Erie County Medical Center Corporation RFP # 21425 Addendum Number 1 Erie County Medical Center Corporation Addendum Number 1 to RFP # 21425 DOCUMENT ARCHIVING, SCANNING AND IMAGING The deadline for submission of proposals still remains Tuesday, September 23, 2014 at 2:00 PM EST. The following questions were submitted to the Designated Contact: 1. Can you elaborate on the number of users that will need full read/write access to the system, and how many will need read-only access? How many users need to access the record system? Could please provide clarity about the number of concurrent users who will use the ECMCC system. Please clarify. ECMCC has approximately 5,200 active users in our Meditech system, which is the main Healthcare System of the facility. At any given point in time, ECMCC has 1,500 unique users actively working with Meditech. Based upon this information and your previous experience with a facility of similar size, please use your best estimate. We are unable to quantify the number of concurrent users nor the breakout between View Only and Full Access users. 2. Is this RFP open to any qualified vendor? We have reviewed this RFP and believe we can provide the solution you are looking for. We just want to confirm that this selection is open to any vendor. Yes, any qualified vendor may respond to this RFP. 3. Can you please let me know who your preferred hardware partner is for this project and send me contact information? ECMCC plans to procure our own hardware based on the specifications provided by the successful vendor. 4. The RFP references in Section VII Proposal Requirements; Section B a number of forms/exhibits to be completed and returned with the RFP response. Can you provide a copy of these forms/exhibits to us or provide a link so we can access these forms/exhibits for completion? The RFP on ECMCC s web site has been updated to include the referenced exhibits.
5. Customer has Meditech as an EHR. Please confirm if the "Scanning & Archiving (SCA)" Module has been activated or not? Likewise, is AEHR in use for Allscripts? ECMCC does not own the SCA Module in Meditech. The areas using Allscripts are scanning with their software called Impact. 6. Is the Meditech environment 100% or partially on Magic v 5.x still? CS is mentioned, but migration to version 6 is also mentioned on page 12, suggesting ECMCC is still on v 5.x. ECMCC is currently on Meditech Client Server 5.66 PP7. 7. Has HL7 been enabled? If so, what version? (ie: version 2 or version 3, XML, etc.) ECMCC actively used HL7 today. ECMCC utilizes multiple versions to meet various vendor requirements. 8. Does the customer have or plan to obtain from Meditech the "ECM Filer" module? ECMCC does not have this module but will evaluate the purchase of it as we are evaluating the proposals. 9. In the Archiving Section, there is mention of moving data. What format is preferred? (examples : PDF, TIF, PDF/A, JPEG, etc.) ECMCC would likely prefer a PDF file so it cannot be edited, but this would need to be reviewed based upon vendor system capabilities. 10. Who is responsible for purging the data from Meditech upon completion? The various module owners would be responsible for purging data from Meditech at the appropriate time. It is ECMCC s desire to automate this process if possible, based upon the ability to set purge parameters. 11. In terms of scanning, will the functionality be enabled on existing devices? If so, what are the make/model of these devices? Yes, ECMCC plan to utilize our current scanners if possible. ECMCC is using Fujitsu models fi-4120, 5120c, 6000 series and 7160. 12. Has ECMCC considered also (in addition to desktop scanners) enabling the identical process on the fleet of MFD units to add convenience for the users? ECMCC has not considered this to date, but our equipment has the capability to do this. 13. Will any of the documents that need to be scanned, arrive via inbound fax? If so, is this paper pulled from analog fax machines? Potentially there could be documents that need to be scanned that are received from an analog fax machine or multi-function device. 14. Please describe in detail the product referred to as the "Forms Automation System". Who makes it? How many form types are involved? Access eforms is the system used for forms automation. ECMCC currently has hundreds of forms in use (orders, admissions, consents, etc). We are unclear if this is what you are referring to by type.
