Sample ECM-DMI RFP Toolkit from Quest Diagnostics

Sample ECM-DMI RFP Toolkit from Quest Diagnostics Your Checklist to Create a Comprehensive Request for Proposal (RFP) Your healthcare organization has identified particular needs such as the elimination of paper, management of content in different formats and from different sources. Additionally, you might need help regarding the location of critical documents for clinical, administrative and compliance purposes and have too much duplication of data with the organization. That is why an Enterprise Content Management or Document Management solution would be ideal. So how do you communicate those needs and build the RFP that will assist and support you in your search for the right vendor partner and solution? What Should You Look for in an ECM? Enterprise Content Management (ECM) helps hospitals take control of a wide variety of content such as scanned documents, eforms, digital pictures, electronic data, radiology images and more. A comprehensive ECM solution empowers hospitals to refine and streamline processes, improve collaboration and boost productivity while managing the life cycle of content. An ECM solution should enable hospitals, healthcare systems and IDNs to build processes that fit and support their business practices, instead of having to change business processes to comply with system limitations. The successful ECM solution needs to streamline and automate business practices, improve efficiency, enable meaningful and timely collaboration across teams and departments, and reduce costs. A robust ECM solution can deliver alerts and notifications, raise visibility of and resolve bottlenecks, and help you identify processes that are non-functioning or in need of refinement. Your organization can also identify individual performance issues for both recognition and coaching, and also empower executives to stay on the pulse of the organization by receiving mobile alerts for critical processes, real-time analytics and KPIs. How to Create an ECM Request for Proposal (RFP) Most RFPs typically consist of two main parts. The first part clearly expresses the compelling factors that are leading your healthcare organization to search for an ECM solution and your organization s expectations for the benefits that you expect to gain by installing an ECM solution. The second part of your RFP should provide detailed technical requirements in a format that allows the candidate vendor to include responses and supporting documentation. Compelling Factor or Event Use this portion of your RFP to talk about what led your organization to begin the search for the ideal ECM solution. Identify your organization s challenges and outline the processes that are causing issues and concerns that need to be addressed. Clearly express your pain points and the improvements that you expect to realize by implementing this software solution. Setting clear and detailed expectations will help responding vendors offer feedback that is more meaningful and specific to your organization. This section should also include details regarding the facilities that are going to use the solution, and your mission statement. The more the vendor understands your organization and what you are trying to achieve, the better. Identify Needs/Technical Requirements

The Technical Requirements section should be the largest portion of your RFP. After defining the reasons why you are searching for an ECM solution, you need to identify the critical needs and technical requirements necessary for a successful implementation. These may include vendor stability and longevity in the market, domain expertise, functional capabilities, technical and architectural considerations, training details and options, and technical support methodologies. Here are some key factors that the winning ECM solution should include: Vendor Stability and Domain Expertise It is important to ensure that your ECM vendor will be a stable, available and an innovative partner to your organization for the long term. In this section, the questions are designed to determine how long the vendor and product have been working in the healthcare industry, how much the healthcare product that you are considering are a focus for the organization, and how well prepared it is to provide the support that you will need throughout the implementation process and beyond. Privacy and Security The winning solution should offer flexible and configurable security tools to control user access based upon a variety of criteria including Care Site, Visit Type, and Document Type to name a few. All documents that the user has permission to see should be presented in an easy to navigate and intuitive format regardless of the document s original source (scanned, interfaced, imported etc.) The vendor of choice should offer multi-level security for permissions to edit and modify documents. All changes need to be automatically audited by the system and multiple versions of the document should be stored and accessible to those who have permission to see prior versions. The vendor should exhibit a thorough understanding of HIPAA, and the software should have comprehensive tools for ensuring compliance including auditing, reporting, and user permissions that protect patient information. Scanning and Indexing The ECM software will be used to digitize remaining paper documents including legacy charts, nursing home transfers, ambulance run sheets and any other documents that are still in paper form. You ll want to ensure that the solution you choose leverages efficiency tools including bar code recognition for automating document and patient indexing and a variety of tools to make the Quality Review process flexible, quick and efficient. Workflow A comprehensive ECM system needs to provide flexible workflows that can be easily designed by a business analyst level resource and require no programming experience. The workflows should be capable of reaching across systems and departments, performing automated tasks in the background, and providing worklists and alerts to the proper user when human intervention is required. Worklists should be fully configurable and access should be permission based. The workflow design tools should have full reporting capabilities and should be easy to modify, providing an iterative approach to workflow design. Electronic Forms This capability is unique among top vendors in the ECM space. Electronic forms should resemble their hand-written counterparts so they are easy to navigate and use, but offer many additional features including collection and use of real-time actionable data that can drive workflows and reports, and can be sent via outbound interface to other databases, the ability to perform calculations, and tools that promote data integrity including pick lists, dropdown lists and radio buttons. The eforms tool should be capable of producing anonymous 2

