B26_SQA_-_Draft_RFP_Answers_7.pdf

Draft RFP No. 140D0424Q0069 Attachment C

QUESTIONS & ANSWERS*

# Draft RFP Section

Question Response Change to RFP?

Description of Change Technical/ Contractual

PWS 5.3

Has the Analysis of Alternatives (AoA) expanded beyond a single prototype?

Has IHS performed Total Cost of Ownership assessments of alternatives?

If the current prototype is not deemed satisfactory to meet IHS’ cost, security, performance, resilience and business continuity objectives, how will the viability of the existing 4DW prototype be assessed to determine if it can be reused or if a new cloud environment needs to be established?

The existing prototype is the basis for the AoA described in PWS 5.3 for possible use of existing components.

No.

The existing prototype was a proof of concept and was not developed to the production ready stage however, there are components or concepts that may be desirable to be re-used in the efforts to build a production environment.

No N/A Technical

PWS 5.3

If cloud services will be procured separately and provided to the selected contractor, will this be a competitive procurement?

IHS will used the existing Azure Government Enclave FedRamp High environment.

No N/A Technical

PWS 5.3

What technology stack 4DW prototype for re-use or replacement mentioned are built upon?

Primarily Azure services available at the time the prototype was built.

No N/A Technical

4 PWS 5.8 What are the existing EMPI or similar capability in legacy system?

RPMS does not include an EMPI capability.

No N/A Technical

PWS 5.9

Item 1

What are HIE Gateway-DB capabilities and its technical stacks we can refer to?

See Overview | Health Information Exchange (HIE) (ihs.gov)

No N/A Technical

PWS

5.11.1

How will the agency monitor and address any potential performance, cost, or functionality gaps that may arise from the more limited cloud service options available in the FedRAMP High environment?

FedRAMP High government enclave has been stipulated by the IHS CISO as the minimum requirement for cloud based services storing/processing PHI/PII for the Indian Health Service so the operational support must conform to this requirement.

No N/A Technical

PWS 5.2.2

What analysis has the agency conducted to compare the functionality, performance, and total cost of ownership of open-source solutions versus legacy, licensed database solutions?

There has been limited analysis conducted on open-solutions.

No N/A Technical

PWS 5.2.9

Have a PIA, SCA and A&A assessments been conducted for the prototype environment? Will the prototype environment meet IHS requirements?

The existing prototype was a proof of concept and was not developed to the production ready stage however, there are components or concepts that may be desirable to be re-used in the efforts to build a production environment.

No N/A Technical

PWS 5.2.9

Has IHS assessed DHITMO requirements and the Indian Health Manual against both FedRAMP High and FedRAMP Moderate controls? Given that healthcare systems generally focus on HIPAA eligible services for storing healthcare data, are the additional

FedRAMP High government enclave has been stipulated by the IHS CISO as the minimum requirement for cloud based services storing/processing

No N/A Technical https://www.ihs.gov/hie/overview/ https://www.ihs.gov/hie/overview/ https://www.ihs.gov/hie/overview/ controls for FedRAMP High specifically necessary if HIPAA, PHI/PHI, and 100+ additional compliance control systems are built into FedRAMP Moderate cloud services?

PHI/PII for the Indian Health Service.

PWS 5.3

Has the Analysis of Alternatives (AoA) expanded beyond a single prototype? Has IHS performed Total Cost of Ownership assessments of alternatives? If the current prototype is not deemed satisfactory to meet IHS’ cost, security, performance, resilience and business continuity objectives, how will the viability of the existing 4DW prototype be assessed to determine if it can be reused or if a new cloud environment needs to be established?

The existing prototype is the basis for the AoA described in PWS 5.3 for possible use of existing components.

No.

The existing prototype was a proof of concept and was not developed to the production ready stage however, there are components or concepts that may be desirable to be re-used in the efforts to build a production environment.

No N/A Technical

5.3.1

How will the agency ensure that the cloud-based 4DW solution is able to adapt and scale to meet future changes in technology, regulatory requirements, and user needs?

This is addressed in 5.11.2 as maintenance support activities for adaptation and scale and in 5.12 as optional activity to support changes to regulatory requirements.

No N/A Technical

5.3.1

Has the agency considered and / or implemented containerization and orchestration technologies, such as Docker and Kubernetes, to help manage and scale any open-source components of the system?

These technologies have been considered but not implemented in a production health information system to date.

PWS 5.3.1

Has IHS evaluated risks associated with cost and schedule to obtain and maintain the authorization to operate (ATO) for the 4DW environment?

IHS has identified risks associated with obtaining and maintaining the ATO for the 4DW environment.

Technical

PWS 5.3.1

What measures will the agency take to ensure that the potential additional costs, lock-in and complexity of a FedRAMP High environment are justified and do not exceed the project's budget?

FedRAMP High government enclave has been stipulated by the IHS CISO as the minimum requirement for cloud based services storing/processing PHI/PII for the Indian Health Service. The additional costs associated with this environment will need to be considered in budgeting activities.

