224925 Data Systems Change that Reflects Innovation in Training and Supports Community Health Representatives (CHRs) as Members of Health Teams

Tuesday, November 9, 2010

Cathy Stueckemann, JD, MPA , IHS Headquarters Community Health Representatives (CHR) Program, Indian Health Service, Rockville, MD
Dione Harjo, MPH , Oklahoma City Area Indian Health Service, Indian Health Service, Oklahoma City, OK
Pamela Aguilar, LPN/CHR , Data Network Corporation, Wynnewood, OK
Over 1,600 CHRs serve more than 250 Tribes in 12 areas. Tasked legislatively to provide a quality training program for “Indian health paraprofessionals” and to demonstrate program worth, the IHS Headquarters (HQ) CHR Program collects and summarizes the CHR Patient Care Component (PCC) data software application to document patient services and activities which CHRs provide. Historically, non-CHR data instructors, unfamiliar with CHR practices or CHRs' wide range of services, unintentionally enabled minimal consistency or standardization of content and delivery. CHRs initiated the idea to engage CHRs, already culturally competent, as volunteers to teach coding, data entry and reporting in a train-the-trainer format. A CHR Subject Matter Expert (SME) was identified to coordinate planning and training efforts. Qualifications for student-instructors were jointly addressed; in deference to tribal sovereignty, forms were developed specifying selection and participation criteria along with Tribal approval for volunteer selection. The training approach consisted of in-person group instruction, online assignments, monthly phone calls and testing. Challenges and barriers to training and ways those were overcome will be described. In July 2008, six students (22 started originally) certified as Coding Instructors. Those 6 currently train CHRs in their own Tribal CHR Programs, in their Areas (IHS regions) and as needed, nationwide. Their participation has enhanced the data system locally, at the area and nationally, facilitating integration of CHRs into clinical health teams and allowing CHRs to use their data to improve access to health services, target specific population groups for services and identify training needs.

Learning Areas:
Advocacy for health and health education
Communication and informatics
Diversity and culture
Implementation of health education strategies, interventions and programs
Other professions or practice related to public health

Learning Objectives:
• Describe how tribal sovereignty impacts health policy and system changes for the federal government • Describe how the CHR data system supports improved decision-making to improve patient access to care at the local, area and national levels; • Describe the challenges, barriers and process of partnering with CHRs as trainers to improve the Indian Health Service (IHS) national CHR data reporting system.

Keywords: Health Care Access, Community-Based Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I lead, managed and approved the national project on behalf of the federal government which this entry describes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.