Attachment 1 - FY24 RPMS InterSystems Software Bundle SOW_FINAL draft.docx

Statement of Work (SOW) InterSystems Software Bundle Licenses and Product Support Services For the Resource Patient Management System Health Information Technology Platform and Program

1. General Information

1.1. General: This is a non-personal services contract to procure InterSystems product licenses and support services. The Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to Contractor who in turn shall be responsible to the Government.

1.2. Description of Services/Introduction: Contractor shall provide all non-personal services necessary to perform operations support services as defined in this Statement of Work except for those items specified as government furnished property and services. Contractor shall perform to the standards in this SOW. Comment by Corbin, Julie (IHS/HQ): Delete per conversation with Darby this afternoon.

1.3. Background: The Indian Health Service (IHS) develops and supports a comprehensive integrated health information system of systems which support a broad range of clinical and business functions at IHS, Tribal and Urban (I/T/U) hospitals and clinics across the country. The Resource and Patient Management System (RPMS) is similar to the Veterans Health Information Systems and Technology Architecture (VistA) in use at the Veterans Administration, having been derived from the same legacy system and sharing many of the same infrastructure and business applications. The RPMS as currently deployed has a Massachusetts General Hospital Utility Multi-Programming System (MUMPS) (InterSystems Cache) database architecture and VA FileMan file structures. A number of graphical user interface (GUI) applications utilizing various languages, ranging from Delphi to C# .NET, have been developed to support certain business processes, while other applications retain legacy character-based interfaces. RPMS GUI applications principally use a two-tiered architecture utilizing broker-based remote procedure calls, although recent development has focused on a three-tier architecture using web services.

Business functions supported by the RPMS include, but are not limited to, practice management (e.g. patient registration, scheduling, billing and accounts receivable, release of information), ancillary clinical applications (e.g. inpatient and outpatient pharmacy, laboratory, radiology, image archiving, consults and referrals), and point of care clinical applications for behavioral health, inpatient and ambulatory care. The RPMS is certified as a Complete Electronic Health Record (CEHR) for inpatient and ambulatory settings according to the 2015 version certification criteria published by the Office of the National Coordinator (ONC) for Health Information Technology (HIT). In recent years, the system has been extended to include a personal health record (PHR) system, RPMS Direct secure messaging, a health information exchange (HIE) system, and supporting middleware services.

2. Objectives: The objectives of this contract are to provide license(s), maintenance, software updates, training and technical assistance of InterSystems software products. Key products and service areas are listed below.

· InterSystems IRIS for Health

· Includes legacy Caché, Ensemble, HealthShare HS4 products and DeepSee features

· HealthShare Unified Care Record

· HealthShare Patient Index

· HealthShare Health Connect

· Option to include licensing in bundle for HealthShare Health Insight

· Consultation

· Option to include Training Development and Delivery

· Maintenance and Software updates

3. Qualifications:

Support services for all products included in this SOW for maintenance, technical assistance and training will be provided by qualified manufacture certified employees.

4. Period of Performance: The period of performance outlined is this SOW shall consist of one base year plus 4 option years.

5. Place of Performance: All work shall be performed at Contractor’s place of business. No travel will be required. Comment by Corbin, Julie (IHS/HQ): No travel per conversation with Darby last time.

6. Contractor’s personnel are expected to conform to the duty hours of 8:00 AM to 6:30 PM Mountain Standard Time, Monday through Friday, with the exception of Federal Government holidays. Federal holidays should be staffed at an operational level that provides for qualified personnel to respond to emergency situations. While 24/7 support is not expected on a regular basis, however when the need arises to address an emergency, a request for support will be initiated via the Contractor’s World Wide Response Center (WRC) helpdesk.

For the purposes of planning the work identified in this SOW, recognized federal holidays are listed below. Contractor shall not perform training services on federal holidays.

Independence Day

7. Scope: This SOW provides the following task areas. Comment by Corbin, Julie (IHS/HQ): Delete per conversation with Darby this afternoon.

