Erie County Medical Center Corporation RFP #21402 Addenda Number 2 Erie County Medical Center Corporation Addenda Number 2 to RFP #21402 PATIENT PORTAL SYSTEM The deadline for submission of as been extended to: Tuesday, February 11, 2014 at 10 a.m. EST Exhibit A to the RFP incorrectly states the MWBE goal applicable to the RFP is 20%. This RFP is not subject to MWBE goals, although MWBE participation is strongly encouraged. Please note that Section II.A of Exhibit A ( ERIE COUNTY MEDICAL CENTER CORPORATION MWBE AND EEO PROGRAM REQUIREMENTS ) to the RFP is hereby amended to read as follows: For purposes of this procurement, ECMCC hereby establishes an overall goal of 0% for Minority and Women-Owned Business Enterprises ( MWBE ) participation, 0% for Minority-Owned Business Enterprises ( MBE ) participation and 0% for Women-Owned Business Enterprises ( WBE ) participation (based on the current availability of qualified MBEs and WBEs). The following questions were submitted to the Designated Contact: 1. Are you willing to accept a custom built software/hardware solution for this RFP? The selected vendor must have proven experience interfacing with the EHR vendors noted in the RFP and having provided the services noted as a patient portal provider. ECMCC is not confident that a custom solution could meet the specific requirements noted in the RFP. 2. Can an Extension can be granted to change the due date from February 4 th and push out 2 weeks with a new due date of February 21 st? A one week extension has been approved. The new due date is Tuesday, February 11, 2014 at 10 a.m. 3. Is the implementation date a mandatory requirement or will a later date be considered to have the Patient Portal fully implemented? Please provide an acceptable date/range. The Patient Portal must be implemented in production to meet MU Stage 2 requirements no later than 6/1/2014. Additional enhancements that are not mandated by federal regulations may be implemented after that date as agreed by ECMCC. 4. Can you please clarify the number of physicians that you expect to utilize this system once deployed?
ECMCC expects approximately 750 providers and 350 residents with 569 licensed beds. 5. Is the implementation date requirement of 6/1/14 flexible? No, there is no flexibility on the implementation date. 6. Does ECMC have an existing relationship with any public cloud services provider? If so, please specifiy the vendor and the services covered. No, ECMCC does not. 7. What is the data encryption model required if the solution has to be hosted in the cloud? Minimum 128-bit AES or equivalent for data at rest. Data in transit for application level at a minimum transmitted over SSL using strong security protocols such as SSLv3 or TLS. If application level encryption is not available, implement network level encryption such as IPSec or SSH tunneling. 8. What are the features from the Patient portal that needs to be available in the mobile enabled version? From an IT Security perspective, all required IT security controls, including patient authorization and authentication controls 9. What are the platforms, devices and OS versions required to be supported by the mobile enabled patient portal? (We understand it is a patient based portal, hence customer devices will not be under the control of ECMC; but still it is suggested that we put an acceptance criteria of operating systems and mobile devices) Patient Portal must be cross browser compliant. 10. Does the client have any preference for the usage of MADP's / MEAP's for this mobile initiative or can we provide recommendations? Please provide recommendations. 11. What is the development methodology that Client prefers to follow for the patient portal customization and implementation? SDLC. 12. Will the support requirements include the upgradation of the mobile enabled portal for supporting new browser versions? Yes. 13. What is the organization structure for managing this patient portal opportunity?
ECMCC is looking toward a tier structure in which the patient community requests will be routed to the appropriate resource. This solution would be a hybrid model in which the vendor and ECMCC activity supports the end user. This model will be developed during the implementation phase of this project. 14. Is the RFP vendor expected to provide hardware configuration for production, testing & training environments. Kindly confirm if these are the only environments in scope? The vendor is expected to provide hardware configuration requirements for production, test and training environments. These are the only environments in scope. 15. What are the availability requirements for the entire setup? 24/7 availability. 16. Can the environment use a shared firewall (multi-tenant) with logical separation of firewall rules? This is dependent on the identity of the other shared firewall multi-tenants. Only similar entities with similar security controls can be on the shared firewall. Also, all firewall rules must be available for review and assessment on a regular basis upon request. 17. Does the environment need an Intrusion Detection/Protection System? IDS/IDP is preferred, especially in regards to monitoring the traffic between the firewall control and the application/data environment. 18. Can the storage environment be shared with other vendor clients? Only if there are appropriate mechanisms and security controls in place to prevent access by unauthorized entities and prevent data leakage. Also, the storage environment has to be such to allow for confirmed data removal if services are ever terminated with the vendor. 19. What are the RTO /RPO expectations for Diaster Recovery? The expectations are that the system would be back up and running within 24 hours from vendor notification. 20. Are you planning to propose Intrusion Detection/Protection System? IDS/IDP is preferred. 21. What is the data size being proposed be backed up? Data volume requirements will be determined during the analysis phase of project. 22. What is the frequency of data being proposed be backup?
