BORIM RFR QA Document 1.docx

Commonwealth of Massachusetts Department of Public Health Board of Registration in Medicine (BORIM)

QUESTIONS AND ANSWERS #1

regarding the

Request for Responses for the Physician Online License Management System

Document Number: 19CBBORIMLICENSERFR

COMMBUYS Bid Number: BD-19-1039-EHS01-EHS01-39914

Q & A Issue Date: June 14, 2019

This document contains responses to questions received regarding the Request for Responses for the Physician Online License Management System issued by the Executive Office of Health and Human Services (EOHHS) on behalf of BORIM on May 17, 2019. Answers have been provided to those questions which are of general interest and relevant to the preparation of a response to the RFR. BORIM expects to issue an additional question and answer document at a later date.

Capacity Information Q1. How many users does the Commonwealth anticipate having on the proposed solution? What are use expectations for each user type? In particular, in what capacity will external users be involved in the system and do they need authenticated logins?

A1. It is anticipated that there would be multiple categories of users requiring access to the system, currently as follows:

a. BORIM Staff: There are currently no more than 75 BORIM staff and contractors. Of that number, approximately 20 are continually involved in licensing functions, including 6 in Licensing Supervisors and 14 Licensing Analysts. Attachment 1: Requirements for the Online Initial Licensing Application of the RFR details the functions performed by the BORIM staff, which we anticipate would dictate their level of user access.

b. Training Facility Administrators: There are also approximately 100 Training Facility administrators who participate in Initial Limited licensing functions at their respective facilities. Attachment 1: Requirements for the Online Initial Licensing Application of the RFR details the functions performed by the Training Facility administrators, which we anticipate would dictate their level of user access.

c. External Users: External users can include applicants, licensees and prior licensees, as well as submitters of complaints. It is expected that all applicants, licensees, and prior licensees will maintain a user account to apply for and manage licenses using authenticated logins; information regarding the number of applicants and licensees is provided in the response to Question 2.

d. Public Users: Public users include viewers of physician profiles and individuals who file a complaint, which would not require user accounts.

BORIM would expect any solution to be scalable to accommodate an increase in all user types.

Q2. How many applications, renewals, licenses (by type) and complaints are processed each year?

A2. Below please find information regarding the applications, renewals, licenses and complaints processed by the system:

Full Licenses and Limited Licenses BORIM issued 2129 Full Licenses and 1803 Limited Licenses in 2018.

Seasonality effects of higher volumes occur based on the Medical school education cycle, with Full License applications peaking at double the average in February to approximately 360 applications, and with Limited License applications peaking in April at six times the average to approximately 912 applications. In April of this year, over 959 applications for both Full Licenses and Limited Licenses were received and needed to be processed.

The process by which Full Licenses and Limited Licenses are obtained is set forth in Sections 1.2 and 1.3 of Attachment 1 to the RFR, respectively.

Renewals Full Renewals occur every two years, and renewal date is driven by physician date of birth, such that renewals are expected to be spread uniformly over the year, with history showing more renewals occurring in odd years.

Limited Renewals are yearly, and most training programs are of three year’s duration.

In 2018, there were 14,703 Full Renewals and 3,447 Limited Renewals. In 2017, there were 20,901 Full Renewals and 3,084 Limited Renewals.

The process by which Renewal Licenses are obtained is set forth on www.mass.gov/massmedboard.

Lapsed Licenses Lapsed Full Licenses are those which were not renewed by the due date. The process to reinstate a Lapsed License is similar to an initial Full license (given that BORIM does hold the vast majority of information already.) BORIM reinstated 198 lapsed licenses in 2018, and 237 lapsed licenses in 2017.

Temporary Licenses There were 8 Temporary Licenses issued and 13 renewed in 2018, and there were 17 Temporary Licenses issued and 19 renewed in 2019. The process to grant a Temporary License is similar to an initial Full license, and is done when the physician intends to practice in Massachusetts for a defined duration or specific event.

Complaints There were 480 complaints received in total in 2018. The five-year annual average of complaints received between 2014 and 2018 is 438 complaints.

BORIM would expect any solution to be scalable to accommodate an increase in all application types, including during times of stress / high volume.