15. Does ECMCC currently have active ADT messaging in real-time? If not, how often is ADT updated? Yes, currently real-time ADT messaging is in place. 16. Is there a master patient index in Meditech that can be queried by patient number? Yes. 17. Because it will impact scanning capacity in the design, can Customer provide and average census information? Looking for average new patient registrations per day, daily encounter averages, etc. ECMCC s average census for 2014 is approximately 400 patients at ECMCC and 390 at Terrace View. 18. What information can you provide prior to proposal submission due date, regarding the current configuration of the Valco scanning solution? Currently, ECMCC is running Valco on three servers: Master Release: OS Windows 2k3 Enterprise SP2. Hardware HP G4 2.5GB Xeon 8GB Ram PAE. Secondary Release: OS Windows 2k3 Enterprise SP2. Hardware HP G4 2.5GB Xeon 8GB Ram. Archive: OS Windows 2k3 Enterprise SP2. Hardware HP G4 3GB Xeon 3GB Ram. 19. In Scanning section M, please confirm the quantity of locations from which files will be imported? Any document from eforms can be converted. All registration sites and departments may have files that potentially could be imported, but a specific number in unknown. There is also a potential for files from outside sources to be imported, but that is unknown as well. 20. What software do you plan to use for E-Signature? Meditech s esign functionality is being used for E-Signatures. 21. How many registration booths / desks kiosks are in use today? How many ER registration desks? ECMCC has approximately 60 registration booths between the Hospital, Terrace View and offsite Clinics. ECMCC has approximately 15 ER registration booths. 22. Do you have any immediate plan to do bedside registration or consent documentation? if so, what is the product you use/plan for this function? Yes, we intent do perform bedside registration and consent documentation. As part of this RFP, ECMCC is looking to the vendors to guide us on how we could incorporate this in to our workflow and use esign pads for consents and the like. 23. What is the type of barcode in use today? (ie: 2D, Linear 3-of-9, UPC, etc.) Please be specific. The barcode type USS-128 is in use today, but we may utilize others in the future. 24. What print device is used to print barcodes (ie: datamax, Zebra, etc.) Are barcodes printed on to labels or directly onto the forms themselves? Bar codes on are printed on the forms and labels. Datamax printers are used for the labels and HP laser printers are used for form printing. 25. Since there are two EHR systems (Allscripts for the clinics)...does ECMCC have a single patient number between both systems or a different patient number in each system?
ECMCC does have a single patient number between both systems, since the Clinic patients are registered within Meditech. 26. Can you provide any documentation on the manual workflows currently in place for referring patients between Outpatient and ECMCC locations? We cannot identify a manual workflow in place. 27. In Pharmacy Scanning section I, you mention scanned orders. What is the percentage of orders that are CPOE vs. the scanned process outline in section I? (Understanding the downtime in section iii, this question is specific to the non-downtime process if applicable) Most orders are entered via CPOE, but we still have 8-10% that are scanned to Pharmacy (not including downtime orders). 28. Since it is mentioned on page 10, is Meaningful Use Attestation of any important for the client in 2014-2015? If so, what specific measures will ECMCC (both Core and CQM) attest to currently? Yes, MU Attestation is critical for all measures for 2014-2016. 29. In order to reduce or eliminate any potential for fines relating to HIPAA - Omnibus breach, what security measures need to be enabled as part of the project? Details are contained within the HIPAA Security Rule, located in 45 CFR Part 160 and Subparts A and C of Part 164 and its accompanying regulations. Among other things, vendor will likely be required to enter into a business associate agreement with ECMCC as required by HIPAA to govern access to patient data throughout the process. 30. Does ECMCC seek to leverage the expertise of the selected vendor for this effort? No. 31. In Registration Scanning, section R. iv...you mention the capture of photos. May we assume that you are interested in learning about the various products available to handle the photo capture, perhaps in the burn unit, etc? (note: Ricoh makes a specific camera designed to capture and index patient photos in healthcare) ECMCC is interested in pursuing photos for a variety of uses including patient photos, wound photos, photos on wristbands, etc. 32. Imprivata is mentioned. What version do you currently use? Imprivata client version 4.9.103.31 is currently in use. 33. Regarding Security Question #9 at top of page 12...may we assume you mean HITECH Security specific to 45 CFR 164, Technical Safegaurds and Omnibus, etc? Yes. And by ARRA, you are asking about Meaningful Use ONC CCHIT Accreditation? If not, please clarify. Yes. 34. Are the customer-provided servers on which the proposed archiving system will be placed, virtual? If so, please describe both the data center (VMware? vcenter or vsphere?) and desktop (citrix? version?) architecture currently in place. Or please clarify if you prefer the proposal to include new server hardware, etc. Turnkey is an option, but may impact cost significantly.
