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Attachment I Amubulatory EHR COTS Functionality

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Data Collection (#)

Relative Weights:2110.5
USCG PriorityRequired FeatureRequired?Relative BenefitRelative PenaltyTotal ValueValue %Relative CostCost %Relative RiskRisk %Priority
Architecture00.00.00.0ERROR:#DIV/0!
Citrix Client architecturey215100.01100.01100.00.667
Operate across 6 time zones from one server00.00.00.0ERROR:#DIV/0!
Plug-in (Portlet) to MHS Interface (uses CareFx)00.00.00.0ERROR:#DIV/0!
System housed at CG Operational Support Center, Martinsburg, WV00.00.00.0ERROR:#DIV/0!
System currently supports customers with over 300 providers and 1200 users00.00.00.0ERROR:#DIV/0!
Retail Pharmacy electronic interface00.00.00.0ERROR:#DIV/0!
Quest Laboratory Interface00.00.00.0ERROR:#DIV/0!
DINPACS interface00.00.00.0ERROR:#DIV/0!
NHIN compliant data exchange protocols with DoD, VA, and Private Sector00.00.00.0ERROR:#DIV/0!
Remote Access (e.g. outside network providers)00.00.00.0ERROR:#DIV/0!
Integrated Patient Health Record with web interface00.00.00.0ERROR:#DIV/0!
Graphical User Interface00.00.00.0ERROR:#DIV/0!
Support multiple user roles and allow “breaking of glass” in certain situations00.00.00.0ERROR:#DIV/0!
Integrated electronic medical and dental records00.00.00.0ERROR:#DIV/0!
Advanced clinical decision support tools00.00.00.0ERROR:#DIV/0!
Broad Spectrum of User roles00.00.00.0ERROR:#DIV/0!
System supports a single sign-on for each user, regardless of which area of the system he or she needs to access. Users do not need to log out and log back in to move between functionality in applications.00.00.00.0ERROR:#DIV/0!
Multi-simultaneous access to record for viewing with limited simultaneous access for editing with alerts to inform user of why access is prohibited and who has record in use /open00.00.00.0ERROR:#DIV/0!
Hardware00.00.00.0ERROR:#DIV/0!
Wireless tablet Option (optimized for data entry and patient interaction)00.00.00.0ERROR:#DIV/0!
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Kiosk00.00.00.0ERROR:#DIV/0!
1EMR supports a Kiosk system with a touch screen-enabled, self-service system that is built on the same database as the EMR, registration, scheduling and billing systems.00.00.00.0ERROR:#DIV/0!
2Has functionality for check-in, Acute Care arrivals, walk-in scheduling, demographic updates, card scanning, customizable questionnaires, and document signing.00.00.00.0ERROR:#DIV/0!
3The self-service system allows a patient to perform the following activities:

a Be notified of upcoming or overdue health maintenance reminders as specified in the patient’s medical record.

