Exhibit 300 (BY2010) for IHS Resource and Patient Management System (RPMS) - Maintenance & Enhancements

1. Date of Submission:

2009-04-10

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 FY2010?

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.

The Indian Health Service (IHS) Resource and Patient Management System (RPMS) is a comprehensive health information system (HIS) created to support the delivery of high quality health care to American Indians and Alaska Natives who attend several hundred Federal and Tribal hospitals and clinics nationwide. RPMS integrates practice management, medical, behavioral, population health and performance reporting functions into a fully capable electronic health record (EHR) suite. A government-developed and owned system, RPMS evolved alongside the Veteran's Health Administration's acclaimed VistA HIS but occupies a unique place as the only system designed specifically to support the direct care and public health mission of IHS. RPMS captures administrative data that allows management to strategically distribute workforce while managing operating budgets, supporting the President's Management Agenda (PMA) Human Capital initiative. RPMS supports the PMA E-Gov strategy through electronic sharing of information with states, interoperability with commercial laboratories, electronic communication among medical staff, and automating processes to reduce costs. RPMS supports the HHS goal to improve the quality of health care services by providing current and accurate patient information and clinical decision support. Ongoing development ensures that RPMS remains aligned with standards for interoperability, security, and feature sets. Certification of RPMS as an ambulatory EHR by the Certification Commission for Health Information Technology will be complete in August 2008. RPMS is classified as a major IT investment, comprising 72 percent of invested resources by the IHS Office of Information Technology. The investment is in the mixed lifecycle phase; much of the suite is in operations and maintenance, while modernization and enhancements continue especially in the areas of revenue cycle management, population health, clinical decision support, and user interface design. RPMS has been evaluated and scored as "effective" under the Performance Assessment Rating Tool. RPMS is critical to operations at IHS and Tribal health facilities, offering a repository of historical medical information, documentation of care, medication management, order entry and results reporting, third party billing, and numerous other features. As a high quality, low cost public domain system, RPMS has also proven attractive to private and public sector health care entities outside of IHS.

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

yes

9.a. If "yes," what was the date of this approval?

2009-02-12

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?

Waiver Issued

11.b. When was the Program/Project Manager Assigned?

2006-07-01

11.c. What date did the Program/Project Manager receive the FACP/PM certification? If the certification has not been issued, what is the anticipated date for certification?

2009-07-31

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?)

RPMS captures administrative data that allows management to strategically distribute workforce while managing operating budgets, supporting the President's Management Agenda (PMA) Human Capital initiative. RPMS supports the PMA E-Gov strategy through electronic sharing of information with states, interoperability with commercial laboratories, electronic communication among medical staff, and automating processes to reduce costs.

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?

10001058 - Indian Health Service 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	14
Software	1
Services	82
Other	3

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

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 -2007	PY 2008	CY 2009	BY 2010
Planning Budgetary Resources	35.569	1.045	4.881	3.958
Acquisition Budgetary Resources	142.275	9.404	43.931	35.619
Maintenance Budgetary Resources	215.031	6.717	19.289	20.001
Government FTE Cost	30.163	29.063	46.393	48.662
# of FTEs	258	283	283	283

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.

Summary of Spending table has been modified since initial 2010 submission to accommodate ARRA funding increases and reflect sunk costs for 2008 projects.

