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[Federal Register Volume 83, Number 142 (Tuesday, July 24, 2018)]
[Notices]
[Pages 35012-35016]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-15740]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service

Draft Indian Health Service Strategic Plan Fiscal Year 2018-2022

AGENCY: Indian Health Service, IHS.

ACTION: Request for comments; notice of Tribal Consultation and Urban 
Indian Confer.

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SUMMARY: The Indian Health Service (IHS) is developing an Agency-wide 
Strategic Plan to guide the work and strengthen partnerships with 
Tribes and Urban Indian Organizations. The IHS is

[[Page 35013]]

seeking public comment on its Draft IHS Strategic Plan fiscal year (FY) 
2018-2022 (Draft IHS Strategic Plan FY 2018-2022). Additionally, notice 
is given that the IHS will conduct a Tribal Consultation and Urban 
Indian Confer regarding the Draft IHS Strategic Plan FY 2018-2022. In 
addition to the virtual town hall sessions, the IHS will seek other 
opportunities to solicit input from Tribal and Urban Indian programs on 
the Draft IHS Strategic Plan FY 2018-2022 during the comment period. 
For IHS Strategic Plan events during the comment period, please check 
the IHS Event Calendar at: https://www.ihs.gov/ihscalendar/.

DATES: Comments due by August 23, 2018.
    The IHS virtual town hall sessions:
    1. Urban Indian Confer on August 3 2018, from 2:00 p.m.-3:30 p.m. 
(Eastern Time).
    2. Tribal Consultation on August 6, 2018, from 2:00 p.m.-3:30 p.m. 
(Eastern Time).

ADDRESSES: Written comments on the Draft IHS Strategic Plan FY 2018-
2022 may be provided by email, or by United States (U.S.) postal mail.
    E-mail addresses are as follows:
    For Tribes: [email protected].
    For Urban Indian Organizations: [email protected].
    For IHS Employees and the General Public: [email protected].
    Please use ``DRAFT IHS STRATEGIC PLAN FY 2018-2022'' as the subject 
line.
    U.S. Postal Mail: RADM Michael D. Weahkee, MBA, MHSA, Acting 
Director, ATTN: Draft IHS Strategic Plan FY 2018-2022, Indian Health 
Service, 5600 Fishers Lane, Mailstop: 08E86, Rockville, Maryland 20857.

FOR FURTHER INFORMATION CONTACT: CAPT Francis Frazier, Director, Office 
of Public Health Support, IHS, 5600 Fishers Lane, Mail Stop: 09E10D, 
Rockville, Maryland 20857. Telephone (301) 443-0222 (This is not a 
toll[dash]free number).

