Request for Proposal (RFP)

Transcription

1 Request for Proposal (RFP) March 7, 2012 RFP Response Contact: Andrew Lombardo 1413 Stuart Place Rd. Ste. C Harlingen, TX (956) Andrew@rgvhie.org 1

2 Contents Introduction, Objectives and Background... 4 RGV HIE Mission, Vision, Principles... 5 Formation, Planning Process and Context... 5 Primary Objectives with RFP... 6 Alignment with Meaningful Use... 6 Member Organizations and Community Profile... 6 Request for Proposal Guidelines... 8 Key Dates... 8 Meaningful Use Implementation... 8 Solution Format and Delivery Information... 9 How to deliver the answer... 9 Contacts... 9 Contractor Cooperation... 9 Confidentiality... 9 Protected Health Information Access to/use of Proposal Modifying/Withdrawing Request for Proposal Initial Reviews and Scoring Request for Proposal Requirements Business Qualifications Functional Requirements Clinical Requirements Privacy & Security Requirements Quality & Reporting Requirements Technical & Operational Requirements Project Planning & Implementation Requirements Additional Documentation Cost Model Final Contract Provisions Appendix A Vendor Business Qualifications Business Qualifications Matrix

3 Appendix B Functional Requirements Matrix Appendix C Technical & Operational Requirements Matrix Appendix D.1 Project Planning & Implementation Requirements Matrix Appendix G Cost Model

4 Introduction, Objectives and Background The Rio Grande Valley Health Information Exchange (RGV HIE) is a not-for-profit organization committed to facilitating health information exchange to improve health care for residents covering eight counties in the Lower Rio Grande Valley. The HIE is a collaboration of key health care providers in Brooks, Cameron, Hidalgo, Jim Hogg, Webb, Willacy, Starr, Zapata. The RGV HIE is incorporating in the State Of Texas as a non-profit corporation and will apply for 501(c)(3) status from the federal government. The Rio Grande Valley healthcare industry is currently experiencing unprecedented changes and uncertainty due to Health Care Reform and Texas Managed Medicaid rollout in March Hospitals and physicians are also facing financial pressure to either upgrade or purchase Electronic Health Record systems to meet Meaningful Use requirements specified in CMS EHR Incentive program. Communities, physicians and hospitals are all challenged to deliver needed care using traditional models of healthcare delivery, which currently consists of only 13 acute hospitals, four federally funded Health Centers and slightly over 1,000 primary care physicians to care for a population of approximately 1.4 million people (which grows at least 10% when adding the Winter Texans and which does NOT include the constant heavy influx of patients from Mexico). The RGV also faces major health disparities in a population that is among the poorest, if not the poorest, in the U.S. and that is medically underserved. There are serious medical challenges in the Valley. Approximately 90% of the population in the Valley is Hispanic and Latino. While the rate of diabetes in the United States is about 8-9% of the adult population, the Valley rate is over 20%. The consequences of diabetes, including heart disease, renal disease, blindness and overall disability, are very pervasive (50% of those with diabetes receive no treatment) and are common in the Valley, driving both healthcare costs and access. All these chronic diseases are fed by significant obesity in the population (52% obesity and 30% overweight). With that said, the future implementation of the Rio Grande Valley Health Information Exchange (RGV HIE) intends to offer services and technology to address these challenges, particularly the ability to gather, share and use health data to improve patient outcomes. As the case with any successful business, the true value of an HIE is in its ability to offer value added services its members can either measure financially or through improved work efficiencies. The goals of the RGV HIE are straightforward: Reduce administrative costs associated with manual data and paper-based systems, reduce costs related to improved information access by decreasing redundant testing, avoidance of unnecessary hospitalizations due to missing information, more efficient visits, improving co-ordination of patient care with timely and accurate information across providers, and more effective medication reconciliation. The RGV HIE value will be determined by helping our members achieve these goals to help improve patient outcomes in our community. The RGV HIE constituents consist of hospitals, first responders (ambulance, police and fire department), public health, clinic groups, safety-net or essential care clinics (including federally qualified health 4

