SOO_3_29_2017_RFP.docx

Statement of Objectives Plan, Acquire and Implement a Credentialing Management Solution

March 29, 2017

Request for Proposal Overview:

The Indian Health Service (IHS) intends to award a contract for the planning, acquisition and implementation of a Commercial-Off-The Shelf (COTS) enterprise credentialing management solution. Implementation shall support data collection redesign, business process redesign, change management, and sustainability planning across at least nine Areas and IHS Headquarters (HQ). The Contractor shall ensure that all training, technical support, helpdesk support post-implementation, and end user optimization plans are deployed as part of the comprehensive solution.

Statement of Objectives

1. Introduction and Overview The Indian Health Service (IHS), an agency within the Department of Health and Human Services, is responsible for providing federal health services to American Indians and Alaska Natives. The mission of IHS is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level and assure that comprehensive, culturally acceptable personal and public health services are available and accessible to members of the 567 federally recognized Tribes across the United States.

Improving and standardizing the credentialing and privileging process of licensed independent practitioners (LIPs) is a priority for IHS as part of broader agency quality improvement activities. IHS finalized the Quality Framework and Implementation Action Plan in November 2016 that outlines the agency plan to develop, implement, and sustain a quality program intended to improve the patient experience and ensure the delivery of reliably high quality health care. In addition, IHS provided a statement of planned actions in response to findings in a recent Government Accountability Office study published in January 2017 (Actions Needed to Improve Oversight of Quality of Care- GAO 17-181) related to automating and standardizing the credentialing process in IHS across the organization.

IHS seeks to transition from multiple, inconsistent data collection processes (manual and electronic) performed in each IHS Area to a single standardized process in all IHS Areas to support sharing of credentialing and privileging information, enhancing and improving the collection, maintenance, and verification of credentialing-related data and transition to a single enterprise Commercial-Off-The Shelf (COTS) software application throughout the agency. IHS also seeks to transition from multiple business processes performed in different IHS Areas to a standardized and streamlined organization-wide business process. Based upon the recommendations found through an independent market analysis and assessment of IHS business and technical requirements, IHS seeks a contractor to support the planning, acquisition and implementation of one of the following recommended COTS solutions, or an equivalent solution: Morrissey MSOW, Echo, Vistar eVIP, MDStaff, or Newport CARE. IHS intends to implement only one of these solutions. The contractor shall recommend and propose a software solution for at least 9 (nine) federally managed IHS Areas and IHS Headquarters (HQ) based on an optimal business process that standardizes credentialing, and maintains a decentralized privileging process at 26 hospitals and a large number of ambulatory facilities (Attachment 2: Estimated Active Files by IHS Facility). IHS intends to require all federally managed IHS Areas to use a single COTS software system unless a system currently in use can be demonstrated to be fully interoperable with the chosen product.

In Calendar Year (CY) 2015, approximately 2,000 new LIPs applications (federal and contractors, including but not limited to doctors, nurses and pharmacists) were processed across nine IHS Areas. IHS currently has over 4,000 active provider files across 9 Areas. In a recent independent review of the current credentialing business processes, the estimated Time to Credential (Tc) varied based on a variety of factors, including but not limited to: the volume of workload for each Area, staff available to conduct credentialing functions, whether or not the Area was using a paper-based or COTS solution, submission of complete applications, the time taken to receive peer recommendations, affiliations and medical malpractice history verifications, and whether the practitioner would be providing services via a telehealth modality. The average Tc ranged between 14-34 workdays.

2. Purpose

The purpose of this contract is to plan, acquire, and implement a COTS software solution to standardize the data collection, storage, access and communication process for IHS credentialing and privileging. The enterprise planning services shall include a standardized data collection redesign, business process redesign, sustainability planning, and change management services to support the software solution. The Contractor shall select a product that can support the improvement of the current credentialing and privileging business processes in use and standardize the software application and processes used to credential. Three of the nine Areas currently use an electronic credentialing application solution. Albuquerque Area uses EchoCredentialing by HealthStream. Navajo Area uses Morrissey by HealthStream, and Phoenix Area uses PrivPlus, but will be migrating to MDStaff.