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	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	95%
2	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	24%
3	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%	36%
4	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	Certification planned for June 30, 2008
5	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%	79%
6	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%	41%
7	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.	49 sites
8	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.	86%
9	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	8 states
10	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	Increased by more than 350% for a total of 54,820 images in 2007
11	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	64 sites
12	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 patients identified by RPMS Clinical Decision Support logic as at-risk who have a comprehensive assessment for all Cardiovascular Disease-related risk factors	30%	Maintain at 30%	30%
13	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 15-40 years of age as identified by RPMS Clinical Decision Support tools who are screened for domestic violence at health care facilities	28%	Maintain at 36%	42%
14	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 as identified by RPMS Clinical Decision Support tools.	78%	Maintain at 78%	78%
15	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 as identified by RPMS Clinical Decision Support tools: Pneumovax vaccination among adult patients age 65 years and older.	79%	Maintain at 79%	82%
16	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 alcohol use screening as identified by RPMS Clinical Decision Support tools (to prevent Fetal Alcohol Syndrome) among female patients (15-44 years of age)	41%	Maintain at 41%	47%
17	2008	S.O. 1.2 - Increase health care service availability and accessibility	Customer Results	Customer Impact or Burden	Number of sites with Electronic Health Record	Target baseline is 109 sites	Implement Electronic Health Record at 40 additional sites	43 new sites, total of 152
18	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. Supported by RPMS Clinical Decision Support tools.	86% of the registered population.	Increase by 1% over FY2007 levels.	86%
19	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	External Data Sharing	The number of states with which IHS currently exchanges immunization data	8 states	Increase by 25% over baseline	25% - 10 states
20	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.	54,820 images (2007)	10% over FY2007 target (60,302 images)	91,302
21	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Number of nationwide sites using the Patient Safety System	64 sites	Increase 15% over baseline (74 sites)	94 sites
22	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 patients identified by RPMS Clinical Decision Support logic as at-risk who have a comprehensive assessment for all Cardiovascular Disease-related risk factors	30%	TBD	TBD
23	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 adults ages 18 and over as identified by RPMS Clinical Decision Support tools who are screened for depression.	24%	TBD	TBD
24	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 15-40 years of age as identified by RPMS Clinical Decision Support tools who are screened for domestic violence at health care facilities.	42%	TBD	TBD
25	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 alcohol use screening as identified by RPMS Clinical Decision Support tools (to prevent Fetal Alcohol Syndrome) among female patients (15-44 years of age)	47%	TBD	TBD
26	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 the Electronic Dental Record	0%	10% of 230 sites	TBD
27	2009	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Customer Results	Service Availability	Number of Patient Education handouts downloaded from the NC4 Clinical Resources web site	Baseline TBD	Establish baseline # of downloads	TBD
28	2009	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Customer Results	Service Availability	Number of user hits recorded on the IHS Quality Measures web site; supports Executive Order #13410 compliance	Baseline TBD	Establish Baseline %	TBD
29	2009	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Innovation and Improvement	Percentage of applicable RPMS DME projects using Serena Requirements Management Tool	Baseline TBD	Establish Baseline %	TBD
30	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Number of nationwide sites using the Patient Safety System	74 sites	Increase 14% over FY08 actual	TBD
31	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	Percentage of patients identified by RPMS Clinical Decision Support logic as at-risk who have a comprehensive assessment for all Cardiovascular Disease-related risk factors	FY2009 Actual	TBD	TBD
32	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	Percentage of adults ages 18 and over as identified by RPMS Clinical Decision Support tools who are screened for depression.	FY2009 Actual	TBD	TBD
