Exhibit 300 (BY2009) for Indian Health Service (IHS) Resource and Patient Management System (RPMS) - Maintenance & Enhancements

PART ONE

OVERVIEW

1. Date of Submission:: 2008-02-04

2. Agency:: 009

3. Bureau:: 17

4. Name of this Capital Asset:: IHS Resource and Patient Management System (RPMS) - Maintenance & Enhancements

5. Unique Project Identifier:: 009-17-01-02-01-1010-00

6. What kind of investment will this be in FY2009?: Mixed Life Cycle

7. What was the first budget year this investment was submitted to OMB?: FY2001 or earlier

8. Provide a brief summary and justification for this investment, including a brief description of how this closes in part or in whole an identified agency performance gap.: RPMS is a comprehensive electronic healthcare information system intended to support improvement of the health status of American Indians/Alaskan Natives (AI/AN), the primary mission of the Indian Health Service. RPMS is based on the VA's core HIT with significant adaptation. RPMS supports clinical and administrative services across the IHS network's 12 regional areas, including more than 591 clinics and 48 hospitals. RPMS consists of more than 60 clinical and practice management applications. Data are recorded at service points and are available throughout RPMS, ensuring that any of the multidisciplinary providers who see a patient have quick and easy access to all pertinent information. Case management applications are designed to address the inordinate burden of certain diseases that are prevalent within AI/AN communities, as well as population health tracking. The RPMS system is in the mixed life cycle phase of the investment lifecycle. To address performance gaps from federal mandates and from local requests for improved clinician access to RPMS data, IHS is continuing to implement a graphical user interface (RPMS Electronic Health Record - EHR) and expanding telemedicine access and availability. Requirements for improved dental case management have resulted in development of an Electronic Dental Record that will be integrated into the RPMS application suite. Additional GPRA clinical quality measures and harmonized measures with the VA and DoD are being added to the CRS tracking system to measure improvement in the health of the patient population. A Patient Safety tracking system is in implementation. Work continues on identifying and integrating interoperability standards into applications consistent with guidance from FHA. RPMS captures administrative data that allows management to strategically distribute workforce while managing to operating budgets, supporting the Human Capital PMA initiative. RPMS supports the PMA E-Gov strategy through electronic sharing of information with states, sharing of information internally among medical staff, and automating processes to reduce costs. RPMS directly supports the HHS goal to improve the quality of health care services by providing medical staff with up-to-date and accurate patient information. The Community Health Network of West Virginia is using RPMS at six community clinics and a number of public and private entities are investigating the use of RPMS as their HIT solution.

9. Did the Agency's Executive/Investment Committee approve this request?: yes

9.a. If "yes," what was the date of this approval?: 2007-06-26

10. Did the Project Manager review this Exhibit?: yes

11.a. What is the current FAC-P/PM certification level of the project/program manager?: Senior/Expert-level

12. Has the agency developed and/or promoted cost effective, energy-efficient and environmentally sustainable techniques or practices for this project.: no

12.a. Will this investment include electronic assets (including computers)?: yes

12.b. Is this investment for new construction or major retrofit of a Federal building or facility? (answer applicable to non-IT assets only): no

13. Does this investment directly support one of the PMA initiatives?: yes

If yes, select the initiatives that apply:

Initiative Name
Expanded E-Government
Human Capital

13.a. Briefly and specifically describe for each selected how this asset directly supports the identified initiative(s)? (e.g. If E-Gov is selected, is it an approved shared service provider or the managing partner?): Human Cap: allows managers to strategically redistribute the workforce through accurate forecasting. Elec Gov't: Electronic Health Record is expected to reduce medical errors through electronic ordering of medications and diagnostic tests, improve quality of care through automated clinical decision support, improve access to critical clinical information at remote facilities, and improve data quality.