eforms that can be completed by users outside the system such as patients via portals and kiosks. Technology and Integrations The winning ECM system should include a comprehensive and proven suite of integration methods including Service Oriented Architecture (SOA) technology to enable real time information sharing. Your chosen ECM system should integrate seamlessly with your ADT system, your Clinical Information System, a wide variety of other clinical systems and other business applications including Lawson and PeopleSoft. Rather than a rip and replace strategy, your ECM solution should form a solid, flexible bridge between your existing systems to eliminate information silos, drastically reduce duplication of data and enhance the functionality and longevity of your current IT investments. Scalability The solution should be both horizontally and vertically scalable. The vendor should be able to substantiate their ability to support your organization whatever the size and complexity from very small hospitals up to very large IDNs. The goal should be to work with the winning vendor to determine the planned growth for features, applications, hardware, and storage, and configure a system that will allow for growth by simply adding processors, memory and software modules instead of requiring replacement of equipment and software. Reporting The solution should have robust reporting features including the ability to schedule reports, customize reports, and design reports from scratch. The system should have the ability to provide alerts and dashboards. The reporting tool should be able to reach across systems and departments. The vendor should offer a variety of reports at no charge and should offer consulting services to develop or assist your site in developing custom reports if needed. Release of Information The vendor should be able to customize options for file version control that have the ability to keep all versions of a document, and to make the prior versions visible to only certain audiences to avoid confusion for clinicians and release of information purposes. All actions and activities performed by users and by the system itself are audited, which will facilitate compliance with healthcare privacy regulations, risk avoidance, privacy breach detection and other hospital compliance policies. The Release of Information module should be able to fulfill requests in paper and electronic forms, be able to calculate any applicable fees, product in invoice and include the reports you need to comply with HIPAA and other privacy regulations. Registration The vendor should be able to support a variety of methods to integrate with other systems. For example, make sure the vendor supports command line launch, Active X, and CCOW to collect the MRN, Account Number, and other information including Visit Type and Payor Class. This can help greatly reduce the amount of time to register the patient and also to train the Registrar on the system. Also be sure that the vendor can integrate with Star and the Client Server platforms to collect ADT data. For ADT in particular, the most common scenario is for the vendor to receive ADT data from the source system to create encounters (accounts) to which documents are attached and stored in the repository. Much of the ADT data is stored discretely and can be used for other purposes. For example, the generation of barcodes for wristbands and labels is done out of the registration system. 3

The Registration system should product a pick list of the correct documents to collect, depending on the visit type and/or insurance coverage. The following technical overview questions are provided to provide your healthcare organization with a solid foundation of questions to include in your RFP. Technical Requirements Questions Vendor Stability and Domain Expertise 1. How long has the vendor been providing this solution? Does the vendor provide other solutions for healthcare? Does the vendor provide solutions for other markets? 2. How many installations of this software solution are there across the U.S. and Canada? 3. Can the vendor provide references for hospitals that are similar to yours? 4. Does the vendor specialize in healthcare? 5. Does the vendor use Value Added Resellers or other external resources? 6. What is the average tenure of the vendor s support and implementation staff? Provide resumes for a representative team that might work on the installation and implementation of the solution at your facility. 7. Do they offer tools to enable your site to be an active member of the user community including newsletters, a portal, a forum for addressing questions to the entire user base, an annual User s Group, etc? 8. How does the vendor perform in impartial rankings such as KLAS? Privacy and Security 1. The solution supports user-specific printing restrictions at what levels; e.g., user, account, document type, etc. Explain 2. The solution supports patient consent management; allows locking of records at the patient, account and document level. Explain 3. The solution provides an override to be recorded in the audit trail and a notification automatically sent to the Privacy Office via workflow. Explain 4. The solution date and time stamps all entries, edits, and views so there will be an audit trail giving details of who entered, changed, or viewed what data and when. Explain 5. The system should restrict access based on various parameters and flag and report on suspected inappropriate accesses (Breach Detection). Explain 6. The solution will display a confidentiality statement to the user as per hospital standard policy at initial login. 7. Documents can be secured or locked down to a single user if necessary. 4

