Attachment_A_Collin_County_Requirements_10-4-24.xlsx
XLSX spreadsheet 67 KB Posted
- Attached to
- Electronic Health Records
- Solicitation number
- 2024-280
- Issued by
- Collin County, Texas
About this file
This document is a comprehensive Electronic Health Records (EHR) Requirements Attachment from Collin County, Texas, specifically for the Collin County Health Care Services (CCHCS) department. The county is seeking an integrated, cloud-based Electronic Health Record and Practice Management System (EHR/PMS) to support five clinics: Immunizations, Employee Health, Tuberculosis, Sexually Transmitted Infection (STI), and Substance Abuse. The proposed system must accommodate 65 users, be web-accessible via Google Chrome, provide role-based permissions, and comply with HIPAA regulations. The system should support comprehensive functionality including patient scheduling, charting, reporting, document management, patient portals, interfaces with external laboratories and imaging centers, and robust security features.
The requirements document specifies detailed technical, functional, and operational expectations for the new EHR/PMS, with particular emphasis on customization capabilities, workflow efficiency, and adaptability during public health emergencies. While pricing details are not explicitly outlined in this attachment, the county requires a solution that can handle approximately 5,100 unique patient records annually, support multiple clinic types with distinct operational needs, and provide advanced features such as telemedicine, immunization tracking, and comprehensive reporting. The system must integrate with existing county systems like Tyler Technologies' Munis for financial transactions and support potential future expansions like insurance billing and comprehensive patient record management.
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Requirements Draft Reference Number IMPORTANT INFORMATION:
Proposers shall acknowledge and respond to each requirement on this spreadsheet.
| Any responses that are answered as a yes, mean that the system will fully comply with no setup required, configurable with no changes to source code, or are provided with reporting tool. If the functionality is not available at this time the response shall be answered as no and shall be included in your proposal as "exceptions" with further explanation. Refer to Section 7.0 of the specifications for more details on Exceptions. | Technology Currently Used by Collin County? (Y/N) | Required (R), Strongly Preferred (S), Preferred (P) |
| (R/S/P) | Yes | |
| System currently performs these functions and/or agree to requirement | No |
System does not perform this function and/or cannot agree to requirement
| Written Response: Include additional comments below. If additional space is needed, you may include this as a part of your attachment titled "Detailed Response to Requirements" and note accordingly below. The detailed responses shall be in order and include the reference numbers for each requirement response. | |||
| GENERAL REQUIREMENTSGe | |||
| 5.15 | MAJOR APPLICATION COMPONENTS OF THIS PROJECT INCLUDE: | ||
| 5.15.1 | Solutions shall comply with federal Health Insurance Portability and Accountability Act (HIPAA). | Y | R |
| 5.15.2 | System shall accommodate 65 CCHCS users. | Y | R |
| 5.15.3 | System shall be integrated cloud-based and web-based solution accessible via Google Chrome. | N | R |
| 5.15.4 | System shall be role based, allowing multiple levels of permissions by groupings. | Y | R |
| 5.15.5 | System shall have search capabilities within the application. | Y | R |
| 5.15.6 | Cloud-based solutions shall comply with Collin County Information Technology Cloud Services Agreement. (Refer to Attachment C, Collin County SaaS Subscription Agreement) | N | R |
| 5.15.7 | Contractors submitting cloud-based solutions shall complete Collin County Information Technololgy's SaaS Questionnaire. (Refer to Attachment D, Collin County SaaS Questionnaire.) | N | R |
| 5.15.8 | The vendor shall have been in EHR/PMS sales and installation for more than 5 years. | Y | R |
| 5.15.9 | The vendor shall provide both an EHR system and PMS. | Y | R |
| 5.15.10 | The vendor’s EHR Product Classification shall be a “Complete” software system according to standards outlined in the Medicare Electronic Health Record Incentive Program. Modular systems will only be accepted if Modules are available that meet all requirements. (https://www.healthit.gov/data/datasets/ehr-products-used-meaningful-use-attestation) | Y | R |
| 5.15.11 | The EHR shall have a Certification Status of “Active” according to the Certified Health IT Product List (CHPL). | Y | R |
| 5.16 | CONTRACTOR QUALIFICATIONS/RESPONSIBILITIES - Shall include, but are not necessarily limited to: | ||
| 5.16.1 | The vendor shall design, engineer, order, deliver, install (with coordination and assistance from the County IT department and the API integration), produce, implement, test, develop, input software databases, document, and warrant all systems and applications proposed. | Y | R |
| 5.16.2 | The vendor shall perform all tasks necessary to develop and install all operating systems and user databases including data conversion from the existing system with coordination and assistance from the County IT department. | Y | R |
| 5.16.3 | The vendor shall meet with all necessary user groups (CCHCS, IT, and if applicable Auditor and Third Party Credit/Debit Payment contractors) to gather the information necessary to complete all final station and application database designs for all systems and applications that may be a part of any contract resulting from this RFP. | Y | R |
| 5.16.4 | The vendor shall enter all system, user and application database(s) into the appropriate systems, and test them comprehensively with coordination and assistance from the Collin County IT department. | Y | R |
