Request for Proposals: Using Electronic Data Standards to Communicate Laboratory Orders

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1 Request for Proposals: Using Electronic Data Standards to Communicate Laboratory Orders Proposals Due: Tuesday, January 17, 2012 Summary Up to $300,000 is available to support six to eight pilot implementations of the ELINCS Orders specification to deliver laboratory orders electronically from ambulatory practices with electronic health records to clinical laboratories. About the California HealthCare Foundation The California HealthCare Foundation (CHCF) supports ideas and innovations to improve health care for all Californians. To learn more, visit Background In today s fragmented health care delivery system, communication between a physician and a laboratory can be a fractured process in which lab orders and results are sent by fax or mail, leaving physicians challenged to make informed decisions often without complete and timely medical data. As a result of the Health Information Technology for Economic and Clinical Health (HITECH) Act, physicians are increasingly implementing electronic health records (EHRs). However, adoption of EHR systems can be expensive and technically daunting; real time clinical data exchange has been hindered by the lack of standard specifications that can be used by a variety of clinical information systems. The use of standard specifications will help physicians who adopt EHRs to implement plug and play interfaces and more easily communicate with their contracted laboratories. This will reduce the costs and complexity of system installation and configuration. In 2005, the California HealthCare Foundation, in collaboration with national health care organizations and on behalf of the Office of the National Coordinator for Health Information Technology, created the

2 EHR Lab Interoperability and Connectivity Specification (ELINCS) to standardize the real time transmission of laboratory results from lab information systems (LIS) to ambulatory clinical information systems. Today, ELINCS is a HL7 approved specification supported by clinical laboratories and leading health IT vendors. (To learn more, visit ELINCS Orders Building on its prior work, the California HealthCare Foundation, again in collaboration with leading national health care organizations, has created a standard specification for the real time transmission of laboratory orders from ambulatory EHRs to lab information systems. This new standard (ELINCS Orders) is compliant with HL7 version and designed to complement the current ELINCS HL7 R1 specification for reporting of lab results. The ELINCS Orders specification is available at ELINCS Orders version 1.0 is a complete specification ready for implementation testing. The pilot implementations funded by this Request for Proposals will require the collaboration of organizations that exchange laboratory orders to develop and test ELINCS Orders interfaces. CHCF intends to demonstrate the electronic delivery and use of lab order information in an ambulatory environment. It is expected that iterative testing will be required as part of this pilot implementation. Issues may arise that require modifications to both the systems being tested and the specification itself. This project will jump start adoption of ELINCS Orders by providing a fully tested specification for widespread use nationally. Project Overview and Objectives CHCF is providing grants to support pilot implementations of the ELINCS Orders specification. The foundation has allocated up to $300,000 for grants to implement and test the exchange of laboratory orders from ambulatory EHRs to lab information systems using the ELINCS Orders specification. This initiative will provide technical assistance and award six to eight grants over nine months. CHCF s goals for this initiative are to: Implement the ELINCS Orders specification to deliver laboratory orders to close the communication loop between ambulatory EHRs and laboratories Receive feedback from ELINCS Orders pilot implementations to improve the specification and enable widespread adoption Facilitate adoption of ELINCS Orders by organizations nationally Demonstrate models for adoption in diverse settings Demonstrate the benefits of communicating lab data electronically Support national efforts to standardize the electronic exchange of lab data Sujansky and Associates, which has managed development of the ELINCS Orders specification on behalf of CHCF, will offer technical assistance to grantees, including hosting teleconferences to brief Request for Proposals: Using Electronic Data Standards to Communicate Laboratory Orders page 2 of 6

3 participants on the specification and providing telephonic and support to troubleshoot problems. Grantees will also be provided with additional resources to support implementation testing. At the end of the grant period, CHCF expects that participating organizations will have fully implemented ELINCS Orders and will be delivering real time electronic lab orders from ambulatory EHRs to lab information systems. More importantly, CHCF expects to demonstrate the impact of the real time communication of lab data in patient care processes, and ideally, clinical outcomes. Who Can Apply CHCF is interested in supporting organizations with a commitment to improving health care delivery through adoption of clinical information systems and data exchange standards in the ambulatory setting. Potential applicants may include: Ambulatory care provider organizations (such as independent physician associations, foundation model, and group practices, etc.) Community clinics (federally qualified health centers, urban and rural health clinics, etc.) Clinical laboratories that service ambulatory care provider organizations (such as commercial, independent, and hospital based) Health information exchange (HIE) organizations Health IT vendors (including EHR, HIE, and interface/middleware) Health plans, local initiatives, and county organized health systems As this project will require significant collaboration between provider organizations, clinical information system vendors, and laboratories, CHCF anticipates that organizations will partner on the RFP applications. While any of the aforementioned potential entities can be the lead applicant, eligible applications must include an organization that provides direct clinical care. Given the significant collaboration that will be necessary, applicants must therefore have participation and commitment from each of the following: Ambulatory practice or clinic providing direct patient care Clinical laboratory providing outpatient laboratory services Either a health IT vendor (e.g., EHR, HIE, or interface/middleware) or a health information exchange organization Applications must include letters of support from all participants acknowledging their roles and responsibilities in the project. In addition, all applicants must support real time laboratory messaging using the HL7 v2.5.1 standard. HL7 is a widely used and accepted set of standards for delivering and exchanging clinical information in the United States and abroad. Grant funds may be used to support the technical changes required to implement ELINCS Orders. Request for Proposals: Using Electronic Data Standards to Communicate Laboratory Orders page 3 of 6