5 centers [FQHCs]), mental health service providers, laboratories, pharmacies, physical therapists, patients, university medical systems, and tribal health systems. The RGV HIE membership is expected to grow. Constituents currently believe that they can make significant progress towards improving medical care economically by enabling collaboration between themselves, and have therefore designated health information exchange as the primary focus and purpose for the RGV HIE. RGV HIE Mission, Vision, Principles Mission: The mission of the RGV HIE is to provide a patient centric system for the secure exchange of protected health information to improve patient care and communication. We will accomplish this by providing timely and accurate patient information in a secure and collaborative manner by establishing partnerships with common organizations to improve health outcomes in the Rio Grande Valley. Vision: Secure Private Trusted Health information Exchange to improve the quality of healthcare for the Rio Grande Valley. Principles: Consumer Confidence The RGV HIE will build trust and confidence with consumers to ensure their personal health information is secure and used appropriately. Phased Implementation The RGV HIE will maximize grant funds and other investments through strategic planning and phased implementation of the HIE. Transparent Governance and Approach The RGV HIE will support the entire health care community through the collaboration and commitment of all health care stakeholders participating in the HIE. o The RGV HIE will have representation from a variety of qualified and stable leadership promoting communication and collaboration with full transparency, openness and trust. o The RGV HIE governance structure will provide guidance and support to local, State and National health information exchanges. o The RGV HIE will coordinate its efforts in support of State Medicaid and public health requirements as well as Federal meaningful use criteria for health information exchange. Sustainable Infrastructure The RGV HIE infrastructure will align with State and National Interoperability standards in order to provide secure, scalable and robust exchange of patient health information. Formation, Planning Process and Context The RGV HIE is one of 17 grants awarded by the Texas State and Human Health Services to plan, implement, and develop a Health Information Exchange. The RGV HIE is expected to be one of several local health information exchanges in the State of Texas. Other HIE s are forming around McAllen, Corpus Christi, and more are expected to form around the state. The RGV HIE, as well as each of the other HIE s, will need to either develop interconnections with one another, or to connect with a Texas state regional health information exchange (RHIO) in order to fit into the developing nationwide health IT infrastructure (National Health Information Exchange). 5

6 Primary Objectives with RFP The RGV HIE is requesting proposals from proven vendors qualified to act as RGV HIE s strategic partner(s) to provide the systems, functionality, and operations support required to link with and exchange clinical information among health care providers and other organizations in the target counties and its surrounding region. The RFP process is intended to be fair and open, with the intention of adhering closely to federal acquisition regulations, though the organization is currently under no requirement to do so. The RGV HIE is looking for vendor partners with modular, flexible, scalable, and cost-efficient solutions to support substantial provider adoption, seamless interoperability with existing systems, and a roadmap for increasing functionality and information exchange, adhering to established and planned federal guidelines for certification and meaningful use. The RGV HIE business strategy anticipates a phased implementation approach, with implementation phases consisting possibly of discrete time frames in which groups of providers achieve certain levels of functionality. Significant milestones with corresponding delivery dates are requested to help monitor the progress of implementation. Inasmuch as community organizations have different levels of technological capabilities, it is anticipated that health organizations will be grouped into implementation groups. An implementation group is anticipated to be given basic information exchange functionality initially consisting of just the core set of requirements identified as Priority Level 1 in Appendix B, and any additional functionality deemed necessary to realize meaningful use under developing federal guidelines. Each implementation group is anticipated to continue on its own deployment plan until group members reach the level of functionality they require, can support, and can afford. Multiple implementation groups may progress on parallel implementation plans, so an initial implementation group may achieve advanced functionality (such as full EMR integration) while a subsequent implementation group progresses towards basic functionality (such as a basic connection and portal). Eventually, all participating community organizations will be connected with one another, enabling the meaningful use of information while remaining at different stages of functionality as their requirements and circumstances dictate. Alignment with Meaningful Use Underlying the success of RGV HIE is our stakeholder participation in the HIE and the achievement of EHR meaningful use requirements as defined by the HITECH provisions of ARRA. While a pre-determined level of participation has not been set at this time, we expect a continuing increase in provider participation over the next four years after our initial rollout. We will strive to achieve this goal through the adoption of EHRs and EHR applications with connectivity to the HIE utilizing the NWHIN specifications and standards as the basis. The RGV HIE will work closely with the Gulf Coast REC to assist providers with achieving Meaningful Use. The Gulf Coast REC will assist its client providers who seek full function EMR/EHR with the selection and adoption of these systems and connection to the RGV HIE. Member Organizations and Community Profile Provider Practices Nationally, adoption is heavily skewed towards larger practices. Large practices have three times more adoption in any EHR system, and seven times more adoption in fully functional systems. Small practice adoption of fully functional systems is not expected to reach 15% by

7 The RGV HIE conducted a telephone survey of the physicians who submitted a Letter of Support to the RGV HIE in hopes to find a target of physicians who are indicative and ready to participate in the RGV HIE. Attachment 7.2 shows 136 out of 152 physicians who submitted a letter of support to the RGV HIE responded to a telephone survey indicating 68% have an EHR in place while 32% of physicians surveyed have no EHR or they have an EHR but are not certified to meet Meaningful Use. On the contrary to the letter of support telephone survey which was skewed towards physicians who are up to date and educated on meeting meaningful use standards, the overall adoption rate of an EHR to meet meaningful use in the lower south Texas is low. The RGV HIE findings are based on opinions from community leaders, several independent physician alliances, Hospital CIOs, and physicians contacted in the area that all are in agreement that the Provider EHR adoption rate is fractured in the lower South Texas area. Health Care System Profile The Rio Grande Valley healthcare system is undergoing dynamic changes and is predominately dominated by Health Systems. Two health systems in particular, Valley Baptist Health System (1) and South Texas Health System (2) make up quarter of anticipated participants in the RGV HIE. 14 of the 24 hospitals in the RGV HIE serving area have the information technology adoption to support HIE activities in the area. In attachment 7.1, the Hospital Questionnaire indicates 58% of responding hospitals (14 of 24) have functional EHRs in place, or were in the process of implementing one. The other 41% of responding hospitals (10 of 24) have no EHRs in place and are unaware of when they will be implementing one or when they will be applying for meaningful use. Hospital Name EHR Product Name EHR Certified Year applying for MU/EHR Incentives Cornerstone Regional Hospital (2) Cerner Yes 2013 Doctors Hospital Laredo Cerner Yes 2013 Edinburg Regional Medical Center (2) Cerner Yes 2013 McAllen Heart Hospital (2) Cerner Yes 2013 McAllen Medical Center (2) Cerner Yes 2013 South Texas Behavioral Center (2) Cerner Yes 2013 Starr County Memorial Hospital CPSI Yes 2011 Valley Baptist Medical Center Brownsville (1) GE 6.1 No 2013 Valley Baptist Medical Center Brownsville In GE 6.1 No 2013 Patient Psychiatric (1) Valley Baptist Medical Center Harlingen (1) GE 6.1 No 2013 Brownsville Doctors Hospital Healthcare Yes 2012 Management Knapp Medical Center (2) McKesson Yes