80% of our servers are virtualized and 20% are physical. ECMCC has two virtual environments; one is v5.1 and the other is v5.5 and only runs Meditech. Virtual servers are preferred. ECMCC may need to purchase additional hosts. 35. The best practice is to defer and comply with client desired strategy for back and high-availability. Our back up and DR planning is fully customizable and can vary the impact on the bandwidth requirements. Can ECMCC give any clarification on the current backup plan, QoS or recovery point objectives? A redundant network is required. Backups are done via a networker. The servers may become part of the ECMC DR plan. 36. What is PN&P? Is this an existing 3rd party vendor you work with? If so, can you provide the full name and a little about what service they provide? PN&P RMS (Resident Management System) is a 3 rd party software package that is not integrated with Meditech. Historically it was used for MDS documentation and file submission to Medicare/Medicaid as well as other reporting needs. Today, we are only using the system for historical information. 37. Is there Meditech on premise or cloud based? Meditech is operated on servers located at the hospital. 38. What database does their Meditech use? Meditech uses three database types: a. The Data Repository server uses Microsoft SQL b. The Electronic Medical Record [EMR] server uses proprietary a Meditech database referred to as HUBS c. The other 15 file servers use a proprietary Meditech database called Nonprocedural Representation [NPR]. 39. Can Meditech export docs to a directory? In what format? Meditech has a variety of interface methods. In general, Meditech can export a text file to a directory. ECMCC cannot answer this question in details without knowing precisely what the vendor wants to accomplish. 40. Can Meditech form a directory? Meditech cannot create a directory. What format is required? N/A Or can it exchange data on the DB level via ODBC? Only the MS SQL based Data Repository has an ODBC connector. The respondent will have to contact Meditech to see if it is available for use by a third-party. The other file servers are not accessible via ODBC. They are accessible through Meditech Other Vendor [OV] intervaces. 41. How many users will need access to SmartSearch? ECMCC is not familiar with SmartSearch.
42. Are there backfile (paper to digital) conversions necessary? If so, how many boxes.? There are many boxes, but the quantity is undetermined at this point. 43. Would ECMC be open to considering a best practices program based upon the centralized ingestion, imaging, and indexing of documents, as opposed to utilizing individual scanners at nursing stations/floors? ECMCC would consider a solution that would host scanning equipment and staff at our facility, but we are not interested in sending our records off-site to be scanned. 44. Would ECMC be willing to implement a SaaS record management system with the data hosted on a secure cloud, along with the ability to host the backup on servers within your own environment for redundancy? We are unclear what the SaaS record management system is that is referred to. Images and/or any PHI data cannot be stored in the cloud. 45. On a prioritization basis, please list 5 to 10 issues that you would like the selected vendor to solve, i.e. how crucial is auto archiving versus single sign on? ECMCC is seeking that all vendors provide their best solution for all items listed in the RFP. 46. From a time frame perspective, what is the expectation for implementation and go live? We anticipate a product selection by the end of October. We hope to begin implementation as soon as possible based upon vendor scheduling and availability. 47. How many full time equivalent staff are dedicated to this process today? (how many nurses are scanning, how many staff process invoices in AP, how many across the organization (inclusive of outpatient and LTC ) are dedicated to the following services? (Pharmacy, scanning, imaging, records management, AP, etc?) ECMCC does not have any one person dedicated to scanning today. Many users dedicate a portion of their day for scanning and record management, but the specific quantity has not been identified. We will expect the number of staff who use the new system to grow, based on its capabilities. 48. How many scanners are currently used? Are they leased or owned? Our current scanners are owned by ECMC and we currently use approximately 250. 49. Do ECMCC s pharmacies accept electronic orders today? What type of files? The only electronic orders ECMCC accepts within Pharmacy are CPOE via Meditech or MIQS. 50. How much data is there to convert from Meditech currently? Approximate annually moving forward?
