ESBD_File_341038_Addendum - Vendor Questions - RFP 739-SL3551742.pdf

REQUEST FOR PROPOSALS

Remote Patient Monitoring Solution

Addendum No. 1

RFP 739-SL3551742

Addendum No. 1

Remote Patient Monitoring Solution

RESPONSE TO QUESTIONS

The following responses to participant questions are fully incorporated into the Request for Proposals 739-SL3551742.

Question TTUHSC Response

1. Can you share some patient demographics (basic numbers) such as:

Of the first 1,000:

• Health insurance make-up (% Medicare w/ secondary, % Private with copay etc.) rough numbers Ex: 600/400 split or other Health condition make-up (% HTE, CHF, COPD etc.)

• We will be targeting several geographically diverse areas and therefore don’t have specific payor mix numbers at this time.

• Patient diagnoses we expect to be included in the RPM program include but aren’t limited to HTN, CHF, high-risk pregnancies, diabetes, and COPD.

2. Requirement states that “Monitor/manage patient conditions on a daily/weekly/monthly basis without having to present in clinic for a face to face visit.”

• Does this require vendor to have MD/NP provider network to treat patients?

• Does this require clinical decisions or just monitoring/ escalation / refer to higher level of care back to the client?

• We don’t require the vendor to have MD/NP provider network.

• We are open to the solution including clinical decision team provided by the vendor but isn’t required.

3. Requirement states that “Nurse on demand integration”:

• What kind of nurse licenses are needed from vendor? RN? LPN? Or NP?

• We don’t have a specific nursing license requirement. We would like the option for integration of an external nurse on demand in the escalation tree.

4. Requirement states that “Escalation tree & Levels of scope”

• Will the patients referred / enrolled have a supervision provider from the client’s side with established patient-provider relationship?

• Or Does the vendor need to have its own providers (NP

/ MD)?

• Patients will have an established relationship with a provider within the TTUHSC system.

• We don’t require the vendor to have MD/NP provider.

5. Requirement states “Full patient recruitment”

• Where does the vendor get the patient list? How many total patients does the vendor have access to?

• What are the eligibility criteria for patients to enroll in the RPM program?

• Is the patient list shared already screened for insurance benefit coverage?

• Is the vendor expected to do insurance benefit verification prior to enrollment?

• What ways are allowed for the vendor to recruit the patients (call, SMS, email, mail)?

• Will the patients get to hear about this RPM program from providers/ clinicians first before vendor reaches out?

• Patient list be provided by TTUHSC, ITDI, and participating sites preferably via integration with the EMRs.

• Eligibility criteria will differ based on the provider, the condition, and the need but generally be based on patients with one or more chronic conditions.

• Insurance verification process is yet to be determined and we are open to solutions.

• Once the patients have been identified by TTUHSC and the list provided to the vendor, a process for contacting the patients will be agreed upon and may include a phone call, SMS, email, and mail.

• Identified patients will receive a letter from TTUHSC notifying of eligibility.

The letter should be sent prior to the vendor contacting the patient.

6. Billing:

• Is the RPM program for these patients going through the patients’ healthcare insurance claim and billing? Or is it not related to insurance?

• Who is doing the billing submission, the Client or the vendor?

• Whose NPI will be used for the billing, if applicable?

The client’s NPI? Or the vendor's?

• Insurance will be utilized for the billing process.

• The responsibility of billing will be performed by TTUHSC and reconciled against data provided by the RPM vendor

• The client’s NPI will be used except in cases in which there is not an NPI available in which case the vendor’s NPI will be used.

• Are you willing to share your billing software or EMR software names?

• IDX (Lubbock and Odessa) and Allscripts (Amarillo)

7. Requirement states “Single sign-on”

• Is it asking the sign on to EMR triggering the same sign on to the vendor’s monitoring platform?

• The reference of “single sign on” is in reference to the vendor monitoring platform.

8. Requirement states “White labeling”

• What levels of white labelling do you need?

• Does it require the patient facing mobile app from the vendor to be re-named to the client?

• Does it require the vendor’s monitoring dashboard

URL include client org name?

• Does it require the monitoring service team / care team do inbound/outbound calls as part of the client team in the client org name?

• We are open to a variety of white labeling options. Specifically, we would like the devices themselves to be white labeled or the packaging at a minimum

• The patient facing mobile app would also need to be white labeled

• The vendor’s monitoring dashboard URL include client org name would be preferred

• The monitoring service team / care team do inbound/outbound calls as part of the client team in the client org name would be preferred

9. Requirement states “Compliance goal of 85% or more”

• Is the 85% relative to the enrolled patient population, not to the total qualified patient population?

