AHRQ-11-10006-Attachment 2-Statement of Work.pdf

Attachment 2: HCIE II Statement of Work

This contract is for the operation, maintenance, and enhancement of the Health Care Innovations Exchange – an existing internet repository for the collection, classification, distribution of and dialogue around health care policy, practice and system innovations and related information and tools. The Health Care Innovations Exchange is a searchable database of innovative strategies and tools used to improve health care quality and reduce health care disparities. This Web resource has a database-backend, is indexed and searchable, and adheres to the HONcode ethics. Learning and networking opportunities are offered to promote dialogue and exchange of information about innovation, adoption, spread and specific innovations and tools.

Objectives

Goal of the AHRQ Health Care Innovations Exchange Version 2 (HCIE2)

The goal of the Innovations Exchange is to be a national repository of health system and health care policy, practice and system innovations and related information and tools, promoting change and further innovation and tool development in the health care system for the purpose of improving health care quality and reducing health care disparities for all Americans.

Objectives of HCIE2

• Maintain the efficient, systematic collection, and high quality classification and representation of innovations and tools; continue to emphasize innovations targeting public health priority diseases/conditions, priority populations, and efforts to reduce disparities in quality; continue to maintain relationships with other databases (such as AHRQ’s National Guideline Clearinghouse and National Quality Measures Clearinghouse)

• Expand the database and resource to include policy/public health innovations aimed at improving health care quality or reducing disparities in care; show parent-child relationships between policy innovations (parent) and clinical processes or community services innovations (child)

• Operate and maintain a back end and front end that reflect attention to the systems development life cycle, complies with relevant government IT regulations and requirements (such as privacy and security), and earns value for the government;

design, develop, test and deploy enhancements to the back end and front end as approved by AHRQ.

• Establish a project expert panel that will provide feedback and guidance, and establish an editorial board with capacity to review submissions and write expert commentary critiquing innovation successes and failures, offering insights and addressing the nuances of innovation, implementation, and change

• Continually improve the design of the Innovations Exchange incorporating feedback from user testing, expert panel, editorial board and others

• Provide appropriate and timely technical assistance to users

• Provide dynamic opportunities for learning and networking among the users of the

Web site

Specific Requirements

Independently and not as an agent of the Government, the Contractor and its subcontractors (if applicable) shall furnish all the necessary services, qualified personnel, material, equipment, and facilities, not otherwise provided by the Government as needed to perform the specific requirements below.

There are five (5) major tasks for this contract, each having specific requirements and deliverables:

Task 1: Content Task 2: Enhancements Task 3: IT Task 4: Learning and Networking Task 5: Project Management

Task 1: Content

Note: Use of the word system in the context of this task relates to a collection of detailed editorial methods, processes and controls needed to deliver the high quality innovations and tools content associated with this project; it does not refer to an IT system.

Subtask 1.1: Establish and Maintain an Editorial Board

Purpose. The Contractor shall propose, establish with AHRQ approval, and maintain an editorial board with capacity to review submissions and write expert commentary on select innovations and/or lessons learned. Their comments shall critique innovation successes and failures as they relate to policy, environment, care delivery or payment systems, health care professional, and climate issues (cultural, regulatory, legal, etc…), offering insights not obvious from the information provided by the submitters and educating users on the nuances of innovation, implementation and change.

Board Composition. Candidates for the editorial board, which can include members of the Project Expert Panel, shall be selected based on their national recognition and relevant background and responsibilities to include, for example, health service delivery innovation, health care quality improvement, quality improvement implementation research, health care disparities reduction, change management, health professions education, social and/or behavioral sciences applied to health service delivery, health care administration, informatics, human factors engineering, etc.

Board Leader. An Editor-in-Chief shall be proposed from among the set of board members.

The Contractor shall work with and support the Editor-in-Chief to set board meeting frequency, board meeting agendas, identify materials needed for the meetings, lead and facilitate board meetings, identify action items and who will be responsible for those items.

The Contractor shall finalize the editorial board by the first (1) month of the project.

Note: The editorial board can be voluntary or paid, as a reimbursable cost to the Contract.

Subtask 1.2: Establish and Maintain an Expert Panel

Panel Purpose. The Contractor shall work with the Contracting Officer’s Technical Representative (COTR) to assemble a multidisciplinary panel of experts to provide feedback and guidance to the Contractor on broad project areas including:

• the state-of-the-art in innovations and change, both within and outside the healthcare industry

• emerging health care policy and health service delivery topics

• the unique needs of Innovations Exchange users

• methods for obtaining the maximum number of health service delivery innovations possible for inclusion into the Innovations Exchange