8 Laredo Medical Center McKesson Yes 2012 Valley Regional Medical Center Meditech Yes 2013 Harlingen Medical Center No EHR No Unknown Laredo Specialty Hospital No EHR No 2013 Lifecare Hospitals of South Texas - North No EHR No Unknown Lifecare Hospitals of South Texas - South No EHR No Unknown Solara Hospital Edinburg No EHR No Unknown Solara Hospital Harlingen No EHR No Unknown Solara Hospital Harlingen, Brownsville Campus No EHR No Unknown Solara Hospital McAllen No EHR No Unknown South Texas Rehabilitation Hospital No EHR No Unknown Weslaco Rehab Hospital No EHR No Unknown Request for Proposal Guidelines Key Dates The first phase must be implemented by August 2012 to comply with the basic requirements specified in the agreement between the Texas Health & Human Services Commission and RGV HIE. The timeline below is a draft and subject to change. RGV HIE reserves the right to change dates below upon communication to respondents in a timely manner. Event Dates Submit RFP to Vendor March 7, 2012 Deadline for Question Submission March 12, 2012 Deadline for Vendor Responses March 23, 2012 Notification to top Vendors April 6, 2012 Top Vendor Orals/Demos/Site Visits April 6 April 30, 2012 Vendor and Alternate Selected May 1, 2012 Final Contracts Settled May 31, 2012 Work Commences June 1, 2012 Meaningful Use Implementation The RGV HIE wishes to provide its community participants with the opportunity to conform to meaningful use sharing as defined by Office of the National Coordinator for Healthcare IT. The RGV HIE plans to offer low cost, simple tools (Core Service Components) to help providers achieve Meaningful Use. Initially, the Core Service Components will include: support for a Provider Directory, Secure Messaging, a Master Person Index and a Record Locator Service. Clinical information exchanged from the provider level will be augmented with support for e-prescribing, and Structured Laboratory Results through connections with these data and/or support services. Ideally, vendor respondents will propose preliminary requirements, to which participants must comply by the end of Vendor respondents will ideally then develop and deploy interfaces for these advanced adopters, preparing 8

9 connections and solutions in time to provide for a short ramp-up period prior to August, Other implementation groups may proceed with other timetables in the meantime, but this accelerated option is valuable to the RGV HIE community. Solution Format and Delivery Information Each respondent should provide their responses in the following format: Response Format Respondents must submit a complete response to the RFP to be considered. Responses should be submitted in MSWord or PDF format. Supporting documents and external links should be clearly labeled and arranged for easy access and readability. How to deliver the answer Send the attached form in MSWord or PDF format by to Andrew@rgvhie.org Contacts For questions regarding this RFP, you are welcome to contact: Andrew Lombardo Project Director mailto: Andrew@rgvhie.org Contractor Cooperation This RFP is non-exclusive. RGV HIE may, in its sole discretion, award other contracts to other vendors for services, deliverables or projects additional or related to the services, deliverables, and projects discussed in the RFP. Vendor will fully cooperate with, and will not interfere with the performance of, such other contracts or vendors. RGV HIE prefers for proposals involving multiple vendors to partner to designate one vendor as prime, or the responsible entity for coordinating the joint effort. Confidentiality This RFP, all responses to this RFP, all questions and communications relating to this RFP (including answers or replies to any questions or communications), and all other information, data, content, materials, ideas, or specifications submitted by or exchanged with respondent in connection with this RFP (the Confidential Information ) is deemed confidential and proprietary to RGV HIE and must be treated as such by respondent. Notwithstanding the foregoing, Confidential Information does not include information that: (1) was already lawfully known to respondent at the time of disclosure by RGV HIE; (2) is disclosed to respondent by a third party who had the right to make such disclosure without any confidentiality restrictions; or (3) is, or through no fault of respondent has become, generally known to the public. Respondent agrees that all Confidential Information shall be received by respondent in strict confidence in accordance with these terms. Accordingly, any confidentiality legend or statement on respondent s response will be subject to this confidentiality section, and this confidentiality statement controls in the event of any conflict between this confidentiality statement and any other confidentiality legend or statement of respondent. Respondent agrees not to use or reproduce the Confidential Information in any manner or form, except as necessary for respondent to prepare its response to this RFP. In cases where the respondent is working with additional vendors or partners to respond to this RFP, respondent will have appropriate agreements in place extending these confidentiality requirements to those 9