8. The solution has pre-defined data elements, such as document types and security profiles, to optimize implementation timeframes. 9. The solution supports a multiple facility configuration where each location can be customized or configured separately. Explain Scanning and Indexing 1. Describe your system s document capture solutions in detail. 2. Explain how your solution supports auto indexing of documents using a barcode. 3. In regards to electronic data feeds, the solution supports Bitonal, JPEG, GIF, TIFF, grey scale, pictures and color images and they are interfaced and viewed exactly as they appear on the original. Explain 4. The solution supports the insertion of individual loose pages or documents received after the initial scanning and indexing within the appropriate date sequence. Explain how it can be inserted in the appropriate date sequence within the indexed document type. 5. The solution makes all documents available online immediately after scanning and indexing as well as electronic transfer. Explain 6. The solution can store documents at the MRN level without being attached to a specific encounter (i.e. medical alerts, Advanced Directives, etc.) 7. Describe your system s ability to perform Quality Review (QR) and verification of captured image documents. It should also provide a simple document re-scan process that automatically replaces a poorly captured image with a newly-scanned image. Chart Completion, Clinical and Other Workflow 1. The solution provides for Health Information Management chart deficiency reporting for various disciplines including Doctors, Nurse Practioners, Psychologists, etc. Explain 2. The solution allows batch letter printing on demand or automatically for delinquent deficiencies. Explain 3. The solution provides electronic signature capability via the web (intranet and internet) for chart completion. Explain 4. The solution provides document versioning. Explain 5. Missing text completion allows the physician to type the missing text directly on the image and save the changes. Explain 6. The solution automatically identifies which required documents are missing for a specific visit type including electronic and scanned images that can generate workflow. i.e. Missing Operative Report after 48 hours." Explain 5

7. The solution allows physician/users doing chart completion to send messages back to the person who assigned the deficiency. Explain 8. The solution allows a physician to securely send another physician documents to review with a comment. Explain 9. The solution supports restriction of editing discreet data elements associated with the document by anyone (physicians) for chart completion. Explain 10. The solution deficiency completion screen has tool tips providing more detailed information for the user when the mouse hovers over the deficiency. Explain 11. The solution allows unique user work lists or queues of charts that are not part of chart completion. i.e. Charts requested for research or studies, consulting requests etc. 12. The solution provides users with a notification screen at logon indicating number of charts in personal work list and number of charts that are deficient. 13. The solution is capable of integrating with (name your ADT system here) for the generation of patient data (including barcodes) on wristbands, labels, and forms. Explain 14. The solution when integrated with Horizon Provider Portal (McKesson) and Clinical Connect (Med Seek) and accessed through either is capable of generating patient specific electronic forms. 15. The solution allows access to patient records that may have both Electronic Data Fed documents as well as scanned documents. Explain 16. The solution can support access to all scanned documents as well as multiple Electronic Data Fed documents for redundancy and access during Portal downtime. Explain 17. The solution allows multiple users to view the same patient records simultaneously. 18. The records are searchable by patient ID as well as by specific care provider (e.g. by Physician) 19. The solution includes workflow design tools that enable the hospital to create and maintain their own workflows 20. The workflow solution is capable of reaching across systems and departments. 21. The workflow tools are customizable and can be used for non clinical workflows in other departments such as Human Resources, Patient Accounts, and Procurement. Electronic Forms 1. Solution provides a tool for the creation of electronic forms. 2. The solution/tool supports the creation of a smart form from existing forms. 3. The solution/tool supports the creation of electronic forms via conversion technology. (e.g. from MS Word, PDF) 6

