Stewart Ferguson, PhD
& Karen Sidell

Alaska Native Tribal Health Consortium (ANTHC)
CTO & Director of Statewide IT Services

Can you tell us a little about ANTHC and each of your roles within the organization?
The Alaska Native Tribal Health Consortium (ANTHC) was formed in 1997 and is the largest, most comprehensive tribal health organization in the United States. ANTHC provides healthcare for 229 Alaska Native Tribes. ANTHC in partnership with Southcentral Foundation, jointly owns and manages the Alaska Native Medical Center which is the largest tribally owned and operated hospital in the U.S. ANTHC also partners with more than 30 other tribal health organizations in Alaska to provide comprehensive statewide healthcare for Alaska Natives and American Indians through the Alaska Tribal Health System (ATHS), which is fully compacted and supports 6 regional hospitals and more than 200 remote clinics. The question you may be asking yourself is, how does one organization set the standards in technology for 200 facilities operated by 30 different tribal organizations? How do you provide the absolute best birth to death care across an environment that is so complex, not just in geography but distance, weather, challenges of communications, informatics, support, training and process variations? That’s what we’d like to talk about today.

Stewart is the CTO for ANTHC serving previously as their CIO and before that Director of Telehealth. His work in telehealth is well-known globally and he lives currently in Israel working still with ANTHC but also overseas. Karen is the Director of Statewide IT Services for ANTHC and is responsible for coordinating and communicating with all the ANTHC tribes and organizations. Her focus on outreach and education puts her at the center of several initiatives and resources within ANTHC. We also had the opportunity to have James Spillane on the interview with us. James is a private consultant for Sitnasuak Health Solutions working with tribes primarily on improving patient care through work flow and process improvements.

ANTHC is working on so many great initiatives, what are some areas of focus you think we should discuss today?
We think there are three main focus areas that are important to cover: Health Information Exchange, our approach to electronic health records (EHR), and how telehealth which has an 18% penetration rate in Alaska is impacting patient care. Being a State-Wide healthcare system I imagine Health Information Exchange (HIE) is an important initiative- what can you tell us about what you guys are doing with it? The State of Alaska has a single Health Information Exchange and is partially funded by the State of Alaska. The goal is to get every EHR connected to it so patient information is available wherever patients go- whether it’s in the most remote clinics to the largest hospitals in the State. The data is centralized. We have developed a tool kit for our tribal partners which is immensely helpful for assisting them to connected their EHR to the HIE. A major challenge in getting them all tied in is that they need to be on the most current version of electronic health records (EHR) which brings us to our next area of focus.
What can you tell us about your approach to EHR?
The complexity and diversity of electronic health records across all the ATHS is overwhelming. With the goal of centralizing data in the health information exchange initiative we find the challenge lying first, in the fragmentation of EHRs. What we mean by that is some tribes are on RPMS, some are on NextGen, Cerner, and so on. The records and systems don’t match, and even within the same systems, different tribes are on different versions and patches and customization levels. Our goal is to make patient data available wherever care is delivered. Connecting disparate EHRs to the HIE is a key element. But we also have a major initiative to share the Cerner EHR deployed at ANMC with other tribal partners. We currently have 29 sites throughout Alaska on this single EHR, with the potential of doubling that number within the next 18 months. James said it best, 1 patient, 1 chart, 1 EHR. We know from experience that one EHR dramatically improves the patient and provider experience with seamless access to the complete patient record. Just imagine the opportunities this affords for shared training, support, educational and staffing opportunities! We get excited thinking about all the possibilities. How much of an impact does tele-health have on Alaskan Native Tribes? Just to give you some stats on tele-health in Alaska- as a system there are 45,000 tele-health encounters annually. It amounts to 5% of all our patient encounters in ATHS, and more than 18% of all Alaska Natives participate in telehealth annually. It’s estimated that over $8 million is saved each year just in travel costs alone. The access to specialty care that people can get in some of the most remote parts of the country sometimes is better than you can get at your local clinic. Over 40% of specialty consultations over tele-health are responded to in 60 minutes or less!
Where do you see the future of healthcare heading?
It’s a virtual healthcare world we are moving to, where data is key. The industry is looking to focus on improving patient care and internal operations through the use of technology. Capturing and sharing data is a critical first step, but turning data into knowledge is how we will dramatically improve patient care. ANTHC is one of the groups trying to bring it all together.