10 vendors and partners (and their respective employees). Respondent will identify all such vendors or partners, and provide copies of all such agreements as part of respondent s response to this RFP. Respondent specifically acknowledges that the information contained in this RFP is proprietary to RGV HIE, and consequently assumes all risks and liabilities associated with all information in the RFP and in respondent s response and the release of such information. Upon request by RGV HIE at any time, respondent will return to RGV HIE, or, at the request of RGV HIE, will destroy, all Confidential Information and all documents or media containing any such Confidential Information and any and all copies or extracts thereof. Upon the request of RGV HIE, an officer or director of respondent will certify in writing to such return or destruction. Any sections that respondent requests to be kept confidential should be clearly marked and RGV HIE will make its best effort to honor such requests, within reason. For example RGV HIE anticipates the need to keep pricing models confidential. Protected Health Information The respondent acknowledges that the services and deliverables requested in this RFP will necessarily involve protected health information as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other laws and regulations relating to the privacy of patient information, and that such information shall not be disclosed. Access to/use of Proposal This RFP, all responses to this RFP, all questions and communications relating to this RFP (including answers or replies to any questions or communications), and all other information, data, content, materials, ideas, and specifications submitted by or exchanged with respondent in connection with this RFP will be the property of RGV HIE. RGV HIE is under no obligation to return any of the materials submitted in response to the RFP. For the avoidance of doubt, the foregoing does not provide or transfer to RGV HIE any rights in or to any patents or patent applications relating to any technologies, methodologies or concepts described in respondent s response to this RFP. Modifying/Withdrawing Request for Proposal RGV HIE reserves the right to modify or withdraw this Request for Proposal or to reject any proposals at any time. A proposal that has been submitted to RGV HIE may be modified by a letter ( is acceptable), complete with the signature of the vendor representative, so long as the modification letter is received before the Deadline for Vendor Responses set forth in the Schedule of Events section of this RFP. A proposal that has been submitted to RGV HIE may be withdrawn by a letter ( is acceptable), complete with the signature of the vendor representative, so long as the withdrawal letter is received and acknowledged by RGV HIE before the Deadline for Vendor Responses set forth in the Schedule of Events section of this RFP. 10

11 Initial Reviews and Scoring An Evaluation Committee will review all proposals submitted in response to this RFP. The Evaluation Committee is made up of stakeholders with experience in health care, operations, finance, procurement, budget, policy, technology, HIE functionality, and operations. Each proposal will be evaluated against all criteria listed in this RFP and Amendment, which includes those requiring qualitative scoring and additional quantitative evaluation criteria. The following table depicts the initial draft of the methodology that will be used for the quantitative evaluation of all received proposals: Scoring Key: Evaluation score 0 = Does not meet expectations / not likely to 1 = Does not meet but plans to meet (with reasonable expectation) 2 = Meets and can demonstrate Vendor Qualifications (Appendix A) Score Business Position / Background/Experience of 2 Business Capabilities of 2 Product Roadmap of 2 Change Management Process of 2 Governance Structure of 2 Total Vendor Qualifications Score 0 Maximum Vendor Qualifications Score 10 Section Weight (as a percentage of overall 100%) 25% Functional Requirements (Appendix B) Score Clinical Requirements Master Patient Index of 2 Record Locator Service of 2 Provider Directory of 2 Web Based Portal to Access ephi of 2 Order Results Delivery of 2 Clinical Messaging of 2 Clinical Alerts / Notifications of 2 DIRECT Project Support of 2 E-Prescribing of 2 EMR-Light/ EHR certified of 2 Clinical Data Mapping of 2 Patient Portal of 2 Eligibility and Benefits Inquiry of 2 Total Clinical Requirements Score 0 Maximum Clinical Requirements Score 26 Functional Weight of Clinical Score 33.3% 11

12 Analytic & Reporting Capabilities Data Analytics of 2 Immunization Registry of 2 Public Health Reporting of 2 Bio Surveillance Tracking of 2 Disease Management Dashboard of 2 Total Analytic & Reporting Requirements Score 0 Maximum Analytic & Reporting Requirements Score 10 Functional Weight of Analytic & Reporting Score 33.3% Privacy Requirements Privacy & Security Functionality of 2 User Authentication & Access Management of 2 Provider Roles of 2 Audit Logs & Monitoring of 2 Security & Breach Policies of 2 Patient Consent functionality of 2 Total Privacy Requirements Score 0 Maximum Privacy Requirements Score 12 Functional Weight of Privacy Score 33.3% Functional Requirements Aggregation Standardized Clinical Requirements Total Functional Requirements Score 0 Score 0 of 4 Standardized Privacy Requirements Score 0 of 4 Standardized Quality Requirements Score 0 of 4 Maximum Functional Requirements Score 12 Section Weight (as a percentage of overall 100%) 25% Technical & Operational Requirements (Appendix C) Solution Compatibility of 2 Solution Architecture & Performance Operations of 2 User Portals of 2 Data Interfaces of 2 Scalability / Extendibility of 2 Security and Compliance of 2 Reliability and Service of 2 Total Technical & Operational Requirements Score 0 Maximum Technical & Operational Requirements Score 14 Section Weight (as a percentage of overall 100%) 25% 12