4. The solution allows forms that are stored and retrieved for use to be editable only with sufficient security. 5. The solution supports inclusion of external, third-party forms as part of forms library. 6. The solution allows flexibility to change or add fields to respond to changing data requirements with appropriate security permissions. 7. The solution supports business continuity and downtime process with the ability to produce inpatient and outpatient forms with patient and form identifiers (for current patients) or non-patient identified forms in the event of network downtime. 8. The solution supports the ad-hoc retrieval of packages of forms, inclusive of patient demographic information and bar-coded patient identifiers. 9. The solution/tool supports the creation of package distribution routes by service, location and by printer. 10. The solution supports an audit trail of printing/re-printing of forms/packages for patients and for users. 11. The solution supports the conversion of faxes (via a fax server) to electronic forms and vice versa. 12. The Electronic forms are capable of performing calculations and enforcing business rules. Provide an example of forms that perform both of these actions. 13. List the reports that are included with the system. 14. Does the vendor provide services to design custom reports and to assist our facility with developing custom reports if needed? Technology and Integrations 1. Explain how the solution meets the requirement to complete a data migration for documents that reside in our transcription system. (specify the number of documents and the specific transcription system) 2. The solution proposed includes a fully functional test environment that includes all features of the production solution. Explain 3. The solution provides the administrator the ability to support and manage the applications from either a network workstation or remotely as defined by security and client installation. Explain 4. The solution has the same user interface of the application for the client-based and webbased user interfaces. If not, explain what functions are lost in the web-based user interface. Explain 5. The solution is web-enabled for chart review, document editing and deficiency processing (including signature, missing text, and diagnosis) 7

6. Solution supports an ODBC or API type interface. 7. List the web browsers and versions that are supported to run the solution. 8. The solution uses encryption for the storage of all PHI data within the database. 9. Describe and diagram the high availability configuration that is being proposed. 10. The solution provides an established methodology and plan for upgrades, new releases and hot fixes. Explain 11. The solution has automatic database backup and archiving that does not require downtime access during the process. Explain 12. Technical support for the solution is available 7 days per week, 24 hours per day and 365 days per year. Explain 13. Document printing is supported utilizing multiple printer models and media trays. List supported printers. 14. The solution provides seamless integration with our Clinical Information System (specify the specific solution and current version) 15. The solution and support staffs have extensive experience with designing workflows and integrations. (List the specific systems you want to integrate with your ECM and any specific workflows that would be part of your initial project) Scalability 1. The solution supports scalability and access for (insert estimated number of concurrent users for your organization) simultaneous users with expected growth of 10% per year. Explain 2. The solution provides the administrator the ability to support and manage the applications from either a network workstation or remotely as defined by security and client installation. Explain 3. Describe how your system supports deployment of installation and configuration updates. 4. Describe how your solution allows for development, test, training, production and disaster recovery environments with no additional licensing fees. 5. Describe how your system accommodates future growth (adding additional departments, clinics, etc.). 6. Describe how your system supports multiple application and web servers in a load balanced configuration environment for redundancy. 7. Please provide examples of scalability using real customer examples and metrics. 8

8. Does your system utilize a file storage system to store document or does it store directly into the database? Reporting 1. The solution has detailed reporting capabilities. 2. The solution generates reports on an ad hoc and pre-designed batch basis. 3. The solution allows for the creation of custom reports by system admin. 4. The solution allows audit trail report capabilities for access of complete health record for patient on a scheduled or adhoc basis. 5. The solution allows audit trail report capabilities for access of individual pages of a health record on a scheduled or adhoc basis. 6. A service level agreement report is provided monthly to include scanning volumes, turnaround times, helpdesk calls/response time, retrieval times, image quality levels etc. Release of Information 1. The solution allows users to preview both images and electronic documents prior to releasing the documents for Release of Information. Explain 2. The solution can identify the physician of record and automatically fax the document to them based on a workflow rule. Explain how the solution accesses the physician table. 3. The solution allows outbound faxing of documents to selected recipients (e.g. lawyers, insurance companies, etc). 4. The solution has the ability to create and maintain a list of third party requestors. Explain 5. The solution produces an audit trail and log at the patient level for all Release of Information including electronic documents and scanned images. Should log user, date, time, duration and what was done (e.g., printing). 6. The solution supports release of information via print, secure email and CD/DVD. Explain Registration 1. Describe how your solution can be used during the registration process and how it integrates with other systems. In particular, can the MRN and/or Account Number be obtained from the registration without re-keying, and can the application be launched from other systems? 2. Does the system present a checklist of documents to gather depending upon the patient s visit type and/or insurance coverage? 3. Can the system present a base set of documents that must be gathered for every registration? 9

4. How does the system store and locate pre-registration documents and information? 5. The solution is capable of integrating with ADT platforms for the generation of patient data (including barcodes) on wristbands, labels, and forms. Explain 6. Does your solution have the ability to gather electronic signatures at registration? 7. Can your solution create an archive insurance card and other images that registration clerks can view and re-scan as necessary? 8. Describe how the system utilizes electronic signatures and electronic confirmation (if applicable). 9. Does the system support the ability to produce admissions or other documentation kits on demand, based on hospital or enterprise defined criteria or attributes? 10