| 5.16.5 | The vendor shall provide customer service, help desk, and disaster recovery services for the duration of the contract. | Y | R |
| 5.16.6 | The vendor shall provide Collin County with a comprehensive, final detailed system design configuration, including the practice management system and EHR system and all associated application systems prior to start of system installation and in accordance with an agreed upon delivery schedule reviewed and approved by Collin County. | Y | R |
| 5.16.7 | The vendor shall provide a primary contact on behalf of the contractor who will work with CCHCS and Collin County’s Information Technology (IT) department for the duration of this project and is subject to Collin County’s approval. | Y | R |
| 5.16.8 | The vendor shall clearly identify proven expertise to provide the required functionalities to meet the business needs of the CCHCS through the implementation of a practice management and EHR system. | Y | R |
| 5.16.9 | The vendor may propose optional or value-added services related to the scope of goods and/or services described in the specifications and/or listed on the Pricing/Delivery Information sheet(s) of this RFP by identifying other items and/or brands not identified by Collin County in this RFP. At a minimum, discuss service capabilities and reasons why it would be valuable for this project. | Y | P |
| FUNCTIONAL REQUIREMENTS | |||
| 5.17 | DASHBOARD | ||
| 5.17.1 | The EHR/PMS should have the ability to display automated reports, email/messages, calendar, or other important functions on an easily accessible dashboard. | N | S |
| 5.18 | FINANCIALS | ||
| 5.18.1 | Financial Record: Munis/Tyler Technologies is Collin County government’s official procurement and financial software. It is the system of record for financial transactions and the location where financial audits will be conducted. All financial transactions that occur in the EHR/PMS (payments, voids, refunds, etc.) shall be stored in Munis. All information regarding transactions shall be recorded as a permanent audit record in Tyler Technologies’ Munis system. The vendor should provide information regarding whether they have previously completed and interface with a Tyler Technologies product. | Y | R |
| 5.18.2 | Credit/Debit Card Payments: Certified Payments is Collin County’s current debit and credit card payment processor. Other payment processors may be utilized. If other vendors are proposed for this service, their fees should be listed as part of the RFP. | Y | S |
| 5.18.3 | Collin County does not currently process financial transactions using an EHR/PMS.The EHR/PMS may be integrated with Collin County’s current financial software, Munis, and have the ability to complete point of sale payment processing, generate a receipt/invoice, record a payment, void a record or receipt, debit an account, adjust a balance, reconcile a cash draw, close out collections, and comply with accounting standards that control who may perform certain tasks based on a previous action (e.g. the same person may not assess and verify a fee). | N | S |
| 5.18.4 | The EHR/PMS shall submit billing reimbursement claims to Medicaid and the Children's Health Insurance Program (CHIP). | N | R |
| 5.18.5 | In the future, Collin County Health Care Services may begin billing public and private insurance. The EHR/PMS should be able to have features turned on to complete invoicing and billing for private insurance and public insurance other than Medicaid (Medicare, etc.). If this were to occur, the solution would need to be: |
• Able to verify if insurance valid and estimate current coverage, deductibles, and coinsurance available.
• Able to generate an estimate/invoice that contains all charges, indicates the portion covered by insurance, and amount owned by patient/responsible party.
o Allow the portion of the fee owed by the patient/responsible party to be paid at the time of service.
• Provide access to an insurance clearinghouse to process all transactions and reimbursements with public and private insurance companies.
o The clearinghouse will process the insurance reimbursement payment and report transactions of payments received from insurance in Tyler Technologies’ Munis system.
| • Communicate with EHR/PMS system regarding the remaining balance not covered by patient/responsible party or insurance. Generate remaining billing statement to send to patient. | N | S | I added all but one of the items previously in 5.18.20 to this entry since they were connected. ***It is up to healthcare if you want multiple items listed in one group. It is recommended to have separate items where possible as vendors may answer "Y" but only actually meet 3 of 5 requirements or something similar. *** | |||
| 5.18.6 | System may provide the ability to build receipt template(s) and allow authorized personnel to edit template as necessary. | N | P | |||
| 5.18.7 | System may provide the ability to find any receipt after a transaction is completed and re-print the receipt when needed. Receipts may not be deleted from the system. | N | P | If Munis is still used for all non-Medicaid transactions, then this would be preferred. However, if the new EHR is completing all financial transactions (5.18.3-5), this feature would be required. | ||
| 5.18.8 | System may have ability to search transactions by claim number, transaction number, check number, party name, dollar amount, date/time recorded, or batch number. | N | P | If Munis is still used for all non-Medicaid transactions, then this would be preferred. However, if the new EHR is completing all financial transactions (5.18.3-5), this feature would be required. | ||
| 5.18.9 | System may provide ability to enter customer’s email address to automatically email their receipt when transaction is completed. Emails must only contain HIPAA-compliant information. | N | P | |||