We will not be converting data from Meditech. We will be converting data from our current scanning system Valco, which has 3,000GB of data on the three servers today. We cannot estimate the volume moving forward until after implementation. 51. What is the monthly volume of scanning from each department? We are unable to determine this until we implement the new system. 52. What is the current yearly volume of Invoices being processed? Approximately 65,000 invoices are processed on an annual basis. 53. What percent of the current volume has a PO associated with it? 50% of our purchases have a PO associated with it. 54. What percent of the Invoice are submitted electronically? Approximately 40%. 55. What is current number of Vendors in the system? We have approximately 6,700 active vendors in our system. This year we have made payments to 1,700 unique vendors. 56. Please describe what professional services Erie County Medical Center Corporation is expecting a vendor to provide in a turnkey solution for the Business Office? We are asking if there is an option for the vendor to manage the implementation of this project from start to finish based upon the specs provided by the various user groups at ECMC. If this service is offered, please clearly define how much and what type of involvement you would require from ECMC staff. 57. Please elaborate and explain man-in-the-middle attacks? From Wikipedia: The man-in-the-middle attack in cryptography and computer security is a form of active eavesdropping in which the attacker makes independent connections with the victims and relays messages between them, making them believe that they are talking directly to each other over a private connection, when in fact the entire conversation is controlled by the attacker. The attacker must be able to intercept all messages going between the two victims and inject new ones, which is straightforward in many circumstances. 58. You describe a proof of concept trial periods for objectives 1 4. Will you please provide clarification on what your vision for this proof of concept, what it entails and also the timing and duration? We would like the vendor to choose a complex issue and implement a solution. ECMC would then test and evaluate the solution for approximately 1-2 months. 59. What is the name of their recently implemented forms automation system?
Access eforms. 60. Describe your use of a forms solution and what departments are using this forms solution. How many active forms do you currently have in use? We are using eforms in departments such as registration, billing and nursing among others. We have hundreds of forms in use. 61. Will you accept electronic version by September 23 rd at 2 PM with hard copy to follow overnight? No. Vendors are expected to plan ahead and strictly follow the procedures outlined in the RFP. Late submissions by hard copy will not be accepted even if an electronic version has been provided earlier. 62. Number of documents, encounters and years to be converted. ECMCC cannot provide the number of document to be converted. However, we can inform you ECMCC has been using Valco since 2006 at our registration desks, scanning the complete ED record after discharge as well as various other documents. ECMCC does not scan inpatient records. 63. Will you provide information about visit types and documents to be scanned annually. At this time, the only information we can provide is the number of encounters per year based on 2013 data (see below). This is for the hospital only and does not include Terrace View. Visit Type Encounters/Year Inpatient 16,500 ER 50,000 Outpatient 19,000 Observation 2,200 64. The question Do you provide regulatory and evidence base updates? How often? List all specialties, will you please provide clarification on exactly what is meant by evidence base updates. Regulatory is pretty straightforward, but with respect to a document scanning, imaging and archiving solution, we are not completely clear with that part of the question. In a number of regulations, evidence has to be logged and collected to verify compliance of the entity within scope. When regulations change and the required evidence of compliance, does the entity provide updates to the appropriate regulations are part of their annual maintenance costs or are regulation updates an additional cost.