14. Does this investment support a program assessed using the Program Assessment Rating Tool (PART)?: yes

14.a. If yes, does this investment address a weakness found during the PART review?: yes

14.b. If yes, what is the name of the PARTed program?: 2005: IHS - Resource and Patient Management System

14.c. If yes, what rating did the PART receive?: Effective

15. Is this investment for information technology?: yes

16. What is the level of the IT Project (per CIO Council's PM Guidance)?: Level 3

17. What project management qualifications does the Project Manager have? (per CIO Council's PM Guidance): (1) Project manager has been validated as qualified for this investment

18. Is this investment identified as high risk on the Q4 - FY 2007 agency high risk report (per OMB memorandum M-05-23)?: yes

19. Is this a financial management system?: no

20. What is the percentage breakout for the total FY2009 funding request for the following? (This should total 100%)

Area	Percentage
Hardware	4
Software	5
Services	90
Other	0

21. If this project produces information dissemination products for the public, are these products published to the Internet in conformance with OMB Memorandum 05-04 and included in your agency inventory, schedules and priorities?: yes

22. Contact information of individual responsible for privacy related questions.

Name	William Tibbitts
Phone Number	301-443-0035
Title	Management Analyst (Agency Privacy Act Officer)
Email	William.Tibbitts@ihs.gov

23. Are the records produced by this investment appropriately scheduled with the National Archives and Records Administration's approval?: yes

24. Does this investment directly support one of the GAO High Risk Areas?: no

SUMMARY OF SPEND

1. Provide the total estimated life-cycle cost for this investment by completing the following table. All amounts represent budget authority in millions, and are rounded to three decimal places. Federal personnel costs should be included only in the row designated Government FTE Cost, and should be excluded from the amounts shown for Planning, Full Acquisition, and Operation/Maintenance. The total estimated annual cost of the investment is the sum of costs for Planning, Full Acquisition, and Operation/Maintenance. For Federal buildings and facilities, life-cycle costs should include long term energy, environmental, decommissioning, and/or restoration costs. The costs associated with the entire life-cycle of the investment should be included in this report. All amounts represent Budget Authority Note: For the cross-agency investments, this table should include all funding (both managing partner and partner agencies). Government FTE Costs should not be included as part of the TOTAL represented.

Cost Type	Py-1 & Earlier -2006	PY 2007	CY 2008	BY 2009
Planning Budgetary Resources	33.712	7.378	7.649	6.751
Acquisition Budgetary Resources	135.095	19.283	20.041	20.065
Maintenance Budgetary Resources	192.078	24.360	37.759	42.875
Government FTE Cost	26.616	3.547	3.760	3.987
# of FTEs	229	29	29	29

2. Will this project require the agency to hire additional FTE's?: no

3. If the summary of spending has changed from the FY2008 President's budget request, briefly explain those changes.: Estimated funding for FY09 is higher than the previous budget request due to a requested allocation of IHS budget to specifically fund changes to the electronic health record and ICD 10 ($13.915 million). In addition, estimated funding requests for 2013 have been included. The changes have been approved by the IHS CPIC Council, the IHS ITIRB, and the HHS ITIRB. The increases will be funded by IHS.

PERFORMANCE

In order to successfully address this area of the exhibit 300, performance goals must be provided for the agency and be linked to the annual performance plan. The investment must discuss the agency's mission and strategic goals, and performance measures (indicators) must be provided. These goals need to map to the gap in the agency's strategic goals and objectives this investment is designed to fill. They are the internal and external performance benefits this investment is expected to deliver to the agency (e.g., improve efficiency by 60 percent, increase citizen participation by 300 percent a year to achieve an overall citizen participation rate of 75 percent by FY 2xxx, etc.). The goals must be clearly measurable investment outcomes, and if applicable, investment outputs. They do not include the completion date of the module, milestones, or investment, or general goals, such as, significant, better, improved that do not have a quantitative measure.

Agencies must use the following table to report performance goals and measures for the major investment and use the Federal Enterprise Architecture (FEA) Performance Reference Model (PRM). Map all Measurement Indicators to the corresponding Measurement Area and Measurement Grouping identified in the PRM. There should be at least one Measurement Indicator for each of the four different Measurement Areas (for each fiscal year). The PRM is available at www.egov.gov. The table can be extended to include performance measures for years beyond FY 2009.