Other Systems Information and Requirements Q3. Please list all required integrations, and if there is an available API? Is there an available API to integrate with the Federation Credentials Verification Service (FCVS)?

A3. It is incumbent on the bidder to replace all functionalities of the current system. If a bidder’s solution proposes replacing licensing functionality all at once, then APIs may not be needed. However, if the bidder suggests a phased approach, then APIs may be needed, as further discussed in the response to Question 5. There is a web service capability to verify that an FCVS profile exists and return rudimentary demographic and biographic data, however there is no capability as of yet to transfer the complete contents of the profile for consideration of licensing, other than manually downloading the profile. As further discussed in the response to Question 4, BORIM welcomes the maximum use of external data where possible, and the flexibility to adopt further integration opportunities is strongly preferred as stated in Section 2.1.1. General Business Requirements of Attachment 1 of the RFR.

Q4. Attachment 1, Section 1.2: Where does the data to pre-populate an application with a current integration come from? Please provide information regarding the specific data sources and any integration methods required.

A4. Data in the system already for an applicant should pre-populate, e.g., a Limited Licensee when applying for a Full license will have demographic and biographic data prepopulated.

The additional data that BORIM desires to prepopulate includes data such as US, Canadian, Puerto Rican, and other International Medical Schools; Board Certifications and related Subspecialties; and Massachusetts Healthcare facilities.

Q5. What is the Commonwealth's payment gateway?

A5. As set forth in Sections 2.3.24 and 2.4.18 of Attachment 1 of the RFR, the Commonwealth’s payment provider is FISERV.

Q6. Is a date/time stamped tied to a validated electronic signature adequate, or is the Commonwealth expecting integration of a tool like DocuSign or other e-signature company?

A6. Using a validated and date/time-stamped electronic signature is adequate, but preference will be given to solutions that use technology to provide the most efficient solution that will be viable for many years. Additionally, the expectation is that any vendor solution would be compliant with the Massachusetts Uniform Electronic Transactions Act, Mass. Gen. Laws ch. 100G.

Q7. Will the Commonwealth need off-line inspection capability for remote areas, as part of this project or at a later date? If so, how many field inspectors require offline inspection capability?

A7. It is not anticipated that BORIM staff or any other users will require an offline capability.

Q8. Is the expectation that your centralized IT and/or IT department will maintain and support the solution after Go Live? If not, as Post-Go Live Managed Services are provided with cloud hosting, are you open to cloud hosting your solution?

A8. We expect the contractor to take on management support as set forth in Section 3.2 and Attachment 2 of the RFR. Our expectation is that the vendor would maintain / manage the system post Go Live. BORIM is open to a cloud hosted solution.

Q9. Would you prefer UAT to be managed by the vendor or internally by your project team?

A9. We expect the contractor to take on management support as set forth in Section 3.2 and Attachment 2 of the RFR. BORIM prefers that UAT will be managed internally with support from the vendor. The vendor will develop all UAT scripts in concert with the SMEs. The vendor may propose testing tools currently used which would be available to BORIM at no additional cost.

Q10. Has a cost analysis of hardware needed for On Premise solutions vs Cloud hosting been performed? If so, is there a preference between the two? For an on premise solution, what DB technology does BORIM anticipate using? Can you disclose what capacity BORIM has for a virtual environment, specifically with respect to CPU cores and server RAM?

A10. As stated in Attachment 1: Requirements for the Online Initial Licensing Application Section 2.1.2, “should the Bidder propose an on-premises solution, understand that the solution will be hosted by a Massachusetts EOTSS cloud hosting provider partner.” There is no provision for a locally-hosted solution, with “locally” meaning within BORIM’s Wakefield location or any Commonwealth data center.

Q11. For a SaaS solution, does BORIM prefer a dedicated application and database environment over a multi-tenant solution (agency users and data in same environment as other clients)?