| 5.18.10 | System may provide configurable list for payments associated with each account and allow system administrators to associate the account that will be applied to each charge type. This feature will include the ability to generate a report showing the individual charges per account by date. | N | P | If Munis is still used for all non-Medicaid transactions, then this would be preferred. However, if the new EHR is completing all financial transactions (5.18.3-5), this feature would be required. | ||
| 5.18.11 | System may have ability to reconcile unpaid transactions for an account. | N | P | |||
| 5.18.12 | System may have ability to void any transaction including related fees, and include a comment box for private clerk’s notes detailing the reason for the void. | N | P | If Munis is still used for all non-Medicaid transactions, then this would be preferred. However, if the new EHR is completing all financial transactions (5.18.3-5), this feature would be required. | ||
| 5.18.13 | System may provide ability to run a report on voided transactions to include detail of transaction, reason for void, clerk/supervisor who processed the void and any comments entered regarding the void. | N | P | If Munis is still used for all non-Medicaid transactions, then this would be preferred. However, if the new EHR is completing all financial transactions (5.18.3-5), this feature would be required. | ||
| 5.18.14 | System may have the ability to document supervisor approval for processing transactions voids, refunds, or fee waivers. | N | P | If Munis is still used for all non-Medicaid transactions, then this would be preferred. However, if the new EHR is completing all financial transactions (5.18.3-5), this feature would be required. | ||
| 5.18.15 | System may allow for the waiving of full or partial fees associated with a transaction. | N | P | If Munis is still used for all non-Medicaid transactions, then this would be preferred. However, if the new EHR is completing all financial transactions (5.18.3-5), this feature would be required. | ||
| 5.18.16 | System may have a simple user interface for cashiers that includes, but is not limited to, end of day balancing, till reconciliation, and daily reporting. | N | P | If Munis is still used for all non-Medicaid transactions, then this would be preferred. However, if the new EHR is completing all financial transactions (5.18.3-5), this feature would be required. | ||
| 5.18.17 | System may provide ability for any authorized cashier to run cash register report by user defined date range. | N | P | If Munis is still used for all non-Medicaid transactions, then this would be preferred. However, if the new EHR is completing all financial transactions (5.18.3-5), this feature would be required. | ||
| 5.18.18 | The system may have the ability to capture eligibility information that determines which transaction code is utilized by the system. The system would have multiple fields that apply to eligibility for different clinics and programs that would be customizable. Ideally, the system would be able to utilize logic to determine which billing rate should be utilized based on the service provided and eligibility data (i.e. A patient with no insurance and a household income of $500 per month will have a cost of $0.00 per vaccine). | N | P | |||
| 5.18.19 | System shall be compliant with all Center for Medicaid and Medicare Services (CMS) laws and guidelines. | Y | R | |||
| 5.19 | PHOTOS/VIDEOS/STORAGE | |||||
| 5.19.1 | System should have the ability to capture multiple photos within a client's record. | Y | S | The current system does not allow photos to be taken, only uploaded. |
Required for clinicians to be able to upload photos into a patient chart; preferred to be able to capture with an HIPAA compliant (i.e. encryption) and system compatible camera.
| 5.19.2 | System may have the capacity to upload unlimited photos. | N | P | |
| 5.19.3 | Each photo shall have the ability to associate with a category, subject, date taken, and system date stamped when uploaded. | Y | R | No camera is provided by the EHR system, making it difficult to determine HIPAA |
compliance.
| 5.19.4 | Vendor shall outline storage cost structure (Documents, Pictures, Video) | N | R | |
| 5.19.5 | Vendor shall outline costs associated with digital storage (if any) and identify if this is a one time, annual, or other cost association for documents, pictures, videos, and similar that will stored within the solution. Vendor shall also outline if there is the ability to archive data to help reduce storage and the retrieval process as necessary. | N | R | |
| 5.20 | ALERTS | |||
| 5.20.1 | The EHR/PMS system should provide an in-system solution that generates the next date in which a patient is to be given the next immunization, medication, or titer. | N | S | |
| 5.20.2 | The EHR/PMS system shall grant Collin County staff the ability to tag records based on categories such as order notes, labs, progress notes, referrals, no shows, Spanish-speaking, do not schedule, walk-in only, in-person only, etc. These categories should be be customizable. These categories shall be available for analysis in the reporting feature. | Y | R | The current system allows for clinicians to tag records, however, the tagging system is not extensive and very limited. |
| 5.20.3 | The patient chart should have a feature that alerts clinicians if there are interactions between medications a patient is taking. | Y | R | I have recently discovered that this is required as part of our Class D Pharmacy licensure. |
| 5.21 | CALENDAR | |||
| 5.21.1 | The system shall have an integrated appointment-scheduling calendar. Appointments will be created in the calendar and that appointment will be associated with a patient, a provider, work group, or multiple parties. |
• Examples of these appointments may include: immunizations appointment, drug screening, pre-employment physical, Functional Physical Capacity Assessment, wellness visit, sick visit, follow up visit, STI testing visit, STI treatment visit, TB testing visit, TB treatment visit, Substance Abuse assessment, etc.