No N/A Technical

PWS 5.3.1

Item 8

Does “FedRAMP-authorized Cloud Service Provider” meaning FedRAMP Moderate might be acceptable as an exception? If that is the case, what is the condition and process to obtain this type of exception?

No. No N/A Technical

PWS 5.3.2

Has a BIA been performed on the prototype environment? Will the prototype environment meet the specified 99.99% downtime requirement / up to 53 minutes of unplanned downtime per year?

No. No N/A Technical

PWS 5.3.3,

5.3.4

What is the planned approach for establishing the 4DW environment within the IHS-provided FedRAMP-High Government-only cloud environment, including the process to achieve ATO? What are the key considerations and

The successful vendor will work with existing IHS staff to establish the cloud environment.

The key considerations for the requirements for this cloud environment?

cloud environment are performance, cost, and security.

PWS 5.4.1

How will IHS and the contractor ensure the 4DW cloud environment provides the required cost controls, capacity, scalability, and performance to support the 4DW application services and data volumes over the 75-year retention period?

It is anticipated that this will be conducted as a collaborative activity.

No N/A Technical

PWS 5.4.2

Item 2

What is the current FHIR specification and US Core Implementation Guide version to be implemented? Is there need for backward compatibility in order to support previous FHIR and US Code version data?

Per the ONC, USCDI version 4 has been published with an anticipation of USCDI version 5 being published in July 2024.

USCDI is backward compatible.

Per HL7.org, FHIR is currently at Release 5. Backward compatibility will be required to the release ONC requires for certification of EHRs (currently release 4).

No N/A Technical

PWS 5.5.1

Item 1

What are the legacy EHR systems being used, and what data formats associated with them will the 4DW need to support?

There are multiple EHR systems in use in the IHS system. RPMS will be the primary focus initially, other systems will be identified if an organization wishes to join the 4DW environment. Identifying the systems associated with this activity will not be possible until the systems are accepted. The desire is for 4DW to create a data transfer specification that can be provided to those legacy systems for them to export their data into.

RFP

Volume I, Section 6:

Factor C:

Past Performanc e

How will IHS assess Past Performance relevance of an offeror’s cloud computing capabilities beyond “magnitude, scope, and complexity”? We recommend specific experience with cloud-based database models, including both relational and non-relational database types and configuration of Extract/Transform/Load services.

We also recommend evaluating experience protecting patient data using HIPAA and PIA controls, also providing Business Continuity and Disaster Recovery assurance.

The Government appreciates the recommendation.

No N/A Contractual

RFP

Attachment B – Pricing Spreadshee t

There are approximately 2-2 ½ Cloud Developers and Cloud Engineers scoped for the base year.

The staffing level (hours) reduce by more than half in the option years. What is the rationale for the reduction, and has HIS considered a Cloud Architect position for the base year to design the solution elements so that a smaller staffing contingent for Development and Engineering could remain level throughout the period of performance?

Proposals should include the vendor’s staffing approach and plan, with their associated rationale for the government’s evaluation.

No N/A Technical

23 B08_SQL_

_Pricing_S preadsheet _2.xlsx

Will we receive LC description of the non-key personnel before the final release of the RFP?

All labor category descriptions were added to B08 SOL – Attachment B – Pricing Spreadsheet. This was uploaded on SAM.gov on May 22, 2024.

No N/A Contractual

24 B08_SOL_

_Draft_RF P_140D04 24R0069_I

HS_4DW_

1.PDF

Page 12 States: Factor B, Sub-factor Prompt B.2 – Schedule: The Government will evaluate the extent to which the Offeror’s master schedule meets the requirements outlined in the IHS

4DW PWS…

Question: The particular requirements are unknown. The duration of the tasks are therefore uncertain at best. Could the Government please explain the purpose of including a draft IMS when there is such uncertainty?

Would the Government consider removing the Draft IMS requirement?

The Government understands there is uncertainty and unknowns; however, the delivery remains 1 year from date of award.

No N/A Technical

25 B08_SOL_

_Draft_RF P_140D04 24R0069_I

HS_4DW_

1.PDF

Page 12 States: Factor B, Sub-factor Prompt B.2 – Schedule: The Government will evaluate the extent to which the Offeror’s master schedule meets the requirements outlined in the IHS

4DW PWS…

Question: Can the Government please define to what level in the PWS (e.g., Level 2 PWS 5.1) or Level 3 PWS 5.2.1) would define “meets the requirement of the

RFP”. ?

The PWS has a requirement to stand the environment up within 1 year after award in section 2:

“Tribal, and Urban (I/T/U) health care delivery operations, the 4DW will provide the following initial technical capabilities within 1 year from date of award:

• The ability to store clinical and administrative designated record set (DRS)1 in a clinical data repository (CDR) within the 4DW infrastructure.

• The ability to archive all clinical and administrative patient data from legacy and other EHR databases in accordance with (IAW) IHS-specified records retention and disposition schedule.

• The ability to store and archive medical imaging studies and scanned clinical and administrative documents IAW IHS-specified records retention and disposition schedule.

• The ability to support migration of select data from the 4DW to the new electronic health record (EHR) system.”

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