Row	Fiscal Year	Strategic Goal Supported	Measurement Area	Measurement Grouping	Measurement Indicator	Baseline	Planned Improvement to the Baseline	Actual Results
1	2006	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	Percentage of patients screened for depression through the annual clinical GPRA reporting process.	Baseline TBD in FY2006 (new measure)	Establish the baseline rate	Established the baseline of 15%
2	2006	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	Percentage of women screened at health care facilities for domestic violence	13% (FY2005)	Increase the rate to 14%	Exceeded goal - 28%
3	2006	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	Percentage of Childhood Immunizations ages 19-35 months	FY2005 rate of 75%	Maintain rate of 75%	Exceeded goal - 78% as reported in CRS
4	2006	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	Percentage of Adult Immunizations: Pneumovax vaccination among adult patients age 65 years and older	69% (based on FY2005 target)	Increase rate to 72%	Exceeded goal - 74%
5	2006	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	Percentage of appropriate female patients screened for Fetal Alcohol Syndrome	FY2005 rate of 11%	Increase the rate to 12%	Exceeded goal - 28%
6	2006	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Customer Impact or Burden	Number of sites with Electronic Health Record	Baseline from FY2005 of 20 sites	Implement EHR at 40 additional sites	39 additional sites
7	2006	S.O. 1.2 - Increase health care service availability and accessibility	Processes and Activities	Productivity	Percentage of National clinical performance data of registered population	86% of the registered population.	Increase by 1% over FY2005 levels.	Exceeded goal - 90%
8	2006	S.O. 1.2 - Increase health care service availability and accessibility	Technology	External Data Sharing	Number of states with which IHS currently exchanges immunization data	Baseline consists of 3 states.	Increase to 6 the number of states.	Met goal of 6 states
9	2006	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Internal Data Sharing	Number of new electronic images and scanned documents available online.	Baseline to be determined by FY2006	Baseline to be determined in FY2006	Established baseline of 14,952 images
10	2007	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	Percentage of at-risk patients who have a comprehensive assessment for all Cardiovascular Disease-related risk factors.	Baseline TBD in FY2007	Establish the baseline percentage
11	2007	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	Percentage of patients screened for depression.	15%	Maintain at the FY2006 rate
12	2007	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	Percentage of women screened at health care facilities for domestic violence.	28%	Maintain at 28%
13	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Delivery Services	Pass CCHIT certification of Electronic Health Record	not certified	Pass certification at the end of calendar year 2007
14	2007	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	Percentage of Adult Immunizations: Pneumovax vaccination among adult patients age 65 years and older	72% (based on FY2006 target)	Increase rate to 76%
15	2007	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Research and Practitioner Education	Percentage of appropriate female patients screened for Fetal Alcohol Syndrome	28%	Maintain at 28%
16	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Customer Impact or Burden	Number of sites with Electronic Health Record	Target from FY2006 (60 sites)	Implement EHR at 40 additional sites.
17	2007	S.O. 1.2 - Increase health care service availability and accessibility	Processes and Activities	Productivity	Percentage of National clinical performance data of registered population	90% of the registered population.	Increase by 1% over FY2006 levels.
18	2007	S.O. 1.2 - Increase health care service availability and accessibility	Technology	External Data Sharing	Number of states with which IHS currently exchanges immunization data	FY2006 target of 6 states	Increase to 8 the number of states
19	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Internal Data Sharing	Percentage increase in the number of new electronic images and scanned document available online	14,952	10% over baseline
20	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Number of sites with patient safety measurement system	3 reporting areas	Deploy to 10 sites
21	2008	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	The percentage of risk patients who have a comprehensive assessment for all Cardiovascular Disease-related risk factors	Baseline TBD in FY2007	Maintain at FY07 target
22	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Delivery Services	# of interoperability standards implemented	Baseline TBD in FY2007	TBD FY2007
23	2008	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	Percentage of women screened at health care facilities for domestic violence	28%	Maintain at 28%
24	2008	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	Percentage of childhood immunization ages 19-35 months	75%	Maintain at 75%
25	2008	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	Percentage of Adult Immunizations: Pneumovax vaccination among adult patients age 65 years and older	76% (based on FY2007 target)	Maintain at 76%
26	2008	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	Percentage of appropriate female patients screened for Fetal Alcohol Syndrome	28%	Maintain at 28%
27	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Customer Impact or Burden	Number of sites with Electronic Health Record	Target baseline is 100 sites	Implement Electronic Health Record at TBD sites
28	2008	S.O. 1.2 - Increase health care service availability and accessibility	Processes and Activities	Productivity	Percentage of National clinical performance data of registered population	86% of the registered population.	Increase by 1% over FY2007 levels.
29	2008	S.O. 1.2 - Increase health care service availability and accessibility	Technology	External Data Sharing	The number of states with which IHS currently exchanges immunization data	Baseline consists of 8 states (from previous targets)	Increase to 10 the number of states.
30	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Internal Data Sharing	Percentage of number of new electronic images and scanned documents available online.	14,952 (FY06)	10% over FY2007 target
31	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Number of sites with patient safety measurement system	10 sites	Increase TBD# over FY07 target
32	2009	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	The percentage of risk patients who have a comprehensive assessment for all Cardiovascular Disease-related risk factors	Baseline TBD in FY2007	Maintain at FY07 target
33	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Delivery Services	# of interoperability standards implemented	Baseline TBD in FY2007	TBD FY2007
34	2009	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	Percentage of women screened at health care facilities for domestic violence	28%	Increase the rate to TBD% over FY08 target
35	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Delivery Services	Percentage of healthcare facilities utilizing Electronic Dental Record	0%	10% of 230 sites
36	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Customer Impact or Burden	Number of sites with Electronic Health Record	100 sites	Implement Electronic Health Record at TBD sites
37	2009	S.O. 1.2 - Increase health care service availability and accessibility	Processes and Activities	Productivity	Percentage of National clinical performance data of registered population	86% of registered patient population	Increase by TBD% over FY08 target
38	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Number of sites with patient safety measurement system	Target baseline from FY2008	Increase TBD# over FY08 target
39	2010	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	The percentage of risk patients who have a comprehensive assessment for all Cardiovascular Disease-related risk factors	Baseline TBD in FY2007	Increase TBD% over FY2009 target
40	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Customer Impact or Burden	Number of sites with Electronic Health Record	100 sites	Implement Electronic Health Record at TBD sites
41	2010	S.O. 1.2 - Increase health care service availability and accessibility	Processes and Activities	Productivity	Percentage of National Clinical perforamnce data of registered population	86% of registered patient population	Increase by TBD% over FY2009 target
42	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Number of sites with patient safety measurement system	Target baseline from FY2009	Increase TBD# over FY09 target
43	2011	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	The percentage of risk patients who have a comprehensive assessment for all Cardiovascular Disease-related risk factors	Baseline TBD in FY2007	Increase TBD# over FY2010 target
44	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Customer Impact or Burden	Number of sites with Electronic Health Record	100 sites	Implement Electronic Health Record at TBD sites
45	2011	S.O. 1.2 - Increase health care service availability and accessibility	Processes and Activities	Productivity	Percentage of national clinical performance data of registered population	86% of registered patient population	Increase by TBD% over FY2010 target
46	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Number of sites with patient safety measurement system	Target baseline from FY2010 target	Implement at TBD sites
47	2012	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Mission and Business Results	Health Care Delivery Services	The percentage of risk patients who have a comprehensive assessment for all Cardiovascular Disease-related risk factors	Baseline TBD in FY2007	Increase TBD% over FY2011 target
48	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Customer Impact or Burden	Number of sites with Electronic Health Record	100 sites	Implement Electronic Health Record at TBD sites
49	2012	S.O. 1.2 - Increase health care service availability and accessibility	Processes and Activities	Productivity	Percentage of national clinical performance data of registered population	86% of registered patient population	Increase by TBD% over FY2011 target
50	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Number of sites with patient safety measurement system	Target baseline from FY2011 target	Implement at TBD sites

