TeleRadiology_Questions_and_Answers.docx.pdf

TeleRadiology Questions and Answers

1) Question:

a. It is understood that the Contractor will provide fully trained radiologists to perform the service, Response: Yes.

b. Is there a central credentialing facility where all the required documents should be forwarded?

Response: All credentialing documents should be forwarded to IHSC Headquarters Credentialing Unit. Contact information will be provided once the contract is awarded. Each IHSC site that is conducting digital x-ray will be required to obtain/verify/maintain the credentials for the Radiologist(s) for accreditation purposes.

Radiologists Credentials: it will be mandatory for the contractor to provide copy and verification of Radiologists credentials to IHSC Credentialing Unit every year and every time a new Radiologist is hired.

c. By service; it is assumed that the document is referring to the reading of the digital image (x-ray) after it is electronically transmitted to the appropriate location?

Response: By service (Sites): the Radiologists/Contractor will forward report of findings after the X-Ray interpretation is completed to every specific site as requested.

2) Question: Do all sites have existing Radiology Rooms in place and are able to produce x-rays at the site?

Response: Yes. All listed sites are able to produce x-rays on site, with the installed teleradiology equipment.

3) Question: Are all sites that have Radiology Rooms currently able to send digital images?

Response: Yes. Currently all sites are capable of transmitting digital images, with the installed teleradiology equipment.

4) Question: Do all facilities have a router/firewall that is VPN capable?

Response: No. ICE expects that the vendor to provide a “turn-key” solution and that all networking components and connectivity are included.

5) Question: Is there currently a central repository for all images?

Response: Yes. At this time all images are in storage at the current vendor’s site.

6) Question: Is upload bandwidth at all facilities greater than 5Mb/sec? (OCIO)

Response: ICE expects the vendor to provide the appropriate bandwidth to support the proposed solution. Consider the turnaround metric is 2 hours.

7) Question: Is the EMR centralized for all facilities allowing access from all sites to a central management repository for EMR patient data and images? (OCIO)

Response: Yes. The ICE electronic Health Record System (eHR-S), electronic Clinical Works (eCW) is centrally hosted with CGI Federal (a Federal Risk and Authorization Management Program (FedRAMP) certified facility) in Phoenix, AZ.

8) Question: What is the time period to save the studies for?

Response: The vendor will ensure they have the capability to save studies for the duration of the contract period of performance. The government’s expectation is to make all studies available upon request within 7 calendar days. The vendor will be required to provide for the transfer of all images taken, upon the completion of the contract. The online storage will also be required for the duration of the contract. Off-line storage must be provided by the vendor and be available within a 24 hour period or as needed by the Government.

9) Question: Are there a certain number of years for online storage, near-line storage, and off-line storage? Online storage is storage readily accessible by the end user; near-line storage is storage that the end user would query and retrieve studies from, off-line storage is storage that would require the end user to request the studies from the contractor to be available within a 24 hour period.

Response: The online storage will be requested for the number of the years assigned to the contract by the Federal Government. Off-line storage must be provided by the contractor to be available within a 24 hour period or as needed by the Government.

10) Question: Will Homeland Security allow the contractor remote access into the X-ray systems for upgrades and repairs?

Response: The vendor must comply with all DHS security standards and protocols to be granted remote access authorization into the X-ray systems for upgrades and repairs as needed. Also, the vendor must comply with eCW requirements and standards.

11) Question: Are all the studies currently produced already in a digital format? Are they being stored in a central location? If they are being stored in a central location would the contractor be able to utilize this location or provide their own location for storage? What is the current size of the images being stored? (OCIO)

Response: Yes. Images are currently stored in a digital format. Yes, the studies are being stored at a central location, however the new vendor will be responsible for providing their own location for storage of their own images in a FedRAMP approved hosting center. Current average size of the image file is 15 MB and the average report file is 400kb.

12) Question: Will there be any other interpretation read requirements other than TB?

Response: The report will include the TB results interpretation and any other significant findings or abnormalities noted in the chest X-ray.

13) Question: Is there an X-ray technologist onsite to upload the chest X-rays and patient information onto the contractor's server?

Response: The images are handled by Registered Nurses, and Public Health Commissioned officers assigned to each facility. The following facilities have Radiology Technicians: Krome, Eloy, and Port Isabel that perform this task. The contractor will not provide on-site personnel.

14) Question: Is it simply a matter of the contractor establishing a secure connection to the facilities to transmit images and patient information?

