Request for Proposal (RFP) Supporting Efficient Care Coordination for New Yorkers: Bulk Purchase of EHR Interfaces for Health Information

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1 Request for Proposal (RFP) Supporting Efficient Care Coordination for New Yorkers: Bulk Purchase of EHR Interfaces for Health Information ISSUE DATE: April 10, 2013 RESPONSE DUE DATE: May 3, 2013 Region: New York State Released by the NY ehealth Collaborative 1

2 Introduction The New York ehealth Collaborative, Inc. (NYeC) is a 501(c)(3) nonprofit corporation established as a public-private partnership to service as a focal point for health care stakeholders to build consensus on state health information technology (IT) policy priorities, and collaborate on state and regional health IT implementation efforts. NYeC serves as a trusted, independent voice that can reflect a diverse array of interest and perspectives on key policies and standards to ensure that health IT efforts are successful, and to realize the state s return on investment under the Health Care Efficiency and Affordability Law for New York (HEAL NY) Capital grant Program and other funding mechanisms. NYeC is a recipient of the United States Department of Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology (ONC) Regional Extension Center (REC) Grant. The purpose of the REC is to locally furnish assistance, defined as education, outreach and technical assistance to help providers in their geographic service areas select, successfully implement, and meaningfully use certified electronic health record (EHR) technology to improve the quality and value of heath care. In addition, NYeC received additional grant dollars from ONC for the project titled Expanding New York State s Health Information Infrastructure. The purpose of this grant is to promote health care information exchange (HIE), the meaningful use of certified EHR technology and the integration of EHR and HIE services to further efforts to improve quality and value of health care in New York State. The progressive work in health IT afforded by these funding opportunities provided the infrastructure to support a connected New York. Through the development of technology that can support health information management and exchange, the development of policy and the implementation of standard, NYeC looks to engage the EHR vendor community to further the vision of New York and support the installation of the pipelines needed to share information between the adopted New York Physician and the State Health Information Network of New York. 2

3 New York State RHIO Landscape Regional Health Information Exchange Organizations, or RHIOs, are the nodes connecting together the statewide health network. A RHIO is a non-governmental, not-for-profit corporation enabling interoperable health information exchange via the Statewide Health Information Network for New York (SHIN-NY). RHIOs participate in setting information policies through a statewide policy framework and governance process, along with implementing policies and ensuring adherence to such policies with a mission of governing its use in the public s interest and for the public good to improve health care quality and safety and reduce costs. To fulfill this mission, RHIOs require commitment from multiple health care stakeholders in a geographic region, including physicians, hospitals, long term care and home care providers, patients, insurers, purchasers, and government. RHIOs are responsible for enabling interoperability through which individual stakeholders are linked together both organizationally and technically through the SHIN-NY in a coordinated manner for health information exchange and quality and population health reporting. New York State has eleven RHIOs that support connectivity in their geographic regions. NYeC in conjunction with the department of health is actively working with all RHIOs to connect and share health information with the SHIN-NY service platform. RHIOS can participate in the SHIN-NY by connecting their region to the state exchange or by joining the shared architecture supported by SHIN-NY and benefit from the joint platform. State Health Information Network for New York (SHIN-NY) The SHIN-NY is a secure network for sharing clinical patient data across New York State via Regional Health Information Organizations (RHIOs). The SHIN-NY is coordinated by NYeC in conjunction with the New York State Department of Health, and the state s 11 RHIOs. Currently, the two main capabilities of the SHIN-NY are Direct Messaging and Patient Record Look-Up. Direct Messaging functions like a highly secure , giving clinicians the 3