Enterprise Architecture

In order to successfully address this area of the business case and capital asset plan you must ensure the investment is included in the agency's EA and Capital Planning and Investment Control (CPIC) process, and is mapped to and supports the FEA. You must also ensure the business case demonstrates the relationship between the investment and the business, performance, data, services, application, and technology layers of the agency's EA.

1. Is this investment included in your agency's target enterprise architecture?: yes

2. Is this investment included in the agency's EA Transition Strategy?: yes

2.a. If yes, provide the investment name as identified in the Transition Strategy provided in the agency's most recent annual EA Assessment.: IHS Resource and Patient Management System (RPMS)

3. Is this investment identified in a completed (contains a target architecture) and approved segment architecture?: no

4. Identify the service components funded by this major IT investment (e.g., knowledge management, content management, customer relationship management, etc.). Provide this information in the format of the following table. For detailed guidance regarding components, please refer to http://www.whitehouse.gov/omb/egov/. Component: Use existing SRM Components or identify as NEW. A NEW component is one not already identified as a service component in the FEA SRM. Reused Name and UPI: A reused component is one being funded by another investment, but being used by this investment. Rather than answer yes or no, identify the reused service component funded by the other investment and identify the other investment using the Unique Project Identifier (UPI) code from the OMB Ex 300 or Ex 53 submission. Internal or External Reuse?: Internal reuse is within an agency. For example, one agency within a department is reusing a service component provided by another agency within the same department. External reuse is one agency within a department reusing a service component provided by another agency in another department. A good example of this is an E-Gov initiative service being reused by multiple organizations across the federal government. Funding Percentage: Please provide the percentage of the BY requested funding amount used for each service component listed in the table. If external, provide the funding level transferred to another agency to pay for the service.