• mechanisms for reaching the Innovations Exchange’s target audience

Panel Composition. The Contractor shall establish an expert panel limited to twelve (12) members plus one (1) Chairperson. Members of the project expert panel and the Chairperson shall represent a broad range of interests related to innovation and change, health service delivery, health systems redesign, health informatics, and professional education. Representatives may include health system and practice innovators and implementers of quality improvement, patient safety or disparities reduction strategies;

change management and quality improvement methodologists and researchers within and outside the health care industry; recipient of the Innovations in American Government Awards Program sponsored by the Ash Center for Democratic Governance and Innovation or staff member from that Center; recipient of the HHSinnovates Awards Program or staff member of that Program; experts in knowledge transfer and Web-based exchange; health systems design and analysis experts; health informatics experts; experts in organizational transformation; accreditation, health professional, and insurance organizations; and users such as clinicians, quality assurance specialists or organizations, managed care organizations, hospitals, employee benefit managers, and State and Federal government programs. No more than two (2) of the (12) panel members will be Federal experts. The Government will be responsible for identifying and recruiting the appropriate Federal experts, although the Contractor may offer suggestions. The COTR will serve on the panel in an ex officio status.

Panel Selection, Nomination, Membership. Final expert nominations shall be provided to the AHRQ COTR for review and comment no later than two (2) months after the effective date of the contract (EDOC). The criteria for selection shall include factors such as knowledge of issues concerning public and private health service delivery improvements; current activity and research in the area of health system redesign and analysis or change management;

proven track record in innovation and design; accomplished adult educator, especially knowledgeable regarding virtual learning and in the context of a government resource;

ability to represent the needs of a significant segment of the Innovations Exchange target audience; and ability and interest in fostering public-private partnerships.

A single individual may represent expertise in more than one domain.

The Contractor shall finalize recruitment of experts by the third (3) month of the project.

Subtask 1.3: Hold Expert Panel Meetings

Meeting Support, Frequency. The Contractor shall hold and provide support (i.e., pre-, post-, and interim support) for Project Expert Panel meetings. The Project Expert Panel is expected to meet at least one time in each year of the contract. The meetings will be one day in length and held on a date in which at least 90 percent of expert members can attend.

It is also anticipated that quarterly conference calls of select panel members and periodic electronic and paper correspondence will occur between meetings.

Meeting Purpose. The purpose of the meetings and communications will be to provide feedback to the Contractor on issues related to broad project areas including the state-of-the-art in health system policy and practice innovations and change; the unique needs of the Innovations Exchange users; methods for obtaining the maximum number of innovations possible for inclusion into the Innovations Exchange; and mechanisms for reaching the Innovations Exchange target audience.

Meeting Substance. In consultation with the COTR, the Contractor shall work with the panel Chairperson to plan all activities in support of all meetings and inter-meeting conference calls and mailings. Specifically, the Contractor shall plan agendas; assemble, prepare, print, and distribute materials needed for meetings; prepare audio-visual materials as required;

distribute materials to meeting participants; reserve meeting facilities and hotel accommodations; notify members and confirm participation in the meetings; arrange travel and process expense vouchers for non-Federal participants; and prepare detailed written summaries of the meetings. All agendas and materials shall be provided to the COTR for review, comment, and approval at least 21 calendar days prior to the meeting, and all materials shall be sent to the Project Expert Panel and participants at least 14 calendar days before the meeting.

Meeting Travel. Federal experts will be responsible for their own travel arrangements and lodging costs. The Contractor shall provide hotel reservations at the Federal Government lodging per diem for non-Federal participants. All non-Federal expert members will be reimbursed at the rate of $200 per day for their participation in the meetings. It is estimated that all of the Expert Panel members will require overnight accommodations for one (1) evening for each meeting.

Meeting Summary. The Contractor shall provide a detailed written draft meeting summary within two weeks after the expert meeting. The summary shall include names and titles of participants and observers, agenda, and a substantive, detailed summary of the discussions, action items, and recommendations. The summary shall also include the Contractor’s comments/reactions to those discussions and recommendations. The

Contractor shall provide a final meeting summary one (1) week after receiving Agency comments.

Subtask 1.4: Establish and Apply AHRQ-Approved Inclusion Criteria

Expanding Criteria. The Innovations Exchange will expand to include policy/public health type innovations and tools. The Contractor, in consultation with the COTR and editorial board, shall consider how to modify the current inclusion criteria and shall deliver proposed changes for AHRQ approval within three (3) months of contract award. In modifying the inclusion criteria, the Contractor shall show consideration of impact, if any, on the existing innovations template of attributes.

Innovations - The modified inclusion and exclusion criteria for innovations shall show consideration of the following:

- AHRQ requires innovations in health service delivery AND health care policy that are novel (creative and never been done before) and innovations that are perceived as new (have been done before but in a different setting, time period, environment, or climate).

- AHRQ requires health service delivery and health care policy innovations that aim to improve quality and/or reduce disparities; service delivery or policy innovations that reduce cost are of interest provided they address positive or neutral effect on quality or disparities.

- AHRQ requires innovations that have been rigorously tested (i.e., formal research methodology was applied in designing, piloting, or implementing a change in service delivery).