Response: No, it is a not a matter of “simply” establishing a secure connection. All x-ray equipment and teleradiology services as described in the Performance Work Statement (PWS) are needed (See paragraph 4.1 through 4.1.11). The vendor is responsible for all connectivity between the facility and the vendor’s radiologist(s), and image storage. ICE is expecting a “turnkey” solution. Transmission of x-ray images needs to include time requirements for sending facility as well as requirement for time to send the results back.

15) Question: Why do you wish to replace the current x-ray equipment?

Response: The equipment is the property of the current vendor and in many cases past its life cycle.

16) Question: Please give specifications of the current equipment.

a. Brand

b. Model

c. Current site configuration

d. MA

e. KV

f. Detector configuration and number

g. Maximum imaging technique permitted for large patients.

Response: The X-Ray equipment will be for a Brand Name or Equal (see paragraph 4.1.1 TeleRadiology Equipment of the Performance Work Statement (PWS) for the salient characteristics. If you are quoting on an equal, you must submit your product's specification along with proposal in order to be considered for this solicitation. If this is not provided, your company will be eliminated from the competition. The salient physical, functional, or performance characteristics that “equal” products must meet are specified in the solicitation.

17) Question: Site Electrical (Facilities) What is the voltage, phase, and amperage of the electrical supply to each facility x-ray room for connection to the equipment?

Response: 480 Volts 130 Amp service

Three (3) phase system Frequency 60 Hz

18) Question: Do all exam rooms have their own electrical panel for connection with the new equipment?

Response: All IHSC facilities with the exception of the Krome location in Miami have a dedicated electrical panel inside the radiology room. For the non-IHSC facilities Otero County has a dedicated panel inside the radiology room, further information will be provided for the other

Non-IHSC facilities when it becomes available.

19) Question: Who is responsible for any requirements to have the necessary electrical power to the rooms modified if necessary?

Response: No modifications will be done to the electrical outlets/power supplies or rooms.

20) Question: Exam Volume

a. What is the greatest known volume of chest radiographs performed in a single 24 hour period for each site? (This is important for the through put of patients and the placement of the correct equipment).

Response: Please refer to Attachment 3: Historic Monthly and Daily Volumes (revised).

21) Question: T1 line

Response: The vendor is responsible for all connectivity between the radiology equipment, the facility, and the image storage.

22) Question: Is this a dedicated line for image transmission?

Response: Yes.

23) Question: Do all T1 lines terminate in the exam rooms?

24) Question: What is the type and brand of equipment used for interface with the T1 line?

Response: Vendors are responsible for providing the equipment to be used along with the T1 and additional equipment as needed, that is part of the vendor’s responsibility to quote the project.

25) BLANK

26) Question: Will the T1 modems and routers have to be replaced?

Response: Yes. The current T1 modems and routers belong to the incumbent.

27) Question: Who pays for them?

Response: The vendor pays for them and the cost is included in the proposal. The vendor should not expect to leverage existing DHS or ICE network assets for connectivity.

28) Question: Transmission Security

Do you allow VPN for image and report transmission?

Response: See section 5.4.1 “Remote Access and Dial-on” of Directive 4300A (Sensitive

Systems Handbook.) SEE DHS DIRECTIVE 4300A http://www.dhs.gov/department-homeland-security-management-directives#3

29) Question: Do you allow HTTPS for image and report transmission?

Response: SEE DHS DIRECTIVE 4300A

30) Question: Please provide you specific requirements for IT/data security.

Response: SEE DHS DIRECTIVE 4300A

31) Question: During the installation phase for the project will there be a single project manager?

Response: Yes. That information will available to the awardee.

32) Question: For Homeland Security to discuss and resolve any and all issues regarding IT? (OCIO)

Response: IT issues will be resolved in a collaborative and mutually beneficial arrangement between the vendor and ICE.

33) Question: New Equipment installation (Facilities)

a. After de-installation of the current equipment, will the room be cleaned and repaired prior to installation of new equipment? If no modifications are required to support the new equipment the final cleanup will be performed by ICE or its representatives

Response: Yes

34) Question: Who performs this task?

Response: ICE or its representatives

35) Question: What is your timeline for completion of this task?

Response: The rooms will be cleaned and repaired in an estimated 4 days. This could change once actual damage has been determined. The awardee will be notified as soon as ICE is made aware.

36) Question: Who will be Homelands onsite supervisor during the installation period for the equipment to include IT support?

Response: The onsite POC will be identified upon award of the contract.

37) Question: Who provides final approval to use the equipment after installation?

Response: ICE Health Services Corps (IHSC)

38) Question: Will Homeland Security be constrained by state laws regarding the installation, approval and use of the equipment?