| Y | R | |||
| 5.21.2 | A master calendar view shall be avalable for the entire organization as well as master view for individual clinics that can be grouped and sorted by different appointment types or features. | Y | R | |
| 5.21.3 | The patient’s next scheduled appointment date should appear on the calendar as a shared appointment between the primary worker (physician, nurse, etc.) and patient and an alert should appear on the primary workers’ dashboard. | N | S | |
| 5.21.4 | The calendar function shall allow for a query of the workers’ schedules, as well as accessing a patient’s specific schedule. For example, a physician has an appointment scheduled for 12:00 p.m. in the Employee Health Clinic with Patient X. The appointment shall be viewable by the patient from the patient portal. The appointment shall also be viewable by physicians and office staff on the Employee Health Clinic Calendar and the Master Calendar. From the Master Calendar, physicians and office staff shall have the ability to filter appointments by appointment type and physician/mid-level provider assigned. | Y | R | |
| 5.21.5 | The calendar shall have the following functions: Show and hide certain calendars from a user's view based on roles and business rules | Y | R | |
| 5.21.6 | The calendar shall have the following functions: Allow overrides of a restricted calendar view by authorized personnel | Y | R | |
| 5.21.7 | The calendar shall have the following functions: Show/print calendar in day, week, or month format | Y | R | |
| 5.21.8 | The calendar may have the following functions: Visual indicator of a change/new calendar appointment | N | P | |
| 5.21.9 | Printed reports from the calendar shall have the following: List of patients with specific appointment types in a date range | Y | R | |
| 5.21.10 | Printed reports from the calendar shall have the following: Individual patient calendar | Y | R | |
| 5.22 | SCHEDULING | |||
| 5.22.1 | The scheduling system shall allow for each specific clinic to maintain a schedule for booking appointments. | Y | R | |
| 5.22.2 | The system shall have the ability to set up a queue system in which a specific number of appointment slots will be available for staff to book for patients as well as the ability to assign staff to specific types of appointments. | Y | R | |
| 5.22.3 | The scheduling system shall have a tracking component for the outcomes of each appointment such as office cancelled appointment, patient cancelled appointment, no-show, office rescheduled, patient rescheduled, appointment completed, active appointment, mistake, patient deceased, other, etc. | Y | R | |
| 5.22.4 | The system shall have strong scheduling tools for administrative staff (e.g. rescheduling, messaging, automated appointment reminders) that can be easily scaled in surge events (may include significant increase in the number of appointments, quantity of messages, number of administrative staff using the system, etc.) | Y | R | |
| 5.22.5 | Collin County staff shall be able to create custom appointment reminders according to specific clinic(s) and/or appointment type(s). Collin County staff shall be able to send patients reminders, per patient preference, for preventive/follow-up care, to complete paperwork, etc. (i.e. phone, text, email, within patient portal based on preference). | Y | R | |
| 5.22.6 | New patients, not previously registered in the patient portal, should be able to request appointments online for certain clinics. | N | S | |
| 5.22.7 | During public health emergencies, the system should allow patients not previously affiliated with the clinic to make an appointment with basic demographic data only. These patients should be required to complete an eligibility-screening form prior to scheduling an appointment. Once their appointment is scheduled, they should be incorporated into normal pre-appointment form and appointment reminder workflows. | N | S | |
| 5.22.8 | When the EHR/PMS system is utilized by reception staff on the scheduling screen, basic patient information may be easily visible, such as patient name, phone number, email address, additional editable notes, and the specific appointment type. | Y | P | The current system includes some but not all of the listed information. |
Access to patient demographic information is limited in the scheduling view.
| 5.23 | FORM BUILDER | |||
| 5.23.1 | The system shall be able to create custom forms/letters in real time based on specific data in the system as well as use a set of pre-made forms based on the work flow (with embedded tokens). | N | R | |
| 5.23.2 | The business requirements for a form builder shall allow a place within the application to create needed forms for documentation purposes. | N | R | |
| 5.23.3 | The forms will range in complexity and content. The majority of the forms shall contain the basic "header" information of a client. | N | R | |
| 5.23.4 | The system shall have the ability for Collin County staff to create custom patient forms, custom charting templates, and customize system options for laboratory tests. During public health emergencies, the EHR/PMS system shall have the ability to setup a new “clinic” within the system quickly (within 24 hours), containing new appointment types, custom forms, and custom charting templates. | N | R | |
| 5.23.5 | Fields for questions/headings and responses in custom forms and charting templates shall have very high or unlimited character limits. Free text entry shall be allowed in both form/chart template questions/headings and the associated response field. | N | R | |
| 5.23.6 | A minimum of 300 custom forms and custom charting templates shall be allowable within the EHR/PMS system. | N | R | |
| 5.24 | REPORTS | |||
| 5.24.1 | The system shall include the ability to run reports based on all fields in the system. | Y | R | |
| 5.24.2 | The reporting module shall be robust and allow for staff to pull individual level reports as well as aggregate reports from all data points. | Y | R | |
| 5.24.3 | System shall have ability to export data on a designated schedule or by user defined date range without limitations. Examples of reports are: Various immunization (Texas Vaccines For Children) reports, Functional Physical Capacity Assessment reports, STD reports, TB reports, Employee Health Clinic reports, etc. | N | S | |
| 5.24.4 | Contractor shall provide examples of the reports outlined in Attachment B - Reports and show that they are able to meet the requirements for each report. | R | We do not have a copy of attachment B to reference. ***This would be list for healthcare to compile*** | |
| 5.24.5 | The system may have report scheduling tools and exporting capabilities, which include but are not limited to, automated reports with the capability to export in various formats, email distribution features, dashboard capability, etc. | N | S | |
| 5.24.6 | Fields within clinical charts shall be able to be included in customizable reporting. | Y | R | |
| 5.24.7 | Fields within patient forms shall be able to be included in reporting and analytics. | N | R | |
| 5.24.8 | The EHR/PMS system shall have the ability to track the following non-exhaustive list of data: vaccine lot numbers, vaccines administered, patient eligilibility types, number of patient visits, appointment types, diagnoses, duration of appointments, detailed lab reporting, appointments completed per health care provider, patient demographics, veteran status, etc. | N | R | The requested items in this line item resemble what is required to produce the |
