Indian Nation Finds Technology
Is Prescription for Success
By
Kathy Millar
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.
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.