b Confirm his or her current medications, allergies and conditions during check-in and display his or her responses to the provider during that visit.00.00.00.0ERROR:#DIV/0!
4System can also provide a concierge application that allows a customer service representative to monitor multiple kiosks.00.00.00.0ERROR:#DIV/0!
5Allow the theme to be fully customized including details such as front page graphics, button colors and shapes, background, text fonts and colors.
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General Features00.00.00.0ERROR:#DIV/0!
Applications including scheduling, ambulatory care, lab, and pharmacy are fully integrated at database level creating one central patient record without duplicate data fields/elements.00.00.00.0ERROR:#DIV/0!
Reporting and Forms00.00.00.0ERROR:#DIV/0!
Population Health Management and reporting
Occupational Health Reporting & Surveillance
Medical Readiness Reports
Ability to incorporate mandatory government Forms (document in and print)
DD 2807, DD 2808, SF 508, SF 513, DA 4497, CG 602000.00.00.0ERROR:#DIV/0!
System provides a flexible, template-driven reporting tool within the main user interface.
1A table-based interface allows users to execute queries by checking boxes and selecting choices from lists to filter their searches.
2Allows for real-time reports that administrators and end users can write and run to identify patients, orders, results, encounter diagnoses, and other data fields that meet the criteria defined by the user. (e.g. ad hoc customizable queries)
3Reporting tools are fully integrated with patient data, allowing users to drill down into patient records, jumping into patient charts for further review directly from the report.
4Allows for batch communication to patients identified in the search via letter or secure messages to the patient via the patient Web portal.00.00.00.0ERROR:#DIV/0!
Clinical Content and Decision Support00.00.00.0ERROR:#DIV/0!
1Relevant data entered in one department is used for decision support in all departments: For example, when a corpsman updates a patient’s allergies, the new allergies are immediately available without interfacing and are used in drug-allergy interaction checking for pharmacists in the pharmacy system.00.00.00.0ERROR:#DIV/0!
2System supports context management. The patient that the user accesses in one module is automatically the same patient as the user moves to another module.00.00.00.0ERROR:#DIV/0!
3Offers a pre-populated system with clinical and administrative content:00.00.00.0ERROR:#DIV/0!
a. templates with orders and documentation elements for routine visit types00.00.00.0ERROR:#DIV/0!
b. outpatient medications configured with suggested discrete doses00.00.00.0ERROR:#DIV/0!
c. Warnings based on protocols validated by live users of the system00.00.00.0ERROR:#DIV/0!
d. Analytical and operational reports, including reporting home pages for users00.00.00.0ERROR:#DIV/0!
4Provides access to a library of clinical and administrative content provided by healthcare organizations including:00.00.00.0ERROR:#DIV/0!
a. Order sets containing medications, labs and procedure orders00.00.00.0ERROR:#DIV/0!
b. Questionnaires including medical history forms, chronic condition self-evaluations, pediatric growth and development00.00.00.0ERROR:#DIV/0!
c. Documentation templates for notes00.00.00.0ERROR:#DIV/0!
5System provides decision support features including actionable alert windows driven by patient data that let providers take recommended actions such as reviewing lab results and placing orders or sending messages directly from the alert window without having to change screens.00.00.00.0ERROR:#DIV/0!
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Remote Access for Cutters00.00.00.0ERROR:#DIV/0!
Provides real time access to information while on boats or capability to sync information to ensure consistency between what is captured about ships and what it on land (network) e.g Store & Forward capability for operational platforms (e.g. USCG Cutters)
System provides a module that allows users to securely “borrow” records from the enterprise repository and store them on laptops for times when away from the network. This will allow clinicians to document on the “borrowed” patient visits including orders, medications, allergies, and care planning without being connected to the database.