• What is the definition of compliance?

• The compliance goal of 85% is referencing the total enrolled patients and patients taking their required readings.

• Compliance is related to meeting the requirements of the RPM CPT codes and the ability to bill for the targeted codes.

10. Requirement states “Multi-language”

• Besides English & Spanish, what any other languages does the client need support?

• Future language needs to be determined based on geographical location and patient population need.

11. Requirement states “Patient Experience > Single Sign On”

• In our patient experience, patients only have one login for accessing their information. Does this refer to the login for a patient app or a portal?

• Please clarify the reference of a single sign on in the patient experience.

• This is referencing ease of use for both the clinician side and the patient side.

• The patient will have an account that they can log into via their smartphone, laptop, or other internet enabled device.

12. Can you provide more details about the composition and roles of the proposal evaluation team responsible for assessing the submitted proposals?

• See Section 4 of the RFP

• The evaluation team is a diverse group within TTUHSC led by the Institute of

Telehealth and Digital Innovation along side internal stakeholders that have been chosen for the evaluation committee.

13. What specific factors will be considered when determining the "best value" to TTUHSC as mentioned in the RFP? Can you elaborate on how these factors will be weighed?

• Evaluation criteria can be found on page 9 (section 4.3.2)

14. Can you provide further information on how the reputation of the proposer and their goods or services will be assessed during the evaluation process?

• The evaluation process will include reviewing security and Tex/Fed/State Ramp certifications as well as the history of the company, and previously successful programs implanted by the vendor.

• See Section 4 of the RFP

15. How will the quality of the proposer's goods or services be evaluated, and what specific criteria will be used for this assessment?

• The quality of the proposer's goods or services will be evaluated by committee.

16. Could you clarify what is meant by "TTUHSC's needs" in the context of evaluating the proposals? Are there specific needs or requirements you prioritize?

• The quality of the proposer's goods or services will be evaluated by committee.

17. Can you provide more details about the past relationship between TTUHSC and proposers and how this will be considered during the evaluation?

• There is not an existing relationship with any vendor. During the planning phase, research and information gathering was performed by the Institute of Telehealth and Digital Innovation.

• See Section 4 of the RFP

18. How will the total long-term cost to TTUHSC be assessed when evaluating proposals, and what factors will be considered in this cost calculation?

• The total long-term cost will be assessed based on but not limited to # of enrolments per month, integration with our systems, ease of use for our patients, compliance with readings, ease of working with the vendor, # of patients kept out of the ER due to timely intervention, not to mention sustainability and scalability.

19. Can you specify if there are any other relevant factors that proposers should consider during the proposal preparation, which are not explicitly mentioned in the

RFP?

• Relevant factors include sustainability and scalability.

20. Will proposers have the opportunity to address any subjective judgments made by TTUHSC during the evaluation process?

• The RFP process, including the evaluation committee is set up to prevent a subjective judgement.

• See Section 4 of the RFP

21. Are there any specific weights or percentages assigned to each of the evaluation criteria mentioned in the RFP, such as pricing, experience, and solution specifications?

• See question 13

22. How will additional written information and comments be considered in the evaluation process? Can proposers submit such information, and if so, how will it impact their evaluation?

• Proposers may be reached out to by the solicitation manager for clarification as needed

23. Can you clarify the process for oral presentations or interviews? How and when will selected proposers be invited to participate in them?

• Finalists will receive a letter from the solicitation manager stating that they have been selected for a presentation round of evaluation

24. Is there a specific format or structure expected for oral presentations or interviews, if conducted?

• No specific format or structure is required.

25. What is the timeline for the award process, and how will TTUHSC make its final selection of the successful proposal?

• See Sections 2.3 and 4 of the RFP

26. Can you explain the "Best and Final Offer" phase in more detail, including when and under what circumstances it will be used?

• BAFO may or may not be necessary. More details will be provided if the evaluation team deems it necessary.

27. How will TTUHSC ensure transparency and confidentiality during the opening of proposals, especially regarding price information?

• All evaluation team members have signed an NDA and no proposal information will be available on any public sites

28. Are there any specific rules or regulations governing the award of the agreement that proposers should be aware of?

• See Section 4 of the RFP

29. Can you provide more information on the Texas Legislature House Bill 1295 and the Ethics Commission Reporting requirements mentioned in the RFP, and how they will apply to the agreement?