A backup image of the database should be consistently made while it is online and usable. In the event of a needed restore, the database should have the ability to be brought up-to-date to the point the system was brought down. 23. Which version of HL7 standard/version needs to be supported by the patient portal? 2.3. 24. Details of the type of HL7 messages (Ex. ADT, SCH etc) that need to be supported by the patient portal? ADT for patient demographics, SCH for schedule data, ORU for results lab results or transcribed documents. 25. Which are the systems that will be needed to interface with the patient portal? Please give us the details of these systems used by ECMC.- technology, Architecture, modules, standards. Systems include Meditech 5.66 C/S and above, and Allscripts Enterprise 11.4 and above. 26. Apart from the HL7 format, are there any other data formats in which data will be sent to the patient portal? No. 27. Please elaborate on the billing functionality you expect in the patient portal. Can you please provide us with a list of functionality you need in this area? 28. Please elaborate on the ability to view bills and make payments through the patient portal. What types of payments need to be supported? 29. Which system would send the billing information to the patient portal for display? What would be the data format sent by this billing system (for interfacing)? 30. Do you want the patient portal to display this information in any specific document format (pdf/word etc.)? PDF.
31. With which systems should the patient portal interface for billing and payments? Meditech 5.6 C/S and above. 32. Do you have an existing payment gateway that we can leverage? Should the patient portal interface with this payment gateway for payment processing? 33. Do you want the entire patient portal functionality to be available on hand held devices, pagers and smart phones? If you want only specific functionality to be accessible through mobile/handhelds, please give us the list. Yes. 34. What languages do you want the portal to support? Should the patient portal show options to choose the preferred language so that all the content is displayed in that language dynamically? English and Spanish. 35. What kind of alerts need to be supported on hand held devices? From where will these alerts originate? Please elaborate. No alerts required. 36. Any technology requirements for the Patient portal solution specifically for database? MS SQL Server 2008 R2. 37. Do we need to support the Eligibility check process(x12 communication with payer system) in the payment/billing modules? Not at this time. 38. Do we need to support the claim process and or claim status in the patient portal? 39. Does ECMC have a preferred payment gateway vendor? If so, what services are covered under the current contract.
40. Does ECMC have a standardized process for reconciliation of the payments received in the website 41. Is phase-wise implementation of the solution fine? Do we need the whole solution (including mobile enablement) to be implemented by Jun 2014 or is phase-wise implementation of the portal fine? ECMCC would be open to discussing a phase-wise strategy, but needs to develop strategy to meet MU Stage 2 requirements. 42. Are you open to a global delivery (onsite/offshore) model? Offshore support and maintenance is only allowed if the support personnel do not have native access to the systems to be supported (i.e. only virtual remote access is allowed from offshore). At no time can the data provided via the application or the database utilized be located temporarily or permanently offshore. In addition, the contract and the BAA have to be legally enforceable and binding in any country where offshore resources will have access to HIPAA/HITECH data. 43. How is the Patient portal roll out for ECMC linked to the MU rollout? For how many years is it expected that ECMC will retain the current solution being proposed? The Patient Portal is linked to the MU rollout based on the organizational requirements defined by HealthIT.gov below: 1.) Patient Ability To Electronically View, Download & Transmit (VDT) Health Information - Provide patients the ability to view online, download and transmit their health information within four business days of the information being available to the EP. http://www.healthit.gov/providers-professionals/achieve-meaningful-use/core-measures- 2/patient-ability-electronically-view-download-transmit-vdt-health-information 2.) Use Secure Electronic Messaging - Use secure electronic messaging to communicate with patients on relevant health information. http://www.healthit.gov/providers-professionals/achieve-meaningful-use/core-measures- 2/use-secure-electronic-messaging. We will retain the current solution being proposed as long as it meets the needs for meaningful use and functions advantageously for ECMCC. 44. Provide the approximate/projected number of concurrent users accessing patient portal system and mention the throughput required from the Internet and Intranet(LAN) Number of concurrent users accessing portal to be determined.
