Statewide HIO: RFP

Yolande CalhounChris Davis, M.D.

Kyle JohnsonJoanne Rimac

Natalie Schwartz, M.D.

Med. Inf. 408Project #2

February 8, 20111

Introductions

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Statement of the Problem– Chris Core Objectives– Chris Technical Requirements– Yolande Administrative Information-Joanne Cost Requirements-Kyle Referenced Documents– Joanne Deliverables– Natalie Proposal Format-Natalie Terms and Conditions-Natalie Submission and Decision Deadlines- Chris Delphi Method- Kyle Questions

Agenda

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Statement of the Problem

Statewide HIO Service Area

State Capital

70% of all hospitals & 55% of physician in State Capital Metro area

Remaining % hospitals &Physician s in communityOr rural settings

Provide the state with a Health Information Exchange (HIE) in order to:◦ Improve the quality, safety, and efficiency of

healthcare.◦ Reduce healthcare disparities.◦ Improve coordination of care.◦ Ensure security of personal health information.◦ Engage patients and families.◦ Improve population and public health.

Statewide HIO Mission

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A Vendor is being sought to partner with Statewide HIO to provide:◦ HIE infrastructure.◦ HIE software.◦ Implementation.◦ Ongoing service to support the HIE.

Statement of the Problem

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Objectives

Exchange of clinical information in a standard format, such as Continuity of Care Document (CCD)

Exchange of clinical messaging and referrals The ability to connect to the following entities

through virtual or HL7 gateways:◦ Hospitals◦ Physician offices◦ State Public Health agencies (for immunization,

syndromic surveillance and reportable lab registries)◦ ePrescribing entities◦ Payers

Core Objectives

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Provide HIPAA compliant security of clinical information

Conform to national standard vocabularies and code sets

Provide technology which delivers high availability of HIE services

Provide the ability to connect to HIEs in other regions, states, and with a National Health Information Network (NHIN)

Support the information technology needs of the HIO (internet, email, web services)

Core Objectives

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Provide an electronic consent repository Provide directory services for providers, payers,

and public health entities Provide Public Key Infrastructure (PKI) to allow for

more sophisticated secondary authentication Provide the ability to electronically submit quality

reporting to state and federal agencies

Additional Objectives

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Technical Requirements

Example HIE Technical Framework - Axolotl

CRISP-Axolotl Arch: 5/25/10

Technical Requirements

Architecture ◦Business◦Application◦Data◦Technical◦Security

HIE Systems Services Capabilities

Registry and Directory Services Person and Entity Identification Record Locator and Search Services Identity Management Consent Management Secure Data Transport Data De-Identification and Aggregation Analytics Referral Services

Integration Capability and Experience EHR Systems

◦ Allscripts/Misys◦ McKesson◦ Epic◦ eClinicalWorks◦ MEDITECH◦ NextGen◦ GE Centricity◦ Cerner

Kinds of Interfaces ◦ Event-driven service interfaces◦ Multiple protocols and standards (including legacy HL7)◦ Client API technologies◦ Message oriented middleware◦ Asynchronous, loosely coupled interfaces

StandardsTable 1

Message Standards and Transport ProtocolsCCD

CCR

DICOM

EDI X12 – Administrative transactions

HL7 V2.x

Hl7 V3

NCPDP

SOAP (Web Services)

SSL/TLS

XML

Table 2Clinical Terminology Standards

CPT

HCPCS

ICD -9/10

LOINC

RxNorm

SNOMED-CT

Privacy and Security Compliance with and Support for

encryption, networking and connectivity standards specified by the ONC

“Single Sign On” approach User Provisioning

◦ Unique User IDs for each user◦ Role based security◦ Automated workflow◦ Encryption on passwords◦ Capability to reset passwords

Log all data access and transmission events

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Administrative Information

Required experience within the last two

years Prime vendor in the operation of 3 HIE’s Provide basic HIE components Conform to National Standards Comply with privacy and security

requirements

AdministrativeRespondent Qualifications

Administrative

The Intent to Bid

5:00 P.M. CST March 2, 2011.

Closing Date for Proposals

5:00 P.M. CST April 15, 2011

Selection Criteria ScorePrice of the system 15

Vendor respondent experience 15

Vendor qualifications meet the Minimum Requirements stated in the RFP

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Response to requests for additional information from vendor respondent

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Scalability of the proposed system to meet future growth of the HIE

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Vendor respondent ability to provide all aspects of the RFP:Infrastructure, design and host services

15

Usability of the system for end-users and IT staff maintenance within theHIE

10

Vendor References 10

Total Score 100

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Cost Requirements

Implementation Costs◦ All vendors to provide

Implementation costs will include: Hardware - Upgrades Software - Shipping Implementation labor - Handling Maintenance labor - Training Software maintenance - Travel Other

◦ Total cost of ownership Multi-year TCO model requested for period of proposal (typically 5 or 7

years) TCO will be recorded in the HIE RFP TCO & Pricing spreadsheet

Vendor Pricing

Software Pricing◦ All vendors to provide pricing for:

License fees Subscription fees 3rd party software Annual software maintenance or subscription fees

◦ Vendors are asked to describe pricing methodology. Will price be based on: Concurrent users # of physicians # of encounters Some other metric?