- AHRQ requires innovations that, if not formally researched, have been formally evaluated upon implementation so that users of the Web site can learn what health outcomes or other gains (customer satisfaction, financial, risk management, patient safety, etc…) were achieved.

- AHRQ also requires innovations for which evidence of its impact does not meet scientific standards (e.g., only anecdotal accounts of success or failure are available), with a method for distinguishing among the difference classes of evidence.

- AHRQ does not want innovations in health service delivery or health care policy that contradict evidence-based care. For example, a regional health system sets up a creative strategy to screen all men for prostate cancer using the prostate specific antigen (PSA) laboratory test. This creative strategy is not of interest to AHRQ because screening all men for prostate cancer using the PSA test is not an intervention supported by scientific evidence.

Pilot Testing. The Contractor shall pilot test the proposed modified inclusion criteria against a heterogeneous group of no less than 100 - 120 innovations to test the appropriateness, reliability, and ease of application. AHRQ will negotiate a lower number provided the Contractor submits a reasoned justification.

Approval. The proposed modified inclusion criteria shall be distributed to the entire Project Expert Panel for comment and the COTR for both comment and approval. The COTR will coordinate AHRQ review.

Public Display. The modified inclusion criteria shall be deployed to the Innovations Exchange Web site and announced prominently.

Broadening Content. A call for policy/public health type innovations shall be coordinated by the Contractor through the COTR and other AHRQ staff.

Systematic Application of Approved Criteria. The Contractor shall have each submitted or Contractor-identified innovation and tool being considered for potential inclusion in the Innovations Exchange evaluated by at least two persons. In the event of a disagreement, the Contractor shall have a third person review the innovation and/or tool.

That third person shall be from the editorial board. The Contractor shall forward questionable innovations along with all three reviewers’ comments to the COTR who will take these evaluations under advisement and make a final decision on the inclusion of specific innovations and tools.

Handling Submissions Not Meeting Criteria. The Contractor shall forward to the COTR all submissions that are determined by the Contractor to have failed to meet inclusion criteria, including a detailed summary of reasons for exclusion.

Electronic Log of Actions. The Contractor shall keep a detailed electronic log of actions related to submitted innovations. The electronic log will be submitted to the COTR monthly with the progress report and shall be maintained on a password protected Web page accessible to the project team and Agency staff.

Publishing Policy/Public Health Type Innovations. No less than 20-25 policy/public health type innovations meeting inclusion criteria and fully developed into profiles shall be deployed within 12 months of EDOC if OMB clearance is not needed; if OMB clearance is needed, deploy within 15 months of EDOC.

Note: Quality Tools is a compilation of practical tools for assessing, measuring, promoting, and improving the quality of health care. Its purpose is to give health plans, providers, purchasers, consumers, and policymakers easy access to a variety of resources they can use to improve the delivery of care, inform decisions, and educate people about their health care needs. In some cases, these tools complement or directly support innovations presented on the Innovations Exchange site.

Examples of tools include worksheets, questionnaires, fact sheets, databases, benchmarks, software, planning resources, calculators, algorithms, checklists, and brochures.

Proposed modifications to the existing inclusion criteria for quality tools shall show consideration of the following:

- AHRQ requires tools used in assessing, measuring, promoting, and improving the quality of health care.

- AHRQ requires tools used to improve delivery of care, inform decisions, and educate people about their health care needs.

- AHRQ requires tools associated with policy/public health type innovations.

- AHRQ requires tools associated with health service delivery innovations.

- AHRQ requires tools designed for use by a varied audience, including providers, clinicians, purchasers, consumers, health plans, policy makers, community groups, quality alliances/organizations, and others.

- AHRQ requires tools that are freely available (i.e., without a fee or charge) in an electronic format via the Internet (web, social network, cell, etc). This format includes free tools that can be ordered or require free registration to obtain the tool.

- AHRQ requires tools developed and/or sponsored by an identifiable agency, organization, or committee OR tools developed by an individual or team as the result of an innovation challenge sponsored by an identifiable agency, organization, or committee.

- AHRQ requires tools associated with guidelines only if the tool is derived from an evidence-based clinical practice guideline that meets criteria for inclusion in AHRQ’s National Guideline Clearinghouse (NGC).

Subtask 1.5: System to Obtain, Publish, Update, Archive Innovations, Tools and Associated Content

The Contractor shall establish, validate and maintain a system to obtain, publish, update, and archive innovations, tools, and associated content.