4 ability to seamlessly exchange authenticated, encrypted clinical data with one another. Patient Record Look-Up is comparable to a highly secure search engine, allowing healthcare providers to retrieve individual patient records from across the network once they receive patient consent. A network is only as good as the quality and quantity of its information, so as more healthcare providers sign on and begin sharing clinical data, the better the results available to all. Providers can only sign-on and participate if their technology is capable of supporting the required communication protocols for data exchange and query. Promoting Standards Based Exchange NYeC has worked to reduce barriers to interoperability and continuously advocate for the implementation of standard approaches for connectivity. The use of widely recognized standards reduces the need for custom interfaces that in turn should drive the cost of connectivity down and affordable for the provider. NYeC created the EHR HIE Interoperability workgroup with the goal of creating an integrated marketplace of EHR capabilities, in which the interfaces between EHRs and HIEs will be compatible more easily across and between states. Currently the EHR HIE Interoperability Workgroup is a coalition of 19 States (representing nearly 52% of the U.S. population), 20 EHR vendors, and 22 HIE vendors. The workgroup was launched in February 2011 to leverage existing standards and develop consistent implementation guides for interoperability between HIE software platforms, and the applications that interface with them. The current market lacks a single set of standards to connect various information exchanges prompting the development if custom interfaces with virtually every new effort in the field. The development of these interfaces drastically increases cost and time spent by physicians, HIEs, and vendors alike. This has limited both adoption of EHRs, and usage of HIE services. The merger of efforts with other states creates economies of scale and provide the vendor community with a single, consistent set of specifications. Commitment to common standards creates a larger potential market and a clearer development roadmap for vendors. Vendor collaboration and commitment to common APIs, and certification of a common HIE platform, creates a potentially larger opportunity for all of them by guaranteeing interoperability. This effort builds on and accelerates consensus on national standards, adopting EHR certification criteria and testing procedures as relevant and finalized for Stage 2 of meaningful use. Members of the Workgroup provide feedback from real-world implementations to the national health IT standard setting initiatives established by the U.S. Department of Health and Human Services Office of the National Coordinator for Health Information Technology (ONC). 4

5 The workgroup has developed a set of specifications that will ultimately allow out-of-thebox EHR connectivity, to simplify and align the process of EHR and HIE development. The first set of functional, technical, and test specifications developed by the workgroup focus on two use-cases. The technical specifications include: Statewide Send and Receive Patient Record Exchange allows encrypted health information to be transmitted over the internet (Direct Exchange) Statewide Patient Data Inquiry Service allows clinician to query an HIE for relevant data on a specific patient (Patient Record Lookup) Continuity of Care Document (CCD): Complements and constrains ONC specifications (C32/C83) to reduce variances and state-specific customization New York State will leverage the functional and technical specifications for connectivity to the SHIN-NY. NYeC Statewide Activities in Support of Connectivity to the SHIN-NY Provider adoption on connected capabilities supported by this RFP needs to be supplemented with broad scale implementation of an infrastructure that enables exchange as well as education and promotion of the benefits of contributing to and retrieving information from the connected community to support clinical decision making and the quality of care provided to patients. This RFP addresses a small but critical component of the infrastructure that will lead the way for HIE. To ensure the vision is achieved NYeC commits to the following: Statewide provider education on health information exchange in conjunction with the HIT stakeholder community Wide scale marketing on the connected capabilities of the SHIN-NY, RHIO and vendor community including high visibility PR and marketing of the vendors awarded contracts from this RFP Strategic alignment of the New York RHIOs to support the SHIN-NY Seeking funding strategies that will continue to keep costs of this network reasonable for the providers of the state Continued work with the New York State Department of Health to ensure SHIN-NY capabilities align with the state s expectations and health priorities Purpose of the RFP To support the realization of an interoperable New York, NYeC issues this RFP to obtain proposals from the EHR vendor community for the procurement of interfaces in bulk on behalf of the providers of New York State. NYeC envisions partnership with the EHR vendor community to identify providers interested in connecting to the SHIN-NY, the development of the interface from their EHR to the SHIN-NY, to support price transparency and to implement the technical specifications ratified by the EHR HIE interoperability WG via the approach designated by that stakeholder group. Upon review of the submitted proposals NYeC will invite several vendors to participate in this unique opportunity to support the foundation of data exchange in New York State. 5