◦ Vendors asked to provide future pricing for licenses associated with growth of the HIO Discounted, tiered pricing structure Determine future license increments to be purchased (e.g. 10, 50, 100

licenses)

Vendor Pricing

Professional Services◦ All vendors are requested to provide total labor hours and dollars

required to implement and support the HIE solution. ◦ Professional Service costs will include:

Implementation hours & dollars Post implementation hours & dollars Non-IT labor hours & dollars Titles and roles needed for implementation and support

◦ Vendors will submit a complete project plan◦ Vendors will record professional services costs in HIE RFP TCO &

Pricing spreadsheet◦ (Reminder to vendors to plan for a two-phase approach to

implementation)

Vendor Pricing

Hardware or Hosting Costs◦ All vendors have been requested to submit both a self-hosted &

remote hosted hardware approach◦ Provide technical configuration for both models◦ Provide cost comparison for both models◦ Record costs in HIE RFP TCO & Pricing Spreadsheet

Vendor Pricing

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Referenced Documents

Axolotl©

Epic©

Medicity©

RelayHealth©

Product Literature

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Deliverables

Required Deliverables Documentation Software Training Hardware and Equipment Warranty Development and Test Tools

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Proposal Format

Proposal Response Format

Cover Letter

Table of Contents

Response to Company Information/ ViabilityResponse to Technical Requirements

Response to Standards Support and CommitmentResponse to Provider Workflow

Response to Hosting

Response to Implementation and Support

Response to Vision for State “X”

Response to Experience and References

Response to Pricing

Statement of Work

Appendices:

• Financial Report

• Technical Diagrams

• Resource Resumes

• Pricing Spreadsheets

• Acceptance of Terms

• Standard Contract

Response to Company Information Company overview Organizational chart Profile of senior management Anticipated change of ownership # Employees focused on HIE solution Certificate of Insurance Disclosure of actual/ potential conflicts of interest Subcontractor Relationships:

◦ Organization name◦ Area outsourced◦ Partnership length◦ Name of previous successful effort together◦ % of total effort

Response to Company Viability

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Finance Sheets Financial BackgroundGross and net revenues in 2008, 2009, 2010 Current litigation issues, litigations

over the past 5 yearsProjected revenue in 2011 Bankruptcies filed

% of revenue attributable to HIE solution Current investigations by governmental agencies

Most recent annual report and 10 K form

Committed projects in the next 12-18 months with anticipated revenues over $100KAudited financial statements for 2009 and 2010• Income statement

• State of Cash Flow

• Balance Sheet

• Opinion statement of independent CPA

• Current Dun and Bradstreet Comprehensive Insight Plus Report

Response to Provider Workflow Describe the process of the provider’s

ability to access, publish, and consume HIE data from within the EMR.

Are there any provider organization requirements for their EMR’s to access, publish, and consume data from your HIE solution?

Does the vendor have the ability to host the solution?

Does the vendor have an existing relationship with a host provider?

Description of the suggested hosting approach

How the hosting solution will impact implementation timelines and cost

Response to Hosting

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Response to Implementation and Support

Core Infrastructure Roll-Out Data Source and Participation Integration Support and Training

Response to Experience and References

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Company’s experience in the development and implementation of all HIE’s of similar

Size Scope Complexity

Names of three HIE customers Client references Site visits

List of All HIE ProjectsNames Status of each implementationProject descriptionsLaunch and production datesProducts installed

Deployment statusRelevant metrics around their successesApproximate # organizations and providers attached to each project

Response to Experience and References (cont.)

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Statement of Work Understanding of the objectives of this Statewide

HIE

Major activities that must be performed

Solution to all service and system requirements

High level work plan

Work Breakdown Structure

Milestone-based Project Schedule

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Terms and Conditions

Terms and Conditions Proposal Response Confidentiality Formal Contract Maintaining Pricing Cost of Proposal Preparation Applicable Law

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Submission and Decision Schedules

Description Date

RFP Release Date February 11, 2011

Intent to Respond Due Date March 2, 2011

Vendor Questions and Clarification Requests Due

March 16, 2011

RFP Due Date April 15, 2011

RFP Selection Committee Review Complete

May 29, 2011

Vendor Demonstrations May 30 – June 16, 2011

Award Announcement July 1, 2011

Submission and Decision Schedules

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Delphi Method

Statewide HIO continues to find the Delphi methodology useful as a framework for decision making

The Delphi process was used specifically to determine:◦ Technical requirements◦ Pricing information and spreadsheets◦ Proposal response formats◦ Submission and decision schedule◦ Features and functions questionnaire

Various experts from HIO committees were used to create the sections of the RFP. The Delphi process was used to collaborate and make decisions about the final request for proposal document.

Delphi Methodology Used to Create RFP

Questions?

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