Row	Agency Component Name	Agency Component Description	Service Type	Component	Internal or External Reuse?	Funding %
1	Audit Trail Capture and Analysis	Audit Trail Capture and Analysis - Support the identification and monitoring of activities within an application, system, or network.	Security Management	Audit Trail Capture and Analysis	No Reuse	2
2	Identification and Authentication	Defines the set of capabilities that support obtaining information about those parties attempting to log on to a system or application for security purposes and the validation of those users.	Security Management	Identification and Authentication	No Reuse	2
3	Access Control	Access Control - Support the management of permissions for logging onto a computer, application, service, or network; includes user management and role/privilege management.	Security Management	Access Control	No Reuse	2
4	Query	Defines the set of capabilities that support retrieval of records that satisfy specific query selection criteria.	Search	Query	No Reuse	2
5	Software Distribution	Defines the set of capabilities that support the propagation, installation and upgrade of written computer programs, applications and components.	Systems Management	Software Distribution	No Reuse	1
6	Forms Creation	Defines the set of capabilities that support the design and generation of electronic or physical forms and templates for use within the business cycle by an organization and its stakeholders.	Forms Management	Forms Creation	No Reuse	2
7	Forms Modification	Defines the set of capabilities that support the maintenance of electronic or physical forms, templates and their respective elements and fields.	Forms Management	Forms Modification	No Reuse	2
8	Threaded Discussions	Defines the set of capabilities that support the running log of remarks and opinions about a given topic or subject.	Collaboration	Threaded Discussions	No Reuse	2
9	Email	Defines the set of capabilities that support the transmission of memos and messages over a network.	Collaboration	Email	No Reuse	1
10	Inbound Correspondence Management	Defines the set of capabilities that manage externally initiated communication between an organization and its stakeholders.	Routing and Scheduling	Inbound Correspondence Management	No Reuse	2
11	Outbound Correspondence Management	Defines the set of capabilities that manage internally initiated communication between an organization and its stakeholders.	Routing and Scheduling	Outbound Correspondence Management	No Reuse	2
12	Case Management	Defines the set of capabilities that manage the life cycle of a particular claim or investigation within an organization to include creating, routing, tracing, assignment and closing of a case as well as collaboration among case handlers.	Tracking and Workflow	Case Management	No Reuse	2
13	Process Tracking	Defines the set of capabilities that allow the monitoring of activities within the business cycle.	Tracking and Workflow	Process Tracking	No Reuse	1
14	Document Imaging and OCR	Defines the set of capabilities that support the scanning of documents.	Document Management	Document Imaging and OCR	No Reuse	2
15	Document Review and Approval	Defines the set of capabilities that support the editing and commendation of documents before releasing them.	Document Management	Document Review and Approval	No Reuse	2
16	Document Retirement	Defines the set of capabilities that support the termination or cancellation of documents and artifacts used by an organization and its stakeholders.	Records Management	Document Retirement	No Reuse	2
17	Tagging and Aggregation	Defines the set of capabilities that support the identification of specific content within a larger set of content for collection and summarization.	Content Management	Tagging and Aggregation	No Reuse	2
18	Information Mapping / Taxonomy	Defines the set of capabilities that support the creation and maintenance of relationships between data entities, naming standards and categorization.	Knowledge Management	Information Mapping / Taxonomy	No Reuse	2
19	Standardized / Canned	Defines the set of capabilities that support the use of pre-conceived or pre-written reports.	Reporting	Standardized / Canned	No Reuse	2
20	Ad Hoc	Defines the set of capabilities that support the use of dynamic reports on an as needed basis.	Reporting	Ad Hoc	No Reuse	2
21	Modeling	Defines the set of capabilities that develop descriptions to adequately explain relevant data for the purpose of prediction, pattern detection, exploration or general organization of data.	Knowledge Discovery	Modeling	No Reuse	5
22	Data Mining	Defines the set of capabilities that provide for the efficient discovery of non-obvious, valuable patterns and relationships within a large collection of data.	Knowledge Discovery	Data Mining	No Reuse	2
23	Imagery	Defines the set of capabilities that support the creation of film or electronic images from pictures or paper forms	Visualization	Imagery	No Reuse	2
24	Graphing / Charting	Defines the set of capabilities that support the presentation of information in the form of diagrams or tables.	Visualization	Graphing / Charting	No Reuse	2
25	Demand Forecasting / Mgmt	Defines the set of capabilities that facilitate the prediction of sufficient production to meet an organization's sales of a product or service.	Business Intelligence	Demand Forecasting / Mgmt	No Reuse	2