Innovations (successes and attempts at innovation) and Tools

Subtask 1.5.1: Identify and stimulate or create submissions

The Contractor shall identify novel ways to stimulate submissions in addition to engaging in the following:

• Search the peer-reviewed literature for published innovations or tools or references to innovations or tools under study

• Search AHRQ-commissioned research reports

• Search existing Web sites, databases, compendiums, source books, and news sources for reference to innovations and tools and change in health care delivery and policy

• Tap into networks of innovators and adopters

• Contact known innovators and researchers, including AHRQ-funded researchers, to further identify innovation-related documents

• Connect with AHRQ’s Office of Communications and Knowledge Transfer (and their contractor(s), at AHRQ’s discretion) for impact case studies, a potential source of innovative implementers of AHRQ products

• Subscribe to AHRQ and relevant others’ Web sites’ e-mail newsletters and update services

• Monitor social networking sites; use AHRQ Health Care Innovations Exchange social networking sites to solicit submissions (see task 4)

• Participate on ListServs or other discussion forums used by potential submitters

• Enlist the help of the Project Expert Panel in identifying candidate innovations

• Collect electronic copy, and hardcopy if necessary, of identified innovations, including references and accompanying supplemental material

• Explore opportunities at meetings, conferences, organizations to identify candidate innovations

• Work collaboratively with AHRQ’s Contractor for the National Guideline

Clearinghouse and National Quality Measures Clearinghouse for relevant tools

• Other mechanisms deemed appropriate by the Contractor

For potential submissions that appear to meet inclusion criteria, the Contractor shall promote submission through one or more of the following:

Education. The Contractor shall explain the purpose of the Innovations Exchange and the advantages of submitting.

Assistance. The Contractor shall assist the submitter in understanding submission requirements, discussing whether the innovation was implemented in conjunction with (concurrently or sequentially) with other complementary innovations, assembling the necessary materials, and reviewing completeness and adequacy of submissions, providing comments or making revisions as necessary.

Development. In some cases, the potential submitter may be unable to articulate the elements of the innovation, or possess insufficient resources to be able to compile a submission. In these cases, if the innovation is deemed by the COTR to be of sufficient importance, the Contractor shall collect the information and develop the submission.

Subtask 1.5.2: Develop and maintain database of innovators and organizations that promote innovation

The Contractor shall develop and maintain an on-going database of innovators and organizations that generate health care policy, promote health service delivery innovation, implementation of health care quality improvement or disparities reduction strategies, and change initiatives in public health and health care facilities. The database shall be shared with the COTR. The Contractor shall ensure that this relational database includes full name, mailing and electronic mail addresses, telephone and facsimile numbers, and name (or names) of contact person(s) for innovations, quality improvement strategies, and change initiatives. Public accessibility to the database is strictly forbidden. Retrieval of records based on personal identifying information is forbidden. The Contractor shall maintain the database on an on-going basis, in both hard and electronic copy and forward updates to the COTR for dissemination by AHRQ as appropriate. This database shall be implemented within four (4) months of the EDOC, maintained continuously thereafter, and delivered at the end of the contract as a project artifact.

Subtask 1.5.3: Review innovations and tools against inclusion criteria

The Contractor shall review all innovations (successes and those not successful [Attempts]) and tools against established inclusion criteria. These criteria are minimum eligibility requirements. The decision to publish a description of an innovation ultimately depends on several factors including an evaluation by the Editorial Team, AHRQ's priorities, and the number of similar innovations currently in the Innovations Exchange collection. (See subtask 1.4)

Subtask 1.5.4: Obtain copyright permissions

The Contractor shall obtain written copyright permission as appropriate from the innovators to make their innovation(s) and associated tool(s) available for Innovations Exchange users through downloadable files or hyperlink to the innovator’s Web site, if applicable. When innovations or associated tools are proprietary the Contractor shall obtain copyright clearance for purposes of inclusion in the Innovations Exchange for abstracting and posting the abstract on the Web site. The Contractor shall include language in the Innovations Exchange Web site that will refer users back to the developer, using hyperlinks if possible, to obtain or purchase the full documentation, specifications, etc.

The Contractor shall maintain copyright permissions on file for the life of the project and deliver them to AHRQ at the end of the contract.

Subtask 1.5.5: Publish

The Contractor shall publish a minimum of 75 - 80 new and updated innovation structured abstracts and 100 -110 new and updated tool abstracts to the Web site within the first 12 months of the project. The Contractor shall establish a mechanism to publish transitioned content within 2 months EDOC and begin publishing that content beginning 3 months EDOC. Once added to the Web site, the Contractor shall be continually responsible for ensuring that they are accurate and current.

Each year it is estimated that at a minimum of 75 – 80 new or updated innovation structured abstracts and a minimum of 100 -110 new or updated tool abstracts shall be added to the Web site. These innovation abstracts include health care policy, practice and systems innovations – those that succeeded and those that did not.

The Contractor shall publish content on a regular basis (currently it is biweekly) and identify for the users what is new, updated, and withdrawn (if applicable).

Collateral content

Subtask 1.5.6: Supplement innovations with additional content

The contractor shall propose and seek supplementary content for inclusion in the Innovations Exchange. Supplementary content presently included on the Innovations Exchange is a) expert commentary which is associated with a profile, b) “Back Story” – brief, journalistic treatments of human interest that present the impact of an innovation in a more emotionally resonant manner; c) articles and perspectives; and d) multimedia materials.