Response: YES

39) Question: Will exam rooms be cleaned and cleared of all storage units and miscellaneous equipment, materials, and furniture not relevant to the room?

Response: YES, see question 35.

40) Question: Room Diagrams (Facilities)

Please provide better diagrams for the following sites.

Response: See response below:

Krome > provide better master floor plan of site

Response: We were unable to determine the problem with the document provided. Please try to enlarge the document for a better view using the + symbol at the top.

Dessert Sands > show location of x-ray room on master plan and provide diagram of room area.

Response: For Desert Sands – Please disregard this document. This is not one of the 26 facilities.

Varick > show location of x-ray room on master plan

Response: There are 2 documents associated with this location. The first one is a hand drawing of the hallway and the room. It also states the dimension of the room and the hallway. The second page includes the facility layout. Refer to the instructions stated above for facility

Krome, listed under question 40. Try enlarging it for a better visual. See the yellow sticky on page 2 of the Varick document pointing you to the information previously stated.

Farmville > provide better copy, the x-ray room is blacked out.

Response: The document for Farmville’s x-ray room should be shaded blue, not blacked out.

Suggest you close out and try reopening the document. If that doesn’t work, try opening it from a different computer. Although this site is shaded blue, the dimensions are provided for you outside the blue shade so it should be visible. Unfortunately ICE is unable to provide better diagrams. The vendor will be afforded an opportunity to visit any facility that they have question on to verify the room dimensions.

41) Question: Temporary X-ray room (Facilities)

Does each site have a room that can be used temporarily during the de-installation of existing equipment and installation with final approval of the new equipment?

Response: Facilities will provide the necessary arrangements for temporary space at each of the locations.

42) Question: Electronic Health Records (OCIO)

a. What is the name of the software/system

Response: eClinicalWorks

b. What version are you using?

Response: V9c (Correctional)

c. Is it HL7 compatible?

d. Please provide the interface specifications.

Response: Health Level 7 (HL7).

43) Question: Exams What imaging views are performed of the chest, i.e. single view PA or PA and Lateral radiographs?

Response: Equipment should be able to conduct all views of chest, if necessary.

44) Question: Am I correct only chest radiographs will be performed?

Response: Yes. Only chest radiographs will be performed.

45) Question: Radiologists

a. Do the interpreting radiologists have to be licensed in the state of service?

Response: Radiologists must have a United States license in the state in which they reside and practice medicine to be able to perform the requested service for the U.S. government.

Assuming this requirement is met, Tele-radiologists may be sent radiographs from other states and perform radiological services.

46) Question: Equipment Servicing Downtime

a. It is not practical to have a 4 hour period to repair the equipment. Minor repairs can be done in this period. But if an x-ray tube requires replacement that could take 24 to 48 hours depending on the geographic location of the facility, time of the year and weather. A modification of this requirement is requested.

Response: This 4 hour period is the maximum amount of time to have a technician on site to troubleshoot the issue. If a machine will be down for longer than 24 hours, the vendor will make arrangements to continue x-ray service, i.e. mobile x-ray.

47) Question: Are there storage data requirements? Do the images have to be stored uncompressed in DICOM format or can they be stored in compressed files? (OCIO)

Response: Compressed images are desirable.

48) Question: What is the maximum compression ratio for storage? (OCIO)

Response: To the maximum extent possible, assuming that uncompressing an image does not take more than 5 seconds to load within the ICE eHR system (eClinicalWorks - eCW).

49) Question: (Section 4.1.3) Can we verify that the reading physician only needs to be licensed in ANY one state and not for each state the center that is providing the x-ray is in?

Response: Radiologists must have a United States license in the state in which they reside and practice medicine to be able to perform the requested service for the U.S. government.

Assuming this requirement is met, Teleradiologists may be sent radiographs from other states and perform radiological services.

50) Question: (Section 4.1.3.1) Do the results have to be faxed within 2 hours of completion of the study or 2 hours from the time the images are received at the teleradiology work list?

Response: The report of findings should be transmitted to IHSC and Non-IHSC facilities, preferably electronically through an eHR interface within two hours from the time the images are received by the contractor.

51) Question: What the requirements for the health record (eClinicalWorks)? Specifically, what has to be transmitted into the record? Is it the furnished X-ray report generated by the teleradiologists or do the images have to be entered into the medical chart along with the report?

Response: ICE assumes that an interface will need to be developed that transmits the results into the eCW medical chart designated folder for provider review. The image will not be placed in eCW, but will be referenced by the eCW medical record and available through a link for viewing that the contractor will provide as part of the storage requirement. ICE will not manage the integration of eCW and the Tele-radiology system.