33	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	Percentage of women 15-40 years of age as identified by RPMS Clinical Decision Support tools who are screened for domestic violence at health care facilities.	FY2009 Actual	TBD	TBD
34	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	Percentage of alcohol use screening as identified by RPMS Clinical Decision Support tools (to prevent Fetal Alcohol Syndrome) among female patients (15-44 years of age)	FY2009 Actual	TBD	TBD
35	2010	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Customer Results	Service Availability	Number of Patient Education handouts downloaded from the NC4 Clinical Resources web site	FY2009 Actual	Increase # of downloads by 5% over FY09 target	TBD
36	2010	S.O. 2.3 - Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery	Customer Results	Service Availability	Number of user hits recorded on the IHS Quality Measures web site; supports Executive Order #13410 compliance	FY2009 Actual	Increase the rate 5% over FY09 target	TBD
37	2010	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Innovation and Improvement	Percentage of applicable RPMS DME projects using Serena Requirements Management Tool	FY2009 Actual	Increase the rate 5% over FY09 target	TBD
38	2010	S.O. 1.2 - Increase health care service availability and accessibility	Customer Results	Service Availability	Percentage of RPMS Systems that install key software within 45 days of release	Baseline TBD	Establish the baseline percentage	TBD
39	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Number of nationwide sites using the Patient Safety System	84 sites	Increase 10% over FY09 target (92 sites)	TBD
40	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	Percentage of patients identified by RPMS Clinical Decision Support logic as at-risk who have a comprehensive assessment for all Cardiovascular Disease-related risk factors	FY2010 Actual	TBD	TBD
41	2011	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Innovation and Improvement	Percentage of applicable RPMS DME projects using Serena Requirements Management Tool	FY2010 Actual	Increase the rate 5% over FY10 target	TBD
42	2011	S.O. 1.2 - Increase health care service availability and accessibility	Customer Results	Service Availability	Percentage of RPMS Systems that install key software within 45 days of release	FY2010 Actual	Increase the rate 5% over FY10 target	TBD
43	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Number of nationwide sites using the Patient Safety System	92 sites	Increase 10% over FY2010 Target (101 sites)	TBD
44	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	Percentage of adults ages 18 and over as identified by RPMS Clinical Decision Support tools who are screened for depression.	FY2011 Actual	TBD	TBD
45	2012	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Innovation and Improvement	Percentage of applicable RPMS DME projects using Serena Requirements Management Tool	FY2011 Actual	Increase the rate 5% over FY11 target	TBD
46	2012	S.O. 1.2 - Increase health care service availability and accessibility	Customer Results	Service Availability	Percentage of RPMS Systems that install key software within 45 days of release	FY2011 Actual	Increase the rate 5% over FY11 target	TBD
47	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Number of nationwide sites using the Patient Safety System	101 sites	Increase 10% over FY2011 Target (111 sites)	TBD
48	2013	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 adults ages 18 and over as identified by RPMS Clinical Decision Support tools who are screened for depression.	FY2012 Actual	TBD	TBD
49	2013	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Innovation and Improvement	Percentage of applicable RPMS DME projects using Serena Requirements Management Tool	FY2012 Actual	Increase the rate 5% over FY12 target	TBD
50	2013	S.O. 1.2 - Increase health care service availability and accessibility	Customer Results	Service Availability	Percentage of RPMS Systems that install key software within 45 days of release	FY2012 Actual	Increase the rate 5% over FY12 target	TBD
51	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Number of nationwide sites using the Patient Safety System	111 sites	Increase 10% over FY2012 Target (122 sites)	TBD
52	2014	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 adults ages 18 and over as identified by RPMS Clinical Decision Support tools who are screened for depression.	FY2013 Actual	TBD	TBD
53	2014	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Innovation and Improvement	Percentage of applicable RPMS DME projects using Serena Requirements Management Tool	FY2013 Actual	Increase the rate 5% over FY13 target	TBD
54	2014	S.O. 1.2 - Increase health care service availability and accessibility	Customer Results	Service Availability	Percentage of RPMS Systems that install key software within 45 days of release	FY2013 Actual	Increase the rate 5% over FY13 target	TBD
55	2014	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	Data Reliability and Quality	Number of nationwide sites using the Patient Safety System	122 sites	Increase 10% over 2013 target (134 sites)	TBD