4 Selection Criteria Full proposals will be evaluated on these criteria: Extensibility of the implementation: The degree to which the implementations could be leveraged to other organizations (that is, interfaces developed through the project would be made available to other care delivery organizations at no additional cost). Strong project management and a clear articulation of: - An implementation plan for EHRs to send ELINCS compliant orders to laboratory information systems - An implementation plan for laboratory information systems to receive and process ELINCS compliant lab orders Commitment of the partnering organizations to implement and sustain ELINCS Orders. Commitment by multiple trading partners: Organizations that submit plans to implement ELINCS Orders for the delivery of laboratory orders from multiple trading partners (e.g., from one or multiple ambulatory EHRs to labs) will be preferred. The completeness of laboratory data exchange; initiatives that are able to demonstrate delivery of the majority of lab orders for all patients cared for by the participating clinic/practice sites will be preferred to demonstrations that only report a small portion of lab orders (e.g., less than 10%). The stage of clinical information system deployment: Organizations that have already implemented or are pilot testing EHR or health information technology systems will be favored over organizations that are in the planning or purchasing phases. Ability to demonstrate clinical impact (number of providers and patients in the delivery system, as well as process and outcome measures) due to improved data flow to clinicians. Commitment to Participation In addition to the criteria above, organizations must commit to the following activities: Provide technical feedback regarding the ELINCS Orders specification that would improve future implementations Participate in an independent evaluation of the initiative Share lessons learned with CHCF and other organizations Participate in regularly scheduled conference call updates with CHCF Provide quarterly progress reports Provide in kind support (financial or staff) to implement the project Request for Proposals: Using Electronic Data Standards to Communicate Laboratory Orders page 4 of 6

5 Project Timeline Activity Date RFP Released Monday, December 5, 2011 Informational Conference Call Monday, December 19, :00 11:00 AM PST Question Submissions Due Friday, December 30, 2011 Proposals Due Tuesday, January 17, :00 PM PST Grant Recipients Announced Monday, February 6, 2012 Projects Begin Late February 2012 Proposals Applicants should submit a proposal no more than ten pages, double spaced in 12 point font. The proposal should include the following (suggested length for each provided in parentheses): 1. Project Cover Sheet, available for download at aproposal. (The cover sheet does not count in the ten page limit.) 2. A statement of the project s objectives and relevance to all partner organizations strategies. (one page) 3. Description of the state of health IT adoption within the provider organization (for example, currently in use in X practices treating Y patients; currently being tested at Z pilot sites; purchasing/planning stage, etc.). (half page) 4. A project plan describing the phases of implementation, including (but not limited to) project kick off, relevant milestones, organization roles and responsibilities, testing and implementation phases, and go live dates. Overall project plan must include: - A plan to send test ELINCS Orders compliant messages to laboratory information systems - A plan for laboratory information systems to receive and process ELINCS Orderscompliant messages Plan may include a matrix of responsibilities by all participating members. (three pages) 5. Description of organizational commitment to full participation in project including project evaluation, monthly conference call check ins, site visits, phone and online support, and sharedlearning activities. (half page) Request for Proposals: Using Electronic Data Standards to Communicate Laboratory Orders page 5 of 6

6 6. A brief description of the organizations that would be involved in the pilot. Describe the following for each partner (three pages): a. Provider organization/clinic: Name, size (number of physicians and FTEs), population served (size, demographics, insurance types, etc.) and geographic service area(s) b. Clinical lab vendor: Name, geographic service area(s), size (e.g., number of tests performed per year), population served, and approximate share of lab testing volume the entity represents to the clinic/provider group, etc. c1. Health IT vendor: Name, approximate number of deployments including breakdown by types (numbers of provider offices, clinics, hospitals, etc.) and geography, corporate and technical qualifications (number of FTEs, net revenues, ability to process HL7, etc.) c2. HIE organization: Name, size (number of staff), geographic service area(s), population served, service offerings, transaction volumes, etc. 7. Explanation of how your demonstration can lead to increased availability and accessibility of ELINCS compliant data to other provider organizations. (one page) 8. Discussion of the anticipated challenges to implementing and sustaining the effort and how those might be overcome. (one page) 9. A full budget in Microsoft Excel format (available at: aproposal) that reflects actual project costs along with a budget justification. Note that there are two separate budget templates. Please use the template that corresponds with the lead applicant s financial status. The budget should reflect both grant funds and additional funds provided as in kind resources by the organization. (The budget and budget justification do not count in the ten page limit.) 10. Written and signed support from each participating organization including an executive sponsor at both the provider organization/clinic and outpatient/hospital lab(s). Support statement from labs and vendors should include a statement to make ELINCS Orders available to future deployments. In all cases, indicate the leadership support including the owners and managers of the project within each organization. (These letters of support do not count toward the page limit and should be included as appendices.) Proposals should be sent by Tuesday, January 17, 2012, 5:00 PM Pacific Standard Time to: Kanelle Barreiro, Program Assistant California HealthCare Foundation Inquiries should be directed to: Glen Moy, Senior Program Officer California HealthCare Foundation Request for Proposals: Using Electronic Data Standards to Communicate Laboratory Orders page 6 of 6

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