Documentation is synced to the centralized integrated database when the user has an internet connection.00.00.00.0ERROR:#DIV/0!
Patient Problems, History and Laboratory Tests00.00.00.0ERROR:#DIV/0!
Offers tools to increase caregiver efficiency in reviewing patient medical history including graphics:
Users can review problem-specific labs and medications from the problem list.
Users can set patient-specific goals in the problem list.
Physician can control which problems appear in the patient web portal and can set patient-friendly names for problems that patients see when reviewing their chart in the patient portal.
When a specialist, such as an optometrist, views the patient’s record, the problem list items for that specialty are automatically at the top of the list.00.00.00.0ERROR:#DIV/0!
Charting and Drawing00.00.00.0ERROR:#DIV/0!
Behavioral Health Charting (limited access- role based)
Providers are able to take notes using free text, speech recognition tools, or point-and-click list options that generate narrative notes. Documentation efficiency capabilities include:
1Users can copy notes forward from a previous encounter.
2Individual note templates are preselected to default to a user’s most common review of systems and physical exam.
3Users can create templates that include customized orders, notes, level of service, follow up and patient instructions.
4A WYSIWYG designer allows users to create and modify visual forms.
5Includes pre-written and formatted notes and text shortcuts that clinicians and other users can use as templates to create documentation. Users can select values from lists to include in notes. End-users can create their own templates and share them with other users.00.00.00.0ERROR:#DIV/0!
6Drawing tools including provider ability to customize stencils.00.00.00.0ERROR:#DIV/0!
7Users can embed a drawing within a note.
8Users can use templates for parts of the note and can record dictation for other parts. Users can use speech recognition with the system for:
Free-form note taking
o In some cases, navigating the system including signing notes and opening and closing workspaces.
Embedding macros into notes. For example, a provider could insert a full list of a patient’s current medications or problems with a short verbal command.
Medications00.00.00.0ERROR:#DIV/0!
Has tools for providers to reconcile medications and to document medication administrations including:00.00.00.0ERROR:#DIV/0!
1Users can document patient reported meds and place new orders within the same screen.00.00.00.0ERROR:#DIV/0!
2System warns providers about duplicates (including across brand name and generic equivalents) and recommends action before orders are signed.00.00.00.0ERROR:#DIV/0!
3System provides a method for documenting facility administered medications on select schedules for administration00.00.00.0ERROR:#DIV/0!
Web Access00.00.00.0ERROR:#DIV/0!
System provides various levels of access to patient charts via the web including different levels of access for organization providers and affiliates.
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1Organization physicians and nurses can use the web portal for remote access to review patient charts, document encounters, place orders, sign transcriptions, and schedule appointments.00.00.00.0ERROR:#DIV/0!
2System allows organization to control what data in patient charts can be seen by affiliates and can limit affiliates to viewing only their patients’ records.00.00.00.0ERROR:#DIV/0!
Interoperabilty00.00.00.0ERROR:#DIV/0!
1Can exchange data with other EMRs using NHIH standards00.00.00.0ERROR:#DIV/0!
2Interfaces with MHS SSO/CM Unified GUI (CareFx)00.00.00.0ERROR:#DIV/0!
Sick Call / Triage Center00.00.00.0ERROR:#DIV/0!
1The triage center allows corpsman or nurses to document, evaluate, and triage sick calls by reviewing the patient’s chart and using clinical protocols.00.00.00.0ERROR:#DIV/0!
2System allows the use of custom clinical protocols to help guide corpsmen and nurses through the triage process.00.00.00.0ERROR:#DIV/0!
Ambulatory EDR00.00.00.0ERROR:#DIV/0!
1Share the same medical & surgical history, meds, and allergies with the EMR.00.00.00.0ERROR:#DIV/0!
Patient Portal00.00.00.0ERROR:#DIV/0!
1The patient portal gives patients web access to portions of the same medical records their physicians use.