13 Planning & Implementation Evaluation Criteria (Appendix D) Score Project Work Plan (end-to-end) of 2 Implementation Methodology and Project Plan of 2 Assumptions of 2 Risks of 2 Participant Implementation Plans of 2 Participant / Patient Education (English/Spanish) of 2 General Testing Capabilities of 2 Acceptance Testing of 2 Total Planning & Implementation Score 0 Maximum Planning & Implementation Score 16 Section Weight (as a percentage of overall 100%) 25% Each section above will have its score converted to a percentage and multiplied by its weight (25%) * 100 to map it to a 25-point scale. Points will then be added together to give each proposal a score on the scale of TOTAL Proposal Scores: Total Combined & Weighted Score Maximum Combined & Weighted Score The RGV HIE RFP lists features we would like to have in a system. Like every complex project, priorities must be weighed and choices must be made. For the first round, RGV HIE intends to select a vendor whose product offering most closely aligns with our goals. Vendors who cannot satisfy all criteria, but can provide niche functionality, or who have significant proficiency in base functions are encouraged to respond for consideration. We suggest that respondents answer with these in mind: 1. Cost efficiency we need to be able to afford this system. This is a major component of the scoring, and will be a major determinant of adoption going forward. 2. Effectiveness the solution needs to be proven to work (reliability and responsiveness), be easy for physicians to adopt, and deliver useful content, even if the solution doesn't offer everything we want immediately. 3. Commitment to meeting meaningful use we aim to satisfy the federal meaningful use guidelines for an initial group of members in time to maximize benefit from increased Medicaid and Medicare reimbursements. While we are aware that each RGV HIE member organization must chart their own course, we are committed to providing a solution that will be ready if they are to meet the meaningful use guidelines. 4. Scalability the cost of the solution should relate to the number of participants who choose to participate, and cost should scale proportionally as additional organizations join. 13

14 5. Security and Privacy this concern repeatedly comes up, and a successful proposal must include viable controls to assure the general public that their information is safe from unauthorized access. In addition to overall scores, vendor proposals will also be evaluated using more subjective criteria, such as the criteria listed below: Reputation/Experience of Partners/Sub-Contractors Economic Considerations: Quality and Cost-Effectiveness of the Proposal Perceived Commitment (keenness, enthusiasm) to Partnering with RGV HIE Quality of RFP Response and Questions Submitted Perceived vendor understanding of HIE policy & political landscape Professionalism exhibited by vendor in all aspects of the RFP process Vendor's ability to meet timelines and deadlines during the RFP process Vendor's willingness to negotiate and find solutions that meet their needs and ours Gap analysis in areas vendors fall short of meeting RGV HIE critical requirements The evaluation of each response to this RFP shall be made by RGV HIE, in its sole discretion, and shall not be subject to appeal. Respondent should recognize that the evaluation process will take into account the evaluation criteria listed above along with other factors in making decisions and selections associated with this RFP. RGV HIE will determine, in its sole discretion, whether a respondent is invited for oral presentations or finally selected based on both quantitative and qualitative measures in each proposal as well as external factors and other criteria regarding each respondent and each proposal. RGV HIE anticipates inviting the top respondents for oral presentations and demo sessions. RGV HIE also expects to conduct site visits and reference checks before selecting the final respondent(s). Subsequently, RGV HIE s Evaluation Committee will present its findings and make a recommendation to the members of RGV HIE s Board of Directors, who will make the final determination. Request for Proposal Requirements Business Qualifications Please provide detailed and supportable responses of how your proposed solution(s) and approach meet each of the requirements listed in Appendix A. Please provide your business position, background, capabilities, current product roadmap, change management process for RGV HIE participation in feature/functionality requesting and prioritization, and governance strategy. With each answer, please consider how all community stakeholders will use the product. Functional Requirements In this section, RGV HIE is looking for clear and concrete information on how each requirement is supported. Please provide detailed and supportable responses of how your proposed solution(s) and approach meet each of the requirements listed in Appendix B. With each answer, please consider how the product will be used by all community stakeholders. Additionally, please indicate, where appropriate, whether the supporting functionality is the responder s intellectual property or a partner s product. Attachments/addenda may be provided but must be clearly identified and referenced, and it must be clear within the attachment/addendum which requirement(s) is being addressed. References to marketing materials and company web pages are not encouraged. 14