26	Decision Support and Planning	Defines the set of capabilities that support the analyze information and predict the impact of decisions before they are made.	Business Intelligence	Decision Support and Planning	No Reuse	2
27	Credit / Charge	Defines the set of capabilities that support the use of credit cards or electronic funds transfers for payment and collection of products or services.	Financial Management	Credit / Charge	No Reuse	2
28	Expense Management	Defines the set of capabilities that support the management and reimbursement of costs paid by employees or an organization.	Financial Management	Expense Management	No Reuse	2
29	Billing and Accounting	Defines the set of capabilities that support the charging, collection and reporting of an organization's accounts.	Financial Management	Billing and Accounting	No Reuse	2
30	Travel Management	Defines the set of capabilities that support the transit and mobility of an organization's employees for business purposes.	Human Resources	Travel Management	No Reuse	2
31	Data Cleansing	Defines the set of capabilities that support the removal of incorrect or unnecessary characters and data from a data source.	Data Management	Data Cleansing	No Reuse	2
32	Extraction and Transformation	Defines the set of capabilities that support the manipulation and change of data.	Data Management	Extraction and Transformation	No Reuse	2
33	Loading and Archiving	Defines the set of capabilities that support the population of a data source with external data.	Data Management	Loading and Archiving	No Reuse	2
34	Data Exchange	Defines the set of capabilities that support the interchange of information between multiple systems or applications; includes verification that transmitted data was received unaltered.	Data Management	Data Exchange	No Reuse	5
35	Property / Asset Management	Defines the set of capabilities that support the identification, planning and allocation of an organization's physical capital and resources.	Asset / Materials Management	Property / Asset Management	No Reuse	2
36	Asset Cataloging / Identification	Defines the set of capabilities that support the listing and specification of available assets.	Asset / Materials Management	Asset Cataloging / Identification	No Reuse	2
37	Quality Management	Defines the set of capabilities that help determine the level that a product or service satisfies certain requirements.	Management of Processes	Quality Management	No Reuse	1
38	Risk Management	Risk Management - support the identification and probabilities or chances of hazards as they relate to a task, decision or long-term goal; includes risk assessment and risk mitigation.	Management of Processes	Risk Management	No Reuse	2
39	Change Management	Defines the set of capabilities that control the process for updates or modifications to the existing documents, software or business processes of an organization.	Management of Processes	Change Management	No Reuse	5
40	Requirements Management	Defines the set of capabilities that gather, analyze and fulfill the needs and prerequisites of an organization's efforts.	Management of Processes	Requirements Management	No Reuse	1
41	Configuration Management	Defines the set of capabilities that control the hardware and software environments, as well as documents of an organization.	Management of Processes	Configuration Management	No Reuse	1
42	Invoice / Requisition Tracking and Approval	Defines the set of capabilities that support the identification of where a shipment or delivery is within the business cycle.	Supply Chain Management	Invoice / Requisition Tracking and Approval	No Reuse	2
43	Procurement	Defines the set of capabilities that support the ordering and purchasing of products and services.	Supply Chain Management	Procurement	No Reuse	2
44	Internal Controls	Support the methods and procedures used by the organization to safeguard its assets, produce accurate accounting data and reports, contribute to efficient operations, and encourage staff to adhere to management policies and mission requirements	Financial Management	Internal Controls	No Reuse	2
45	Customer Analytics	Defines the set of capabilities that allow for the analysis of an organizations customers as well as the scoring of third party information as it relates to an organization's customers.	Customer Relationship Management	Customer Analytics	No Reuse	2
46	Customer / Account Management	Defines the set of capabilities that support the retention and delivery of a service or product to an organization's clients.	Customer Relationship Management	Customer / Account Management	No Reuse	2
47	Partner Relationship Management	Defines the set of capabilities that provide a framework to promote the effective collaboration between an organization and its business partners, particularly members of the distribution chain (e.g., channel and alliance partners, resellers, agents, brokers, and dealers) and other third parties that support operations and service delivery to an organization's customers; includes performance evaluation of partners, if necessary.	Customer Relationship Management	Partner Relationship Management	No Reuse	2