TVFC, FPCA, and medical request reports outlined in line 5.24.3. These can be combined if preferred. ***Healthcare decision on whether to keep separate or combine.***
| 5.24.9 | The EHR/PMS system shall provide Collin County with a reporting feature that enables compliance with federal and state laws surrounding producing patient records upon receipt of a formal medical record request. This system feature would provide the ability to retrieve and print a specific patient’s entire or partial chart. This feature shall have the ability to filter by a date range and by document type to retrieve the items listed in the formal record request. | Y | R | |
| 5.24.10 | Reports on vaccine current inventory levels and historic inventory changes shall be available. | N | R | |
| 5.24.11 | The system shall have the capability for Collin County system administrators to generate a report of all record changes, including the user, type change, and date/time of change. | Y | R | |
| 5.25 | DOCUMENT UPLOADER/SCANNED DOCUMENTS/DOCUMENT VIEWER | |||
| 5.25.1 | The system shall allow for documents to be uploaded/scanned and associated directly with a specific patient and within the patient's file to a specific section. | Y | R | |
| 5.25.2 | System shall allow for a range of documents to be uploaded including, but not limited to, portable document format (.PDF). | Y | R | |
| 5.25.3 | System shall have ability to zoom in or out of a document using touch screen, icons or hot keys. | Y | R | |
| 5.25.4 | System may provide Optical Character Recognition (OCR) on all images. | N | P | |
| 5.25.5 | System may provide key word search within each document similar to using the Ctrl+F function in Microsoft Office. | N | P | |
| 5.25.6 | System shall have the ability to scan paper documents into the chart . | Y | R | |
| 5.26 | PATIENT PORTAL | |||
| 5.26.1 | The EHR/PMS system shall provide the ability for Collin County staff to message all patients with appointments during a specific date/time range (i.e. an emergency closure or other incident). This must be able to occur via phone, text, email, and within the patient portal. | Y | R | |
| 5.26.2 | The EHR/PMS system shall provide a patient portal that is user-friendly for both patients and staff. | Y | R | |
| 5.26.3 | The patient portal shall allow patients to self-schedule their appointments online, with the ability to handle multiple clinics, schedules, appointment types, and vaccines (with minimized need for staff interaction). | Y | R | Current system does not allow for new patients to schedule within the patient portal. Only preexisting patients who had enrolled / previously visited the clinic are able to self-schedule. |
| 5.26.4 | The patient portal shall have the ability to create forms/questionnaires pertaining to the patient’s appointment and send them via the patient portal for completion prior to their appointment. These forms and questionnaires must have the ability for logic to be included, which will determine the questions to be asked based on previous responses. | N | R | |
| 5.26.5 | The patient portal shall provide patients with electronic access via patient portal to their health information and to print records in real time. | Y | R | |
| 5.26.6 | The telemedicine solution may have the ability to take screenshots and save them in the patient chart. | N | P | Clinicians are currently able to take screenshots utilizing their device, not from within the telemedicine solution. |
| 5.26.7 | Collin County staff and clinicians shall be able to complete text-based communication with patients from within the patient portal. | Y | R | |
| 5.26.8 | Patients shall be able to request medication refills within the patient portal. | Y | R | |
| 5.26.9 | In the event of an emergency, the EHR/PMS system shall provide Collin County the ability to add a new clinic/appointment type in the system and appointments will be available within the patient portal within 24 hours. | Y | R | |
| 5.26.10 | The patient portal should be able to operate with an influx of thousands of patients simultaneously registering for and accessing the system during a public health emergency. | N | S | |
| 5.26.11 | The patient portal should be compatible with computers, cell phones, and kiosk systems to allow patients to check in and fill paperwork. | N | S | |
| TECHNICAL REQUIREMENTS | ||||
| 5.27 | SYSTEM ARCHITECTURE | |||
| 5.27.1 | The system shall utilize a Software as a Service (SaaS) cloud-based system that can be accessed from the web to allow staff to connect to the EHR/PMS system from any computer or mobile device. It is important for the software to update remotely without requiring in-house IT staff manually install updates and components on individual computers. | N | R | |
| 5.27.2 | The vendor should provide telemedicine services: This system should have the ability to chart using custom templates within the EHR/PMS system simultaneously. | |||
| Y | S | |||
| 5.27.3 | The vendor’s EHR/PMS system should contain up-to-date formularies and current procedural terminology (CPT) codes. Updates should be made to all formularies and CPTs within the EHR/PMS system within 3 months of revision(s). | N | S | |
| 5.27.4 | The system shall have the ability to manually enter new or custom products into the formulary. Collin County Health Care Services is sent medication directly from the federal government that is not yet FDA approved or a part of standard formularies in emergencies . | Y | R | |
| 5.27.5 | The vendor should provide a Health Information Exchange (HIE) to maximize the efficient approach to interoperability when receiving, sharing, and reporting clinical data and outcomes with external healthcare providers. This element should have the ability for CCHCS to adjust settings for each clinic regarding if the patient’s data may be shared (some clinics have data that cannot be shared without strict legal requirements being met) and also allow individual patients to opt out of this sharing. | N | S | |
| 5.27.6 | The EHR/PMS system should have a spell check feature within the clinical charts. | N | S | |
| 5.27.7 | System should include advanced search and filter capabilities allowing users to narrow down their search results expeditiously when searching patients, charts, templates, forms, etc. | Y | S | |
| 5.27.8 | System should have alerts to notify the scheduler of potential duplicate patient entries. | N | S | |
| 5.27.9 | The system should have the ability to maximize the efficiency of data entered by both clinicians and patients by having the data entered in one field replicated across duplicate fields in other forms/patient charts (i.e. date of birth or patient name). | N | S | |
| 5.27.10 | The vendor may include an in-system solution with the capability to conduct Video Directly Observed Therapy (VDOT). Collin County typically has 20-30 patients completing daily VDOT at any time. |
1. Alternately, the vendor may provide a solution for an interface between Collin County’s current VDOT vendor, SureAdhere, and the EHR/PMS system so that patient responses to daily forms/surveys and data on whether patients successfully completed each daily VDOT session are logged. This interface may or may not include the video recordings themselves.