15 Clinical Requirements The clinical capabilities and functionality are the keys to a health information exchange. While RGV HIE s HIE solution may become a portal for eprescribing, inter-doctor referral management, online collaboration and more, these applications are peripheral to the focus of this RFP. Vendors who are able to demonstrate the ability to acquire data from community participants and provide effective views of that information for clinical use to the same participants will score well. Once this basic functionality (considered as Priority Level 1) is established, additional capabilities will then be considered to add value to a vendor s proposal. Privacy & Security Requirements Privacy and security functions include the capabilities of the system as well as the governance guidelines on how to use the system. Quality & Reporting Requirements The reporting and analysis capabilities improve the quality of the data and ability to meet security and governance requirements. Technical & Operational Requirements RGV HIE anticipates connecting with neighboring networks as well as an eventual Texas state network, and thus will eventually become a participating component to the National Health Information Network (NHIN). RGV HIE connects a wide variety of different types of healthcare participants, and therefore must be agile and adaptable. Appendix C contains the matrix with the requirements and also space for the detailed and supportable responses of how your proposed solution(s) and approach meet each of the Technical & Operational requirements. With each answer, please consider how the strategy must be altered to accommodate the various stakeholders and their systems as listed. Project Planning & Implementation Requirements RGV HIE is seeking a solution that can quickly get the first implementation group in the community connected sufficiently to satisfy federal meaningful use guidelines and contractual requirements set by the Texas Health & Human Services Commission. Additional implementation activities will continue beyond that point. The selected vendor will be responsible for the implementation, while augmented by RGV HIE and organizational staff. Implementations activities include, but are not limited to, implementation project management, requirements gathering/workflow mapping, interface testing, reference data load, system configurations, user training, business operations/readiness testing, and rollout/launch activities. Appendix D contains the matrix with the requirements and also space for the detailed and supportable responses of how your proposed solution(s) and approach meet each of the implementation requirements. With each answer, please consider how the strategy must be altered to accommodate the various stakeholders and systems. Additional Documentation Additional details for the requirements including charts and diagrams can be included in Appendix E. Please clearly identify the specific requirement being referenced. It is fully expected in the Requirements Matrixes Appendixes that the height of the rows will increase as the Response Details are populated, but please do not increase the row height of a single response to more than one half of the height of a landscape page. Appendix F is also provided for any additional documentation 15

16 Cost Model Please use Appendix G to present your proposed pricing model. Because there are additional providers in the community who will need to be able to join RGVHIE as time goes on, a pricing model needs to be scalable on a provider-level basis, by stakeholder type. Different types of providers may have different rates, or different strategies, such as subscription rates, or per-user rates. As a general rule, organizations with smaller patient loads and lower volume prefer flat subscription fees, whereas organizations with higher patient flow prefer transactional fees. More than one feasible cost model can be proposed. Please provide relevant attachments to clearly identify the total estimated costs for the entire system as well as for each type of participating organization. Additionally, please list any additional products and services required to enable the respondent s proposal to function, with associated prices (and sources, if not provided by respondent) so RGV HIE can assess the total cost of ownership. Preparation of this RFP is not a reimbursable cost. Final Contract Provisions If a vendor proposal is selected, RGV HIE and the vendor will negotiate a definitive agreement setting forth the terms and conditions under which respondent agrees to perform and provide all services and deliverables necessary to develop and implement functionality requested by RGV HIE, and support ongoing operations. The definitive agreement will be prepared by RGV HIE and will include key contractual provisions as deemed necessary or appropriate by RGV HIE and vendor. Unless or until RGV HIE and the selected vendor(s) have entered into such a final definitive agreement, RGV HIE has no obligation to engage any such vendor to provide the requested services and deliverables under this RFP. 16

17 Appendix A Vendor Business Qualifications Business Qualifications Matrix Vendor Response Key: 0 = Does not meet and don t plan to meet 1 = Does not meet but plans to meet (with expected date in description) 2 = Meets requirements/expectations and can demonstrate Response Instructions: Please provide a brief response in the Vendor Response column as noted in the Vendor Response Key. If a response is not provided it will be treated as a score of 0. Substantiate your response in the appropriate section of Appendix A.2 with direct, concise, and complete comments. Attachments/addenda may be provided but must be clearly identified and referenced, and it must be clear within the attachment/addendum which requirement(s) is being addressed. References to marketing materials and company web pages are not encouraged. In this section, RGV HIE is looking for clear and concrete information on how each requirement is supported. Requirement Business Experience Respondent has other clients, with similar solutions to that requested in this RFP. Please list current and former clients of similar products. For each client, provide a brief summary of products and services, a summarized project timeline, and if they are willing to act as a reference for your product. Please indicate at least two clients who are willing to host site visits, and provide rationale for reasons why these clients are good comparisons. Business Capabilities Respondent has adequate company resources (operations infrastructure, capital investment and qualified staff) to sustain ongoing operations and support the proposed solution. Please list resources that will be used in this engagement: - support staff, - average tenure of this staff, - the number and scope of projects currently supported and being bid, - a high-level timeline for other projects, - number of simultaneous implementations in the past - estimate / discuss capability to support RGV HIE in addition to existing and planned clients If subcontractors are needed, please provide roles, functions and experience requirements by role. Product Roadmap Proposed solution is established and continues to evolve. Describe proposed solution's origin, its evolution, pending improvements, and long term vision for the product. Change Management Process 17 Vendor Response Response Details/Reference to Supporting Documents

