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Indian Nation Finds Technology
Is Prescription for Success
The single pharmacy available to the Fond du Lac Band serves more than 7,500 customers a year, but by early 1995, the facility was struggling to absorb costs that their customers could not meet, even with the help of the Indian Health Service. Bridging the Digital Divide The problem was not just financial. Appropriations from the Indian health Service covered 63 percent of client needs and there was third-party funding out there - private insurers who could cover the remaining 37 percent. But these private companies - and their third-party payments - were accessible only to organizations that were already "wired" and ready to do business in real-time and online. In 1995, that ruled out the Fond du Lac Band of Lake Superior Chippewa. The Resource Patient Management System provided by the Indian Health Service wasn’t built to support the sophisticated operations needed to collect payments from insurance providers who required that all bills be submitted electronically. The technology the tribe needed to close the digital divide between their members and the companies who had the resources to guarantee good health care for all was just not there.
So the Fond du Lac Band decided to build it. Just Do It First, tribal officials scoured the private sector for the kind of computerized billing system they needed. The next challenge was to sell the idea to the Indian Health Service and gain its support. The third step was the creation of appropriate contracts with project contributors - it was critical for the Band to prove it could purchase and handle the installation of whatever it needed. Finally, the tribe had to guarantee it could develop an interface between the system it already had -- the Resource Patient Management System provided by the Indian Health Service -- and the new, computerized billing system the Fond du Lac Band needed. No problem. The Band had created strong, collaborative partnerships with project contributors and supporters, so when the time came to preview their accomplishments, everything went off without a hitch. They were almost in business - all the tribe needed was investment capital. For that, they would return to the public sector. Federal Grant Key to Private Sector Technology The Fond du Lac Band submitted a Tribal Management Grant proposal to the Indian Health Service. The money, said the Band, would allow the tribe’s pharmaceutical providers "to harness the technological magic of the private sector to the management information system of the public sector." When the Indian Health Service approved the grant, the rest, as they say, was history. The story of how the Fond du Lac Band overcame a challenge to the delivery of tribal health care is one Indian nations across the country are busy replicating today. As it turned out, what the Band selected was a point-to-point computerized pharmacy billing system using proprietary software. The partnership eventually forged between Viking Computers, a commercial outfit in Minnesota, the Fond du Lac Band and the Indian Health Service has translated into a smooth electronic billing service for the tribal pharmacy and significantly increased revenue for the Band. It has also resulted in a dramatic increase in the speed and accuracy of billings and service. The Undoable Was Doable! What
is equally important for the Fond du Lac Band is that the new
system reduces their dependence on the federal government, moving
them light-years closer to their real goal, tribal self-governance.
Today, the same system that prints out a customer’s prescription
label simultaneously sends billing information to the patient’s
insurance company and updated data to the patient’s medical
e-file -- a technological coup that some claimed was undoable
just a few years ago. Fond du Lac Band Is a Finalist in Harvard’s Honoring Nations Award The innovative spirit and technological achievements of the Fond du Lac Band have not gone unnoticed. Now in its second year, Harvard’s Honoring Nations Award is drawing long-needed attention to a long list of tribal governance success stories. This year the Fond du Lac Band of Lake Superior Chippewa is among award finalists scheduled to receive "honors" at a public ceremony at Harvard in November 2000. "What is most important, " says Andrew Lee, the program’s founder and director, "is that Honoring Nations provides an opportunity for other Indian nations to learn about and replicate these success stories." Model System Benefits Reservations Everywhere Lee’s insight is borne out by the impact that the Fond du Lac project has already had on a number of other reservations - to date, 34 tribal and Indian Health Service pharmacies have purchased and implemented the online billing system developed by the Fond du Lac Band. The new technology has allowed them to do what the Fond du Lac Band has done -- collect hundreds of thousands of dollars in third-party payments that might otherwise have been lost. Phil Norrgard, Director of Human Services for the Fond du Lac Band, credits Viking Computers in Minnesota and regional Indian Health Service MIS personnel for much of the project’s success. Accolades, he says, should also go to pharmacist Greg Eaton and Deb Smith, Evaluation and Development Coordinator. "Without their support and effort," Norrgard stresses, "the project would not have been possible." For More Information For more information about the online billing system developed by the Fond du Lac Lake Superior Chippewa Band, please contact Deb Smith at (218) 879-1227. For more information about the Harvard Award go to- "Honoring Contributions in the Governance of American Indians" or contact Andrew Lee, Executive Director for Programs at the Harvard Project on American Indian Economic Development. He can be reached by telephone at (617) 496-6632 or by email at andrew_lee@ksg.harvard.edu About the Author Kathy Millar is a writer for the National Partnership for Reinventing Government. Contact her at (304) 728-3051 ext. 255 or kathleen.millar@npr.gov.
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Rising
prescription drug prices are a dilemma for millions of Americans,
but when the escalating cost of medicines hit the Fond du Lac
Band of Lake Superior Chippewa, this independent Indian nation
responded with an innovative and creative solution using information
technology. Thirty-four other tribal health-care providers would
eventually adopt it.