| 2. If VDOT is conducted within the EHR/PMS system or an interface is built that includes video being stored in the EHR, video files should be stored for one-year minimum. | N | P | |||
| 5.27.11 | In the event of a record request, the EHR/PMS system may provide the capability for a Collin County staff member to send a direct fax from the EHR/PMS system to the requesting provider, facility, or requestor. This includes the ability to separate records based on specified categories for a record request. | N | P | ||
| 5.27.12 | The vendor may provide Collin County staff with an in-system solution that allows secure emails/faxes that can attach patient chart elements, to be sent directly from the EHR/PMS system to external stakeholders (i.e. attorneys, jail, and juvenile detention). | N | P | ||
| 5.28 | USERS | ||||
| 5.28.1 | The EHR/PMS system shall have a role-based security access within the system, allowing multiple levels of permissions by groupings. | Y | R | ||
| 5.28.2 | The EHR/PMS system may allow homepage/toolbar customization by user type for ease of use. The system may be able to have preset recommended features for each role/position on the homepage/toolbar. | Y | P | ||
| 5.28.3 | For individual access, the EHR/PMS system shall have a fluid role/permission structure that will be defined by role and individual. The roles shall be based on a range of permissions from Administrator to read only access. The roles shall be used as a basis for the permissions at the individual level. The roles shall also be flexible to be in line with supervisor/supervisee as well as independent of the hierarchical structure of the department, allowing for some roles to cut across supervisory groups | Y | R | ||
| 5.28.4 | Users shall have their own username and password to allow access to the system. The password should follow the County's requirements. Department employees shall be attached to the hierarchy of supervisors or other roles. User accounts shall be controlled by the administrative entity in which the records are assigned (e.g. Immunizations, Employee Health, STI, TB, Substance Abuse, etc.) | Y | R | ||
| 5.28.5 | User roles shall be active while employed. The system shall allow any user who is authorized through the permissions/role to suspend accounts. The Super Administrator role shall be the only role to disable an account permanently (no user should be completely deleted since a history record should be maintained of all activity). | Y | R | ||
| 5.29 | SECURITY/ADMINISTRATION AREAS | ||||
| 5.29.1 | The system shall meet all federal and state data security and confidentiality laws, including but not limited to the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology and Economic and Clinical Health Act (HITECH). The ability to establish safeguards to prevent the unlawful deletion of records and set retention policies is required. | Y | R | ||
| 5.29.2 | The system shall have HIPAA auditing and compliance capabilities. | Y | R | ||
| 5.29.3 | The system shall have the ability to customize the EHR/PMS system to specifications needed for multiple public health clinics (e.g. Immunizations, Employee Health, Tuberculosis, Sexually Transmitted Infection (STI), and Substance Abuse) with operations that differ significantly from most routine medical facilities. To be able to operate each of these clinics within the EHR, it must have the ability for Collin County staff to create custom patient forms, custom charting templates, and customize system options for laboratory tests. During public health emergencies, the EHR/PMS system must have the ability to setup a new “clinic” within the system quickly (within 24 hours), containing new appointment types, custom forms, and custom charting templates. | Y | R | ||
| 5.29.4 | A process for remote system access for troubleshooting may be outlined by the vendor. This system must be approved by Collin County IT. | Y | P | This may not be applicable if on a cloud-based system. Need to ensure that vendor is able to remote into our desktops/computers (i.e. resolving a desktop issue). | |
| 5.29.5 | The system shall be compliant with all retention schedules for local public health agencies as outlined in the Texas State Library and Archives Commission, Local Schedule (13 Texas Administrative Code §7.125(a)(11)). | Y | R | ||
| 5.29.6 | The system shall be hosted on a HIPAA compliant server. | Y | R | ||
| 5.29.7 | Where possible, Microsoft Windows Active Directory authentication shall be used to validate the user. The ability to use the Collin County Federated Systems Authentication Portal is desirable. | Y | R | ||
| 5.29.8 | User passwords shall be required to be reset every 90 days maximum. | Y | R | ||
| 5.29.9 | The system administrator for each user department shall have the ability to create, edit and delete user profiles; designate rights and roles, set or reset passwords, establish password criteria (length, character type required, etc.), manage value lists and code tables, modify layouts to include or remove fields, and other functions unique to his/her department including adding/deleting/cloning rights. Changes made by one department will not affect or change the user experience for other user departments. The ability to change the user experience for an individual shall also be able to be applied across all departments for that same user. | Y | R | ||
| 5.29.10 | All changes to any patient record shall be tracked and saved for security purposes and include the user, type, and date/time of the change. This shall include, but not be limited to, accessing a specific patient record as well as any changes to that record. Detailed information of what was changed, both the original content and the new content, must be available for review. Only designated staff will have the ability to see change history and reports. Documentation such as court orders must be allowed to be attached as documentation for changes made. The old record and documentation must be able to be hidden if it is legally required to not be disclosed. | Y | R | ||
| 5.29.11 | Records shall be able to be soft deleted from the system. No users will have the capability to hard delete a record in accordance with HIPAA law. Even if soft deleted, the system shall track any changes to the record accordingly. | Y | R | ||
| 5.29.12 | The vendor shall provide rules of engagement to Collin County for the performance of penetration testing on a yearly basis. | Y | R | ||
| 5.29.13 | The system shall comply with Health Insurance Portability and Accountability Act (HIPAA). | Y | R | ||