1. Licensing for an InterSystems software bundle that will include:

· InterSystems IRIS for Health - Currently used throughout RPMS installations in IHS.

· Includes legacy Caché, Ensemble, HealthShare HS4 products and DeepSee features

· HealthShare Unified Care Record – Currently used in central environment to support IHS health information exchange

· HealthShare Patient Index – Currently used in central environment to support IHS Master Patient Index

· HealthShare Health Connect – Currently used in central for electronic prescribing

· Option to include licensing in bundle for HealthShare Health Insight – Would be used in central environment for potential future analytics purposes Comment by Corbin, Julie (IHS/HQ): Ask for optional CLIN estimate Comment by Corbin, Julie (IHS/HQ): @Darby, per our discussion today, you will create a CLIN table to include optional CLINs. This table should be inserted as section 8 – Requirements. This section can also include Tasks.

· Maintenance (Software Updates and Technical Assistance)

2. Option to include Training Development and Delivery Comment by Corbin, Julie (IHS/HQ): Ask for optional CLIN estimate Comment by Corbin, Julie (IHS/HQ): @Darby, same comments as above.

3. Retrospective Review Meetings

4. Monthly Distributed Licenses Report

8. Requirements:

8.1. Contract Line Items

The following table contains the contract line items (CLIN’s) that will be required or optional to be delivered during the contract’s period of performance.

Base Period

Option Period 1

Option Period 2

Option Period 3

Option Period 4

8.2. Task 1 – InterSystems Software Bundle Licenses:

Contractor shall provide the Licensed Software under a software bundle (“Software Bundle”) that may be used on any number of IHS-operated systems that are used by federal IHS sites as well as tribal and urban organizations that have active agreements with IHS. The Software Bundle may be used for all IHS applications and use cases that currently utilize the Licensed Software, in addition with two further use cases.

The existing applications and use cases are:

· The Resource and Patient Management System Electronic Health record (“RPMS”) as implemented in its current scope.

· Interfacing with the Surescripts electronic prescribing service.

· The 4DH Health Information Exchange project.

The list of additional use cases will include:

· A legacy data archive for RPMS data.

· Interoperability requirements related to the IHS EHR Modernization Project, including Interoperability between the solution that succeeds RPMS and other internal and external IHS applications and services. Additionally, support for certification criteria, policies, and standards such as those updated by the Office of the National Coordinator for Health Information Technology (ONC).

Below is a detailed description of IHS applications and current use cases for the purposes of explaining how each product is utilized within the RPMS architecture. These use cases are not meant to stipulate how the licenses will be used within IHS, only to describe their current usage. Under this software bundle , the IHS has the flexibility to employ the software and licenses where they are needed without restriction within the existing use cases.

8.2.1. InterSystems IRIS for Health:

Contractor is providing IRIS for Health Enterprise to the government as part of the Software Bundle. Contractor shall continue to distribute and support licenses for legacy products and features, including the legacy products and features of Caché, Ensemble, HealthShare HS4, and DeepSee, until all RPMS instances operated by IHS have been migrated to IRIS for Health.

Contractor shall continue to work with the government to support the current licensing schema, which involves distributing discrete, named, and appropriately sized software licenses to individual sites and facilities that are authorized to run the RPMS under the terms of this requirement. Each site will be provided with a production license required to run IRIS for Health or the legacy software required to support its current RPMS system. Standard product licensing includes production licenses needed to support daily operations and licenses to support redundant systems used for failover purposes. Systems used for analytics or reporting shall be considered production systems and be included in Production system licensing. Training and development system licenses are included at no additional cost – see section 7.2.

With the continued payment of fees covering InterSystems Software Updates and Technical Assistance (SUTA) programs according to IHS capacity management metrics (see section 7.1.12), Contractor shall provide the government with the HealthShare and IRIS for Health software licenses required to deploy a cloud-enabled archive data repository that will facilitate the migration and storage of historical information from RPMS systems. This will enable IHS to incrementally decommission RPMS as it works to implement a new Electronic Health Record (EHR) in furtherance of its Health Information Technology (HIT) modernization strategy. This requirement incorporates software licenses only and does not extend to infrastructure (hardware, operating system, cloud hosting, etc.), configuration, or implementation services. However, Contractor shall work with the government to provide advice and guidance on how best to approach this objective.

