Attachment 1_Enterprise Voice Dictation System Tasks Final.docx

Attachment 1: Defense Health Agency (DHA) Enterprise Voice Dictation System Background:

The DHA seeks information from industry regarding solutions, approaches, and best practices for deploying secure, reliable, and scalable enterprise voice dictation capabilities across the DHA network.

Challenges:

The DHA voice dictation deployments present a multitude of challenges that collectively present a large challenge for the deployment of an enterprise voice dictation capability. The challenges presented are:

1. Operating in a global network structure with rigorous security requirements while providing seamless interoperability and identical user experience to every user globally.

2. Ensuring full alignment with Department of War (DoW) Cybersecurity, Zero-Trust Architecture (ZTA), and Defense Information Systems Agency (DISA) Security Technical Implementation Guide (STIG) requirements.

3. Supporting low-latency speech-to-text conversion on congested or medically segmented networks.

4. Ensuring compliant handling of Protected Health Information (PHI) from capture to storage, including encryption in transit and at rest.

5. Capturing detailed logs for cybersecurity, patient safety, and operational oversight while minimizing storage overhead and ensuring log data does not inadvertently record PHI or violate policy.

6. Preventing data leakage between clinical workflows, non-clinical applications, and shared endpoints.

7. Minimizing performance degradation across geographically distributed Military Treatment Facilities (MTFs), telehealth environments, and bandwidth-restricted tactical or remote care scenarios.

8. Seamless interoperability with the Electronic Health Record (EHR) to integrate the reporting of imaging data into the patient's electronic medical record.

9. Support for DHA’s Virtual Desktop Infrastructure (VDI) environments, including but not limited to Citrix, VMware Horizon, Azure Virtual Desktop.

10. Enabling smooth authentication using Common Access Card (CAC)/Personal Identity Verification (PIV), Single Sign-On (SSO), or DoW enterprise identity solutions without limiting application functionality.

11. Supporting mission critical clinical documentation with near zero downtime by ensuring failover capabilities across DoW regions and cloud boundary environments.

12. Managing enterprise-wide licensing, and cost predictability while avoiding vendor lock-in, proprietary hardware requirements, or non-compliant cloud dependencies.

13. Ensure compatibility with DHA’s Standard Operating Environment (SOE) after Operating System (OS) updates, security patches, or application upgrades.

Objectives The DHA seeks to achieve the following high-level objectives through an enterprise radiology dictation capability:

1. Enhance Radiologist Productivity and Report Turnaround Times Provide a streamlined, reliable dictation workflow that reduces administrative burden, accelerates report creation, and supports timely clinical decision-making across all radiology modalities.

2. Ensure Accuracy and Consistency of Diagnostic Reports Deploy voice recognition and structured reporting tools optimized for radiology terminology, subspecialty vocabularies, standardized templates, and macros to improve consistency, reduce errors, and support clinical quality initiatives.

3. Strengthen Cybersecurity and Protection of Diagnostic PHI Ensure all radiology dictation data—including audio captures, structured reports, and associated metadata—is processed and stored in compliance with DoW cybersecurity, Zero-Trust, and PHI/Personally Identifiable Information (PII) protection requirements.

4. Support Interoperability with Radiology Systems and Military Health System (MHS) GENESIS Enable seamless integration with Picture Archiving and Communication System (PACS), Radiology Information System (RIS), enterprise imaging platforms, and MHS GENESIS to support efficient workflow, accurate data exchange, and a unified clinical documentation ecosystem.

5. Enable Scalable Enterprise Deployment Across DHA Implement a solution that can support large, geographically dispersed radiology teams across Continental United States (CONUS) and Outside Continental United States (includes Alaska and Hawaii) (OCONUS) sites, including remote tele-radiology operations, with reliable performance and centralized management.

6. Improve Clinical Standardization and Template Governance Provide tools that allow DHA to define, manage, and enforce enterprise-wide radiology reporting templates, lexicons, and specialty vocabularies to improve uniformity, compliance, and quality.

7. Support Future Artificial Intelligence (AI)-Driven Radiology Enhancements Position DHA for future adoption of AI-enabled capabilities such as automated summaries, structured data extraction, decision support, and ambient workflow assistance, ensuring the platform can evolve with emerging technologies and policy requirements.

Specific Tasks

1.0 System Architecture & Availability

1.1 The Main and Backup systems shall operate in an Active/Active, hot-swappable configuration to enable seamless failover and minimize system downtime impact.

2.0 Workstation, PACS, and OS Integration

2.1 System must fully integrate with PACS client workstations, supporting Windows 10 and Windows 11 operating systems.

2.2 System must support deployment and operation within a government-hosted environment.

3.0 Enterprise Workload, Templates, & Reporting

3.1 System must support approximately 350 Radiologists completing roughly three million reports annually distributed across all MTFs within the enterprise.

3.2 System must automatically map appropriate templates based on: procedure code, patient gender (Male/Female), patient age, and patient location (ED, Inpatient, Outpatient).

3.3 System must allow templates to include multiple pick-lists containing macro statements within any auto-text field.

3.4 Templates must support nested fields that expand to prompt radiologists for additional specificity when completing reports.

3.5 System must allow radiologists to share reports with other radiologists for over-read/consultation purposes.

3.6 System must support Peer Review workflows, including automatic case presentation based on priors, modality type, and review quotas, with a user-initiated Peer Review Score Card.

3.7 System must provide robust administrative reporting and analytics, enabling users to search, quantify, and analyze both textual and order-level data.

3.8 System must provide an Administrator Portal supporting full system management, configuration, and audit functions.

3.9 System must allow creation of custom data sets for the purpose of validating AI algorithms during vendor evaluations.

3.10 System must allow users to search imaging findings for specific measurements (e.g., lung nodule size, AAA diameter, lesion dimensions).

3.11 System must provide functionality to analyze compliance and consistency of recommendations within reports.

3.12 System must identify processes, workflows, and outliers that require quality improvement or attention.

3.13 System must identify critical events and indicate whether communication and documentation requirements were met.

3.14 System must support isolation and extraction of discrete data elements for research activities.

4.0 Hardware & Peripheral Requirements

4.1 System must include all required peripheral input devices, including microphones, suitable for use within a Radiology PACS workstation environment.

5.0 Clinical Workflow & Critical Results

5.1 System must support Critical Results Management, enabling radiologists to easily notify referring providers or clinics during dictation when a critical finding is identified.

6.0 DoW System Integration

6.1 System must integrate with the DoW RIS (Rhapsody) and EHR (MHS GENESIS), via Application Programming Interface (API)(s) enabling bidirectional messaging and enhanced workflow.

7.0 DoW Cybersecurity & Risk Management Framework (RMF) Requirements

7.1 Vendor must provide products that already possess a current Authorization to Operate (ATO) or fully commit to undergoing the DHA RMF approval process.

7.2 Vendors must affirm compliance with all cybersecurity, Health Insurance Portability and Accountability Act (HIPAA), and Business-to-Business (B2B) requirements.

7.3 Vendor shall maintain RMF Approval for the entire Term of Support (minimum 6 years) including:

· OS updates

· Third-party component patching

· Security upgrades

· Vulnerability remediation

7.4 Cybersecurity maintenance must be included during warranty and remain available post-warranty.