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) - Maintenance & Enhancements

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	Reused Component Name	Reused UPI	Internal or External Reuse?	Funding %
1	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Knowledge Management	Information Retrieval			No Reuse	2
2	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Customer Relationship Management	Customer / Account Management			No Reuse	2
3	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Financial Management	Billing and Accounting			No Reuse	2
4	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Reporting	Standardized / Canned			No Reuse	2
5	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Business Intelligence	Demand Forecasting / Mgmt			No Reuse	2
6	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Tracking and Workflow	Case Management			No Reuse	2
7	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Systems Management	Software Distribution			No Reuse	1
8	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Business Intelligence	Decision Support and Planning			No Reuse	2
9	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Visualization	Graphing / Charting			No Reuse	2
10	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Data Management	Loading and Archiving			No Reuse	2
11	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Data Management	Data Cleansing			No Reuse	2
12	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Routing and Scheduling	Outbound Correspondence Management			No Reuse	2
13	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Tracking and Workflow	Process Tracking			No Reuse	1
14	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Knowledge Discovery	Data Mining			No Reuse	2
15	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Records Management	Document Retirement			No Reuse	2
16	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Search	Query			No Reuse	2
17	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Data Management	Extraction and Transformation			No Reuse	2
18	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Visualization	Imagery			No Reuse	2
19	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Content Management	Tagging and Aggregation			No Reuse	2
20	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Security Management	Identification and Authentication			No Reuse	2
21	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Knowledge Management	Information Sharing			No Reuse	5
22	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Security Management	Audit Trail Capture and Analysis			No Reuse	2
23	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Forms Management	Forms Modification			No Reuse	2
24	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Security Management	Access Control			No Reuse	2
25	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Forms Management	Forms Creation			No Reuse	2
26	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Management of Processes	Configuration Management			No Reuse	1
27	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Management of Processes	Requirements Management			No Reuse	1
28	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Collaboration	Threaded Discussions			No Reuse	2
29	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Customer Relationship Management	Customer Analytics			No Reuse	2
30	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Data Management	Data Exchange			No Reuse	5
31	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Management of Processes	Risk Management			No Reuse	2
32	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Management of Processes	Quality Management			No Reuse	1
33	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Customer Relationship Management	Partner Relationship Management			No Reuse	2
34	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Document Management	Document Imaging and OCR			No Reuse	2
35	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Management of Processes	Change Management			No Reuse	5
36	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Document Management	Document Review and Approval			No Reuse	2
37	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Routing and Scheduling	Inbound Correspondence Management			No Reuse	2
38	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Reporting	Ad Hoc			No Reuse	2
39	IHS Resource Patient Management System (RPMS)	The RPMS is a clinical and patient administrative information system that supports the management of the healthcare needs of the American Indian and Alaska Natives populations.	Collaboration	Email			No Reuse	1