Static content

Subtask 1.5.7: Create, maintain, and enhance static content

The contractor shall maintain and propose enhancements to static content such as About the Health Care Innovations Exchange, Resources, Submit Your Innovation, AHRQ Funding Opportunities, Frequently Asked Questions.

Annual verification of all content

Subtask 1.5.8: Verify all content an annual basis

The Contractor shall apply the currently approved annual verification process upon contract award. The Contractor shall contact the innovators included in the Innovations Exchange on an annual basis regarding the status of their innovation and associated tools (i.e., revisions, no longer sustained, further implemented, etc.) The purpose of the annual verification process is to obtain specific information regarding the current state of use of the innovation and associated tools, additional evidence, and plans for further refinement, wider implementation, or withdrawal. The Contractor shall track and maintain copies of the query responses and update the innovations/ tools databases accordingly.

Subtask 1.6: Establish and Maintain a Validated System to Index and Abstract Innovations and Tools

The Contractor shall establish, implement, and maintain a system to index and abstract innovations and tools and validate that system, refining it as needed to achieve validation.

Note: For proposal purposes, offerors should budget for the template for capturing and publishing policy innovations.

Subtask 1.6.1: Index content

Innovations and tools included in the Innovations Exchange, and other site content as appropriate, shall be indexed using standard reference terminologies (e.g. SNOMED RT, etc.), whenever possible.

The Contractor shall utilize the most cost-effective mechanism for tagging and indexing innovations and tools and should consider the utility of the Unified Medical Language System (UMLS) Metathesauraus over more costly proprietary solutions whenever possible. If a needed concept is not adequately represented in the Metathesaurus, the Contractor shall select a term to describe the concept. In doing so, care should be taken to avoid confusion with other recognized terms and to provide consistent and reliable application. Further, the Contractor shall provide mapping to outdated or revised terms when defining and maintaining new terms. The goal should be to utilize already recognized terminologies and to create new terms only when concepts are not adequately represented. In some cases, concepts are defined in existing terminologies but adequately for the purposes of health care innovations. For example, “climate” in the Metathesaurus refers to the meterological environment as opposed to organizational and external (e.g., sociopolitical) conditions – most often used in descriptions of how innovations are implemented and/or spread.

Subtask 1.6.2: Abstract content

Innovations and tools included in the Innovations Exchange shall be displayed using a standardized (structured) format.

The Contractor shall use the existing template of service delivery innovation (both successes at innovation and attempts at innovation) and quality tool attributes and definitions; those templates were designed to contain enough information to facilitate replication or use yet not overburden submitters.

The Contractor shall develop a template for capturing and publishing policy innovations.

The Contractor shall prepare an OMB package to interview innovators for the purposes of completing innovation abstracts nine (9) months before the current OMB clearance expires. If the existing OMB clearance doesn’t cover changes necessitated by the inclusion and representation of policy innovations, the Contractor shall submit a revised OMB package within three (3) months after the revised inclusion criteria and template of attributes are established.

In addition, the Contractor shall include a mechanism to capture (1) user comments about an innovation and (2) editorial expert analysis and commentary on select innovations. The Contractor shall use the existing or establish a secure, Internet-based mechanism to capture user comments, requiring users to provide contact information.

Collection of user comments has OMB implications; the Contractor shall consider OMB Paperwork Reduction Act and associated guidance issued relative to social media, Web-based interactive technologies.1

Subtask 1.6.3: Validate system

Test. New template of attributes and definitions shall be pilot-tested against a heterogeneous sample of at least 100 – 120 innovations, including lessons learned, for

1 http://www.whitehouse.gov/sites/default/files/omb/assets/inforeg/SocialMediaGuidance_04072010.pdf http://www.whitehouse.gov/sites/default/files/omb/assets/inforeg/SocialMediaGuidance_04072010.pdf� ease of use, availability of information, and reliability of abstraction and indexing. A schedule for validation testing must be reviewed and approved by the COTR.

Quality. The Contractor shall be responsible for the completeness and accuracy of content contained in the innovations and tools templates. The Contractor shall contact the innovation submitter when more information is needed but it is not expected that every attribute will be completed for every innovation. However, those attributes that are correlated with the inclusion criteria for innovations in the Innovations Exchange must be completed. In addition, submissions are likely to lack consistency. The Contractor may need to revise submissions to create uniformity among database entries, appropriately informing the submitter. Innovators shall be given three weeks to comment or provide revisions to the structured summary. If no comments are received, the Contractor shall assume the innovation submitter has no comment but designate that the summary has not been verified by the innovation submitter. Innovation summaries shall be identified as “verified” or “unverified” by the submitter.

The Contractor shall make available for download complete innovation documentation, if any, when copyright permission is received from the innovation submitter. The innovation documentation, if any, shall be made available for download in at least two formats one of which must be ASCII text. In the event that the innovation submitter does not provide permission for hosting full-text documentation on the Innovations Exchange, the Contractor shall provide a hyperlink to the submitter’s site (if appropriate) along with ordering information.