45. Is it required for the infrastructure hosting to be within the ECMC premise (Traditional DC) or is it open to get into Private or Public cloud. (Note: All options serve the functional requirements.) We are willing to discuss vendor recommendations. 46. If ECMC's preference is a public cloud; does it have any preferred vendor for the same (like Amazon Web Services Virtual Private Cloud). No. 47. Is ECMC open to outsource the support and maintenance to a complete offshore delivery model? What is expected support models? Do you need a dedicated Support team with named resources? Or Are you open for shared model of service delivery? ECMC is not open to oursource the support and maintenance to a complete offshore delivery model. We expect support to be manage locally. We need a decidated team and are open to discussions of a shared model 48. Please provide insight into the data retention period and policy, if any. ECMCC requires data retention for 7 years. 49. What is the projected number of users/patients per day that will be registered in the system? What is the overall initial patient count and YoY increase; who would use the system projected over the next 3 years? And proportion among smart phones, Tablets and traditional PCs or laptops. To be determined. 50. Can we request an extension to have the opportunity to review and respond to this extensive RFP. A one week extension has been granted. 51. Please confirm the number of staffed beds and number of providers - this will be required for pricing. Refer to question #4. 52. Please provide additional information on the process between RFP submission and final TOC. This includes dates for demo, onsite meetings, etc. The vendor will be selected and contract finalized by the first week of March 2014. 53. Please provide the estimate date in which you are looking to sign a contract. First week of March 2014.
54. Please provide additional information IDX software including version number referred to in question 2 on the Interface Requirements. IDX software integration is not required. 55. Is a custom solution an option given the multiple systems you wish the Patient Portal System to integrate across your HCIS? No. Functional requirements, 2 56. Please confirm that the current EHR systems will make Medical record data (history, allergies, notes, medications, lab, immunization, encounter, Radiology) available in CCDA standard format for unidirectional presentation onto the patient portals. Yes, this is currently being worked on. This will not be an immediate requirement for stage 2 but will certainly need to be supported down the road. Functional requirements, 2 57. Should the demographic/insurance be bidirectional communicated between EHRs and the Patient Portal System? No; it only needs to be unidirectional from Meditech to Portal. Functional requirements, 2 58. Please clarify our assumption that Appointment scheduling, Rx Renewal, Secure Messaging will also take a bidirectional flow between EHR & the Patient Portal. Meditech does not have an inbound scheduling interface, so ECMCC will not be able to schedule appointments in the portal, and SCH would be unidirectional. Secure messaging could likely be bi-directional, but that would require additional research. Rx Renewal will not be required at this point. Functional requirements, 5 59. Please confirm that the Patient Education content will be provided as part of the CCDA data from the EHR systems. Unknown; the CCDA interface is currently being built. Functional requirements, 6 60. Please clarify our assumption that Meditech, Allscripts will be able to send billing related PMS data to the Patient Portal System to support Online Bill Pay functionality? Unknown.
Interface requirements, Q1 61. Apart from the HL7 standard, please clarify if the Patient Portal system needs to cater to any proprietary data interface standards? Unknown. Interface requirements, Q2 62. There is a reference to IDX Software in the RFP document. Please clarify the module/functionality of the IDX Software? IDX software integration not required. 63. Please provide the technical (- Hardware/Software/Network and other relevant) specifications of the hosting environment of the Healthcare information systems (HCIS) (Including Meditech C/S and Allscripts Enterprise) Please refer to Meditech and Allscripts standard setup requirements for specifications The Allscripts environment consist of 13 servers, 10 of which are virtual servers. The specifications break down as follows: Operating System Purpose Type Memory CPU 2008 R2 64 Bit Analytics Virtual 4GB RAM 1 2008 R2 64 Bit Imaging Virtual 6GB RAM 1 2008 32 bit Test Virtual 4GB RAM 4 2003 R2 Test Interface Virtual 4GB RAM 1 2008 32bit Training Virtual 8GB RAM 4 2008 R2 Standard -64bit Event Bus Virtual 6GB RAM 1 2008 32 bit Web Virtual 6GB RAM 1 2008 32 bit Web Virtual 6GB RAM 1 2008 32 bit Web Virtual 6GB RAM 1 2008 32 bit Web Virtual 6GB RAM 1 2008 32 bit Messaging Physical
Cluster IP Cluster NA 2003 R2 Node 1 Physical 2003 R2 Node 2 Physical The virtual servers run on VMWare VSXi. The storage for the cluster is connected via fiber channel to a NetApp SAN. The Meditech environment consists of: 16 Background servers running Windows 2003 SP2 on HP ProLiant DL380 G4 s. 14 Foreground servers running Windows 2003 SP2 on HP ProLiant DL380 G4 s. All servers have an lacp 2gb network connection. These will be replaced in 2014 with virtual servers running VMWare VSXi. The storage is connecting fiber channel to an EMC SAN. Network: ECMCC s backend network consists of Cisco Nexus 7k switches providing Gigabit copper connectivity for the servers. 64. Please clarify while hosting the Patient Portal System in ECMCC premises, will the Hardware, standard third party software be your ownership? Both options of ECMCC owning the software/hardware and leasing the software/hardware will be reviewed during the RFP review process. Please provide pricing for both options if they are offered.