SUPPLEMENTARY INFORMATION: The IHS participated in a strategic planning 
process informed by feedback received from Tribes, Urban Indian 
Organizations, and staff, as described in more detail below, to develop 
the Draft IHS Strategic Plan FY 2018-2022 for consideration. The IHS is 
committed to improving health care delivery services and enhancing 
critical public health services to strengthen the health status of 
American Indian and Alaska Native people throughout the health system.
    The Draft IHS Strategic Plan FY 2018-2022 includes a revised IHS 
Mission statement, a new IHS Vision statement, and articulates how the 
IHS will achieve its mission through three strategic goals. The three 
strategic goals are: (1) To ensure that comprehensive, culturally 
acceptable personal and public health services are available and 
accessible to American Indian and Alaska Native people; (2) To promote 
excellence and quality through innovation of the Indian health system 
into an optimally performing organization; and (3) To strengthen IHS 
program management and operations. Each goal is supported by objectives 
and strategies. To review the current IHS Mission statement and 
priorities, please visit: https://www.ihs.gov/aboutihs/overview/.
    The strategic planning Consultation and Confer process is an 
opportunity for the IHS to further refine and strengthen the Draft IHS 
Strategic Plan FY 2018-2022. The IHS appreciates the invaluable 
feedback received to date on the Draft IHS Strategic Plan FY 2018-2022 
and seeks to ensure all Agency stakeholders have the opportunity to 
comment. As we build on the current Draft IHS Strategic Plan FY 2018-
2022, we look forward to receiving your comments by August 23, 2018.
    The Urban Indian Confer on August 3, 2018, and the Tribal 
Consultation on August 6, 2018, will be held telephonically and by 
webinar. A letter will be sent to Urban Indian Organization Leaders and 
Tribal Leaders to notify them about details associated with conference 
call and webinar schedules and call-in information.
    To develop the Draft IHS Strategic Plan FY 2018-2022, the IHS used 
a process similar to the U.S. Department of Health and Human Services 
(HHS) Strategic Plan FY 2018-2022, including use of goals; objectives 
and strategies; environmental scans; Strengths, Weaknesses, 
Opportunities, and Threats (SWOT) analysis; and workgroup 
participation. The environmental scan reviewed several IHS Areas, 
Headquarters Offices, and other available documents, and the SWOT 
exercise was conducted with IHS staff. Informed by these documents and 
analysis, the IHS developed an initial framework for review and comment 
by Tribes, Urban Indian Organizations, and IHS staff. The IHS first 
initiated Tribal Consultation and Urban Indian Confer on the IHS 
Strategic Plan initial framework on September 15, 2017, and formed an 
IHS Federal-Tribal Strategic Planning Workgroup (workgroup) to review 
all comments and recommend a list of final goals and objectives for IHS 
leadership review and approval.
    During the initial framework comment period (September 15, 2017-
October 31, 2017), the IHS held listening sessions, presented at Tribal 
meetings, and held conference calls with Tribal and Urban Indian 
Organization leaders. The workgroup membership included IHS staff at 
the Area, Service Unit, and Headquarters levels (including a 
representative from the IHS Office of Urban Indian Health Programs); 
Tribal leaders or their designees. The workgroup reviewed the comments 
received from 150 Tribes, Tribal Organizations, Urban Indian 
Organizations and IHS staff on the initial framework and suggested 
strategies during six meetings over a 3-month period, resulting in 
final recommendations on the IHS Mission, Vision, Goals, Objectives, 
and Strategies. These recommendations are the basis of the Draft IHS 
Strategic Plan FY 2018-2022.
    Since initiating Tribal Consultation and Urban Indian Confer on the 
IHS Strategic Plan initial framework, the IHS has issued four letters 
to Tribal Leaders and Urban Indian Organization Leaders to update 
Tribes and Urban Indian Organizations on progress. Additionally, the 
IHS issued several communications stating that comments on the Draft 
IHS Strategic Plan FY 2018-2022 will be accepted throughout the 
strategic planning process. The IHS strategic planning Web site 
includes more information about the IHS strategic plan timeline, as 
well as links to the Tribal Leader letters, Urban Indian Organization 
Leader letters, and workgroup activities.
    The IHS values all feedback and input regarding the Draft IHS 
Strategic Plan FY 2018-2022 and invites Tribes, Tribal Leaders, and/or 
their designees to Consult and Urban Indian Organization Leaders to 
Confer on the Draft IHS Strategic Plan FY 2018-2022. Tribal 
Consultation will be conducted with elected or appointed leaders of 
Tribal Governments and their designated representatives. Those wishing 
to participate in the Tribal Consultation as a designee must have a 
copy of a letter signed by an elected or appointed Tribal official or 
their designee that authorizes them to serve as the representative of 
the Tribe. Urban Indian Confer will be conducted with recognized 
representatives from Urban Indian Organizations, as defined by 25 
U.S.C. 1603(29). Representatives from other Tribal Organizations and 
Native non-profit organizations are welcome as observers. Those wishing 
to be recognized representatives from Urban Indian Organizations should 
provide documentation that their organization meets the definition at 
25 U.S.C. 1603(29) and that the selected participant has the official 
capacity to

[[Page 35014]]

represent the organization. This documentation should be submitted by 
e-mail no later than 3 days in advance of the Tribal Consultation and 
Urban Indian Confer session to the address that follows: 
[email protected].
    The text of the Draft IHS Strategic Plan FY 2018-2022 is available 
at the IHS Web site at: https://www.ihs.gov/strategicplan/and below.

