Indian Health Service CIO Gets Ready to Update One of Government’s Oldest Systems

Indian Health Service CIO Gets Ready to Update One of Government’s Oldest Systems

Located within the Health and Human Services Department, the Indian Health Service provides federal health services to 2.6 million American Indians and Alaska Natives.


The agency relies on a clinical and patient administrative information system—with some 20,000 nationwide users—that first debuted in 1969. Its outdated technical architecture and infrastructure has forced IHS to begin a multiyear modernization effort.


The massive undertaking is fraught with complexity and risk, comparable in nature to concurrent multibillion-dollar, multi-year modernization efforts at the Defense and Veterans Affairs departments. Yet as IHS embarks on its journey to modernize health care for Native Americans across the country, it has an IT leader in Chief Information Officer Mitchell Thornbrugh who boasts both a successful track record of modernization efforts and a strong connection to the population it serves as a citizen of the Muscogee Creek Nation in Oklahoma.


“You’ll find that about 70% of the people who work for IHS are Native Americans across the agency, so it’s very common for us to say, ‘This is where our families get health care,’” Thornbrugh told Nextgov. “So [this modernization] is hugely important to us. The current system is tough.”


Last June, the Government Accountability Office placed IHS’ health system among its “10 Most Critical Legacy Systems in Need of Modernization” list. The audit, which urged HHS to begin modernizing the system immediately, highlighted several inadequacies. The system is coded in C++ and MUMPS, the latter HHS considers a legacy programming language few programmers know anymore. In addition, the system is installed on “hundreds of separate computers,” which has led to variations in configurations at each site. In addition, internal surveys of more than 1,800 users indicated an overwhelming majority—93%—felt “now was the time” for IHS to make a ..

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