a Review their medical history – submit changes for their provider to review Pre-appointment questionnaires a Dynamic questions based on responses to previous questions b Generate list of recommended tests / screenings for provider based on questionnaire responses c Flag certain responses for provider to note during patient visit

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3The system should allow proxy access for children and for elderly parents.00.00.00.0ERROR:#DIV/0!
4The patient portal should let patients and their proxies:

a Request prescription renewals.

b Schedule appointments c Submit ‘telcons’ d Exchange secure messages with providers.

e Receive/review test results including viewing a history of result components in a graph.

f View health summaries and read targeted medical content.

g Review their medical history including current conditions, medications, and a summary of their visit.

h Complete history forms that can then be approved and imported into system by providers.

i Record data — blood pressure that automatically alert their physician of abnormal results.

j Search for available appointment times and make appointments with their doctors.

en.

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5System notifies patients via email when they have new information available to view in the patient web portal and notifies parents when there is new information regarding their childr00.00.00.0ERROR:#DIV/0!
6The organization can control what information the patient can access:

a Organization can control which test results the patient can see or receive automatically or allow clinicians to control which test results to send to a patient.

b Allows physicians to add a message to the patient when making a result available in the portal c Prevents certain sensitive or legally mandated diagnoses from being shared with the patient via the portal

d Organization can control what a parent can see when accessing the record of a child including the ability to automatically transition what parent sees as child ages and ultimately end the parent’s access when child reaches adulthood.00.00.00.0ERROR:#DIV/0!
Scheduling00.00.00.0ERROR:#DIV/0!
1Integrated Scheduling and Billing functions
2Scheduling system integrates with ambulatory clinical so when a provider places a lab or procedure orders, patients are flagged for scheduling and all order information is immediately available to the scheduler.
3
The system can also initiate appointments based on referrals – when an order is placed for an internal referral; the referral appears on the scheduler’s work list and when the appointment is created, relevant information from the order is available.00.00.00.0ERROR:#DIV/0!
4Displays availability for an individual provider’s schedule. The indicator is available per provider or for all relevant providers on the schedule.00.00.00.0ERROR:#DIV/0!
5Tracks no shows, displays them on the appointment desk and can prompt users to overbook no shows.00.00.00.0ERROR:#DIV/0!
6Based on pre-set rules, the system can automatically search for appointments and suggest times and providers. The rules account for appointment types and time slots. For example, an office visit for Dr. Green defaults to 20 minutes, while an office visit for Dr. Brown is 15 minutes, and a physical for Dr. Green is 30 minutes.00.00.00.0ERROR:#DIV/0!
7The system can generate recalls to improve preventative care. For example, patients receive calls, letters and patient portal reminders about annual physicals and other recurring health maintenance events.00.00.00.0ERROR:#DIV/0!
8The system can prompt the schedulers with questions when scheduling and can change the visit based on the answers to those questions. For example, if a questionnaire for a Well Woman appointment indicates that a patient prefers females, the system can narrow the resource choices to female providers.
Ambulatory Pharmacy00.00.00.0ERROR:#DIV/0!
Incorporate the FDA mandated "Medication Guides" into the patient information sheets?
Third-party billing for all prescriptions dispensed by the pharmacy
Incorporate the new DEA Controlled Substance Ordering System (CSOS)
Customized drug lists to provide clinics with only medications that are carried at that facility, providing the provider with an accurate pick list (formularies?)
Pharmacy label customizable, for example be able to add the expiration date of the drug for each prescription
Ability to run reports, for example: pharmacy volume summary (for filling of Rxs per day), Cost reports of medications dispensed for specific areas, Drug Utilization Reviews, etc.
Ability to load "controlled substance vault" for use at specific locations and track inventory
All order-related information is available to pharmacists including comments from the physician, alerts that were seen by physician, and override reasons given for those alerts. A this data should be available for all patients system wide.
Pharmacist/technicians are able to access the provider’s notes to see why the RX is being prescribed.00.00.00.0ERROR:#DIV/0!
Pharmacist/technician can review and add medication allergies.
For orders dispensed by ambulatory pharmacy, complete dispense and refill history (compliance) information can be made available to pharmacists, physicians, and nurses.
Multiple prescriptions for a patient can be adjudicated in real time in a single transaction.00.00.00.0ERROR:#DIV/0!
Refill requests submitted via the web patient portal are routed directly to pharmacy for processing. If a prescription has no refills remaining, an electronic message is sent to the physician to request approval of a new prescription. The physician can approve in a single click, automatically initiating the fill processing in pharmacy.00.00.00.0ERROR:#DIV/0!