18 Respondent can respond to evolving RGV HIE requirements. Describe your change management process for implementation and processes through which RGV HIE can make feature/functionality requests, and receive prioritization. Governance Respondent can advise or provide solution-level governance structure. Please describe how decisions about governance / usage / future development of the proposed solution are made, as well as how RGV HIE can participate. If RGV HIE is one of multiple entities using a solution, describe how the entities interact and affect one another, and how decisions affecting all entities are made. Appendix B Functional Requirements Matrix Vendor Response Key: 0 = Does not meet and don t plan to meet 1 = Does not meet but plans to meet (with expected date in description) 2 = Meets requirements/expectations and can demonstrate Response Instructions: Please provide a response in the Vendor Response column as noted in the Vendor Response Key. If a response is not provided it will be treated as a score of 0. Substantiate your response in the Response Details column with direct, concise, and complete comments. Attachments/addenda may be provided but must be clearly identified and referenced, and it must be clear within the attachment/addendum which requirement(s) is being addressed. References to marketing materials and company web pages are not encouraged. In this section, RGV HIE is looking for clear and concrete information on how each requirement is supported. Requirement Master Patient Index The proposed solution provides virtual records of patients by presenting information from different, disparate sources of data that have information on patients, including mapping (source information) from provider systems. utilizes a Master Patient Index (MPI) database of some nature, that maintains a unique identifier for every patient, regardless of how many participating providers the patient registers with. enables a provider who is performing an initial patient lookup the ability to identify likely matches based on visual cues (such as % match statistics). 18 Vendor Response Response Details/Reference to Supporting Documents

19 handles record merges and/or record deletions in provider's EMR. Describe how this capability works. provides a mechanism for viewing and resolving potential duplicate records, as well as logs detailing mismatched identities describe the data fields used in your MPI and how the MPI can accommodate future data elements (e.g., national patient identifier, death indicator). describe how your MPI logic can be leveraged to serve multiple entities within the state and if additional costs would be incurred anticipate such costs. What are the operational requirements for resolving potential matches? Provider Directory The proposed solution shall provide a centralized provider directory that allows for the authentication and validation of individual healthcare providers; including initial load of provider information and the ability to enroll or update information in the directory. The provider directory will enable NWHIN Direct messaging to and among healthcare providers, facilitating communication of health related information. Note: Message content will not be stored. The solution for the Provider s Registry may be made available to other entities within the state that have a need for such services. describe the data fields captured in the provider directory which must include at a minimum: Provider Business/Legal Name DBA Name Specialty Subspecialty NPI Organizational Identifiers Tax ID Organizational Affiliations Physical Address Phone Number Address describe how providers can use the directory to enroll or update their information describe the functionality available to HIE administrators to manage and query the directory Record Locator Service (RLS): The proposed solution must provide RLS functionality that will locate where health information exists for identified individuals (i.e., a map or pointers to locations of information). Once individuals have successfully been identified, authorized providers can use the RLS to retrieve a copy of the individual s data elements and how those data elements will be formatted and transferred using national standards 19

20 where they exist. Web Portal to access ephi The proposed solution... is designed and implemented to maximize provider adoption. Considerable attention is given to integrating solution with current workflows. Please describe your strategy to encourage provider adoption. supports single sign-on technology, compatible with providers' current solutions. Respondents are able to provide single sign- on solutions for providers who currently lack such.... stores and retrieves the following patient data (listed in order of importance). Note: for each data element, identify your ability to store and retrieve in the Vendor Response column using the 0-2 scale. Provide explanations as relevant. 1. Demographics: name, address, phone, standard group identifiers, etc 2. Encounters: date, location, provider 3. Diagnosis list 4. Procedures 5. Lab results 6. Medications 7. Recorded vital signs 8. Current insurance coverage 9. Discharge information from levels of care 10. Immunizations 11. Allergies & reactions 12. Current Insurance Benefit Exclusions List 13. Plan of Care 14. Imaging Results (interpretations) 15. Current Pharmacy Benefits 16. Advanced Directives 17. Medical Power of Attorney 18. Family / Medical History 19. Sample medications provided to patient 20. Lifestyle, nutrition, activity habits 21. Explanations of Benefits 22. Vital Statistics 23. Actual images 24. Narrative / structured history of acute visits 25. EMS Activation data List other data points deemed necessary to satisfy 'meaningful use' criteria as defined by ONC. provides on-screen alerts about existing drug-drug, drugallergy, and drug-condition interactions based on wellknown information. Alerts can be cleared with appropriate credentials and detailed reporting of rationale 20

