The collaborative partnership involved in this application is unusual in that it includes a rural acute care hospital, a large Native American Tribal entity, an Indian Health Service Hospital, a community health center, a health department, and a community consortium. The end result of this project will be a plan for implementation of health information technology that can be replicated by other communities where similar groups are partnered together. The long-term vision for health in our community is many tiered, and includes: Encouraging the development of an integrated health care system across traditional boundaries; Enabling the community to provide high quality health services across boundaries; Improving the overall quality of health care and increasing patient safety; Identifying key community health issues through a data base integration system; Having the ability to describe population health in greater detail and with current data, leading to targeted strategies aimed at improving health outcomes; Adding new funding opportunities to the community through infrastructure development; Developing an HIT system that can be replicated, and serving as a model of community cooperation. This long-term vision of healthcare can best be accomplished through meeting a series of focused strategies, including 1) Developing an integrated, multifunctional, HIPAA-compliant Community Health Information Network that will enable area providers to better coordinate care and facilitate client access to a wide range of medical services; 2) Developing a telephonic comprehensive nurse line service and triage function to provide appropriate interaction with patients, improve overall quality care, and reduce inappropriate use of hospital emergency rooms for non-emergent care; and 3) Investigating and implementing improvements in and streamlining of existing appointment systems. [unreadable] [unreadable]