• In 2015, the Texas Legislature adopted House Bill 1295, which added section

2252.908 of the Government Code. The law states that a governmental entity or state agency may not enter into certain contracts with a business entity unless the business entity submits a disclosure of interested parties (Form 1295) to the governmental entity or state agency at the time the business entity submits the signed contract to the governmental entity or state agency. The Texas Ethics Commission has adopted rules requiring the business entity to file Form 1295 electronically with the Commission.

• More info:

https://www.ethics.state.tx.us/resources/FAQs/FAQ_Form1295.php

30. Is there any incumbent? If yes, then why you are looking for other companies? Are you not happy with them? If there is an incumbent then are they bidding for this opportunity?

• There is not an incumbent at this time

31. What is the Allocated budget for this project?

• Unable to share at this time.

32. Can you specify the types of medical devices, sensors, or wearables that the solution should be able to integrate with, and any specific requirements related to these devices?

• See Phases I and II in Section 5.4 of the RFP

33. Can you provide further details on the technical requirements, especially regarding cloud hosting, server location, and necessary updates?

• See Section 5.4 of the RFP

34. Given the diverse health conditions TTUHSC aims to address, please elaborate on the EHR integration requirements and how Rhythm’s solution should adapt to different EHR platforms.

• EHR integration should take into consideration that multiple EHRs will need integration as the program is scaled including Cerner, Epic, Allscripts and various instances of Cerner.

35. How does TTUHSC envision the interoperability of a vendor’s solution with various health devices and apps for a seamless patient experience? What is the minimum level of requirements for a program start, vs

• This will be determined by the committee.

https://www.ethics.state.tx.us/resources/FAQs/FAQ_Form1295.php launch + 1 year for example?

36. Please provide a priority list of disease states that need to be tracked immediately upon implementation. If possible, please stack rank with highest priority on the top.

• Unable to rank. Detailed patient population would be needed in order to rank.

37. Bidirectional communication re: is this pertaining to doctor to nurse, or clinician to patient. Please provide guidance.

• This is in reference to bidirectional communication between the vendors platform and TTUHSC EHR systems.

38. How many different EHR platforms does TTUHSC utilize across its network?

• Please list by name and version.

• See question 34

39. What billing solution is TTUHSC currently using?

• Please list by name and version.

• See question 6

40. What type of metrics is TTUHSC interested in as it pertains? Analytics such as, disease state, GDMT (Guideline Directed Medical Therapy), or compliance related matters?

• Vendors should include all analytic tools and capabilities that could be used to improve patient outcomes and address health dipartites.

41. Can you provide more details on the expected “provider dashboard” features and functionalities that would align with the care team's needs?

• Vendors should include all analytic tools and capabilities that could be used to improve patient outcomes and address health disparities.

42. Education resources, is this a development collaboration with TTUHSC, or is this exclusively provided by the vendor?

• This is exclusively provided by the vendor.

43. How do you envision bulk enrollments? Will it be an opt out program?

• Please describe TTUHSC’s process on auto enrollment and unenrollment.

• The process will need to be flexible based on site location.

44. How is TTUHSC determining patient selection for Phase I? Is it determined based on payer mix or other criteria.

• This will be determined by the project team once all relevant data has been collected.

45. Considering the location and demographics of TTUHSC’s patient panel, could you provide more insight into expected phased implementation, equipment distribution and patient onboarding?

• Specific information is unavailable at this time.

46. How would TTUHSC define success at the end of each phase, and are there specific success metrics for Phase I and Phase II?

• The success metrics would include but are not limited to: number of patients enrolled, and patient compliance rates.

47. Compliance goal 85% re: Please elaborate on this objective as it pertains to CPT code, patient satisfaction, and other(s).

• See question 9

48. Could you provide insights into the specific challenges faced by West Texas, especially in rural areas, regarding patient care and connectivity?

• West Texas is a complex healthcare landscape with a large number of rural communities. Patients may need more attention with respect to training on the use of the devices.

49. How does TTUHSC envision leveraging local infrastructure and partnerships to enhance patient care in these regions?

• TTUHSC envisions leveraging local infrastructure and partnerships to enhance patient care in these regions.

50. What would be the best geographical area to start?

• This will be determined by the Institute of Telehealth and Digital Innovation.

51. How does TTUHSC define program success beyond the quantitative parameters, considering the unique health care landscape it serves?