Indian Health Service (IHS)

Draft IHS Strategic Plan Fiscal Year 2018-2022

    The Indian Health Service (IHS) provides a wide range of 
clinical, public health, community and facilities infrastructure 
services to approximately 2.2 million American Indians and Alaska 
Natives (AI/AN) from 573 federally recognized Tribes in 37 States. 
Comprehensive primary health care and disease prevention services 
are provided through a network of hospitals, clinics, and health 
stations on or near Indian reservations. These facilities are 
predominately located in rural and primary care settings and are 
managed by IHS, Tribes, and Tribal Organizations. In addition, IHS 
contracts with Urban Indian Organizations for health care services 
provided in urban centers. The Draft IHS Strategic Plan FY 2018-2022 
includes the Mission statement, a new Vision statement and 
articulates how the IHS will achieve its mission through three 
strategic goals. Each goal is supported by objectives and 
strategies.
    Mission: To raise the physical, mental, social, and spiritual 
health of American Indians and Alaska Natives to the highest level.
    Vision: Healthy communities and quality health care systems 
through strong partnerships and culturally relevant practices.
    Goal 1: To ensure that comprehensive, culturally acceptable 
personal and public health services are available and accessible to 
American Indian and Alaska Native people.
    Goal Explanation: The Indian Health Service (IHS) provides 
comprehensive primary health care and public health services, which 
are critical to improving the health of AI/AN people. The Indian 
health system delivers care through health care services provided in 
IHS, Tribal, and Urban (I/T/U) health facilities (e.g., hospitals, 
clinics) and by supporting the purchase of essential health care 
services not available in IHS and Tribal health care facilities, 
known as the Purchased/Referred Care (PRC) program. Additional 
services include environmental health improvements as well as 
traditional healing to complement the medical, dental, pharmacy, 
laboratory, behavioral health and other primary care medical 
programs. Expanding access to these services in AI/AN communities is 
essential to improving the health status of the AI/AN population. 
This goal includes securing the needed workforce, strengthening 
collaboration with a range of public and private, Tribal, and Urban 
Indian providers and expanding access to quality health care 
services to promote the health needs of AI/AN communities.
    Objective 1.1: Recruit, develop, and retain a dedicated, 
competent, and caring workforce.
    Objective Explanation: Consistent, skilled, and well-trained 
leadership is essential to recruiting and retaining well-qualified 
health care professionals and administrative professionals. 
Attracting, developing, and retaining the needed staff will require 
streamlining hiring practices and other resources that optimize 
health care outcomes. Within the Indian health system, staff 
development through orientation, job experience, mentoring, and 
short and long-term training and education opportunities are 
essential for maintaining and expanding quality services and 
maintaining accreditation of facilities. Also, continuing education 
and training opportunities are necessary to increase employees' 
skill sets and knowledge to keep pace in rapidly evolving areas of 
medical science, prevention science, improvement science, and 
information technology, as well as to increase opportunities for 
employee career advancement and/or to maintain necessary 
professional credentialing and accreditation.
    Strategies--The following strategies support this objective:
    Health Care Recruitment and Retention:
    1. Improve and innovate a process that increases recruitment and 
retention of talented, motivated, desirable, and competent workers, 
including through partnerships with Tribal communities and others.
    2. Continue and expand the utilization of the IHS and Health 
Resources and Services Administration's National Health Service 
Corps scholarship and loan repayment programs, as authorized by the 
law, to increase health care providers at I/T/U facilities.