A11. Multi-tenant solutions are acceptable to reduce operations and support costs, however all BORIM data must be fully segregated from all other customer data, be encrypted in transit and in rest, with distinct administrative privileges assigned to individuals signing the Intellectual Property and Work Effort Agreement for Vendor's Employees, Consultants, and Agents in Attachment 2 Template SOW Exhibit A and bound by the Data Management And Confidentiality Agreement in Attachment 2 Template SOW Exhibit B. All cloud solutions must meet the Commonwealth's established requirements for cloud offerings described in Attachment 2 Template SOW Exhibit D and the application guidelines set out in Attachment 5 EOHHS IT Applications Reference Manual.

Q12. Would BORIM consider maintaining initial application and complaint supporting files in a Bidder’s platform in lieu of OnBase Enterprise Content Management?

A12. OnBase is the enterprise content management (“ECM”) system of record for BORIM. While bidders may propose a document management capability to support their active license processing, any proposal would need to provide information regarding the migration of the data to the new ECM.

Q13. Can the State please provide the version of Hyland OnBase being used by BORIM?

A13. OnBase Version 17 is currently being used by BORIM, with migrations to the newly –released versions in accordance with the EOTSS Business Performance Management group.

Q14. Does not having prior experience using OnBase disqualify a Bidder?

A14. No, however the Bidder should discuss relevant experience with Enterprise Content Management Systems.

Q15. In the RFR section 3.1.2 Implementation of Related Functions of the Online License Management System, it is stated that the bidder will replaced the existing BORIM licensing database, CLARIS, and to provide the functions of the current BORIM Applications Portfolio, as detailed in Appendix A. However, Attachment 1, page 6, states: The application shall have ensured compatibility with current BORIM online tools for physicians and the general public, including Physician Profiles, Online Renewals, and Online Complaints. Is it more desirable for the state to receive proposals for:

A. an online initial applications system that runs in parallel with the other existing BORIM applications (CLARIS, OLR, OLLR, Physician Profiles, Online Complaint Forms, and License Verification Webservice) or B. the proposal to include replacement of all of the applications in a single implementation that potentially decreases the 5-10 year cost of the entire BORIM product suite?

A15. The language in Attachment 1 was included in error. Please see Amendment 2, subsection 3, which deletes the language from Section 2.1.1 of Attachment 1, for clarity. The BORIM desires to procure an Online License Management System that will provide an Online Licensing Application and replace the functions of the existing BORIM Applications Portfolio. It is incumbent on the Bidder to demonstrate how their system will address all of the functions of the BORIM Applications Portfolio and their schedule by which to accomplish this, with consideration to the capabilities of their existing solution. Currently, all data is resident in the CLARIS system which is slated for replacement.

It is anticipated that renewals and web services would be a core function of any Bidder’s solution. Given specific processes, policies, and regulations in the Commonwealth and the Board, it is less certain how a Bidder’s current solution would replace the Profiles and Complaints functions, and this must be addressed in the Bidder’s proposal.

Q16. As a bidder proposing a commercial-off-the-shelf software solution, we assume that the proposed system must meet the functional requirements provided in the RFR and any design-related descriptions (e.g., radio button, dropdown, etc.) are provided as a reference only. Can the State please confirm if our understanding is correct?

A16. Correct. The requirements are intended to demonstrate the level of interaction with the applicant, and the nature of the required data to be retained, however the bidder may propose alternative methods in its bid. BORIM expects that the bidder will maximize data quality through the use of standard data sets where applicable.

Project Planning Q17. Is there a preference for project structure/approach? (e.g. Phased approach or Big bang approach) A17. RFR Section 1.1 states that, “there is an immediate need for the implementation of the Online Licensing Application. BORIM’s expectation is that the Online Licensing Application shall be operational within nine (9) months of contract award. While BORIM would prefer a complete system inclusive of all required functions, due to the timeline, BORIM will consider a phased approach.” Bidders should provide their schedule to replace the functions of the BORIM Applications Portfolio as required in RFR Section 4.3.2.4 Programmatic/Technical Services, and as will be evaluated in RFR Section 4.4 Evaluation Criteria.

Q18. To aid in the development of a project plan, can the state please provide the number of full-time equivalent (FTE) system administrators it plans to make available for this project? System administrators are individuals who will be trained on how to configure and administer the system to meet agency needs.

