Wisconsin HIMSS Advocacy Director, Will Gu met with Krystal Schramm, Director of Native American Engagement and Sr. Technical BA for Michigan Health Information Network. She shared some background, unique healthcare needs, and challenges the Tribal Nations of Wisconsin face.

There are an estimated 450,000 million+ Indigenous people around the world. Their communities and lands overlap with over 90 countries, including the United States, and encompass thousands of languages. Some of the oldest Indigenous cultures are tens of thousands of years old. Tribes are sovereign and independent nations that have their own governments that are responsible for their populations, including their public health and the management of their population’s health data in the tribe’s healthcare system.

Wisconsin is home to 11 federally recognized tribes, accounting for approximately 1.2% of the state population. These tribes include the Bad River Band of Lake Superior Chippewa, Ho-Chunk Nation, Lac Courte Oreilles Band of Lake Superior Chippewa, Lac du Flambeau Band of Lake Superior Chippewa, Menominee Tribe of Wisconsin, Oneida Nation, Forest County Potawatomi, Red Cliff Band of Lake Superior Chippewa, St. Croix Chippewa, Sokaogon Chippewa (Mole Lake), and Stockbridge-Munsee.

Each tribe has their own health clinic that offer a variety of specialty services, including primary care, dental care, behavioral health, pharmacy, chiropractic care, podiatry, eye care, and more. These tribes, like many indigenous communities across the United States, face various challenges including healthcare and socioeconomic disparities. Data shows that the health indicators for American Indians in Wisconsin are far worse than the health metrics of other populations in the state. Poverty is much higher, and this is seen in the national average across all tribal populations in the nation including Wisconsin. Infant mortality is higher, life expectancy is significantly lower than other populations, and there are many diseases and illnesses that affect Native populations in Wisconsin such as diabetes, heart disease, and cancer.

Tribal patients move in and out of non-tribal to tribal healthcare facilities, sometimes across state lines, but their health data typically does not follow them. For example, when tribal patients have referrals out to specialists, patient data is not often connected electronically. Faxing and paper charts are still used for patient care and the inefficiencies of these modalities contribute to lower care coordination due to data not being available at the point-of-care. Tribes have historically not been included in health information exchanges either. In Wisconsin, only the Menominee Tribe of Wisconsin, Ho-Chunk Nation, and Oneida Nation are connected to the Wisconsin Statewide Health Information Network (WISHIN). Improving sharing of digital health information at the individual patient level and at clinic and system-wide levels through increased interoperability can help reduce patient and provider burden while improving health outcomes.

It's important to note that each tribe faces a unique set of challenges based on their specific circumstances and history. Efforts to address challenges and close gaps in care require close collaboration between tribal governments, federal and state agencies, and community organizations to improve the well-being and health of tribal members.

What can you do today?

Deepen your understanding of the indigenous peoples of America with these resources for children of all grades here: https://www.commonsense.org/education/articles/free-learning-resources-for-native-american-heritage-month

Find exhibits and collections across the country here: https://www.nativeamericanheritagemonth.gov/exhibits-and-collections.html

Learn more about the Tribal Nations of Wisconsin here: https://dpi.wi.gov/amind/tribalnationswi

Familiarize yourself on tribal advocacy and supporting their unique needs by learning about the Great Lakes Inter-Tribal Council, Inc, based in Lac Du Flambeau, WI: https://www.glitc.org/ GLITC is a consortium of federally recognized tribes in Wisconsin and the Upper Peninsula of Michigan.

Join the HIMSS community for those interested in tribal healthcare and HIT here: https://www.himss.org/membership-participation/native-american-and-indigenous-peoples-community All HIMSS members are welcome to join communities that fall under the HIMSS Global Health Equity Network, an initiative focused on advancing diversity and inclusion to ensure health and wellness for everyone, everywhere.