21 provides end-user configurability of the display of data through filters, sorts, rules, etc. Provide default templates with most relevant data for different stakeholders to customize at an organizational and/or user level. satisfies end users' expectation of <2 sec delay in system response to queries and other actions; 5-seconds max. Specify how vendor can track this supports manual, selected information flow from HIE to provider EMR using industry standards (ex: CCR, CCD). Clinical Messaging The proposed solution is Ability to provide HIPAA compliant secure messaging between healthcare providers (e.g., request for consultations, summary records, referrals, etc). support the Direct Project initiative. Please describe to what extent your clinical messaging service is integrated with Direct Project. Clinical Information Exchange The proposed solution is support the exchange of patient clinical summaries in compliance with ONC endorsed interoperability standards. This includes the ability to provide a patient-level clinical summary document that is transferred between healthcare providers when a patient is referred to a specialist or admitted or discharged from a hospital. Healthcare providers can view a CCD, or other accepted formats, from other healthcare providers through the statewide HIE via portal, EHR interface or browser-based secure messaging and make a CCD from their patients available to other healthcare providers. Terminology Services: Capability to provide translation between various medical vocabularies in clinical records, to provide LOINC encoding for lab results according to HHS standards, and in later phases to provide mappings and encodings for all meaningful use standards as specified by HHS (e.g., LOINC, SNOMED-CT, RX-Norm, etc.). Transformation Service: Capability to provide transformation between different document formats (e.g., HL7v2 to v3 or EDI to XML), to parse and validate various document formats (e.g., XML and XDS), and to create and map across different message envelopes and content requirements based on source and target requirements. (Note: All interfaces between GHHIE and Qualified Organizations are anticipated to be IHE profile driven and certified.) Lab Connectivity for Structured Lab Results The proposed solution is support the exchange of the Laboratory Orders and Results (e.g., Clinical Pathology Results) in compliance with ONC endorsed interoperability standards. This includes the ability to transmit a patient's laboratory order (i.e., 21 new new

22 computerized physician order entry) and the eventual results, through the statewide HIE, to the receiving Provider s EMR/EHR system. Connectivity is expected with a minimum of three major lab providers. E-Prescribing The proposed solution is providing connectivity to SureScripts, or other like entities, for prescription history and other necessary support services. EHR Lite The proposed solution is ability to provide a certified EHR to qualify for Meaningful Use incentives. allows for or includes integrated eprescribing tools to be used by providers who do not already have a tool. provides ability to electronically send an eprescription, providing either delivery confirmation or delivery failure notice. Upon notice of failure, provide options for troubleshooting and resend. provides an electronic method to deliver clinical results, both within and across entities provides for a clinician s inbox where defined results (e.g., laboratory, radiology) for individual patients are delivered (pushed) to the servicing clinician... provides workflow management functionality whereby results in a clinician s inbox can be (but not limited to) paged through, printed, faxed, filed, deleted, ordered, prescribed, referred, assigned, appointment created, forwarded, responded to, and authorized for further action provides for the transmission of orders, including (but not limited to): lab, radiology, prescriptions, EEGs/EKGs.... supports digital signature functionality (esignature) and electronic ordering, whereby authorized roles can electronically sign outgoing actionable messages (e.g., lab orders, prescriptions) to authenticate the identity of the sender using two-factor authentication and/or digital signatures. provides a role-based secure messaging tool supports the following actions for secure messaging: reply, reply all, forward, archive, purge provides advanced clinical analytics and research capabilities. Patient Portal The proposed solution is Solution has at least a basic web-based portal for patient to see own information. Solution displays splash screen or 'news ticking' banner on load. Describe ability to display configurable narrative text to user upon login, used to remind user of terms for 22

23 appropriate use and to record user acknowledgement of terms....solution allows for patient to schedule appointments with provider or describe other patient interactive tools available. (refill request, secure messaging, etc) describe process for designating what data can be accessed by the patient? How do you ensure providers can communicate abnormal results in advance of the patient discovering them in the PHR? describe how dependent patient relationships are handled? What languages are supported? describe how the patient s health record is made portable by the patient to other systems? describe how patient portal interact with other patient portals that have been deployed by providers in the region? Analytic and Reporting Capability Public Health Exchange Capability solution supports ability to:... exchange required data with relevant public health agencies, including: vital statistics, immunizations, reportable conditions, with ability to request & provide receipts from public health agencies Reporting Capabilities solution supports ability to allow de-identified reporting across data sources, subject to user authorization by Governance, and with support for doctor offices or patient groups opting out of having their information included. set up and enable user to run user-defined reports, with Governance approval. Includes multisource or singlelookup capabilities, as well as ability to group by patient, or by provider. System data should be accessible to facilitate authorized detailed data analysis. In all cases, real-time system performance should not be adversely affected. support aggregate assessments of population health as required by Federal regulations grant authorized agents at each trusted stakeholder full read access to their contributed information via query-inplace or data extract (i.e. so all Hospital 1's contributions can be accessed by Hospital 1 authorized agent). contain default reports specific to Meaningful Use reporting requirements. Provide an overview and examples of your out-of-the-box reports, and the process by which user-defined reports are created and managed provide Disease Management Dashboards for chronic diseases such as Diabetes. 23