3. Objectives

At a minimum, IHS requires an organization-wide credentialing COTS solution that supports the following business, management, and technology objectives. The solution must support criteria-based core privileging to ensure that LIPs who provide services have the training and possess current privileges, and are qualified to perform procedures within their scope of practice. The solution must support the documentation of the process of obtaining, analyzing, reviewing, and verifying the qualifications, experience, and professional status of LIPs. The solution must also track and annotate Governing Board and Medical Staff approvals. The solution must follow The Joint Commission’s Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPPE) processes.

The solution must be operational in at least four pilot sites, by July 2017. At least two of the pilot sites must currently use a credentialing software solution (Albuquerque, NM and Phoenix, AZ), and two Areas should have paper-based processes (Billings, MT, and Oklahoma Area). See Attachment 1: Draft Requirements List for additional federal IT and business requirements.

I. Business Objectives

1. Enhance the recruitment and reappointment experience of LIPs to IHS by streamlining credentialing and privileging processes by providing an electronic based application process.

2. Increase access to the quality of LIPs providing care by enabling information about potential and current practitioners to be shared in a timely, efficient, and confidential manner among relevant stakeholders involved in the process, including: credentialing coordinators/specialists/managers, CEOs, Clinical Directors, Area Chief Medical Officers, Governing Board members, and others essential to identify and track current information in their credentials file that will assist in their efficient application and evaluation, including identifying conduct-related or quality of care problems.

3. Simplify the process for IHS staff involved in credentialing, by allowing them to conduct electronic queries for primary and secondary source information required, including but not limited to NPDB, license and training information. The software solution must document and share credentialing and privileging information with the appropriate staff involved in the credentialing and privileging processes.

4. Facilitate credentialing and privileging decisions by governing bodies of hospitals and freestanding ambulatory clinics at the Service Unit.

5. The solution must comply with all applicable CMS Conditions of Participation, and applicable accreditation standards, including but not limited to: The Joint Commission, the National Committee for Quality Assurance (NCQA), the Accreditation Association for Ambulatory Health Care (AAAHC) and the Commission on Accreditation of Rehabilitation Facilities (CARF).

6. Create, provide and store Notification of Privileges to LIPs when privileges are granted. Provide updates to notifications when there is a modification based on an addition, deletion, termination, or proctorship.

7. The solution must possess up-to-date and compliant policies and procedures that meet CMS and accrediting body specifications.

8. The system shall track and document peer case review activities from initial screening through committee determination electronically.

II. Management Objectives

9. Reduce the administrative time and staff resources associated with the appointment and reappointment of the credentials processes. The COTS product shall be designed to support and strengthen the efficiency and reliability of a standardized, systematic and reliable credentialing and privileging process.

10. Increase employee and LIPs practitioner satisfaction with the credentialing and privileging processes. The system shall support all phases of the processes including: request, collection, verification, review and decision-making to document medical staff and governance actions on the practitioner.

11. Create a standardized credentialing process, including information sharing where allowed, across all of IHS, with oversight of and support for system performance at a Headquarters level.

12. Support any future management decision to contract or perform a central verification service either federally staffed or supported by a third party entity.

III. Technology Objectives

The Offeror must demonstrate a complete and thorough understanding of the notional technical requirements and objectives of the services and solution sought by IHS. The Offeror must describe how it supports the notional technical, interface, integration, and security objectives and requirements. In addition, Offerors should complete Attachment 1: Draft Requirements List to indicate if the specific feature or functionality is included in the standard "software package" as "Out of the Box," if an additional module can be purchased to meet that objective, if a minor or major enhancement will be needed, or if the functionality is not offered. The offeror shall identify whether or not the selected product has the following capabilities:

13. The system shall be a comprehensive and enterprise-level application that can be easily deployed across at least nine (9) IHS Areas, with scalability to potentially accommodate other IHS or tribally managed sites.

14. The system shall support the collection, validation and secure storage of credentialing, privileging and background investigation information, allowing information to be readily accessible as needed.

