A boy in Chignik Bay has
a tube in his eardrum to
equalize pressure and it's bothering him. Does he have to be sent to see a doctor in Dillingham or to see an Ear, Nose and Throat (ENT) specialist in
Anchorage? Not anymore.
Today, he can walk into
the local clinic, where
the Community Health Aide/Practitioner (CHA/P) will take a close-up digital image of the child's inner ear. That image is automatically transmitted to Dillingham or Anchorage, where an ENT doctor can examine it and, within minutes, advise the CHA/P on a course of treatment.
The Alaska Native Tribal Health Consortium AFHCAN Project Office (APO) has worked toward just that outcome for the last four years. It has worked to design and build equipment and software to allow CHA/Ps and other health care providers in Alaska to provide digital images for consultation. The project, called the Alaska Federal Health Care Access Network (AFHCAN), is sponsored by the Alaska Federal Health Care Partnership. The four-year project to provide AFHCAN workstations, or carts, to 235 Alaska health care sites was completed in 2002.
The carts are supplied with a digital otoscope to look inside ears, an EKG to measure heart activity, a digital camera and a scanner. Cases, which are made up of multiple images, are sent over a network to the Alaska Native Medical Center or to other care providers in the partnership. The project recently received a $500,000 grant from the U.S. Department of Agriculture to develop new attachments to add to the carts. The project has also received a $500,000 grant for the University of Alaska to evaluate telemedicine in the state.
If and when this boy does go to Anchorage again-or to a Public Health Nurse or to another Alaska Native health facility-does the Health Aide have to fax a copy of old encounter forms so that provider will know the patient's history? Not today.
Most of these facilities use the Resource and Patient Management System (RPMS) as an electronic medical record. Last year, RPMS staff in Data and Site Support (DSS) upgraded five major RPMS modules, replaced five computers and set up six new sites.
The child's information is sent to facilities where he has a record through an RPMS module called Multi-Facility Integration (MFI). This year, MFI staff added the ability to send laboratory results, medications and newborn immunizations to other facilities.
When any of the CHA/P's equipment breaks, it is covered under a contract with the Alaska Clinical 
Engineering Services (ACES). ACES provides clinical engineering for $44 million worth of equipment at 70 sites around the state. The engineers were involved in AFHCAN cart construction and installation, and nine facility replacement or renovation projects. They created a help desk system to be used in three divisions of the Consortium, and a new step-down unit at the Alaska Native Medical Center. They also installed teleradiology equipment at seven sites.
Alaska Native health corporations depend on continued funding from the Indian Health Service (IHS) and IHS depends on clear and accurate information to determine the level of funding. Health Statistics staff recently completed a project with the Indian Health Service to provide more accurate information about the number of Alaska Native patient visits to health care facilities in the state during the last three years, as well as end-of-the-year workload summaries at those facilities.
The Division of Information/Technology (DIT) was created in July 2002 from other ANTHC divisions to provide a wide range of DIT coordination and services to the Consortium and to Alaska Native health facilities. The four DIT departments (APO, DSS, ACES and Health Statistics) provide a wide range of information technology equipment, training, support and coordination throughout Alaska.