6 Guidance on the technical requirements, scope of proposal and evaluation criteria has been provided in this document. Requirements and Considerations Required Communication Protocols NYeC expects the vendor community to utilize the same communication protocol such that the all data is transmitted to and is retrieved from the HIE via the same standard reducing variations in technical implementations. Connections to this network via this standard include the use of standard IHE protocols namely, PIX/PDQ using XDS.b and XDR. Using these standards, a provider must be able to: Query the network and pull back clinical information via the proposed standards Push clinical information into the HIE network via the proposed standards Communication with other providers via Direct exchange from the EMR The requested capabilities may not be native to the EHR today. Please refer to the RFP proposal section for guidance on how to address current and planned capabilities to meet the communication protocol requirements. Required Certifications Certification is a mechanism used when a developing community is looking to establish a shared method of communication when the market is immature and variability is widespread. NYeC expects the EHR vendor community to obtain two certifications to ensure the product meets current functional requirements to support the provider community. EHR Technology Certification Supporting Meaningful Use. As applicable to the EHR vendor audience, NYeC requires that all EHR vendors responding to the RFP maintain current certification of offered EHR product versions by an ONC Authorized Certification Body (ONC-ACB) and those product versions must be listed as Certified HIT Products in the Certified HIT Product list (CHPL). NYeC expects the vendor to acquire certification in a timely manner such that the certified version of the product is available and in general release in sufficient time for a provider to acquire such version to meet the meaningful reporting requirements at the time beneficial for that practice. Please refer to the RFP proposal section for guidance on how to address current and planned certification. 6

7 HIE Certification. The EHR HIE Interoperability workgroup selected the Certification Commission for Health Information Technology (CCHIT), the most experienced HIT certification organization in the U.S., to carry out the testing. As the compliance testing body, CCHIT will certify that the interfaces between the HIT and HIEs are consistent across multiple states and systems. CCHIT is also an Office of the National Coordinator (ONC) authorized certification body and is an accredited testing laboratory for EHRs. The testing program will be piloted and quickly followed with an initial wave of testing of the first set of systems and HIE implementations in the spring of The program is targeted to be available on a wide-scale basis by late summer The coalition designed the compliance-testing program to align with and compliment the national strategy established by ONC. To that end, the Compliance Testing Program: Includes a technology certification component, building upon the EHR certification program established by ONC to support meaningful use Utilizes an accredited and authorized testing laboratory and certification body, leveraging the strategy implemented for the EHR certification program Verifies conformance with national standards Leverages national standards and work from the ONC Standards & Interoperability (S&I) Framework Initiatives HIE Certification Program. The HIE certification addresses all vendors who have a role in the data exchange event. Within New York State, the SHIN-NY infrastructure is supported by vendors who can meet the exchange protocols diagramed in Figure 1. To connect to the SHIN-NY infrastructure and provide the required services the EHR vendor community, at a minimum must certify and obtain two seals (1) HIE Certified Community and (2) HIE Certified Direct. 7

8 Figure 1. Certification schematic and seal designations HIE Seals. Vendors capable of meeting the standards via participation in the certification program will be provided a seal with the product name and version. This seal will inform the provider community that the product is capable of plug-n-play interoperable capabilities. Below are the seals created to denote interoperable capabilities: All EHR vendors will be required to demonstration the ability to comply with the specifications and communication protocols by obtaining the seals that correlate with the required communication standards identified in this document. 8

9 Proposal Instructions and Guidance This RFP is available for all EHR vendors interested in collaborating with NYeC. Interested parties must address all sections in this RFP. Failure to respond to all required sections may result in rejection of the response. All responses are due no later than May 3rd, 2013 by 5:00 pm ET. All responses must be submitted electronically to Responses received after the designated date and time may be reviewed later at the discretion of NYeC. Please include the phrase in the subject line of the RFP RFP Submission: Bulk Provisioning Inquiries and Questions. NYeC welcomes the opportunity to address questions and concerns prospective respondents may have. Interested parties may submit questions in no later than April 17, Questions should be ed to for consideration. Please include the phrase in the subject line of the RFP RFP Submission Questions: Bulk Provisioning. All questions will be answered via a public Q&A scheduled for April 24, Details of the web session will be available on our website Confidentiality. Due to the competitive nature of this RFP, to the extent permitted by law, all data provided in the response form will be confidential except where explicitly noted. To promote wide-spread implementation of standards based exchange, NYeC may chose to share identified information with stakeholders including the Office of the National Coordinator (ONC), credentialing bodies as well as other states. Vendors who wish for their information not to be disclosed must do so in writing with their proposal. RFP Response Requirements. The following is a short description of the RFP sections to be addressed by respondents. Respondents should record their responses in the template provided. Section 1 Company Profile. All respondents should provide an overview of the organization including the mission and primary market. In addition, respondents should include operational and financial indicators that infer stability and potential longevity of the organization. Section 2 Proposed Timeline for certification(s). EHR software companies are expected to attain the certifications applicable for a practice to attain meaningful use as well as credential for HIE. Please document your timeline for securing EHR technology certification supporting meaningful use certification for the coming stage and the expected date where the certified product will be available to the provider community. If this credential is not applicable to your target market, please indicate that on your response document. Please document your timeline for securing HIE certification (Direct and Community) and the expected date where that certified product will be available to the provider community. Please include in your response an expected general release date for the certified software Please include in your response the version number of the products that will have met the referenced certifications Section 3 Proposed number of connections. Respondents to this RFP commit their EHR software companies to establishing interfaces to the SHIN-NY. Respondents must propose a number of practice connections they are capable of supporting between and the total number of providers this will represent. Please identify the organization types (example: Small practice 1-10, Community Health Centers, Rural Hospitals etc.) 9