5. To demonstrate how this major IT investment aligns with the FEA Technical Reference Model (TRM), please list the Service Areas, Categories, Standards, and Service Specifications supporting this IT investment. FEA SRM Component: Service Components identified in the previous question should be entered in this column. Please enter multiple rows for FEA SRM Components supported by multiple TRM Service Specifications. Service Specification: In the Service Specification field, Agencies should provide information on the specified technical standard or vendor product mapped to the FEA TRM Service Standard, including model or version numbers, as appropriate.

Row	SRM Component	>Service Area	Service Category	Service Standard	Service Specification (i.e., vendor and product name)
1	Data Exchange	Service Interface and Integration	Interoperability	Data Format / Classification	ANSI ASC X12 004010
2	Data Exchange	Service Interface and Integration	Interoperability	Data Format / Classification	Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT)
3	Query	Service Interface and Integration	Integration	Middleware	SQL
4	Query	Service Platform and Infrastructure	Database / Storage	Database	SQL
5	Data Exchange	Component Framework	Data Interchange	Data Exchange	Digital Imaging Communications in Medicine
6	Data Exchange	Service Interface and Integration	Interoperability	Data Format / Classification	Digital Imaging Communications in Medicine
7	Loading and Archiving	Component Framework	Business Logic	Platform Dependent	FILEMAN
8	Inbound Correspondence Management	Component Framework	Data Management	Database Connectivity	Patient Care Component
9	Inbound Correspondence Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component
10	Outbound Correspondence Management	Component Framework	Data Management	Database Connectivity	Patient Care Component
11	Outbound Correspondence Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component
12	Case Management	Component Framework	Data Management	Database Connectivity	Patient Care Component
13	Case Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component
14	Process Tracking	Component Framework	Data Management	Database Connectivity	Patient Care Component
15	Process Tracking	Component Framework	Data Management	Reporting and Analysis	Patient Care Component
16	Risk Management	Component Framework	Data Management	Database Connectivity	Patient Care Component
17	Risk Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component
18	Change Management	Component Framework	Data Management	Database Connectivity	Patient Care Component
19	Change Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component
20	Customer / Account Management	Component Framework	Data Management	Database Connectivity	Patient Care Component
21	Customer / Account Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component
22	Partner Relationship Management	Component Framework	Data Management	Database Connectivity	Patient Care Component
23	Partner Relationship Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component
24	Software Distribution	Service Interface and Integration	Integration	Enterprise Application Integration	VA Kernel Toolkit
25	Requirements Management	Service Interface and Integration	Integration	Enterprise Application Integration	VA Kernel Toolkit
26	Graphing / Charting	Component Framework	Presentation / Interface	Content Rendering	Open Graphics Library
27	Graphing / Charting	Component Framework	Presentation / Interface	Content Rendering	Computer Graphics Metafile
28	Graphing / Charting	Component Framework	Presentation / Interface	Content Rendering	Graphical Kernel System
29	Identification and Authentication	Service Platform and Infrastructure	Software Engineering	Software Configuration Management	Tivoli
30	Property / Asset Management	Service Platform and Infrastructure	Software Engineering	Software Configuration Management	Tivoli
31	Asset Cataloging / Identification	Service Platform and Infrastructure	Software Engineering	Software Configuration Management	Tivoli
32	Threaded Discussions	Service Access and Delivery	Access Channels	Collaboration / Communications	Mailman
33	Email	Service Access and Delivery	Access Channels	Collaboration / Communications	Mailman
34	Audit Trail Capture and Analysis	Component Framework	Data Management	Reporting and Analysis	Patient Care Component
35	Access Control	Service Access and Delivery	Service Transport	Service Transport	PKI
36	Forms Creation	Service Platform and Infrastructure	Database / Storage	Database	Fileman
37	Forms Modification	Service Platform and Infrastructure	Database / Storage	Database	Fileman
38	Document Imaging and OCR	Component Framework	Data Management	Reporting and Analysis	VistA Lexicon Utility (UMLS)
39	Document Review and Approval	Service Platform and Infrastructure	Database / Storage	Database	Fileman
40	Document Retirement	Service Interface and Integration	Interoperability	Data Format / Classification	SNOMED
41	Tagging and Aggregation	Service Interface and Integration	Interoperability	Data Format / Classification	SNOMED
42	Information Mapping / Taxonomy	Service Interface and Integration	Interoperability	Data Format / Classification	SNOMED
43	Standardized / Canned	Service Platform and Infrastructure	Database / Storage	Database	Fileman
44	Ad Hoc	Service Platform and Infrastructure	Database / Storage	Database	Fileman
45	Modeling	Service Interface and Integration	Interoperability	Data Format / Classification	SNOMED
46	Data Mining	Component Framework	Business Logic	Platform Independent	SQL
47	Imagery	Component Framework	Business Logic	Platform Dependent	DICOM 3
48	Demand Forecasting / Mgmt	Service Platform and Infrastructure	Database / Storage	Database	Fileman
49	Decision Support and Planning	Component Framework	Business Logic	Platform Independent	SQL
50	Credit / Charge	Service Interface and Integration	Interoperability	Data Format / Classification	EDI
51	Expense Management	Service Platform and Infrastructure	Database / Storage	Database	Fileman
52	Billing and Accounting	Service Platform and Infrastructure	Database / Storage	Database	Fileman
53	Travel Management	Service Platform and Infrastructure	Database / Storage	Database	Fileman
54	Data Cleansing	Service Interface and Integration	Interoperability	Data Format / Classification	EDI
55	Extraction and Transformation	Service Interface and Integration	Interoperability	Data Format / Classification	EDI
56	Quality Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component
57	Configuration Management	Service Interface and Integration	Integration	Enterprise Application Integration	VA Kernel Toolkit
58	Invoice / Requisition Tracking and Approval	Service Interface and Integration	Interoperability	Data Format / Classification	X12 with HL7
59	Procurement	Service Interface and Integration	Interoperability	Data Format / Classification	X12 with HL7
60	Internal Controls	Service Access and Delivery	Access Channels	Web Browser	MS Internet Explorer