| 5.30 | INTERFACES | ||||
| The purpose of this section is to determine the vendor’s methods, abilities and experience in designing and developing interfaces. The required interfaces with state agencies and other external entities, including existing case management systems, are identified below with brief descriptions. At this time, specifications adequate to provide accurate cost estimates for these interfaces are not available. Specific cost estimates for these interfaces will be discussed at a later time. In your response, please answer the following questions related to your approach for constructing interfaces with external agencies: | |||||
| 5.30.1 | Laboratory Interfaces, Clinical Pathology Laboratories (CPL): An integration shall send laboratory requisitions and receive laboratory results, which can be saved easily in the appropriate patient’s chart. The system shall include a comprehensive tracking system for the reporting of all tests ordered and results received. | Y | R | ||
| 5.30.2 | Laboratory Interfaces, Alere Toxicology (Abbott Toxicology): An integration should send laboratory requisitions and receive laboratory results, which can be saved easily in the appropriate patient’s chart. The system should include a comprehensive tracking system for the reporting of all tests ordered and results received. | N | S | ||
| 5.30.3 | Laboratory Interfaces, LabCorp: An integration should to send laboratory requisitions and receive laboratory results, which can be saved easily in the appropriate patient’s chart. The system should include a comprehensive tracking system for the reporting of all tests ordered and results received. | ||||
| Collin County has two separate LabCorp accounts. This integration would need ensure that for each requisition submitted that there was an option to select which account to utilize. | N | S | |||
| 5.30.4 | Quest: An integration should send laboratory requisitions and receive laboratory results, which can be saved easily in the appropriate patient’s chart. The system should include a comprehensive tracking system for the reporting of all tests ordered and results received. | ||||
| Collin County has two separate Quest accounts. This integration would need ensure that for each requisition submitted that there was an option to select which account to utilize. | N | S | |||
| 5.30.5 | Laboratory Interfaces, Dallas County LabOnline: The vendor may provide an integration to send laboratory requisitions and receive laboratory results, which can be saved easily in the appropriate patient’s chart. The system may include a comprehensive tracking system for the reporting of all tests ordered and results received. | N | P | ||
| 5.30.6 | Laboratory Interfaces, Texas Department of of State Health Services (DSHS) Laboratory - Austin: The vendor may provide an integration to send laboratory requisitions and receive laboratory results, which can be saved easily in the appropriate patient’s chart. The system may include a comprehensive tracking system for the reporting of all tests ordered and results received. | N | P | ||
| 5.30.7 | Laboratory Interfaces, University of Florida Laboratory: The vendor may provide an integration to send laboratory requisitions and receive laboratory results, which can be saved easily in the appropriate patient’s chart. The system may include a comprehensive tracking system for the reporting of all tests ordered and results received. | N | P | ||
| 5.30.8 | Imaging, Envision Imaging: An integration shall send imaging requisitions and receive imaging results, which can be easily saved in the appropriate patient’s chart. | Y | R | ||
| 5.30.9 | Imaging, Solis Mammography: An integration should send imaging requisitions and receive imaging results, which can be easily saved in the appropriate patient’s chart. | N | S | ||
| 5.30.10 | State of Texas, Texas Department of State Health Services (DSHS), ImmTrac2: Bi-directional communication should determine if a patient has had previous vaccinations (data located in ImmTrac2), import patients’ previous vaccinations into EHR/PMS medical record from ImmTrac2, and sends new information regarding new immunizations from the EHR/PMS to ImmTrac2. Collin County currently uses a substitute DSHS system for immunizations data and vaccine management, the Texas Wide Integrated Client Encounter System (TWICES) since the current EHR/PMS does not have an ImmTrac2 API. The system is being ended by DSHS in 2024 and the EHR/PMS should complete this functionality. | ||||
| N | S | ||||
| 5.30.11 | Do you have experience with bi-directional communication with ImmTrac, or another state or federal vaccine record system? If so, do you specifically have experience with Texas' ImmTrac system? | I added this line due to our negative experience with the Greenway and such an intergration. They stated that they had experience doing bi-directional integrations with ImmTrac specifically . When they could not get the integration to work, they claimed that Texas' system, while the same as other states, had a few features turned on/off that made the data sharing impossible. I am not sure if it was true but I want to avoid this scenario in the future. | |||
| 5.30.12 | State of Texas, Texas Department of State Health Services’ (DSHS) National Base System (NBS) Electronic Disease Surveillance System (NEDSS) database for infectious disease surveillance and reporting: Currently, this system does not allow for outside interfaces. In the future, it is believed that this option will become available. The EHR/PMS solution may allow for bi-directional communication with NEDSS to submit and receive disease surveillance reports. | N | P | ||
| 5.30.13 | The EHR/PMS system may include a GIS address verification feature or interface that indicates whether a patient’s address is within Collin County or outside of the county. | N | P | ||
| 5.31 | DATA CONVERSION | ||||
| 5.31.1 | Do you have experience with data conversion from other EHR’s to your system? | N/A | R | ***Data Conversion consists of of assessing the current data types for both the source and target systems, noting the differences in data formats, and then identifying an API or ETL tool that can perform the data conversion. This is assuring the data type is ready to be migrated to the new system.*** |
To Collin County IT - If the vendor cannot migrate the data to the new EHR system, can Collin County IT convert and upload the legacy data to the county's archiving system, Laserfiche, or another server/system solution.