65. In section VII.B., it states that we need to include the Pricing Model Form in our proposal. We could not find that form in the RFP document. Do you have a Pricing Model Form that you would like us to use, or should we use our own? A Pricing Model form is not required. 66. Can ECMC provide the Word version of the RFP? No, ECMCC will only supply the PDF already supplied. 67. Can ECMC provide an extension to the due date to allow vendors more time to prepare their responses once the answers to the vendor questions have been supplied? No. Vendors are expected to complete the responses to the best of their ability in the timeframe supplied. 68. Please provide the number of unique Patients or Patient Records within ECMC. There are approximately 860,000 unique patients within our Meditech system. 69. What is the approximate total number of pages that ECMC would expect to scan on an annual basis? The number of pages necessary to be scanned are unknown at this time. 70. How many locations does ECMC envision where scanning would be taking place? We estimate there will be 200 locations where scanning is used. We anticipate growing this number with the implementation of the new system. 71. What is the # and type of existing scanners being used within ECMC? Does ECMC plan to use these going forward? We plan to utilize our current scanners if possible, but would be open to investigating new scanning technology. We are using Fujitsu models fi-4120, 5120c, 6770, 6770a, 7120 and 7160. There are approximately 250 scanners throughout the hospital today. 72. How many users of the system does ECMC expect? ECMCC does not yet have an expectation of the number of users at this time. 73. What is the amount of data (structured and/or unstructured) that ECMC expects to archive from Meditech on an annual basis? Storage for Meditech scanning: 4000 GB/year and Storage for Meditech archiving: 550 GB/year 74. Please confirm the format of the Meditech-generated documents that would be archived. HL7, PDF, WORD, CDA, Other? We do not know the format of the documents archived out of Meditech. 75. Are there other clinical or back-office systems currently in operation that ECMC is considering for decommissioning or active archiving? None known at this time. 76. Is ECMC a participant in any HIE networks? Yes, WNY Health elink.
77. Does ECMC have a need to share clinical data & documents electronically with other entities external to ECMC? Yes. 78. Please provide an overview of the methodology behind your systems archiving component. In our environment archiving is defined as the process whereby Meditech generated documents are indexed and stored on computer media rather than printed. Please describe the ability to access this information via Desktop routines in Meditech. Could you please throw some light on the type, size and volume of document generated by Meditech? This is undetermined at this time. 79. Converting paper documents to digitized images as early as possible in the business cycle is critical to the success of a document scanning and imaging application. Based on your experience in hospital settings, describe the areas that may benefit from this technology. Propose a typical configuration for scanning hardware in each area. Could you please throw some light on the type, size and volume of images to be scanned? This is undetermined at this time. The scope of what we will be scanning will grow exponentially when we implement a new system. The types of documents we plan to scan are included in the RFP. 80. Could you please provide more information on number of scanning system required? Distributed or centralized scanning? We will have both distributed scanning throughout the hospital in clinical and back-office areas. We will also have more centralized batch scanning completed in our Medical Records department. 81. Does Newgen also have to provide Hardware? We will provide our own hardware based upon vendor specifications. 82. How long do you estimate the proof of concept trial periods for each objective will be? Approximately one to two months. 83. Do you have a paper backfile that will need to be scanned into the new system? There are some back-office areas that will need to backfile documents, however most will be scanning going forward upon implementation. 84. What types of files are there in the Valco system? What is the volume of documents? Currently our data is in various formats including TIF, PZ1 and some with no extensions; simply a flat file DB structure. 85. Please explain the business requirement described on page 5, 2.e. (Document Scanning alternatives and options). We feel this is adequately explained in the RFP. 86. Does ECMCC desire one vendor to provide a complete solution, or would you pick more than one vendor for the project, where those vendors have strengths in certain areas of the project?
ECMC would prefer to select one vendor who can provide a complete solution. 87. Please explain your question on page 7, 2. s.3: launching 3 rd party application from Meditech. We feel this is adequately explained in the RFP. 88. Will ECMCC share the outline format of the RFP for the vendor to respond? The outline format is laid out in subsections C through H of Section IV of the RFP.