• This will be determined as the program progresses and will include but will not be limited to clinical outcomes

52. Beyond the CPT level, fee for service, nature of the economic success, are there value-based care (VBC) initiatives of TTUHSC and the patient cost responsibility thereof?

• This will be determined by the Institute of Telehealth and Digital Innovation.

53. Page 15 > Phase I - For the 1,000 patients in the Lubbock market, is the goal to have 1,000 patients onboarded in one month or that 1,000 patients will be monitored for one month? If the latter, does TTUHSC have a time frame in which they would like the patients to be onboarded (e.g., within 60 days). Additionally, is the patient monitoring on a rolling basis?

• These specific timelines will be determined once the program foundations and process are built.

54. Do you anticipate that an in-house team will manage the monitoring and enrollment, are you interested in outsourced monitoring and enrollment, or a combination of both?

• No in-house team will be available for monitoring.

55. Billing integration is listed as a desired capability. Can you clarify what you mean here? Are you referring to the capability of the RPM vendor to bill on behalf of TTUHSC and provide RCM services or integration to Epic's billing module?

• Yes, we are referring to the capability of the RPM vendor to bill on behalf of TTUHSC and provide RCM services.

56. Do you have any specific requirements around device shipping and management?

• Not at this time however we expect that device will be shipped immediately following the

57. Is there any specific format to submit responses in that we may be missing in the Jaggaer platform?

• Proposals are to be submitted through the TechBid system

58. What Electronic Health Record (EHR) platforms are you currently using and/or would need the provider to integrate with?

• See questions 34 and 38

59. What billing system is currently in use and/or what integration is required?

• See questions 6 and 39

60. What type of multilingual requirements do you require?

Does the platform need to be multilingual and/or Would multilingual translation service in real time be sufficient?

• See question 10

61. Do you require clinical services as well with Registered Nurses to support the RPM solution?

• We open to clinical services that utilize Registered Nurses to support RPM solutions.

62. If clinical services are required, can you expand on the scope required by clinicians?

• We open to clinical services that utilize Registered Nurses to support RPM solutions.

63. Can you provide more details about Automated Triage? • We are interested in how RPM companies use technology to assist in the triage process involved with abnormal readings that demand clinical intervention.

64. Are there specific disease conditions that TTUHSC is requesting clinical service management, such as diabetes, heart failure, COPD? If no, is TTUHSC looking for RPM clinical services for all chronic conditions?

• Patient diagnoses we expect to be included in the RPM program include but aren’t limited to HTN, CHF, High-risk Pregnancies, Diabetes, and COPD.

65. Is TTUHSC intending to provide the Clinical Pathways for the Vendor to configure in their software or is the vendor providing the clinical pathways?

• This has not been determined.

66. Is TTUHSC providing the Educational materials or is the vendor expected to provide educational content?

• See question 42

67. Has an RPM services contract been issued in the past? • There are no prior RFP’s for this service

68. If so, which company won the BID and what pricing BID was accepted?

• There are no prior RFP’s for this service

69. Is there a pricing expectation for the current RFP proposal? Is there an expectation of pricing range (min/max) to stay within?

• This has not been determined however it is an expectation the revenue sharing will be in favor of TTUHSC

70. Is there a pricing tabulation document from prior BIDs available?

• There are no prior RFP’s for this service

71. If a prior contract was awarded, what worked well and what did not work well during the contract term? What things could be improved?

• There are no prior RFP’s for this service

72. Will services be billed to patients' insurance or will TTUHSC pay for the services on behalf of patients?

• See question 6

73. Are Chronic Care Management (CCM) or Medication Therapy Management (MTM) services required as part of service offerings?

• They are preferred and where applicable may also include newly approved Community Health Integration (CHI) and Principal Illness Navigation (PIN) services.

74. If insurances will be billed, is there a list of insurances to anticipate?

• This is not available at this time.

75. How many offices or clinics will be serviced by this solution?

• This is not available at this time.

76. If contract was awarded in the past, did patients retain devices used for RPM or were devices returned to previous vendor/contractor?

• There are no prior RFP’s for this service

77. Will questions for clarification be responded to individually or will an addendum be posted on the official bid site?

• All questions received by the deadline have been answered in this addendum

78. Educational resources:

• We do have capability to deliver educational content and rely on a third-party vendor for that content. Does TTHSC have your own educational resources or are we expected to bring a partner to the table for that content?

• See question 42

79. Care Team capability requirement:

• Is it acceptable to bring in a partner to supplement and provide these services?

• We are open to multiple solutions.