A18. BORIM’s definition of a System Administrator is a Licensing Analyst or Supervisor who can perform the functions as described in Attachment 1 Section 3.2 Supervisor Console Requirements, and as stated in Attachment 1 Section 2.1.1 General Business Requirements, “can add/delete/edit questions and data collection requirements on the application without vendor assistance to meet emergent regulatory requirements.” While BORIM will make available the resources to ensure that the selected proposal can be administered, BORIM will not be providing database administrator / system administrator support; it is expected that the vendor provide this support.

Q19. For systems with just initial applications, we have avoided migrating applications “in progress” by having a period when the current system no longer accepts applications and that group of people has complicated the licensure process. As a result, the data migration budget is dramatically reduced. Is this an option BORIM would consider?

A19. BORIM intends there will be a cutover date to begin using the Online Application, with a goal of minimizing the in-process applications to migrate. However, some licensing processes are of such duration that BORIM would expect to migrate any applications that prevent the retirement of CLARIS. Bidders should also recognize the value of introducing the new system to capitalize on communication and process visibility.

Q20. Attachment 2, Support and Training, ExhD-2: Please provide more clarification surrounding the requirement that the “Service Provider must provide technical support for BORIM Users to contact Provider personnel via online helpdesk and toll-free phone number, Monday through Friday from 8:00 a.m. to 6:00 p.m. Eastern Time, and with contingency availability 24x7x365.” Specifically,

· Will providers contact the Contractor directly?

· What type of support is the Contractor required to provide?

· Please confirm BORIM staff will not need to access the Contractor’s phone system.

A20. BORIM expects that through high system availability and automated features such as auto-registration and password change management, applicants will have a seamless application process, exclusive of specific content –related questions in their specific case which would be addressed by BORIM staff during working hours. BORIM further expects that the vendor would self-monitor the Portfolio and initiate response to outages, and have at a minimum an on-call capability to respond to outages and emergency staff requests as addressed in SOW Exhibit D, Support and Training Section.

BORIM does not anticipate that applicants and licensees will contact the vendor.

BORIM does not expect to require access to the vendor’s phone system.

Budget Information Q21. What is the allocated budget for the initial implementation and ongoing system maintenance, hosting, future enhancements and support beyond the initial implementation of the proposed solution? What has the Commonwealth spent on the initial implementation, annual support, hosting, enhancements and change orders for the current BORIM system(s)?

A21. BORIM is not releasing an anticipated budget for this procurement, or other related historical or current spend information.

RFR History Q22. Please provide the top 5 reasons that are leading you to move from your legacy system.

A22. Pursuant to Section 1.1 of the RFR, as amended, BORIM is replacing the legacy system for the following reasons:

· Shorten the timeframe from application submission to determination for Initial Full License applications

· Improve communication with applicants throughout the process by allowing process visibility for both the physician and the BORIM staff, and accordingly reduce help center inbound call volume

· Alleviate data entry burden on the licensing staff and eliminate partial or incomplete applications as well as transcription errors

· Reduce Total Ownership Cost as set forth in Appendix 3 to the RFR

· Improve analytical and reporting capabilities as set forth in Section 4 of Attachment 1 to the RFR Q23. Has BORIM received any 3rd party assistance in preparing this RFR? If so, can you provide which firm?

A23. The RFR was developed by the Commonwealth of Massachusetts Executive Office for Health and Human Services, with input and guidance from other Commonwealth resources only.

Q24. Has BORIM issued an RFI prior to this RFR seeking possible solutions? Has BORIM issued any prior similar RFRs for similar solutions?

A24. No RFI has been issued related to this RFR. Bidders should note that a previous solicitation did not proceed to contract award – BD-19-1039-EHS01-EHS01-31599 (the “prior RFR”). There are two principal differences between this RFR and the prior RFR: (1) BORIM intends to replace the legacy licensing system CLARIS versus allowing an option to build from the legacy system, and (2) management and support of the current BORIM Applications Portfolio is not included in this RFR.

Q25. Has BORIM's staff conducted any software demonstrations by existing software vendor firms? Has BORIM’s staff interacted with, received presentations, demonstrations and/or pricing from any vendors related to this implementation prior to this RFR? If so, which ones?