The Resource and Patient Management System (RPMS) is the IHS legacy Health Information Technology (HIT) solution. As part of the Health Information Technology Systems Support (HITSS) investment, it is comprised of a network of systems, including a legacy data archive, Health Information Exchange (HIE) network, and interoperability suite known as the Four-Directions Hub (4DH), created to support the IHS mission to deliver high quality health care to American Indians and Alaska Natives, who consist of more than 550 Federal, Tribal, and Urban facilities nationwide. The RPMS is critical to IHS operations; it combines practice management, medical, behavioral health, population health, and performance reporting functions into a comprehensive certified electronic health record (EHR) suite.

8.2.2. HealthShare Unified Care Record Licensing

HealthShare Unified Care Record (UCR) is used in a central environment to support the IHS health information exchange used in the Four Directions Hub (4DH) project. 4DH is an EHR-agnostic interoperability system that supports Electronic Health Record (EHR) modernization.

4DH utilizes InterSystems HealthShare as the foundation for a suite of options that are well-positioned in IHS RPMS Network. The suite includes HealthShare UCR supporting the certified CCDA and other data from all federal and interested tribal and urban facilities and can use this data as a source for health information exchange and access by patients to their personal health information. Uses for the 4DH data and capabilities include business analytics, population health, performance management, and quality reporting.

Production and non-production HealthShare Unified Care Record Enterprise licenses and all required Software Updates and Technical Assistance will be provided with this agreement.

8.2.3. HealthShare Patient Index-Licensing

HealthShare Patient Index is used in a central environment to support IHS health information exchange used for the IHS project named Four Directions Hub (4DH). It is an enterprise master patient index (EMPI) product that provides an automated and easily integrated solution for creating a “single source of truth” for patient identity and demographic information. Patient Index is pre-configured to work with HealthShare UCR to accelerate the merging of multi-source patient information into a single, accurate, unified care record. Patient Index use cases include:

· Automatically linking large volumes of records in accordance with business rules to create a unified care record within a healthcare enterprise, across a health information network, or embedded within another solution

· Recognizing the creation of duplicate records in real time and triggering corrective actions

The HealthShare Patient Index licensing shall include:

· HealthShare Patient Index, Healthcare Enterprise licenses, including Software Updates and Technical Assistance

· Production Instances, including Software Updates and Technical Assistance

· Non-Production Instances, including Software Updates and Technical Assistance

8.2.4. HealthShare Health Connect Licensing

HealthShare Health Connect is used in a central environment for electronic prescribing. HealthShare Health Connect is the platform that connects IHS to a vendor electronic prescribing service to allow for the electronic prescribing of medications to external pharmacies. It is necessary to maintain existing HealthShare Health Connect licenses to ensure continued connectivity and support for the agency’s electronic prescribing functionality.

8.2.5. Option to include licensing in bundle for HealthShare Health Insight Licensing If option is executed, HealthShare Health Insight would be used in a central environment for business analytics and business intelligence. For the purposes of positioning the IHS for potential options to support modernization, the government is planning for optional licensing to support the exploration of using the HealthShare Health Insight product.

The HealthShare Health Insight licensing shall include:

· Development Licenses for HealthShare Health Insight to explore the product. Should the government include Health Insight as a production solution, a contract line item is proposed as optional.

8.2.6. License Capacity Management

The approach that will be used for license capacity management will be annual monitoring of a single capacity metric. The metric that will be used to determine the IHS license is the Annual IHS Patient Encounters (“Patient Encounters”). This metric is publicly available and is directly aligned with the mission of the IHS.

Patient Encounters will be calculated on an annual basis by adding together two values from the most recent annual IHS Congressional Budget Justification report: Annual Inpatient Admissions and Annual Outpatient Visits. To avoid significant annual capacity variations that may result from occasional anomalies, the value of the metric will be based on the largest value over the three most recent annual reports.