10 Section 4 Interface Costs and Development. For the proposed number of practices, Respondents must provide a total cost for connectivity to the SHIN-NY as well as the list price for practices/providers who will connect to the statewide exchange before/after this program. Costs should include: List price to the practice to develop the interface from their EMR to the SHIN-NY. Please stratify by the proposed interfaces if that is consistent with the expected pricing model for your organization. (ex. PIX/PDQ, Direct etc.) Please indicate if these capabilities are expected to be included in a future release at no additional charge. Cost to NYeC to develop the interface from the practice EHR to the SHIN-NY. Please stratify by the proposed interfaces if that is consistent with the expected pricing model for your organization. (ex. PIX/PDQ, Direct etc.) Please indicate if these capabilities are expected to be included in a future release at no additional charge. Subscription/Maintenance Costs the EHR software vendor will charge a practice and their providers. NYeC is waiving the connection costs to the providers for the first nine months of connectivity (subject to change). If your organization chooses to provide a similar pricing adjustment to spark adoption please advise how long would your organization sponsor this model. Vendors must also agree to permit NYeC to disclose the interface costs providers in New York are charged for connectivity Your proposal should also include the estimated implementation timeline from work order to data sharing for each of the interfaces. Section 5 Current NYS Connectivity. There are many providers who are participating in a RHIO and are sharing data. For each of the exchanges in New York that your software is connected to, please identify which capabilities you are supporting: integrated portal, upload, retrieve, and/or direct. Evaluation of Vendor Responses. NYeC will establish a working group to review the proposals received in response to this RFI. During this review process, additional information may be required of the vendors. RFP Schedule All activities are due on the Date below at 5PM EST Date Activity April 10, 2013 RFP release date April 19, 2013 Q&A- Question submission deadline April 24, 2013 Q&A- Live meeting May 3, 2013 RFP submission date June 1, 2013 Awardee Announcement RFP Administrative Conditions Vendor applicants should note the following: The issuance of this RFP does not imply an offer to do business with any RFP recipient. The right to accept any complete response, or portion thereof, or to accept none of the responses even 10

11 if all the stated requirements are met is reserved by the requestor. Only the execution of a written contract will obligate the RFP requestor in accordance with the terms and conditions contained in such contract. Submitted information packages that do not respond to all items in this RFP may be excluded from further consideration and alternative information packages will not be considered. RFP requestors reserve the right to disqualify any vendor in the event the vendor submits the RFP response after the submission deadline. RFP requestors reserve the right to amend or cancel this RFP at any time prior to the selection of vendors, without any liability to the RFI originators if, in its sole determination, such RFI originator believes that its best interest is served by so doing. RFP requestors will not be responsible for any costs incurred by an organization in preparing, delivering or presenting responses to this RFP. Once submitted, vendor responses will be the property of RFP requestors and will not be returned. All responses to this RFP should be clear and concise. Responses of excessive length or containing excessive advertisement are discouraged and may not be reviewed. By submitting an information package, the vendor represents that they have read and understand the RFP and are capable of fulfilling all requirements. 11

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