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	Information Retrieval	Service Platform and Infrastructure	Database / Storage	Database	FILEMAN by: US Department of Veterans Affairs
2	Information Retrieval	Service Platform and Infrastructure	Database / Storage	Database	InterSystems Cache 5.0.2 by: InterSystems Corporation.
3	Customer / Account Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component by: US Department of Veterans Affairs
4	Billing and Accounting	Component Framework	Data Interchange	Data Exchange	Cloverleaf Integration Suite by: Quovadx, Inc.
5	Billing and Accounting	Component Framework	Data Interchange	Data Exchange	Health Level 7 (HL7) by: Health Level Seven, Inc.
6	Billing and Accounting	Component Framework	Data Interchange	Data Exchange	Electronic Data Interchange (EDI) by: National Institute of Standards and Technology
7	Standardized / Canned	Service Platform and Infrastructure	Database / Storage	Database	FILEMAN by: US Department of Veterans Affairs
8	Demand Forecasting / Mgmt	Service Platform and Infrastructure	Database / Storage	Database	FILEMAN by: US Department of Veterans Affairs
9	Case Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component by: US Department of Veterans Affairs
10	Software Distribution	Service Interface and Integration	Integration	Enterprise Application Integration	VA Kernel Toolkit by: US Department of Veterans Affairs
11	Decision Support and Planning	Component Framework	Business Logic	Platform Independent Technologies	FILEMAN by: US Department of Veterans Affairs
12	Graphing / Charting	Component Framework	User Presentation / Interface	Content Rendering	Graphical Kernel System by: International Organization for Standardization
13	Graphing / Charting	Component Framework	User Presentation / Interface	Content Rendering	Computer Graphics Metafile by: IEC
14	Graphing / Charting	Component Framework	User Presentation / Interface	Content Rendering	Open Graphics Library by: Silicon Graphics Inc.
15	Loading and Archiving	Component Framework	Business Logic	Platform Independent Technologies	FILEMAN by: US Department of Veterans Affairs
16	Data Cleansing	Service Interface and Integration	Interoperability	Data Format / Classification	Electronic Data Interchange (EDI) by: National Institute of Standards and Technology
17	Outbound Correspondence Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component by: US Department of Veterans Affairs
18	Process Tracking	Component Framework	Data Management	Reporting and Analysis	Patient Care Component by: US Department of Veterans Affairs
19	Data Mining	Component Framework	Business Logic	Platform Independent Technologies	FILEMAN by: US Department of Veterans Affairs
20	Document Retirement	Service Interface and Integration	Interoperability	Data Format / Classification	Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) by: International Health Terminology Standards Development Organisation
21	Query	Service Platform and Infrastructure	Database / Storage	Database	FILEMAN by: US Department of Veterans Affairs
22	Extraction and Transformation	Service Interface and Integration	Interoperability	Data Format / Classification	Electronic Data Interchange (EDI) by: National Institute of Standards and Technology
23	Imagery	Component Framework	Business Logic	Platform Dependent Technologies	Digital Imaging Communications in Medicine by: National Electrical Manufacturers Association
24	Tagging and Aggregation	Service Interface and Integration	Interoperability	Data Format / Classification	Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) by: International Health Terminology Standards Development Organisation
25	Identification and Authentication	Service Platform and Infrastructure	Software Engineering	Software Configuration Management	Tivoli by: International Business Machines Corp.
26	Information Sharing	Service Interface and Integration	Interoperability	Data Format / Classification	Health Level 7 (HL7) by: Health Level Seven, Inc.
27	Audit Trail Capture and Analysis	Component Framework	Data Management	Reporting and Analysis	Patient Care Component by: US Department of Veterans Affairs
28	Forms Modification	Service Platform and Infrastructure	Database / Storage	Database	FILEMAN by: US Department of Veterans Affairs
29	Access Control	Service Access and Delivery	Service Transport	Service Transport	Microsoft Systems Management Server 2003 R2 by: Microsoft Corporation
30	Forms Creation	Service Platform and Infrastructure	Database / Storage	Database	FILEMAN by: US Department of Veterans Affairs
31	Configuration Management	Service Interface and Integration	Integration	Enterprise Application Integration	VA Kernel Toolkit by: US Department of Veterans Affairs
32	Requirements Management	Service Interface and Integration	Integration	Enterprise Application Integration	VA Kernel Toolkit by: US Department of Veterans Affairs
33	Threaded Discussions	Service Access and Delivery	Access Channels	Collaboration / Communications	Mailman by: US Department of Veterans Affairs
34	Customer Analytics	Component Framework	Data Management	Reporting and Analysis	Patient Care Component by: US Department of Veterans Affairs
35	Data Exchange	Component Framework	Data Interchange	Data Exchange	Health Level 7 (HL7) by: Health Level Seven, Inc.
36	Data Exchange	Service Interface and Integration	Interoperability	Data Format / Classification	Logical Observation Identifier Names and Codes by: Regenstrief Institute, Inc
37	Data Exchange	Service Interface and Integration	Interoperability	Data Format / Classification	Current Procedural Terminology, Fourth Edition by: American Medical Association
38	Data Exchange	Service Interface and Integration	Interoperability	Data Format / Classification	Code on Dental Procedures and Nomenclature by: American Dental Association
39	Data Exchange	Service Interface and Integration	Interoperability	Data Format / Classification	National Drug Codes by: FDA
40	Data Exchange	Service Interface and Integration	Interoperability	Data Format / Classification	Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) by: International Health Terminology Standards Development Organisation
41	Data Exchange	Component Framework	Data Interchange	Data Exchange	ANSI ASC X12 004010 by: ANSI ASC X12
42	Risk Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component by: US Department of Veterans Affairs
43	Quality Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component by: US Department of Veterans Affairs
44	Partner Relationship Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component by: US Department of Veterans Affairs
45	Document Imaging and OCR	Component Framework	Data Management	Reporting and Analysis	VistA Lexicon Utility by: US Department of Veterans Affairs
46	Change Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component by: US Department of Veterans Affairs
47	Document Review and Approval	Service Platform and Infrastructure	Database / Storage	Database	FILEMAN by: US Department of Veterans Affairs
48	Inbound Correspondence Management	Component Framework	Data Management	Reporting and Analysis	Patient Care Component by: US Department of Veterans Affairs
49	Ad Hoc	Service Platform and Infrastructure	Database / Storage	Database	FILEMAN by: US Department of Veterans Affairs
50	Email	Service Access and Delivery	Access Channels	Collaboration / Communications	Mailman by: US Department of Veterans Affairs

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.

IHS leverages software, processes, information and resources from the Veterans 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). IHS is actively involved with all Federal Health Architecture working groups and the Nationwide Health Information Network.

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?

2008-03-29

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:

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 3/29/2008.

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?

yes

3.a. If yes, when was it approved by the agency head?

2009-03-31