Archive. The Contractor shall propose a mechanism for archiving, including an archival work process to create/maintain static copies of every profile and tool. Relaying updated and archived information to users is important to assure they are made aware of the status of the profile or tool they may be using. 100% of outdated innovations and tools shall be moved to archive.

Subtask 1.6.4: Manage Conflict of Interest

The Contractor shall remember at all times that the Innovations Exchange resource is a taxpayer funded initiative and that AHRQ is committed to obtaining and keeping the public’s trust in its investments.

Therefore, the Contractor shall establish and implement an AHRQ-approved policy and procedure for managing real or potential conflicts of interest (COI) of innovators, expert commentators, project team authors/writers, the Editorial Board, and others proposed by the Contractor.

The Contractor shall reference the International Committee of Medical Journal Editors (ICMJE) and the World Association of Medical Editors (WAME) as their policy is formulated.

The Contractor shall address the following issues in its policy and procedure:

• De Minimis Threshold

• Nature of Disclosures

• Evaluating COI

• Look-Back and Look-Ahead periods

• Form to collect COI information

• Transparency

NOTE: Following Thompson’s 1993 definition of conflict of interest, a “conflict of interest is a set of conditions in which professional judgment concerning a primary interest (such as a patient’s welfare or the validity of research) tends to be unduly influenced by a secondary interest (such as financial gain).”2

The Contractor shall develop its COI policy and procedure with this premise in mind:

The primary interest for this project is creation of high-quality, bias-free content objects, including but not limited to innovation abstracts and expert commentaries. Secondary interests that can affect the primary interest include financial and non-financial relationships, associations or affiliations.

Relationships with industry; academic commitments, personal relationships, and institutional affiliations are sources of potential conflicts.

In some instances, bias cannot be avoided and may even be desirable (e.g., in a commentary). In all instances, secondary interests must be disclosed to the public, whether there are any or not.

The AHRQ-approved conflict of interest policy must be implemented within two (2) months of EDOC.

Subtask 1.6.5: Quality Assurance

The contractor shall establish a mechanism to assure that content developed is accurate and complete. No more than 5% of the abstracted content shall require major rework upon verification by the innovator and all indications of quality are obtained. The contractor shall report on quality assurance in the monthly report.

Task 2: Enhancements

Subtask 2.1: Propose Recommendations for Change

The contractor shall propose recommendations for change to the inclusion criteria, copyright form, template of attributes, indexing, search, browse, verification, publication, etc. Changes that potentially affect existing content must take into account how the changes would be piloted and implemented for both existing and new content.

Inclusion Criteria. For changes related to the inclusion criteria, proposed in consultation with the Editorial Board, the Contractor shall pilot test the proposed inclusion criteria

2 Thompson DF. Understanding financial conflicts of interest. NEJM, 1993. 329(8):573-576.

against 100 – 120 profiles showing how the change affects field entries and estimating the magnitude of effect on the entire inventory of published profiles. The proposed inclusion criteria shall be distributed to the expert panel for comment and the COTR for both comment and approval. The COTR will coordinate AHRQ review. Inclusion criteria shall be quickly accessible to HCIE Web site users (i.e., no more than 2 clicks to access via the HCIE Web site).

Template of attributes. Proposed changes to the templates of attributes for innovation or tools shall show consideration of peer-reviewed published literature relative to the area (e.g., modifications to the template of attributes for health care practice and systems innovations must consider published pieces such as Greenhalgh et al* and/or others referenced at the IHI/UAB/VA Scale Up and Spread Conference blog site:

http://www.ihi.org/ihi/files/ScaleUp/8_3_Bibliography_as_of_6_28.pdf)

*Source: Greenhalgh T, Robert G, Bate P. A conceptual model for the spread and sustainability of innovations in service delivery and organization. In: How to spread good ideas: a systematic review of the literature on diffusion, dissemination and sustainability of innovations in health service delivery and organization. Report for the National Co-ordingation Centre for NHS Service Delivery and Organisation R&D. 2004.

Modifications of these attributes and inclusion of additional attributes and definitions shall be done in consultation with the COTR and subject to COTR approval.

Development of the lessons learned template shall be done in consultation with the COTR and subject to COTR approval.

Enhancement frequency. The Contractor shall submit recommendations for enhancement within six (6) months of contract award and yearly thereafter.

Types of and justifications for enhancements. The Contractor shall offer recommendations for enhancement reflective of the Contractor’s knowledge of changes in the fields of innovation, health care policy, practice and systems service delivery to prevent laborious and expensive surprises as submissions are received.

The Contractor shall offer recommendations for enhancement that also reflect users needs, search patterns, frequently asked questions, and suggestions for improvement.

The Contractor shall recommend changes to the content and how it is presented on the Web site.

The Contractor shall recommend changes to existing processes.