8.2.7. Key Management

The COR shall provide an initial listing of sites and current inventory of InterSystems products and licenses utilized that will be considered the baseline for the purposes of this SOW. Contractor shall provide, and IHS will utilize, license keys sized to enable the use of the Software Bundle consistent with the License Capacity Management terms.

Contractor and the government will be responsible for maintaining and reconciling an accurate inventory of licenses used by each facility that includes the respective software products, number of concurrent user license units, license key information, and other pertinent identifying data. Mutual reconciliation of the license inventory list shall be performed by the Contractor and government annually for the duration of this contract.

Any future license request(s) from entities not on the original listing that originate from an IHS/Tribal/Urban healthcare organization shall be coordinated through and originate from the COR or authorized designee to determine if the requesting facility is an eligible participant covered under this SOW. All license requests will be delivered via electronic mail to the following email: IHSDITInterSystemsSupport@ihs.gov

8.2.8. Training, Developer, and Test System Licensing

Contractor shall provide licensing for all non-production systems (training, developer, and test) for products as identified for each applicable system. Non-production systems are used periodically as needed, for the purposes of training, developing, and testing of IHS owned Government-Off-The-Shelf (GOTS) and other Commercial-Off-The-Shelf (COTS) applications, and are not considered production systems. Contractor shall provide complimentary non-production system licenses for all licensed software products that are covered by this agreement. All license requests shall be delivered via electronic mail to the following email: IHSDITInterSystemsSupport@ihs.gov

8.3. Task 2 - Software Maintenance Updates

Contractor shall provide notice of updates concerning maintenance software releases for all products purchased as part of the SOW. Where need arises, Contractor shall provide technical assistance with the maintenance releases.

All technical assistance requests by IHS covered entities for the software maintenance releases and products shall be requested via Contractor’s WRC and validated to ensure the requesting organization is eligible for support under this SOW and conforms to the current configuration of the IHS. Technical support during IHS’ implementation and deployment of the products will ordinarily take the form of remote support delivery.

The IHS strives to maintain a standard configuration throughout its enterprise and therefore Contractor shall coordinate any request from Federal/Tribal/Urban entities covered under this SOW through the COR and task leads in the IHS, Office of Information Technology (OIT), Computer Systems Management Team (CSMT) via electronic mail to the following email: ITSCCSMT@ihs.gov before advising the requesting organization on version upgrades.

Intersystems Software Maintenance Updates are further described in the HealthShare Product Terms attached hereto as Attachment B.

8.3.1. Consultation

Contractor shall provide advice and assistance to IHS staff on its particular configuration and use of the Licensed Software as part of Technical Assistance.

Consultation shall also include provisioning of complimentary conference passes to the annual InterSystems conference whenever it is held during the period of performance of this contract.

8.4. Task 3 - Option to include Training Development and Delivery

8.4.1. Training Development

If option is executed, Contractor shall provide Training Services on topics that support the use InterSystems products purchased by the Indian Health Service under the terms of this contract. Contractor shall consult with the government to help determine an annual training plan for these software products, as required.

Contractor shall make its Learning Services resources available to IHS, which may include the delivery of pre-existing training sessions on particular topics of interest to IHS. Each training session shall include the use of using Best Practice training standards, software and hardware programs and/or simulation and may include the following materials:

· Course manuals, workbooks, handouts, completion certificates, and course evaluation forms.

8.4.2. Training Delivery

If option is executed, Contractor shall deliver training through various modalities agreed upon during the delivery of the annual training plan. Below are acceptable forums.

· Instructor-led remote training (“Virtual Classroom Training”). The subject matter shall be agreed upon and identified in the annual training plan.

· Standard on demand prerecorded audio/video sessions shall be made available over the Internet (“On Demand Training”). These prerecorded audio/video sessions shall be reviewed by the COR annually for content verification. On Demand Training will be made available to IHS at no cost.