15. The system shall be interoperable, utilizing FIPS 140-2 encryption, and interface electronically (link to and/or get data feeds from, and/or have the ability to connect with minimal customization) with verification systems such as the National Practitioner Data Bank (NPDB), and Office of the Inspector General (OIG) Exclusions Database, State Licensing boards, American Board of Medical Specialties (ABMS), AMA (American Medical Association) queries. The system shall be designed and coded in a way that would allow for interoperability or linking to other government web-based human resources job application or human resource verification databases and systems, such as USA Jobs, in the future.

16. The system shall have a simplified graphic interface designed for efficiency of use, optimize workflows, and have capacity to comply with Section 508 of the Rehabilitation Act of 1973.

17. The system shall keep Personally Identifiable Information (PII) data secure per NIST 800-53 and HHS Information System Security and Privacy Policy (HHS OCIO-2014-0001). The system shall comply with the Federal Information Security Management Act (FISMA) 2002 including the National Institute of Standards and Technology (NIST) Special Publication (SP) 800 Series and associated Federal Information Processing Standard Publications (FIPSPUB) standards to meet security control baselines supporting data in accordance with FIPS 199, Privacy Act of 1974 and Public Law (P.L.) 100-503, the Computer Matching and Privacy Protection Act of 1988, E-Government Act of 2002.

18. The system shall allow for the easy tracking and management of LIPs data. The system shall provide IHS Service Units and Areas with automated tracking and reminders of expiration dates for documentation that includes is but not limited to: appointments, reappointments, DEA registration, life support certifications, licenses, board expirations, proof of malpractice insurance, and other required certifications.

19. The system shall allow LIPs and IHS staff to track the status of applications from request to decision.

20. The system shall capture, or require little customization to document final outcomes of federal background suitability determinations, including whether or not the candidate was suitable for employment, met eligibility of the Indian Child Protection and Family Violence Prevention Act (PL 101-630 and 101-647), the date of eligibility, and expiration of those clearances.

21. The system shall have the ability, or require little customization, to interface with data analytics and COTS data visualization tools currently installed or that may be procured by IHS under the contract performance period, without the need to write code or SQL statements (e.g. HealthPic and QlikView).

22. The system shall have the ability to generate, store and print end user, site specific, Area-wide, or enterprise-level standard and custom reports and dashboards.

23. The system shall allow for on-going capture and updating of Governing Board required criteria for continued staff membership based on character, medical knowledge, continued medical education (CME) clinical judgment, communication skills, training, experience, staff interaction, and patient/tribal comments with respect to cultural sensitivity. The system must capture and store grievances and safety issues requiring review and corrective action.

24. The system shall enable facilities to manage an electronic record via a software package of comprehensive LIPs credentials data such as licensure, board certification, peer recommendations, continuing medical education, Drug Enforcement Agency (DEA), other certifications, personnel information, education, malpractice information and past claim history, and past performance.

25. Each practitioner folder in the software package database shall be in a conveniently accessible location for managing practitioner data and for performing all credentialing tasks. This includes entering and maintaining practitioner data, auditing to ensure that all required practitioner documents are present, managing the practitioner's appointment status at one or multiple facilities, processing, tracking and completing verifications, generating and printing practitioner profiles, scanning and storing practitioner credentialing documents, entering and managing core privileges, and tracking meeting attendance.

26. The system shall allow for input of non-LIP staff to include, but not limited to, nursing, pharmacy, respiratory therapy, radiology technicians, dieticians, audiologists, licensed certified social workers, and dental hygienists.

27. Comprehensive data fields shall exist within the practitioner folder that enable timeline tracking of the practitioner's appointment from the initial day of application transmission (to the practitioner) to the day the verifications are completed. Workflow reports must also be generated by the system for aggregated tracking of application and credentials verification timelines with segregation by Practitioner types, Service Units, and Areas.

28. The system shall be able to support multiple users at multiple locations using the system simultaneously, without slowing down. The system shall have the ability to track user access.

29. The system shall automatically route Notification of Privileges and modifications, additions, deletions, and terminations to appropriate internal stakeholders and have the ability to utilize electronic signatures.

30. The system shall provide the ability to store and access files in any format Electronic Records, in a case folder (e.g.; documents, pictures, audio, video, etc.).

31. The system shall provide the ability to authorize and control access to all information in databases, repositories, documents, and correspondence based on designated roles, user accounts, and permissions.