The Contractor shall include with every proposed change an associated rationale for the change along with an estimate of the timeline, cost and resources needed to execute the recommended change, in accordance with an agreed upon change/configuration management protocol (see task 3). Risks of implementing the proposed change shall also be stated clearly.

Subtask 2.2: AHRQ Proposed Changes

The contractor shall address, in the first proposal of enhancements (due at 6 months EDOC), changes of interest to AHRQ that are not specified as requirements elsewhere in this Statement of Work.

Subtask 2.3: Change/Configuration Management

The Contractor shall adhere to the configuration management plan when proposing and implementing the approved enhancements and shall supply a revised work breakdown structure (WBS) that is deliverables-oriented, time-phased, and resource-loaded. (See sub task 3.7).

Task 3: Maintain and Operate the Innovations Exchange Technical Infrastructure and Web Site; Design, Develop, Test, and Deploy Enhancements

Subtask 3.1: Overview Requirements

This resource shall conform to Federal and Department of Health and Human Services (HHS) requirements in laws, policies, and directives for information technology (IT), capital planning and investment, and Internet information management and the security of Agency information and systems.

The Contractor shall follow the guidelines identified in AHRQ’s Publishing and Communications Guidelines at http://www.ahrq.gov/news/pubcomguide/, AHRQ Web Product and Web Site Development Guidelines and updates as they occur. Refer to:

http://www.ahrq.gov/news/pubcomguide/pcguide2.htm

The Contractor shall deliver the documentation specified in Guidelines for Developing AHRQ Web-based Tools, and updates as they occur http://www.ahrq.gov/news/pubcomguide/pcguide5.htm

The Contractor shall deliver baselined versions of all documents, and source code corresponding to production releases for all web sites and databases to AHRQ for storage in the AHRQ Rational library repository.

The Contractor shall comply with the guidelines identified in subtask 3.1 and others identified in subtask 3.3 and 3.5 throughout the life cycle of the contract.

The Contractor shall maintain and operate, and during the cycle of enhancements design, develop, test, and deploy improvements to the Innovations Exchange Web site.

Guidance is available from www.usability.gov, the Department of Health and Human Services resource for designing usable, useful, and accessible Web sites and user interfaces.

The Contractor shall maintain the Web sites presence on the World Wide Web (WWW) via the Internet. The Innovations Exchange Web site is available through www.innovations.ahrq.gov.

The Contractor shall create, implement and maintain all mechanisms necessary to support the Innovations Exchange database and adjust the search algorithm and redesign the interface to render relevant result sets that satisfy Innovation Exchange users. Alternatives can be proposed accompanied by rationale.

Subtask 3.2: Startup/Transition Requirements

Poject Work Plan. The Contractor shall deliver a Project Work Plan (PWP) that details the life cycle of the project including phases, iterations, and key milestones including integration points and procurement events, scope, cost, schedule, risks, and quality assurance for all systems, software, databases and websites.

The Contractor shall deliver with the first year PWP a contract-level Integrated Master Schedule (IMS) that rolls up all time-phased WBSs for the individual tasks. This IMS shall include the dependencies that exist between tasks.

The Contractor shall deliver with the first year PWP a Critical Path at the contract-level.

The PWP shall be submitted on an annual basis and will capture the work to be performed in the particular contract year.

The draft PWP for the first contract year is due three (3) weeks after EDOC. The final PWP is due within one (1) week after the Contractor receives Agency comments.

A draft of each annual PWP is due two (2) months before the start of the contract year.

To guide development of the draft annual PWP and facilitate negotiation with AHRQ on specific work activities for the upcoming work year (assuring all activities are within scope), the Contractor shall deliver to AHRQ a high-level overview of the upcoming year’s work to be performed, identifying major tasks and subtasks, and associated budget allocation for each major task. This PWP overview is dues three (3) months before the start of the contract year. The PWP overview will only be due during the option year periods, pending their exercise.

The PWP shall contain a deliverables-based Work Breakdown Structure (WBS) (including a WBS dictionary) that accurately and completely captures all work specified in the Statement of Work and any other documentation provided as a companion to the RFP. The WBS shall identify dependencies among the activities as well as dependencies with other contract activities. The WBS shall be resource-loaded and accompanied by a time-phased budget.

Migration Plan. The contractor shall submit a final migration plan no later than 2 weeks after the kick off meeting. The migration plan shall address the objectives, resources needed, approach, timeline, training, testing, risks and risk mitigation to affect a smooth transition of the Innovations Exchange databases and Web site into the Contractor’s own or an alternate environment. Of utmost importance is obtaining an approval to operate (ATO) before going live in the contractor’s own or an alternate environment.

Migration/transition plans shall cover a period of time not to exceed four (4) months;

migration and receipt of ATO must be completed by 4 months EDOC.

The work to be performed as part of the migration plan and actual migration will occur during the base year of the contract only.

Subtask 3.3: Technical Requirements

The Contractor shall use an open systems, industry standard, object-oriented software design and software technology solutions, 3-tier architecture, and enterprise reusable object software components to ensure cost-effective system development, operations and maintenance.

