As the debate over health care reform takes center stage, the Oneida Indian Nation, and several other American Indian nations, are already doing more for their patients with less funding than other health care programs.

The Oneidas are among 39 tribes, one of just three tribes east of the Mississippi (the others are the Cherokee and Choctaw), who are participating as a pilot site for the Innovations in Planned Care (Chronic Care Initiative or CCI) through the Indian Health Service and the Institute for Healthcare Improvement. The CCI supports community and individual wellness and strength within the IHS’s federal, tribal, and urban health organizations.

“We have been working diligently as a team for about a year now on a broad range of patient-centered, quality-of-care goals and objectives,” Charmaine Frederick (Turtle Clan), director of the Nation’s Health and Human Services Department, said. “We expect this initiative will actually evolve into a way of providing healthcare within the Indian Health Service in the future.”

Although the department didn’t join the program at first due to other IHS and Nation initiatives such as the Electronic Health Record implementation, “IHS really kept reaching out to us,” Charmaine said. “They recognized that joining this initiative would only benefit us because we were already following a lot of the recommendations in this initiative, such as assigning patients to one of our primary care providers. We have been told we are making great progress and are one of the lead teams involved.”

The initiative strives to effectively address chronic health conditions such as diabetes, cardiovascular disease and depression. The process will create a health care system that is practical and supportive and will heavily promote interactive relationships between patients and the health care team.

“The Indian Health Service can, and will be, one of the leading prototypes for health care in America,” said Dr. Donald Berwick, one of the nation’s leading authorities on health care quality and improvement. “The Indian Health Service is trying to deliver the same or better care with half the funding of other systems in the United States.” Already, health care leaders engaged in national healthcare reform are talking about the successes of the Indian Health Service.

IHS initiatives have made a difference. The Special Diabetes Program was launched in 1997. Although diabetes is still an epidemic, there has been a 40 percent reduction in complications such as kidney disease and retinopathy, and a significant number of Indian diabetics are maintaining blood sugar control since the program began. Valerie Scott, (Turtle Clan), family nurse practitioner, added that “our facility works diligently in aggressive recognition and management of diabetes and our diabetes education program has achieved IHS recognition, similar to ADA recognition.”

“Indian Health Service has long been a leader in excellent diabetic care,” Valerie said. “Statistics show patients receiving care from IHS have demonstrated better glycemic control due to comprehensive clinical management.”

Institute for Healthcare Improvement
Indian Health Service
Mark Trahant, Kaiser Media Fellow, on Indian Health Service