Interviews with Tribal Leaders

Hamed Hemmati, Director of IT

Hamed Hemmati

Pala Tribe
Director of IT

What can you tell us about your team and your background?
I started with the Pala Tribe seven years ago as a network administrator and now am serving in the Director of IT role. I have seen the number of people, locations, and hardware and software that we support grow immensely in the time I have been in this department, all with a staff of just three people. When I started, the IT department was responsible for maintaining Microsoft Office for less than 50 users and managing one file server. We had five buildings and everyone had individual email accounts. We now have over 130 employees at the tribe and18 buildings all connected via fiber. We’ve moved to an exchange server and are in the process of deploying VOIP for a unified communication system stretching across all of our campus. My team provides service and support for all government functions in the tribe such as; tribal administration, GIS, emergency management, fire/public safety, post office, radio station, education and child care. The tribe also owns some non-gaming enterprises that we are involved with deploying and maintain technology at such as the motocross raceway.
What was it like moving from a technical role into a leadership one?
I still remain hands on and don’t remove myself from projects just because of my position. I think it’s important to be involved and remain aware of what’s happening with the projects even if you aren’t the person that’s hands-on in every instance. At the leadership level I also deal more with the tribal council than I did as a network administrator on things like strategic planning and the role IT plays in some of the tribe’s businesses.
What projects are on the horizon for your team?
I would say we have three main projects or areas of focus for the rest of 2015. Security is a topic that is always on our minds, we will be continuing to work on the balance of ensuring that our network is secure while not impeding on user ability/access. We are changing our badging system to include QR codes and microchipping for every area of the tribe from things like employee and visitor badges to accessing the fitness center. Last is a project that will not only foster improvement but could also potentially increase revenue, the deployment of a new A/V system that would be available for use within a rental space owned by the tribe.

Mark Kirk, Director of Information Services Group

Mark Kirk

Osage Nation
Director of Information Services Group

What can you tell us about your department and organization?
The Information Services Group has multiple departments within it, not just Information Technology. All together we are; IT, Communications, Archives, Mail Room, Reception and the Constituent Services departments. I report directly to the Chief’s Office and my role is to serve as the Director of the entire I.S. group which houses 30 people, 17 are in IT. This team handles all the network, communications, telecom, security, access control, A/V, applications, help-desk support, general IT and so on for areas within the tribe such as; enrollment, accounting, housing, TANF, judicial, head start, GIS and more. There are over 19,000 enrolled members of the Osage Nation who are able to utilize the government services we are responsible for providing IT support for.
What would you say is your leadership style?
I try to take a team-oriented approach to leadership. We have several teams defined within our group which primarily include; Help-Desk Team, Communications Team, Web Team, Infrastructure Team and Security Team. Some people cross into more than one team depending on their skill set and job title. We do not have any real “managers” of IT programs, we feel this is the best fit for our organization to keep projects on task and keep everyone engaged. It helps significantly with change management as well and promotes cross-training which is a positive thing not only for our department, but for servicing our customers and personal development for our team members. We have a very low turnover rate in most positions and I am confident that our ability to attack projects together vs working in silos contributes to that. When I first started here, there was a datacenter project that had just kicked off that was falling behind schedule. Once the new approach was implemented and we moved to a more team-oriented approach and started to implement ITIL and COBIT practices, the project started moving along and was a success. It was great to have an opportunity to put this structure in place right at the start. We now use this approach in not just the way we tackle projects but how we structure our department. Also, we have shared our model with some of the other departments in the tribe and they have adopted our team-oriented approach for their internal structure and project management.
What can you tell us about some of your current projects in IT?
Like any IT department there is never down-time, we always have tickets, upgrades and small projects going on, but two projects right now that are at the center of our work load are; the new building project and our SharePoint/CRM project.

The Osage Nation is spread across a coverage are of 2.304 sq miles (U.S. Census). Our main headquarters is in Pawhuska OK on 160 acres. Right now there are 105 facilities that span across the entire coverage area and this building project focuses on putting in two new buildings on the headquarters campus which will house a welcome center and a direct services center which would include departments like accounting and support staff. The master campus plan that is in place and set to be completed over next 3-5 years is to consolidate into as few buildings as we can. Our first two buildings of this multi-phase program are set to open this summer. It’s been a challenge but a very fun project to work on. It’s something that has been needed for a long time and IT has been involved with the development stages so we could ensure that the building was well-equipped with state of the art equipment and the ability for solid coverage. This building program also feeds into our move for improved business continuity. We have been fortunate not to have any major impact due to weather or other factors however we always want to prepare for the worst and hope for the best and have the ability to be fully operational especially with communications, in the event disaster strikes.