    3. Support IHS sponsorship of fellowship slots in certain 
specialized leadership programs for recruitment of future physician 
leaders.
    4. Evaluate new organizational structure options and reporting 
relationships to improve oversight of the Indian Health Professions 
program.
    5. Expand the use of paraprofessionals and mid-level 
practitioners to increase the workforce and provide needed services.
    6. Develop training programs in partnership with health 
professional schools and training hospitals and expand opportunities 
to educate and mentor Native youth interested in obtaining health 
science degrees.
    7. Enhance and streamline IHS Human Resources infrastructure to 
hire well-qualified personnel.
    Staff Capacity Building:
    8. Strengthen the workforce to improve access to, and quality 
of, services.
    9. Improve leadership skills, adopt a consistent leadership 
model, and develop mentoring programs.
    10. Improve continuity processes and knowledge sharing of 
critical employee, administrative, and operational functions through 
written communications and documentation within IHS.
    11. Improve workplace organizational climate with staff 
development addressing teamwork, communication, and equity.
    12. Strengthen employee performance and responsiveness to the 
Agency, Tribes, and patients by improving employee orientation and 
opportunities for training and education, including, customer 
service skills.
    Objective 1.2: Build, strengthen, and sustain collaborative 
relationships.
    Objective Explanation: Collaboration fostered through an 
environment that values partnership is vital to expanding the types 
of services to improve population health outcomes that can be 
achieved within the health care delivery system. These relationships 
include those between Tribes, Urban Indian programs, communities, 
other government agencies, not-for-profits, universities/schools, 
foundations, private industry, as well as internal cooperation 
within the Agency and collaborative project management.
    Strategies--The following strategies support this objective:
    Enhancing Collaboration:
    1. Collaborate with Tribes in the development of community-based 
health programs, including health promotion and disease prevention 
programs and interventions that will increase access to quality 
health programs.
    2. Develop a community feedback system/program where community 
members can provide suggestions regarding services required and 
received.
    3. Support cross collaboration and partnerships among I/T/U 
stakeholders.
    Service Expansion:
    4. Promote collaborations between IHS, other Federal agencies, 
Tribes, and Tribal Organizations to expand services, streamline 
functions and funding, and advance health care goals and 
initiatives.
    5. Work with community partners to develop new programs 
responsive to local needs.
    Objective 1.3: Increase access to quality health care services.
    Objective Explanation: Expanded access to health care services, 
including individual and community health services, requires using 
many approaches and is critical to improving the health of AI/AN 
people and reducing the leading causes of death risk factors. Among 
the needs identified are increased prevention, specialty care, 
innovative use of health care providers, traditional medicine, long-
term and aftercare services (which may require advancing holistic 
and culturally centered population health models), and expanded 
facilities and locations. To assess the success of these efforts, 
measures are needed to evaluate provider productivity, patient 
satisfaction, and align improvements in support operations (e.g., 
human resources, contracting, technology) to optimize access to 
quality health care services.
    Strategies--The following strategies support this objective:
    Health Care Service Access Expansion:
    1. Develop and support a system to increase access to preventive 
care services and quality health care in Indian Country.
    2. Develop and expand programs in locations where AI/AN people 
have no access to quality health care services.
    3. Overcome or mitigate challenges and enhance partnerships 
across programs and