80. ” Bidirectional EHR integration with multiple EHR platforms”

• How many EHR platforms?

• What EHR platforms?

• See questions 34, 38, and 58

81. ” Billing system integration”

• What is the billing system?

• See questions 6 and 39

82. Can we just send our SOC II report and Info Sec policy as answer to the security questions?

• The security questionnaire needs to be filled out as the Soc II report and Info Sec policy will be supporting documentation

83. Is the below section a general statement or are you looking for these specific answers? Do you require answers and examples?

• (Application Development (Web or Mobile) Periodically, the Texas Tech University Health Sciences Center (TTUHSC) engages third party vendors to provide website and web application development

• This is simply a general statement

84. Capabilities Requirements:

• There are specific requirements in this section. What would you like for us to provide in this section?

• TTUHSC would like to know how the vendor’s proposal meets these requirements

85. In Sec. 5.2 we are not a Texas based co. Do we need to complete the TX Risk Authorization Program?

• Yes

86. Do you have an estimated or desired timeline for the contract start?

• Our goal is to launch as soon as possible from contract award

87. Is there a formal presentation expected to be delivered during the review of proposal phase? Or, are the proposals expected to be all inclusive?

• See question 23

88. Which electronic health system/s (EHR) do the campuses currently use?

• See questions 34, 38, 58, and 80

89. What target populations or specialized disease groups will be a part of this program? Will the target population be the same (other than geography) for phases I and II?

• Patient diagnoses we expect to be included in the RPM program include but aren’t limited to HTN, CHF, high-risk pregnancies, diabetes, and COPD.

90. Does TTUHSC have any value-based arrangements or contracts?

• As a state agency, TTUHSC awards all competitive contracts based on best value to the State of Texas.

91. Does TTUHSC desire that the software program have specific KPI measuring tools? If so, are there any specific KPIs that it hopes to measure?

• Vendors should include all analytic tools/KPIs and capabilities that could be used to improve patient outcomes and address health dipartites.

92. In the Security Questionnaire, a requirement is listed that software has to run within TTUHSC IT infrastructure? Our RPM software provided is cloud-based and therefore, would not need to be hosted within any IT network. What additional requirements to integrate with existing IT infrastructure would need to be met?

• The Security Questionnaire is designed for Cloud hosted software and on-premise solutions. SSO integration along with EHR integration will be needed.

93. What level of chronic care management and principle care management is desired?

• This will be based on population need.

94. Are there established clinical goals and KPIs for the program?

• The KPIs will be determined based on the specific population and geographical location.

95. How does TTUHSC envision that your clinical team will be involved in the RPM program and care management?

• Clinical teams will utilize RPM to address healthcare disparities faced by rural communities. The goal of all clinical teams is to improve patient outcomes.

96. For the nurse on-demand integration, are you looking for capability of the software platform for your own clinicians, staffed clinicians by the vendor or a combination of both?

• We are open to creative solutions.

97. Do you have an existing RPM program and patient base? If so, in the initial Phase I population, how many patients will that include?

• There are no prior RFPs for this service.

98. What are the RPM goals for all locations? • These goals will be determined based on population and geographical location.

99. What evaluation metrics will be used for the RPM programs?

• See question 13

100. Do you have a dedicated team of clinicians to

• Identify patients and obtain consent?

• Monitor alerts, conduct nursing assessments, provide patient education, and escalate validated actionable data to medical providers?

• There is not an in-house monitoring team.

101. What are the hours of operations for Clinical Monitoring performed by Vendor?

• We are open to creative solutions.

102. Costs have correlations to acuity, disease conditions (number of co-morbidities), SDOH, etc. Should we give our assumptions and costs associated with those assumptions or do you have a standard Use Case(s)?

• All information would be welcome.

103. In addition to the RPM CPT codes, do you plan to support use cases for CCM and Transitional Care Management CPT codes?

• See question 73

104. For Pricing, could you please elaborate on guidelines for revenue share and risk models, if any?

• Unable to provide at this time.

105. Do you have a risk stratification algorithm already implemented for selection(s)?

• Unable to provide at this time.

106. What are the target chronic conditions (CHF, COPD, Hypertension) and Populations (Payer, ACO, Employees/Self-insured) for RPM?

• Patient diagnoses we expect to be included in the RPM program include but aren’t limited to HTN, CHF, high-risk pregnancies, diabetes, and COPD.

107. How long do you expect patients to be on RPM program? 30/60/90 days or indefinite as needed

• This will be based on individualized patient care plans and patient needs.