6. Will the application leverage existing components and/or applications across the Government (i.e., FirstGov, Pay.Gov, etc)?: yes

6.a. If yes, please describe.: This investment leverages: Federal Health Architecture (FHA), Information Sharing Environment (ISE). IHS leverages software, processes, information and resources from the Veterans Administration and the Veterans Health Administration. IHS also has a letter of collaboration with the DoD on quality measures and methodologies in support of the Executive Order on Health Care Quality and Efficiency (August 22, 2006)

PART TWO

RISK

You should perform a risk assessment during the early planning and initial concept phase of the investment's life-cycle, develop a risk-adjusted life-cycle cost estimate and a plan to eliminate, mitigate or manage risk, and be actively managing risk throughout the investment's life-cycle.

Answer the following questions to describe how you are managing investment risks.

1. Does the investment have a Risk Management Plan?: yes

1.a. If yes, what is the date of the plan?: 2007-04-18

1.b. Has the Risk Management Plan been significantly changed since last year's submission to OMB?: no

3. Briefly describe how investment risks are reflected in the life cycle cost estimate and investment schedule:: Project slack has been built into DME schedules to accommodate schedule variations and uncertainties. Where possible, firm fixed price contracts have been used to limit government risk and maintain the stability of life cycle cost estimates. Performance-based statements of work are generally in place for IHS time-and-material contracts and allow the government more control over outcomes and costs versus outcomes. Life cycles costs are risk adjusted; some of the development work carries more risk due to the nature of unfolding requirements and changing technologies. These development costs have been adjusted to accommodate the risk. Steady State work carries less risk, and the costs have been estimated accordingly. The Risk Management Plan was reviewed and revisions were made for the update on 4/18/2007. Although there is additional funding requested for FY09, the funding covers milestones that have already been reviewed and adjusted for risk.

COST & SCHEDULE

1. Does the earned value management system meet the criteria in ANSI/EIA Standard 748?: yes

2. Is the CV% or SV% greater than ± 10%?: no

3. Has the investment re-baselined during the past fiscal year?: no