52) Question: To keep all bids apples to apples in terms of what ICE will receive in equipment and in image quality; will ICE set a minimum 50 KW standard for the generator requirement?

Response: The vendor should recommend the most appropriate technology to generate good quality images to be interpreted by his/her radiologist staff.

53) Question: Is there a standard established for the size requirement of the DR panels? 14x17 or 17x17 (Facilities)

Response: The DR panel may be compatible with current equipment standards.

54) Question: Can an inventory list be provided detailing what supplies are stocked at each facility?

Response: Tele-Radiology supplies are not currently stored or stocked at IHSC facilities. All storage is currently performed via electronic data media.

55) Question: Will all 26 facilities be cleaned and clear rooms on the same date?

Response: No, IHSC will arrange cleaning and repair days based on the vendor’s timeline.

56) Question: Please confirm that all reports are delivered to a single EMR system via HL-7 and also must be faxed to the sending clinic as per the turnaround times indicated in the RFP.

Response: Fax is required for non-IHSC facilities. HL7 is the desirable format for the IHSC facilities.

57) Question: Aside from proper licensing, are there any additional credentialing requirements for the reading radiologists?

Response: Besides being licensed in the state in which they practice, the Radiologist must maintain a valid/current license during the period of the contract with the government.

Additionally, valid credentials must be submitted yearly to IHSC headquarters, Credentialing Unit. Radiologists must submit credentials as part of the candidate for hire process.

58) Question: Is battery back-up available at each site if there is a power outage? (Facilities)

Response: No, if the facility loses power, the facility will most likely be locked down

59) Question: Will ICE represent that all facilities are up to all local code and have had state health inspections by the appropriate governing agencies (if required)?

Response: IHSC Facilities are accredited under National Commission on Correctional Health Standards and American Correctional Association.

60) Question: Based on providing and/or installing new equipment, will ICE represent that all facilities have adequate power to allow X-RAY equipment (mobile or permanent) to operate at the time of installation? (Facilities)

Response: Yes, the power supply capabilities for current equipment is the same in all facilities.

See question 17 for site electrical requirement.

61) Question: Does each facility have pallet jacks or other equipment to move the XRAY unit to the specified room?

Response: Vendors will be responsible for supplying their own equipment for transporting their equipment.

62) Question: REMOVED

63) Question: If there is damage to the x-ray room in the removal of the current equipment, will the new contractor be responsible for the repair as part of the quote?

Response: The new contractor will not be responsible for any necessary repair to structure, unless requested by the government.

64) Question: Are all of the current locations operating X-ray equipment? Will any of the facilities represent new sites that have never had x-ray equipment installed?

Response: Currently all twenty (26) locations listed on the PWS are equipped with operational X-ray equipment in place.

65) Question: Do networks already exist that we can connect to transmit images or do we need to bring in broadband lines? Will we be able to work with the site IT manager to establish VPN connections or do we need to provide our own firewalls? (OCIO)

Response: All network connectivity must be furnished by the vendor and comply with DHS 4300A.

66) Question: Please clarify the DICOM archival requirement – retention term, location required (Fed Ramp or other commercially available).

Response: 10 years retention for adult patients and 27 years for juveniles. FedRAMP only.

67) Question: Is the contractor required to archive already existing X-rays, or only the ones generated during the term of the contract? If contractor is required to archive already existing x-rays, what is the volume of these x-rays and how much longer is the archival requirement?

Response: The contractor will be responsible for archiving images generated during their contract with the government.

68) Question: Please clarify the # of sites that need permanent machines – 21 or 26?

Response: The total number of facilities is twenty six (26); consisting of 18 IHSC staffed facilities and 8 non-IHSC staffed Inter-Government Agreement Agencies (IGSA) facilities. The X-Ray machines will be for lease, not purchased.

69) Question: Please clarify the pricing, will this be a fixed monthly charge or per click? Also, are there minimums? With potential changes in immigration laws, what pricing structure will be used that is best suited for the government, yet will not expose the contractor to a significant decline in volume?

Response: The pricing will be established for a fixed price per click. This requirement will be awarded under an Indefinite Delivery Indefinite Quantity (IDIQ) contract. Minimum image reads is 150,000 and Maximum image read is 200,000 (see solicitation Standard Form (SF) 1449)

70) Question: Does each of the locations have a relationship with the local hospital to provide chest x-rays during the transition? Is the government billed at Medicare rates or some other rate? What is the rate? Is there a list of the hospitals?