[[Page 35015]]

agencies by identifying, prioritizing, and reducing access 
limitations to health care for local AI/AN stakeholders.
    4. Increase access to quality community, direct/specialty, long-
term care and support services, and referred health care services 
and identify barriers to care for Tribal communities.
    5. Leverage technologies such as telemedicine and asynchronous 
electronic consultation systems to include a more diverse array of 
specialties and to expand, standardize, and increase access to 
health care through telemedicine.
    6. Improve team effectiveness in the care setting to optimize 
patient flow and efficiency of care delivery.
    7. Reduce health disparities in the AI/AN population.
    8. Provide evidence-based specialty and preventive care that 
reduces the incidence of the leading causes of death for the AI/AN 
population.
    9. Incorporate Traditional cultural practices in existing health 
and wellness programs, as appropriate.
    10. Improve the ability to account for complexity of care for 
each patient to gauge provider productivity more accurately.
    11. Hold staff and management accountable to outcomes and 
customer service through satisfaction surveys.
    Facilities and Locations:
    12. In consultation with Tribes, modernize health care 
facilities to expand access to quality health care services.
    13. In consultation with Tribes, review and incorporate a 
resource allocation structure to ensure equity among Tribes.
    14. Develop and execute a coordinated plan (including health 
care, environmental engineering, environmental health, and health 
facilities engineering services) to effectively and efficiently 
execute response, recovery, and mitigation to disasters and public 
health emergencies.
    Goal 2: To promote excellence and quality through innovation of 
the Indian health system into an optimally performing organization.
    Goal Explanation: In pursuit of high reliability health care 
services \1\ and care that is free from harm, the IHS has 
implemented several innovations in health care delivery to advance 
the population health needs of AI/AN communities. In many cases, 
innovations are developed to meet health care needs at the local 
level and subsequently adopted across the Indian health system, as 
appropriate. IHS will continue to promote excellence and quality 
through innovation by building upon existing quality initiatives and 
integrating appropriate clinical and public health best practices. 
Recent IHS efforts have been aimed at strengthening the underlying 
quality foundation of federally operated facilities, standardizing 
processes, and sharing health care best practices with other 
Federal, State, Tribal, and Urban Indian programs.
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    \1\ High reliability health care means consistent excellence in 
quality and safety for every patient, every time. High reliability 
in health care improves: organizational effectiveness, efficiency, 
culture, customer satisfaction, compliance, and documentation. For 
more information about High Reliability Organizations, please see: 
https://psnet.ahrq.gov/primers/primer/31/high-reliability.
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    Objective 2.1: Create quality improvement capability at all 
levels of the organization.
    Objective Explanation: Ensure quality improvement is operational 
in all direct care, public health, administrative, and management 
services throughout the system. Quality improvement will be achieved 
at all levels of the organization including Headquarters, Area 
Offices, and Service Units and will be made available to Tribes, 
Tribal Organizations, and Urban Indian Organizations, as requested. 
Creating quality improvement capability at all levels will require 
training, resources, commitment, and consistency to assure that 
every employee shares a role in continuous quality improvement in 
all IHS operations and services. This objective will build upon 
current efforts of the 2016-2017 IHS Quality Framework \2\ to 
strengthen quality improvement related to data, training, and 
standards of care.
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    \2\ The IHS Quality Framework 2016-2017 is available at: https://www.ihs.gov/newsroom/includes/themes/newihstheme/display_objects/documents/IHS_2016-2017_QualityFramework.PDF.
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    Strategies--The following strategies support this objective:
    Quality Data:
    1. Improve the quality of data collected regarding health care 