A25. There have been no vendor demonstrations or other information received related to this RFR.

Proposal Submissions and Timing Q26. Can companies from outside of the USA can apply for this (e.g., India or Canada)? Can the selected bidder perform tasks related to the services under this RFR outside of the USA?

A26. Due to the restrictions on the sensitive personal data and the background verification required for all team members that will contact customer data, the solicitation is limited to US-registered corporations only, and it is expected that the tasks associated with this RFR will be provided onshore.

Q27. Will the Selected Bidder need to travel to Boston for meetings?

A27. BORIM will evaluate the Project Management and Communications Plan as included in RFR sections 4.3.2.5 and 4.4. On-site presence for meetings at a minimum is preferred.

Q28. If a Bidder’s financial statements are not audited by an external third party, will BORIM accept a letter from a CPA indicating revenues reported to the IRS for the last several tax years as an alternative?

A28. In accordance with Section 4.3.1.1.6, complete audited financial statements for the bidder’s last two fiscal years are among the minimum required financial documents to be submitted. Please note that BORIM may disqualify a bidder for failure to submit the documents required by Section 4.3.1.1.6.

Q29. Can Bidders submit the proposals via email?

A29. No. See RFR Section 4.2 for submission instructions.

Q30. Please confirm that no hard copies of the proposal are required.

A30. That is correct. See RFR Section 4.2 for submission instructions.

Q31. May bidders also submit a redacted copy on USB where bidders black out confidential/proprietary information? This copy can then be released in the event of a FOIA request.

A31. No. As stated in Section 4.3, all Responses and related documents submitted to EOHHS in response to this RFR are subject to the Public Records Law and, subject to certain exemptions, may be made available to members of the public who request them. All statements included in Responses regarding the confidential and proprietary nature of the Bidder’s submission shall be null and void. Accordingly, Bidders should refrain from including confidential and/or sensitive information in their submissions.

Q32. We understand that bidders shall not include any costs in the Programmatic/Technical Response and that three separate files are to be submitted through COMMBUYS by the due date. In addition to COMMBUYS, bidders are to submit two USB drives each containing the three files by the due date. Do bidders need to provide separate USB drives for the Programmatic/Technical Response vs the Cost Response?

A32. No, each of the two USB drives submitted can contain the three files, two of which are the Programmatic. Technical Response and the Cost Response information.

Q33. Under the project schedule, Friday, June 28th is listed as the RFR due date. Would an extension to the RFR be possible? Would BORIM consider additional questions submitted after the deadline?

A33. Please refer to Amendment 1 to the RFR dated 5/31/19 which extended the Open Bids date to 7/12/19, and also adjusts the timeline for questions and answers. BORIM, at its discretion, may address relevant subsequent questions submitted following the amended deadline on an ad-hoc basis by posting additional question and answer documents on COMMBUYS.

Q34. Can you specify how the evaluation of each section will be weighted?

A34. Please see RFR Section 4.4 for EOHHS’s evaluation process of any bids.

Other RFR Clarifications and Related Information Q35. Where can bidders find the BORIM license renewal requirements, continuing education (CE) tracking requirements, physician profile requirements, and public license verification requirements?

A35. While general information regarding the license application is provided in Sections 2.3 and 2.4 of Attachment 1 to the RFR, the specific renewal requirements, CE tracking requirements, profile requirements and public license verification requirements are found on BORIM’s public-facing website, which is www.mass.gov/massmedboard.

Q36. Attachment 1, page 37, states, “The permissible moves between Stage gates are depicted in the diagram below, and the moves correspond to the workflows as discussed in Sections 1.2 and 1.3 of this Requirements for DDI document.” Question: What is meant by DDI document?

A36. The reference of “for DDI” was a scribner’s error and should be struck from this statement. The reference is to Sections 1.2.and 1.3 of this Requirements document, and this is reflected in Amendment 2.

Q37. Section 3.1.2 references Appendix A; however, the RFR does not include a document titled Appendix A. Is the reference supposed to be Attachment 1?

A37. Appendix A is on Page 28 of the RFR document.