Contractor shall provide PowerPoint slides, documents, examples, sample test questions, and other materials as appropriate. Training materials shall comply with HHS Section 508 Accessibility Standards.

Incidental Training Services for the purposes of supporting IHS Health Information Technology innovation shall be provided upon request. Training shall include product areas that the IHS wishes to explore such as HealthShare Personal Community or Health Insight. Incidental Training shall not be included as part of the annual training plan and shall be executed only as an optional task of each period of performance with this SOW.

8.5. Task 4 - Retrospective Reviews

InterSystems shall engage in a quarterly meeting within each period of performance with a team of IHS Personnel to discuss the Retrospective Reviews. The IHS team may include the; DIT Division Director, Enterprise Architect, Supervisor of Development, Supervisor of Configuration Systems Management Team, Supervisor(s) RPMS Informatics and HIT Lead Program/Project Manager. This meeting may occur in person or through a virtual audio/video connection.

8.6. Task 5 - Reporting

InterSystems shall participate in an orientation briefing and thereafter will provide a weekly status report that summarizes all open tickets through the WRC, and provide a monthly report of all distributed licenses to the COR. The Parties will discuss and agree to reasonable reporting schedules and detail appropriate to specific IHS goals and targets over the course of the contract.

Within 30 days of award, as agreed upon by both parties, InterSystems shall conduct an orientation briefing for the Government. The Government does not want an elaborate orientation briefing nor does it expect InterSystems to expend significant resources in preparation for this briefing. The intent of the briefing is to initiate the communication process between the Government and InterSystems by introducing key task participants and explaining their roles, reviewing communication ground rules, and assuring a common understanding of subtask requirements and objectives.

The orientation briefing shall be held at the Government's facility or via conference call and the date and time will be mutually agreed upon by both parties.

The completion of this briefing shall result in the following:

· Introduction of both InterSystems and Government personnel performing work under this contract.

· InterSystems shall demonstrate confirmation of their understanding of the Maintenance and Technical Assistance Services to be provided under this SOW.

· Provide or provision access to the weekly status report (Problem Summary Report through the WRC) – The report shall include Active Open Tickets with details that include:

· WRC Ticket Number

· Date Ticket Initiated

· IHS Representative Initiator, if applicable

· InterSystems Analyst

· Problem Product

· Problem Description

· Priority

· Monthly distributed license report – Details of delivery to be finalized and mutually agreed upon, but shall include a list of all active distributed licenses in a Comma Separated Value (CSV) format, which can be used to assist the IHS with the ongoing monitoring of distributed licenses.

9. Security Requirements Proprietary and confidential Information Contractor shall maintain security processes that prevent the release, publication, or disclosure of information to unauthorized personnel, and protect such information in accordance with provisions of the following laws and any other pertinent laws and regulations governing the confidentiality of sensitive information: 18 U.S.C. 641 (Criminal Code: Public Money, Property or Records); 18 U.S.C. 1905 (Criminal Code: Disclosure of Confidential Information); and Public Law 96-511 (Paperwork Reduction Act).

Security, clinical, and all other product alerts for InterSystems products will be delivered via electronic mail to the following email: ITSCCSMT@ihs.gov, as well as other identified resources as managed throughout the life of the contract.

10. Schedule of Deliverables:

This schedule of deliverables lists any reports or documentation that is required as a deliverable to include the due date, frequency, medium/format and who/where it is to be submitted. Vendors may propose a revised schedule of deliverables in support of their proposed methodology. Schedule of deliverables shall be established during the contract kick-off meeting.

11. Correspondence:

To promote timely and effective administration, correspondence shall be subject to the following procedures:

a) Technical correspondence (where technical issues relating to compliance with the requirements herein) shall be addressed to the COR with an information copy to the Contract Administrator (CA).

b) All other correspondence (that which proposes or otherwise involves waivers, deviations or modifications to the requirements, terms or conditions of this (SOW) shall be addressed to the Contracting Officer with an information copy to the COR.

12. Contract Type:

Firm Fixed Price

13. Government Furnished Equipment N/A