using RPMS or other IT systems… …and CHS data from the Fiscal Intermediary and Area databases.

4. 4 The NDW Environment... Employs healthcare industry standards (HL7) for data transport and messaging … …and an Integration engine to route those data from sites to the proper destinations (e.g., the NDW, an Area database).

5. 5 The NDW Environment... Collects and stores information almost exactly as it is received from the field … …maintaining historical snapshots of those data… …maintaining as much of its informational content, as possible.

6. 6 The NDW Environment... Provides accurate and helpful information about the data it receives to our field colleagues: Record counts Rejected records; reason for rejection Missing data in fields, erroneous codes Less than expected counts based on historical benchmarks

7. 7 The NDW Environment... Supplies data to various data marts from which more targeted information can be gathered Workload/User Pop Export & Error Tracking Data Quality General

8. 8 The NDW Environment... Supplies data to various data marts from which more targeted information can be gathered Outcome measurement (ORYX, CMS measures, GPRA) Organizational units (Area, Urban) Programs (public health nursing, environmental health, patient education, dental, behavioral health, women’s health, ‘Trends’)

9. 9 The NDW Environment... Uses a “probabilistic matching” application to resolve by individual across facilities… …and can interface with a more complete “Master Person Index” application, when available.

10. 10 NPIRS Overview How did the NDW Project come about? How is the new NDW System designed? What are the benefits of the new NDW system? How is data exported to NPIRS? What data can NPIRS collect? How do we add new data elements? How do we assure the integrity of the data we receive? How can users access and use information from the NDW? What do we foresee for the future?

11. 11 Benefits for our Users Improved report accuracy More confidence in data - better able to verify reports with local data Improved export tracking and data quality assessment tools Better able to report patient “outcomes” Better support for Areas’ performance measurements, health status assessments, and surveillance

12. 12 Benefits for our Users (cont.) Better consistency among reports - a rigorously gathered, verified, and maintained “single version of truth” Lessened local burdens responding to national and Area level requests for information National normative data for local and Area reports More choices for ORYX users More information available for Tribal EPI Centers Better information to support Diabetes monies