services and program outcomes.
    2. Develop and integrate quality standards and metrics into 
governance, management, and operations.
    3. Standardize quality metrics across the IHS and use results to 
share information on best practices, performance trends, and 
identification of emerging needs.
    Continuous Quality Improvement:
    4. Provide training, coaching, and mentoring to ensure 
continuous quality improvement and accountability of staff at all 
levels of the organization.
    5. Evaluate training efforts and staff implementation of 
improvements, as appropriate.
    Standards of Care:
    6. Develop and provide standards of care to improve quality and 
efficiency of health services across IHS.
    7. Adopt the Model of Improvement in all clinical, public 
health, and administrative activities in the Indian health system.
    8. Adopt patient-centered models of care, including patient 
centered medical home recognition and care integration.
    Objective 2.2: Provide care to better meet the health care needs 
of Indian communities.
    Objective Explanation: Key to improving health outcomes and 
sustaining population health is culturally responsive health care 
that is patient-centered and community supported. IHS will implement 
culturally appropriate and effective clinical and public health 
tools, as appropriate, to improve and better meet the health care 
needs of AI/AN communities. This objective reinforces current 
efforts addressing culturally appropriate care and support 
dissemination of best practices.
    Strategies--The following strategies support this objective:
    Culturally Appropriate Care:
    1. Strengthen culturally competent organizational efforts and 
reinforce implementation of culturally appropriate and effective 
care models and programs.
    2. Promote and evaluate excellence and quality of care through 
innovative, culturally appropriate programs.
    3. Promote the total health integration within a continuum of 
care that integrates acute, primary, behavioral, and preventive 
health care.
    4. Explore environmental and social determinants of health and 
trauma-informed care in health care delivery. Expand best practices 
across the IHS.
    5. Continue to develop and implement trauma-informed care models 
and programs.
    Sharing Best Practices:
    6. Work collaboratively within IHS, and among other Federal, 
State, Tribal programs, and Urban Indian programs to improve health 
care by sharing best practices.
    Goal 3: To Strengthen IHS program management and operations.
    Goal Explanation: This goal addresses issues of management, 
accountability, communication, and modernized information systems. 
IHS is committed to the principles of improved internal and external 
communication, and sound management. Assuring the availability and 
ongoing development of a comprehensive information technology (IT) 
system is essential to improving access to integrated clinical, 
administrative, and financial data to support individual patient 
care, and decision-making.
    Objective 3.1: Improve communication within the organization 
with Tribes and other stakeholders, and with the general public.
    Objective Explanation: This objective addresses the critical 
need to improve communication throughout the IHS, with employees and 
patients, with Tribes, with Urban Indian Organizations, with the 
many organizations working with IHS and with the general public. 
Most important is to assist Tribes, Urban programs, and IHS in 
better understanding Tribal and Urban Indian needs and IHS program 
needs, to encourage full participation in information exchange, and 
to engage Tribes and Urban programs in partnership and coalition 
building. This includes defining and characterizing community needs 
and health program needs, modifying health programs as needed, and 
monitoring the effectiveness of programs and program modifications.
    Strategies--The following strategies support this objective:
    Communication Improvements:
    1. Improve communication and transparency among all employees, 
managers, and senior leadership.
    2. Develop and define proactive communications plans for 
internal and external stakeholders.
    3. Enhance health-related outreach and education activities to 
patients and families.
    4. Design social media platforms that will ensure wide 
dissemination of information to interested and affected individuals 
and organizations.
    Strengthened Partnership:
    5. Assure quality reporting relationships between service units, 
Area offices, and

