1. Alaska GPRA Pilot Project OUR VISION: Alaska Natives are the healthiest people in the world. OUR MISSION: Providing the highest quality health services in partnership with our people and the Alaska Tribal Health System. April 2008

2. AK GPRA Pilot Project Team History • Operational since 2000 • FY 2004 Alaska submitted GPRA data (women’s health and diabetes) to HIS • FY 2005, 2006, 2007 all national indicators • Focus on data quality • Initially women’s health and diabetes • Expanded focus to entire data generation process for all indicators—including non-GPRA clinical indicators such as medicine education and diabetes prevalence

3. AK GPRA Pilot Project Sites • Original Members (2000) • Alaska Native Medical Center (ANMC) • Bristol Bay Area Health Corporation (BBAHC) • Maniilaq Association • Southeast Alaska Regional Health Consortium (SEARHC) • Tanana Chiefs Conference (TCC) • Yukon Kuskokwim Health Corporation (YKHC)

4. Team Growth • New Members (2005) • Chugachmiut • Council of Athabascan Tribal Governments (CATG) • Eastern Aleutian Tribes (EAT) • Ketchikan Indian Community (KIC) • Kodiak Area Native Association (KANA)

5. Continued Growth • New Members (2007-2008) • Annette Island Service Unit (AISU) • Aleutian Pribilof Islands Association (APIA) • Yakutat • Hoonah

6. Collaborations • Associate GPRA Team Members • ANTHC Epi Center • Alaska Immunization Program • Diabetes Audit Program • ANTHC Tobacco Cessation Program

8. Our Focus • Tribal Leader Confidence • Intra-Tribal Policy Agreement on Propriety & Security of Data • Process in Place to Ensure Data Integrity • Agreement Authorizing Tribal Aggregate Reporting to OMB • Respect for Tribal Sovereign Rights and Recognition of Volunteer Participation

9. Development of a Strong Inter-Tribal Network on Performance Reporting All Disciplines Involved & Engaged at Local Pilot Sites (education & orientation in real applicable terms): clinical, administrative, support Data Integrity & Clean-up Consistent Approach to Data Capturing & Reporting Utility and Applicability of reports with tie-in to local performance initiatives & other internal & external reporting requirements Demonstrate Tribal Success to IHS & Congress Focus – Teamwork!

10. Our Approach • Decentralize Effort to Service Unit Level • Qtrly Networking Meetings of Pilot Project Team + teleconferences • Annual Statewide Multi-disciplinary GPRA Orientation/Training + Face-to-face Technical Support + Consultation on National Measures • Connect Efforts to Budget Formulation • Annual report to Tribal Health Leadership of GPRA results & progress reports to Alaska Tribal Caucus • Develop Incentives & Recognition Awards • Planning Best Practices conference

11. Barriers • Tribal Leadership turnover • “Pilot” project status • Uncertainty/rumors of future IHS/Tribal commitment to RPMS • Multiple, independent EHRs • Limited staff resources

12. GPRA awareness wide-spread Increasing # of sites reporting Engaged in Annual Tribal Consultation at state & national level National GPRA measures input new Meth Amphetamines Measure Sexual Assault measure Strong Network – Pilot Project Team & expanded Associated membership participation Accomplishments

13. Accomplishments • Demonstrated impact on national results, i.e., pap smear rate • Developed statewide capacity to conduct Data Quality Assessments & follow-up • Developed user-friendly templates of measure results that are used by other sites • Established inter-Tribal Data Sharing Matrix & Policy Input into National GPRA measures; • Engaged in 1-on-1 dialogue @ national level

14. Accomplishments • Introduced integration of GPRA into Budget Formulation Process • On State-wide Tribal Leaders Agenda • Field clinical & program staff are actively consulting on GPRA measures/processes at every pilot site • Awards Program – friendly competition • Dashboards – on radar of Tribal organizations for Tribal measure of successful performance • Generated excitement and value-added processes at pilot sites

15. Our Vision • Focus on Continuous Efforts to Improve Health Status of Alaska Natives/American Indians • Tribes will be an integral & valued player with ownership in process & product • Input into GPRA measures • Friendly competition for successful results • Reporting & System of Reporting will be valued as a vital part of day to day operations & incorporated into organizational performance dashboards and Key staff performance evaluations • Strong collaboration & true partnership with the IHS & other Tribes for maximum national impact • Successes will be rewarded – locally & nationally • Support systems will be in place to achieve success

16. Our Future • Expand Tribal Participation • Data Quality / GPRA Review site visits • High Visibility of Performance Outcomes & Friendly Competition • Establish GPRA certification program • Enhance provider involvement thru elevating process to CMO level & participation in statewide Provider conference • Solidifying access to GPRA reporting tools: RPMS, CRS, NDW • Alaska is national leader in Tribal GPRA initiative • Strong Partnership with IHS & Tribes on Performance Evaluation

17. Advocate the importance of Tribal health performancereporting @ national level Commit to education of Tribal leaders, providers,& all staff on benefits & impact Provide quality data results & recommend improvements at local, statewide & national levels Provide vehicle for Tribal voices in the process Support new sites proactively seeking participation & solutions Be available for consultation when IHS goes to Secretary & OMB to advocate on behalf of Tribes Provide a foundation to increase health services to AI/AN by focusing on performance & meaningful/ usable clinical measures that correlate directly to Tribal goals Be RESPONSIVE, PRO-ACTIVE, FLEXIBLE & VOCAL on Health Performance Improvements! Our Promise

18. Thank You!Unalaska Russian Orthodox Church, Alaska

19. Karol DixonHealth Programs AdministratorAlaska Native Tribal Health ConsortiumHealth Statistics4000 Ambassador DriveAnchorage AK 99508(907) 729-2879 (direct)(907) 729-3666 (fax)http://www.anthc.org/ref/hskldixon@anthc.org