Data migration should be a priority - even if the IT team is able to copy over the databases - reproducing items/producing queries or reporting will most likely be a challenge and is not something that is easily reproduced across the broad range of data stored.
| 5.31.2 | If yes to 5.31.2, what EHR systems have you converted? Please identify relevant experience including reference contact information of clients. | N/A | N/A |
| 5.31.3 | The vendor shall describe any existing framework your product may include to facilitate converting data from other systems. | N/A | R |
| 5.31.4 | The vendor shall describe if/how the application’s business logic would be enforced on new data as its being converted. | N/A | R |
| 5.31.5 | The vendor shall create a data conversion plan to convert all current data and images. | N/A | R |
| 5.31.6 | The data conversion plan shall clearly define the roles and responsibilities of the contractor and Collin County. | N/A | R |
| 5.32 | RELIABILITY & DISASTER RECOVERY | ||
| 5.32.1 | The vendor shall describe their backup and business continuity strategies including a disaster recovery plan that would restore data if the cloud system’s data center was rendered unusable as a result of a natural disaster or major catastrophe. | N/A | R |
| 5.32.2 | The EHR/PMS system shall have local data backup capability and redundancy that can handle surge events/high demand periods. | N/A | R |
| 5.33 | WORKFLOW | ||
| 5.33.1 | The system shall have the ability for clinic staff to enter new medications that are not part of the system’s formulary or edit existing formulary medications. As a health department, CCHCS may receive medications from the federal government that are not yet commercially available | N | R |
| 5.33.2 | The system shall provide an enterprise clinical physician order entry and results platform. The results will only be visible by clinical staff initially until reviewed and approved for release to the patient. See required and strongly desired interfaces listed in Technology Currently Utilized by Collin County Health Care Department section. | Y | R |
| 5.33.3 | The EHR/PMS system shall provide the ability to prescribe electronically, where clinical staff can electronically send prescriptions directly to outside pharmacies. | Y | R |
| 5.33.4 | The EHR/PMS system shall maintain data on prescribed medications and controlled substances, and the ability to review and confirm history of electronic prescriptions and those manually entered. | Y | R |
| 5.33.5 | System shall allow users to search patients by any of the following fields to view a record: first name, last name, preferred name, date of birth, and last four digits of social security number. | Y | R |
| 5.33.6 | The chart shall show both the name and title of the clinician completing the charting, plus the date and time. This must also occur in the documentation for each immunization administered. | Y | R |
| 5.33.7 | In immunization records, the name and title of the individual administering vaccines should be editable so that the name and title of another provider who gave the immunization can be entered. During offsite immunization clinics, the individual who gave the vaccine may not be the same person entering the data into the EHR/PMS system. Documentation would still be needed indicating the name and title of the person updating the EHR/PMS system record. | N | S |
| 5.33.8 | The vendor should provide an in-system provider referral feature. This feature will grant clinicians the ability to refer patients to other external providers from within the EHR/PMS system | N | S |
| 5.33.9 | The system should increase productivity among clinical staff through the use of workflows that streamline their work through an integrated plan of care with clinical decision support capabilities. |
1. Within the patient portal, custom workflows should be able to be created and edited to minimize the need for staff interactions.
2. For example, a patient would schedule an appointment through the patient portal and be presented with the relevant patient paperwork to complete. Automatic reminders would be sent based on the appointment type/date and completion status of paperwork. Upon arrival for an appointment, the next required forms/chart templates would become easily available. If any follow up appointments/referrals were needed, reminders would be sent to the healthcare providers.
| 3. Example: The EHR/PMS system would have a feature for clinical staff to see when a patient has been checked-in and is ready to be taken to an exam room. Clinical staff should be able to notate which clinician has assigned themselves to the patient and which exam room will be utilized. | N | S | |||
| 5.33.10 | The system should track current medication and vaccine inventory levels. The system should allow staff to change the inventory on-hand manually as new medications/vaccines are delivered, wasted, expired, or recalled. The system should automatically decrement vaccines from the available inventory as medications are recorded in the patient chart as being administered on site | ||||
| 1. Collin County clinics often have the same vaccine that is purchased from multiple sources and must be differentiated and tracked separately (i.e. one set of vaccines owned by the State that are only available to eligible patients, another set of the same vaccine purchased by Collin County that are available to different patients, etc.). The system should have the ability to select which vaccine will be used (i.e. TVFC influenza vaccine versus Employee Health influenza vaccine). | N | S | |||
| 5.33.11 | The EHR/PMS system should have the capability for clinicians quickly and easily document multiple vaccines in one visit. The immunization record generated should be viewable in a grid/chart format rather than plain text only (i.e. One row for the MMR vaccine that lists all dates it was received, followed by one row for the Influenza vaccine and all dates it was received, etc.). Currently, nurses would rather chart in TWICES when multiple vaccinations need to be documented, as it is much faster and more efficient than the current EHR/PMS system where vaccines have to be documented separately. | ||||
| 1. Collin County clinics often have the same vaccine that is purchased from multiple sources and must be differentiated and tracked separately (i.e. one set of vaccines owned by the State that are only available to eligible patients, another set of the same vaccine purchased by Collin County that are available to different patients, etc.). The system should have the ability to select which vaccine will be used (i.e. TVFC influenza vaccine versus Employee Health influenza vaccine). | N | S | |||
| 5.33.12 | If there are patients with multiple records, the system should have the capacity to link/merge records together so that the record can be attached to a single person. The system would merge the medical record documents into a single medical record while still maintaining both patient accounts. | N | S | It's a manual process currently and does not serve as a true medical record merge. The system holds solely patient record numbers, and not medical record numbers. Whereas a true medical record merge would include both, a patient record and medical record number. (i.e. in a true medical record merge, a patient would have a single medical record number and potentially multiple patient record numbers). | |
| 5.33.13 | The system shall have the ability to expunge and non-disclose records as required by statute and in accordance with the criteria established by each user department. | Unknown | R | ||
| 5.33.14 | EHR/PMS system should have the ability to send alerts/tasks within the EHR/PMS system to all levels of staff as reminders to complete work in queue/process within required timeframes and for monitoring by supervisors (I.e. sign notes, review labs, answer patient portal questions, and renew prescriptions). | N | S | ||
| 5.34 | TEST ENVIRONMENT |
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