32. The system shall comply with IHS Indian Health Manual Records Management disposition schedule dated April 24, 2014 and System of Record Notification (SORN) pertaining to IHS Medical Staff Credentialing and Privileges Records (#09-17-0003).

https://www.ihs.gov/privacyact/includes/themes/newihstheme/display_objects/documents/FRN0909200909170003.pdf https://www.ihs.gov/privacyact/systemofrecords/

33. The system shall capture and store verification of immunizations or proof of immunity.

4. Scope

The scope of this contract includes:

· Finalize business and technical requirements with IHS stakeholders, including Headquarters leadership, credentialing subject matter experts, and governing body members, against the recommended COTS application, to define an optimal business process. The draft Requirements List (Attachment 1) shall serve as the basis for finalizing the requirements before system implementation.

· Acquire, test, and install the selected product in pilot sites by July 2017.

· Implement the selected COTS product within the production environment based at the Albuquerque Data Center.

· Recommend a standard business process workflow for acceptance to the government. Refine and finalize the optimal business process based on evaluation and feedback from end users from first phase sites.

· Provide change management to support system implementation.

· Propose a data migration plan to integrate paper based and electronic files for currently credentialed LIPs, historical records for non-active LIPs, and non-credentialed LIPs.

· The Contractor shall migrate all paper-based and electronic files for currently credentialed LIPs, historical records for non-active LIPs, and non-credentialed LIPs.

· Provide a notional technical and end user support plan with the Performance Work Statement (PWS).

· Provide technical support for initial implementation in accordance with the acceptable technical and end user support plan. Conduct initial application administrative training and knowledge transfer and provide end-user training based upon an acceptable training plan. The plan must identify the helpdesk support that will be available for end users after installation is complete. The technical support plan shall address and identify what if any operations and maintenance for the selected COTS credentialing system is included in the proposed pricing.

Scope does not include:

· Workstations, data centers, server systems, and connectivity.

· Support for legacy applications or systems.

· Software development required for customization (unless required to meet Federal IT requirements).

5. Period of Performance One year from date of award with 4 one-year option periods.

6. Place of Performance The primary place of performance for this effort will be at the following locations:

Phase 1- Pilot Areas Billings Area Office – Billings, MT Oklahoma Area Office – Oklahoma City, OK Albuquerque Area Office – Albuquerque, NM Phoenix Area Office - Phoenix, AZ

Phase 2 Areas:

Great Plains Area Office – Aberdeen, SD Bemidji Area Office – Bemidji, MN California Area Office – Sacramento, CA (2 new Youth Regional Treatment Centers) Nashville Area Office – Nashville, TN Navajo Area Office – Window Rock, AZ Portland Area Office – Portland, OR IHS Headquarters - Rockville, MD

7. Contract Type This contract shall be Firm Fixed-Price.

8. Technical Overview

The COTS product will be hosted in the Albuquerque Data Center, in Albuquerque, NM and must comply with all IHS and federal IT requirements to be hosted on the IHS network.

The platform will contain Controlled Unclassified Information including Sensitive but Unclassified (SBU) and Personally Identifiable Information (PII). No classified information will be contained in these systems. Federal Information Processing Standard (FIPS) 199 classification is likely High for Availability, Moderate for Integrity, and Low for confidentiality.

9. Constraints

Deployment of the software at additional Area Offices and Service Units will be based on the Contractor’s implementation plan, technical approach, and selected COTS solution’s ability to meet business, management and technical objectives. If the selected product is cloud-based, the selected product must meet Federal Risk and Authorization Management Program (FedRAMP) requirements, or must be able to obtain FedRAMP compliance within a reasonable timeframe, to be installed on the IHS network during the contract performance period.

10. Deliverables

The contractor shall ensure proper control and coordination of all deliverables as proposed/accepted in the Contractor PWS and associated work plan and Contractor Quality Assurance Surveillance Plan (QASP), to ensure the deliverables meet the acceptable technical and quality standards. Unless otherwise stated, the Government will review deliverables and notify the contractor of findings within 10 workdays. Representatives of the contractor shall meet with the COR and other members of the Government as necessary as to review status and other deliverables.