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Tribal Government Selects Modern EHR System To Integrate Functions Across Its Health Services

Tribal Government Case Study: Electronic Health Record (EHR) System Selection

By: Panorama Consulting Group

Email: Panorama Consulting Group
Telephone: 720-515-1377 ext 117

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  • The Tribe is a federally recognized Indian Tribe.
  • The Tribal Headquarters is in an urban environment with satellite offices on each of the other reservations or trust land.
  • The Tribe also maintains offreservation offices.
  • The Tribe provides various governmental services to its members and residents of its reservations.
  • The Tribe is also engaged in various business activities.


The Tribe’s Health Services organization includes the following functions:

  • Clinic Operations – Medical
  • Clinic Operations – Dental
  • Pharmacy Operations
  • Health Plan Administration
  • Integrative Health
  • Compliance & Risk – Case Management & Social Services
  • Compliance & Risk – Health Information Management
  • Compliance & Risk – Eligibility & Utilization
  • Behavioral Health Services
  • Advocacy & Guardianship
  • CCDT – Children’s Center for Diagnostics & Therapy


Before engaging Panorama, the Tribe was experiencing several pain points, most of which came down to one of the following root causes:

  • Process constraints
  • System constraints and/or flaws
  • Lack of system integration
  • Insufficient user training

More specifically, some of the overall pain points included:

  • Lack of integrated view of patient information across medical, dental, and behavioral systems
  • Lack of integrated systems and gateways to receive data from outside providers


The Tribe hired Panorama to assist in selecting software to support its Health Service functions. This software would replace the Tribe’s current health systems.

In the first phase of the project, we documented business and technical requirements, reviewed legacy systems, mapped processes, and identified pain points across the Tribe’s Health Department. At the conclusion of this phase, we developed an application roadmap recommending which systems to replace and in what order.

Some of these recommendations included:

  • The Tribal Registry System is an important database for collecting and storing member registration information and should not be replaced. An automated interface should be built from this system into the EHR system to reduce multiple data entry requirements.

  • The existing health systems should be replaced with one integrated system to track and maintain EHR/EDR/Behavioral Health patient information.

We also conducted the following activities during Phase 1:

  • Identifying leading EHR vendors
  • Distributing a functional requirements matrix to each of the vendors
  • Evaluating and scoring the vendor’s responses
  • Determining overall vendor scores and developing a comparative ranking analysis

Phase 2 was also extensive. Following are examples of some of the key activities we conducted:

  • Conducting a detailed evaluation and recommending “short list” vendors
  • Developing demonstration scripts
  • Issuing requests for proposal (RFPs) to vendors
  • Facilitating reference calls/visits Ultimately, we presented our final recommendation to executive management, and the Tribe selected a solution based on this recommendation.


  • The Tribe reached a decision on the best system for their needs: NextGen Healthcare
  • The Tribe achieved integration of the following nine functions that were included in the project scope:
    • Clinic Operations (Medical)
    • Clinic Operations (Dental)
    • Pharmacy Operations
    • Health Plan Administration
    • Integrative Health
    • Compliance & Risk (Case Management & Social Services)
    • Compliance & Risk (Health Information Management)
    • Compliance & Risk (Eligibility & Utilization)
    • Behavioral Health Services

Panorama Consulting Group is a technology-agnostic consultancy specializing in Digital Business Transformation and Enterprise Resource Planning (ERP) System Implementations for mid- to large-sized private- and public-sector organizations worldwide. This highly respected firm is 100% independent of software and technology vendor affiliation. They offer a phased and integrated approach to strategy alignment and execution, enabling each client to achieve its unique business transformation objectives by transforming its people, processes, and technology.

Panorama clients include multi-national conglomerates from Amazon Robotics to Valcor Engineering, as well as governmental entities, including state and local governments, municipalities, school districts, state offices of the attorney general, and tribal governments.

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