The second project that has been ongoing is our; Osage Nation Tribal Information System- (ONTIS). It’s a blend of Microsoft Dynamics and SharePoint to create a document management and CRM solution. Our goal is to have this be in use by all departments. We expect two more years before everything is fully rolled out but realistically it’s going to be something that is always evolving based on the needs of our organization, which is why it’s a great asset to have a flexible system. We are working with Planet Technologies as our partner on customizing the system and helping us to maximize its potential. So far it’s been rolled out to; enrollment, education, TANF, election and constituent services. The goal of the project is to centralize the data, help ensure accuracy of it and improve efficiency and service of every department. We will be focusing a lot of resources in 2015 on moving forward with the ONTIS project. With budgets remaining flat this year, something like this could mean big savings across multiple areas of the organization, which would be a huge plus to the benefits we are already seeing with this project.

What are some things you do you as an IT leader that help you make the best decisions possible?
I have a great team and have met a lot of great people in this industry that I trust. When I first started I went to a TribalNet conference and for me, the ability to be able to sit down face to face and see that other people are dealing with the same things I was, was immediately encouraging. Attending helped me get a better handle on situations I was involved with. I am also part of the Oklahoma Native American Technology Council (ONTAC) which has been a big help to have a collaborative environment to be a part of. I have people right in my back yard at other tribes that I can call up and ask questions, we talk about challenges and seek out solutions together. The willingness to give and take I have encountered in this industry has been great. You can’t afford not to connect with your peers.

Alaska Native Tribal Health Consortium (ANTHC)

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.

John Ormond, Director of Technology Services

John Ormond

Chumash Casino Resort
Director of Technology Services

 

Can you give us a look at your Technology Services department structure and areas of oversight?
The Technology Services department at the Chumash Casino Resort currently oversees an IT portfolio encompassing; a 2000-slot casino, bingo entertainment venue, a 100+-room casino hotel onsite, two offsite hotels, eight restaurants, multiple gas stations, our administrative building and employee resource center. Our Technology Services team is divided into two groups: Infrastructure/Operations- focusing on the daily operations and maintenance service levels and a Solutions Team- dedicated to capitalizing on business opportunities with best use of technology and new innovative solutions. In 2002 when I started we had four people in our department, four servers and one workstation we would all fight over using. We now have a technology staff of 31 and over 200 servers, 90% which are virtualized. We’ve seen steady growth over the years and have our sights set on continuing along that path. Our five-year outlook is constantly being reworked as we identify new business opportunities.
It seems like your entire organization has a very team-oriented approach, what can you tell us about this?
We do have a very team-oriented approach. It really goes “top down” and “bottom up”. In 2013, we recognized the need in our department to develop new strategy and improved documentation. We did a GAP analysis and formed a transition plan to put into motion. Previously we were very operational and didn’t have a formal process for building custom solutions. Everything was in individual silos and when we moved to a more team-centric approach it allowed better focus for development vs daily. Within IT we are following ITIL processes and have set teams focused on different areas of the business. We also have a management team within IT. Our structure also has a technology steering committee that is set in place to manage the IT portfolio. It’s made up of key personnel from Technology Services and the executive team. The executive leadership team, which I joined roughly four years ago, is made up of 10 executive directors from the casino resort. Being a part of this group empowers IT to be part of business decisions and is extremely helpful for IT in aligning with the business. Beyond this level there is a business committee that is an elected body defining governance and serving as the connection of the business to the tribal council. It has taken us several years to get to this structure but we feel fortunate to have all these layers driving the successful use of technology in our enterprise.
What are some of the key projects your team has been involved with recently or has upcoming?
We have had several upgrades to key administrative systems like; accounting, payroll and HR. Specific to gaming solutions, we have had a major push to use technology to advance our marketing plan. These efforts center around evaluating and identifying how to use mobile, social and interactive gaming to our advantage. We now have full wireless coverage on the gaming floor, have virtualized 90% of our servers and are on the cusp of some major advancements in our network with our new data center project. We are always actively seeking resources internally and externally to use technology to drive innovation.
Do you have any expansion projects you are working on that you can tell us about?
We are in the initial stages of a major expansion. Included will be a new data-center build, tripling the number of rooms in inventory onsite, new food and beverage outlets and other amenities. We have been in the planning stages of for a while will kick into high-gear with ground-breaking set for Q4 of 2014.

What would offer up as advice to your peers in the industry?