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headquarters are clearly defined and implemented.
    6. Effectively collaborate with other IHS offices (e.g., the 
Loan Repayment Program) and HHS Staff and Operating Divisions where 
missions, goals, and authorities overlap.
    Objective 3.2: Secure and effectively manage the assets and 
resources.
    Objective Explanation: This objective supports the delivery of 
health care through improved management of all types of assets and 
non-workforce resources. To elevate the health status of the AI/AN 
population and increase access to medical care, IHS must continue to 
help ensure patients understand their health care options and 
improve business process and efficiencies to the health care system. 
IHS will also increase the effectiveness of operations and 
reporting, while providing more assistance and infrastructure 
support to Areas and facilities.
    Strategies--The following strategies support this objective:
    Infrastructure, Capacity, and Sustainability:
    1. Enhance transparency of the IHS management and accountability 
infrastructure to properly manage and secure assets.
    2. Ensure that Federal, State, Tribal, territorial, and local 
Tribal health programs have the necessary infrastructure to 
effectively provide essential public health services.
    3. Provide technical assistance to strengthen the capacity of 
service units and Area Offices to enhance effective management and 
oversight.
    4. Apply economic principles and methods to assure ongoing 
security and sustainability of Federal, Tribal and Urban Indian 
facilities.
    Improved Business Process:
    5. Routinely review management operations to effectively improve 
key business management practices.
    6. Optimize business functions to ensure IHS is engaged in 
discussions on value-based purchasing.
    7. Develop policies, use tools, and apply models that ensure 
efficient use of assets and resources.
    8. Strengthen management and operations through effective 
oversight.
    9. Develop standardized management strategies for grants, 
contracts, and other funding opportunities to promote innovation and 
excellence in operations and outcomes.
    Patient Education and Resources:
    10. Strengthen patients' awareness of their health care options, 
including Medicaid and Medicare enrollment, which may increase 
access to health care and optimize third party reimbursements.
    Objective 3.3: Modernize information technology and information 
systems to support data driven decisions.
    Objective Explanation: This objective is to assure the 
availability and ongoing improvement of a comprehensive information 
technology (IT) system that meets the needs of providers, patients, 
and I/T/Us, including using technology to provide improved, timely 
access to care and to reduce the need for transit. This objective 
recognizes that qualified and capable IT staff and leadership are 
fundamental in achieving the strategies listed below and further 
reinforces the workforce objectives outlined elsewhere in the plan. 
An improved Indian health IT network increases access to integrated 
clinical, administrative, and financial data to support individual 
patient care, decision-making, and advocacy. The need for data will 
require the development of a system integrated with Tribal and Urban 
Indian programs that will address the current and projected 
clinical, administrative, and fiscal data needs. Timely fiscal data 
dissemination to all Federal partners when developing budgets is 
necessary to accurately address health care needs of Indian 
communities. Data quality (i.e., accuracy, reliability, and 
validity) and quality patient care will continue to play a highly 
visible role both within and outside the IHS. Data quality is only 
partially dependent upon technology. Improved data quality also 
reflects other sustained initiatives, such as accuracy of data 
entry, legibility of handwriting, appropriate and timely data 
exports, and accuracy of coding.
    Strategies--The following strategies support this objective:
    Health Information Technology (HIT):
    1. Evaluate electronic health record needs of the IHS and the 
ability for the health information systems to meet those needs, 
create seamless data linkages, and meet data access needs for Tribes 
and Tribal program health information systems.
    2. Develop a consistent, robust, stable, secure, state-of-the-
art HIT system to support clinicians workflow, improve data 
collection, and provide regular and ongoing data analysis.
    3. Modernize the HIT system for IHS Resource and Patient 
Management System (RPMS) or commercial off-the-shelf packages.
    4. Align with universal patient record systems to link off-
reservation care systems that serve AI/AN.
    5. Enhance and expand technology such as the IHS telecom to 
provide access for consultative care, stabilization of care, 
decreased transportation, and timeliness of care at any IHS-funded 
health program.
    Data Process:
    6. Provide available data to inform decision making for internal 
and external stakeholders.
    7. Act upon performance data and standardize data and reporting 
requirements.
    8. Assure system of data sharing to solidify partnerships with 
Tribal Epidemiology Centers and other Tribal programs.
    9. Establish capability for data federation \3\ so that data 
analytics/business intelligence may be applied to disparate data 
stored in a single, general-purpose database that can hold many 
types of data and distribute that data to users anywhere on the 
network.
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    \3\ Data federation provides an organization with the ability to 
aggregate data from disparate sources in a virtual database so it 
can be used for business intelligence or other analysis.

    Note:  This draft plan is developed for public consideration, it 
is intended to improve the management and administration of the IHS 
and strategic direction of the Agency over the next 5 years, and it 
is not intended to create any right, benefit, or legal 
responsibility, substantive or procedural, enforceable at law by a 
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party against the United States, its agencies, or any person.

    The IHS will publish an additional Federal Register Notice with the 
final IHS Strategic Plan FY 2018-2022 after all comments are received 
and considered.

    Dated: July 16, 2018.
Michael D. Weahkee,
RADM, Assistant Surgeon General, U.S. Public Health Service, Acting 
Director, Indian Health Service.
[FR Doc. 2018-15740 Filed 7-23-18; 8:45 am]
BILLING CODE 4165-16-P
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