Response: Local hospitals are not an option for the contractor to utilize. ICE will not be able to provide medical escort at all times to send detainees to local facilities for a chest X-Ray. Mobile X-Ray service are preferred.

71) Question: In reviewing all the documents included on the FBO announcement, it does not appear that Attachment 7 was included in the announcement. Would it be possible to forward that out via the FBO site?

Response: Yes. Attachment 7 has been changed to Appendix 5 Past Performance Questionnaire and is now posted to FBO.

72) Question: Is there an incumbent for this opportunity? If so, could you please provide their name and the contract number for prior contract?

Response: The TeleRadiology services are currently provided by DianAssociates under the VA

BPA V797 (049A3G) P-PPN-053.

73) Question: Would ICE consider expanding the solicitation to full & open primes?

Response: No

74) Question: Are you not concerned about the quality of medical care provided if the lowest price is the penumbra in the determination of this award?

Response: An image that allows for interpretation will aid in the quality of medical care.

75) Question: Please confirm that invoices are to be itemized by site and sent to a single government agent (site) for payment.

Response: It is confirmed that invoices are to be itemized by site and sent to a single government agent (site) for payment.

76) Question: What information do you wish in the invoice?

Response: The costs incurred for the work performed for the month applicable to the invoice by CLIN; i.e. the aggregate number of interpretations and the conclusive price per the solicitation. Also see, Combined Synopsis / Final Solicitation 52.212-4 Contract Terms and Conditions, g. Invoicing.

77) Question: What is the time for payment after government receipt of invoice?

Response: Within 30 days

78) Question: May I propose an alternative pricing model in addition to the solicitation requirement? This could provide better cost savings to the government.

Response: Yes, prior to the release of the final solicitation. If it offers cost savings and practical for use with the requirement, it will be incorporated in the solicitation; thereby, sharing the model for use by other potential Offerors.

79) Question: Because of the desire by Homeland Security to provide this contract to a Service Disabled Veteran Owned Small Business will it provide the following for equipment acquisition?

i. After the award of the contract,

1. Homeland Security will make payment to the equipment vendor for down payment?

ii. Guarantee the term of the contract for a total of 5 years with the understanding the successful vendor must comply with the standards of the solicitation and award contract?

Response: Start-up costs should be included in the transition-in costs. It should be noted that Government intends to lease the equipment not purchase it. The term of the contract will not be guaranteed for 5 years, but it is highly unlikely that none of the one-years will be exercised.

80) Question: How should the proposal be submitted?

Response: Electronic (email) as specified in the solicitation (see Appendix 4 Technical Evaluation, under “Proposal Submission Requirement”).

81) Question: In what format should the proposals be submitted?

Response: Electronic - PDF

82) Question: How many copies do you require?

Response: One email with documents specified in the solicitation (see Appendix 4 Technical Evaluation).

83) Question: Should the CLIN cost include all items including the interpretation as part of the total billable cost to ICE?

Response: Yes, as specified the Tele-radiology CLIN in the solicitation (see solicitation Standard Form (SF) 1449)

84) Question: Please clarify the proposal due date. The FBO posting states May 5th. This conflicts with page three of Appendix 4 which states that the proposal due date will be released with the final solicitation.

Response: The proposal due date will be released with the final solicitation.

85) Question: Please clarify whether the current solicitation is a draft. Will the government release a final solicitation for this procurement?

Response: The current solicitation is a draft.

86) Question: May Offerors submit their respective final proposal as one PDF document that includes all three volumes?

Response: No. Individual PDFs must be submitted per Volume.

87) Question: Please clarify the incoming file size limitation for the government points of contact's email in-boxes. Our proposal will be quite large and knowing this information will limit the number of pieces we have to break it into.

Response: Proposal submittal should be submitted in zipped files/compressed file to manager file size. Incoming files must not exceed 10 MB.

88) Question: Will the government accept similar past performance questionnaires (PPQs) submitted for other proposals? If so, are Offerors allowed to submit these PPQs with our proposal?

Response: Appendix 4 must be used. It was posted to FBO. Questionnaires can be submitted any time prior to the solicitation closing date.

89) Question: Will ICE provide financial incentives to the winning bidder for a start of service prior to 90 days?

Response: No. The 90 days apply to full start of services including all facilities. Full start of services will differ per facility.

90) Question: Will there be penalties for a failure to begin service within 90 days?

Response: It will impact contract performance rating (CPARS).

91) Question: Will a final RFP be issued incorporating the changes?

Response: All changes in reference to the draft solicitation will be incorporated in the final solicitation.