I would say identify the needs of the business, make sure that those needs align to business strategy and put processes in place to make the necessary adjustments to plan in the case that they don’t. Most if not all business activities are dependent on technology giving us a near complete view of operations. We strive to engage the business at multiple levels to ensure alignment from leadership to the front line. What technology can enable the business to do is unlimited, but everything has a cost Never forget that you can always do your job better; the point of innovation is not just to show it but to offer value to the business.

Jon James, CIO & Toni Potts, CAC Manager

Jon James & Toni Potts

Cherokee Nation & Cherokee Nation Health Services
CIO & CAC Manager

What can you tell us about the IT structure for both the Cherokee Nation and the Health Services Division? What are some of the key projects happening in IT at the Cherokee Nation?

Jon: The Cherokee Nation is the largest Native American tribe in the United States with about 300,000 registered Cherokee citizens. The Cherokee Nation land base spreads across 14 counties in northeastern Oklahoma and the tribe employs roughly 3,800 people in its tribal complex and health centers.

The IT team providing direction and support for the Health Services division of the Cherokee Nation is separate than the IT team for the government services, which includes; Career, Commerce, Community, Education, Housing, Human Services, Natural Resources, Real Estate Services, Tag Office and Tribal Citizenship. As CIO, I report to the Cherokee Nation Secretary of State with five key managers reporting directly to me as well as a total of 65 employees in IT.

Toni: The Health IT division currently consists of about 40 positions and is led by Health Services CIO, Donnie Parish. We provide Health IT support to eight clinics across the counties and one major hospital. Other health programs offered include; EMS, Diabetes, Community Health, Cancer Prevention Program, Behavioral Health, youth and elder centers. Cherokee Nation Health Services is the largest tribally-operated health care system in the United States with more than 1 million patient visits per year.

What are some of the key projects happening in IT at the Cherokee Nation?

The main areas we have been focusing on this year relate to; project portfolio management, telecommunications and general upgrade and maintenance schedules. We’ve just been through a major workforce management and ERP upgrade with Kronos and Infor/Lawson. We are coming to the end of life for several main servers and doing major hardware replacements for data recovery and storage. We have a business case out for upgrading our TAG database which is the office and system used for tribally issued car tags and titles. Cherokee citizens living within the state of Oklahoma can register and license their vehicle through the Cherokee Nation. We maintain our own in-house enrollment system and are programming a full ancestry system. We are utilizing open source knowledge management system and will also be modifying our enrollment system for enterprise wide access. This will also be 100 percent in-house developed. We are working on a Microsoft Exchange 2013 upgrade, however with VoIP being tightly integrated with 2010 (which we are running now) adds a level of challenge but we are planning to have this upgrade complete in early 2015. We have several new construction projects, one of which is a large fiber project stretching across a major highway for new or relocated Cherokee Nation offices. We are in the process of replacing all of our wireless access points which will standardize and improve wireless network coverage across the Cherokee Nation for all of our sub offices and clinics. Although the health division is separate than the government IT division, we do work together on infrastructure projects and will be working closely on some of the items mentioned above as it impacts all of us.

What are some of the key projects happening in IT at Cherokee Nation Health Services?

Health IT places a large focus on working with clinical staff on workflow processes, as they pertain to the entries into electronic medical record and the flow of patient medical information. Improving these processes can lead to improved efficiencies and increased standardizations, which all translate to improving patient care and that’s always our main goal. We have also most recently been working on a new health patient portal that allows patients to request pharmacy refills giving more control to the patient for managing their own health care. Since 2004 we have been using electronic health records (EHR), which requires patches, upgrades and maintenance which allows us to continue to meet meaningful use requirements. Recently we have been working on ensuring the right technology is in place for the Million Hearts National Initiative launched by the Department of Health and Human Services in September 2011 to prevent 1 million heart attacks and strokes by 2017. We are proud to be part of such an impactful initiative both for our citizens and the entire United States.

What can you tell us about your involvement with industry organizations and other government entities?

The Cherokee Nation and many of its divisions are very involved with national, state and regional organizations. We make a concerted effort to be involved with groups that allow us to network and connect with others where collaborative efforts stimulate progress that may otherwise not have happened. Our health division has representation with the C4 group and Indian Health Service working groups and we have representation as a board member(s) on TribalNet, the Oklahoma Native American Technology Council and Tribal Telecom. Considering Cherokee Nation as a whole, we work with state and federal agencies in areas such as Indian Child Welfare, our vehicle tag database, housing, U.S. Marshal Service, health information exchange, regional hospitals and more.

Do you have any advice for your peers?

Toni: I would say collaboration is my buzz word. You can spark more ideas with a large group than you can on your own.

Jon: The thing I always stress is the importance of having full project management and steering committees in place. It’s what really steers the direction of the organization and provides a platform for open communication.

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