The Contractor shall adhere to the Agency’s Draft Technical Reference Model (TRM) (See Appendix B to the SOW) or later model as determined by the COTR. The TRM will be provided to the Contractor in electronic format by the Government. Specifications identified as “Standard” in the Disposition column shall be selected, unless the Contractor requests and receives a waiver from the Government. The Contractor shall use commercial off-the-shelf (COTS) components when possible.

If applicable, the Agency may conduct an Independent Verification and Validation (IV&V) of each software solution and associated documentation prior to acceptance; therefore, the Contractor shall consult with the COTR on AHRQ’s intentions. The IV&V review period shall be no more than ten (10) business days for each solution and associated documentation and the Contractor shall not initiate the next major phase of work following a life cycle milestone until written approval is received from the COTR.

Subtask 3.4: Database Requirements

The search engine software solution shall facilitate effective searches by using a combination of indexes and XML metadata tags, numeric primary keys, and use of controlled vocabularies for important concepts. Both manual and algorithmic indexing shall be used.

The Contractor shall maintain and operate, and during the cycle of enhancements design, develop, test, and deploy improvements to the database backbone to house the Innovations Exchange as one module.

The Contractor shall establish a set of common data elements that will serve to appropriately link the contents of the Innovations Exchange and QualityTools. The Innovations Exchange/QualityTools data model shall be expandable to include other clinical information modules.

The Contractor shall establish a set of common data elements that will serve to relate parent policy/public health type innovations with child clinical service delivery or community based service delivery innovations.

Subtask 3.5: Web site Requirements General Requirements. The Innovations Exchange Web site shall include:

• Descriptions of the Innovations Exchange and AHRQ

• Sections that describe how the contents are maintained, including inclusion criteria for innovations, and attributes and definitions used in the structured abstract

• A direct link to a computer readable privacy statement approved by the COTR

• Information on how innovations may be submitted and how users can contact the

Innovations Exchange; this shall be displayed in an easily accessible manner

• Resource sections that contain technical information about the site, a description of the technical assistance support (e.g., where to e-mail for technical assistance when using the Innovations Exchange) and educational pieces about innovations and change in healthcare.

• A site map

• A Frequently Asked Questions (FAQs) section where users can perform both keyword searches or scroll for information

• Search help

• Home page footer using standard HHS language, with links to relevant pages on the Innovations Exchange Web site

• Incorporation of the HHS and AHRQ logos as well as the FirstGov.gov logo, with associated links

• Other information as specified by AHRQ

Comment Feature. The Innovations Exchange Web site shall include a Contractor-moderated mechanism for users to post comments about innovation. Submitted comments shall be reviewed to ensure that they are appropriate; this review process will take place within one working day of submission. Comments will not be posted that may be perceived as a personal attack, use inappropriate or unprofessional language, appear to be commercial in nature, are unclear or seemingly unrelated to the innovation and are inaccurate, unsubstantiated or off-topic. If a comment cannot be accepted as submitted, the submitter will be contacted with suggested revisions to address the stated concerns. The Contractor shall maintain this approach to moderate and decide which comments to post. Changes to the mechanism and/or software to operationalize the user comment feature must be proposed through the change/configuration management protocol.

Domain. The Innovations Exchange Web site shall be accessed via “.ahrq.gov” domains (i.e., a third-level domain name). The Contractor shall coordinate with the COTR responsibilities for registering the appropriate “gov” (top level) domains and analogous non-gov domains.

XML. The Contractor shall use Extensible Markup Language (XML) as the main form of presentation. In using XML, the Contractor shall take into account the importance of obtaining consistency in the use of medical terms and the work of HL7 (Health Level 7) and ASTM (American Standard for Testing and Materials) whenever possible.

Accessibility. The Contractor shall provide Web sites that are in full compliance with all relevant sections of the Americans with Disabilities Act (ADA). The contractor shall offer a systematic procedure to ensure that the Innovations Exchange Web site and all items posted to it or delivered to AHRQ for other purposes (such as mass distribution) are to conform to HHS and AHRQ accessibility standards. AHRQ will provide specific guidance to the Contractor upon award. General information on accessibility can be found at the following Web resources:

www.access-board.gov/508.htm www.usability.gov www.section508.gov

Usability. The Contractor shall employ limited usability testing when developing functional features of the Innovations Exchange Web site. Testers shall consist of Project Expert Panel members, Federal employees, and selected end-users. The Contractor shall consider using the HHS Usability Lab (http://www.dhhs.gov/policies/webpolicies/200505.html).

Web Analytics. The Contractor shall submit a plan to analyze site usage and implement an AHRQ-approved web analytics plan. The plan shall address maintaining and analyzing search logs. It should also address data capture and analysis of all key features of the site (access and/or download and/or sharing of innovations, tools, expert commentary, guides, podcasts, etc).