Pharmacists/technicians are able to modify prescriptions within the pharmacy system, and those modifications do not need to be replicated in any other system (i.e., pharmacists do not need to go into the ordering system to make sure the prescription is updated to reflect what pharmacy is actually dispensing).00.00.00.0ERROR:#DIV/0!
When a prescription order in the ambulatory system is stopped (i.e., discontinued or expired), the prescription will be stopped in the pharmacy.00.00.00.0ERROR:#DIV/0!
Laboratory00.00.00.0ERROR:#DIV/0!
Lab users can manage specimen collection, tracking, testing, and reporting in the lab system. They can track and report quality control to help ensure that patients’ results are accurate.00.00.00.0ERROR:#DIV/0!
Lab system provides the ability to see and act on all outstanding orders for a patient from a single screen, regardless of the source of the order.00.00.00.0ERROR:#DIV/0!
Dynamic work lists allow real-time view of testing in progress without pulling up separate reports.00.00.00.0ERROR:#DIV/0!
Laboratory order details – panels, order sets etc?00.00.00.0ERROR:#DIV/0!
Results reporting specifics – charting results? Trends?00.00.00.0ERROR:#DIV/0!
Ophthalmology00.00.00.0ERROR:#DIV/0!
Includes the ability to graph procedures, medications, imaging measurements, vision, intraocular pressure, and target pressures all in a single view.00.00.00.0ERROR:#DIV/0!
Image annotation tools are built directly into the documentation forms and allow for drawings on pre-configured templates using standard drawing tools or image specific drawing shapes as well as automatic generation of documentation for the exam.00.00.00.0ERROR:#DIV/0!
End User Dashboard00.00.00.0ERROR:#DIV/0!
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Provides a dashboard composer within the main user interface with standard dashboards and homepages for operational metrics.00.00.00.0ERROR:#DIV/0!
Users can print or email the dashboard.00.00.00.0ERROR:#DIV/0!
Presents data as hierarchical tables, graphs, status indicators and trend indicators.00.00.00.0ERROR:#DIV/0!
Users can personalize parts of the dashboard content and layout.00.00.00.0ERROR:#DIV/0!
Managed Care Dashboard00.00.00.0ERROR:#DIV/0!
1Easily identify cohorts of patients and track relevant metrics.
2Without programming knowledge, users can build registries of patients.
3Users can report on cohorts of patients and the associated metrics and can extract this to external warehouse for further analytics.
4For lines of business managed by a payor on the system, provides for a single, uniform benefits build that serves both payor and billing business areas.
5Provides the ability to automatically generate authorization requests from clinical orders placed and make them available to the payor (or administrator of the payor), using the same system, for utilization review/management. As part of this, approved authorizations should be directly available for scheduling on the same system.
6Provides the ability, to users generating authorization requests, to steer referred-to choices based on geography or network affiliation.
7The system provides a single CRM module that can collect both payor customer service requests, as well as requests taken in other areas of the system, e.g., billing office.
8Provides a patient/member web solution that offers both provider side (clinical, scheduling, etc.) information and payor information combined into the same site.00.00.00.0ERROR:#DIV/0!
9Provides an affiliate (external provider) web solution that offers both clinical and payor referral and claims information combined into the same site.00.00.00.0ERROR:#DIV/0!
10Provides the ability to trigger case management requests from incoming referral and AP claims data.00.00.00.0ERROR:#DIV/0!
11
Has the ability to directly connect payor case management cases to related episodes of care and encounters housed in the clinical area of the system.00.00.00.0ERROR:#DIV/0!
12Offers a CRM workflow that can be driven from a pre-defined set of tasks, depending on the nature of the CRM request.00.00.00.0ERROR:#DIV/0!
13Offers a case management capability to send a tickler to case managers when their cases are due for review, and send escalation notices to case supervisors when cases are overdue.00.00.00.0ERROR:#DIV/0!
14Provides real-time physician alerts and completion.
15Releases information online.
16Provides the ability for clinicians to record disclosures.
17Includes secure in-house chart-viewer.
18Includes real-time coder productivity reporting.
19Provides an HIM director dashboard (including status of coding, deficiencies and ROI).00.00.00.0ERROR:#DIV/0!
Miscellaneous00.00.00.0ERROR:#DIV/0!
Ability to create standard templates for CG (what types of templates – progress notes, orders, drawing, etc)00.00.00.0ERROR:#DIV/0!
HIPPA? Record access tracking – time / date stamps for who is viewing records, changing records etc.215100.01100.01100.0ERROR:#DIV/0!
Desired Feature
Able to confirm user role and permissions from Window Active Directory (from CAC
Provider can save personal filters for types of notes to review. For example, when reviewing a patient’s chart, an optometrist could set a default filter to see only notes and visit types related to optometry.
Provider can review the patient’s history in the same window for placing orders
From within a patient’s problem list without leaving the screen, a provider can review the related orders, results, medications, or care plan goals.
A single screen can associate observational data, treatment data, and procedures in a timeline/graph view to facilitate correlation of events with data.
Tracks physician system use to measure efficiency and potential learning needs. Provides a physician efficiency dashboard with integrated e-learning videos that measures and compares an individual physician's performance to their department/specialty on the following metrics:

1. Number of orders placed from order sets

2. Percent of orders placed from preference lists

3. Time spent in the system per visit

4. Percent of visits that have been closed on the same day they were opened

5. Percent of visits that used efficiency or template tools for ordering and documentation

6. Amount of time for providers to review and send lab results in system secure messaging module

7. Amount of time for providers to complete medication authorization and medication cosign in system secure messaging module

Personal Health Record
Freestanding Personal Health record lets patients control the interoperable sharing of their own health documents. Patients should be able to:

a. Pull data from the EHR into their freestanding PHR

b. Share data electronically with organizations through patient portal access to the system

• Tools for patient lookup, duplicate avoidance and clean up

1. Users are presented with a warning prior to creating a potential duplicate chart and can be required to enter a reason, which is reportable.

2. Users can mark two patients for a merge. They can then view a report with a side-by-side comparison of the records and choose which information to keep.

3. Patient overlay events are displayed with the changed information highlighted and changes can be undone with the click of a button.

4. System provides the ability to move visit data or data from other points of patient contact and care between patient records.

Instructions for Completion Instructions for Completing Attachment 1. Ambulatory EHR COTS Functionality

The spreadsheet contains four (4) worksheets.
1. Instructions for Completion
2. Summary
3. Requirements Data Collection
4. Additional Comments per Feature
Summary Tab
1.Enter Company / Vendor name on Summary Tab.
Requirements Data Collection Tab
1. Review all of the listed features on Requirements Data Collection tab. Each of the features is categorized as either mandatory or desired.
Columns F,G, H will need to be completed to answer the question "Is feature apart of an existing product?"
1a. Column F
- Enter Y in column F for each feature that is apart of an existing product.
- Enter N in column F for each feature that is not apart of an existing product.
1b. Column G
- Enter reference details where feature is noted in product manual for all features that are a part of an existing product. i.e. Complete this column for all Ys entered in Column F.
1c. Column H
- Enter details for how requirements will be met for those mandatory features that are not apart of an existing product. i.e. Complete this column for all N's entered for mandatory features in Column F.

2. Enter a Y or N in Column I for those features that will require customization to meet USCG needs.

3. Enter a Y or N in Column J for those components that are supported within the core product without assistance from teaming partners.

4. Enter any comments regarding the requirement and the solution proposed in Column K. Maximum of 500 characters can be entered. Use "Addl Comments Tab" to add characters / text in excess of 500.

Additional Comments per Feature Tab

1.Enter Feature Identification Number from Requirements Data Collection Tab and any additional comments.

Summary

ACQUISITION SENSITIVE
Summary of Requirements
Company / Vendor NameFeatures not Apart of an Existing ProductFeatures Requiring Customization to Meet USCG Need
00

Requirmnts Data Collection

TOTAL N=Total Y=
ACQUISITION SENSITIVE00
Feature Identification NumberFeaturesUSCG Mandatory FeaturesUSCG Desired FeaturesIs Feature Apart of an Existing Product?Requires Customization to Meet USCG Need (Y/N)
Y/NIf Y, Identify Reference in Attached Product ManualIf N for Mandatory Features, Add Details for how Requirements will be MetComponents are Supported Within Core Product Without Assistance from Teaming Partners (Y/N)Comments
APPLICATION MODULES
Urgent Care / Emergency Care
1Provides urgent care / emergency care specialty specific tools.x
2Provides the ability to document pre-clinic, emergency and triage care.x
Dental
3Provides dental charting progress notes with all tooth surfaces and roots.x
4Provides dental charting with all tooth surfaces and roots.x
5Provides check-in functionality.x
6Provides tracking of exam charting data searchable by tooth surface.x
7Provides reminders to clinicians.x
8Provides record codes, including ADA procedure codes (CDT) and an unlimited number of user defined codes.x
9Provides automatically computing and reporting of RVUs(relative value units for work activities performed by individual staff members.x
10Provides automatically computing and reporting of ADA procedure code units for work activities performed by individual staff members.x
11Provides periodontal screening reporting (PSR).x
12Provides periodontal charting.x
13Provides ability to link to images in DINPACs system.x
14Provides drawing tools associated with the diagrams.x
15Provides dental treatment plans computable.x
16Provides Department of Defense dental class computable - store classification 1-4 at encounter level.x
17Provides filters specific for the dental care.x
18Ability to display radiographs in the PACS system.x
19Incorporates SF 513 Referral forms - same as medical.x
Physical Therapy
20Provides specialty specific documentation tools.x
Optometry/ Ophthalmology
21Provides specialty specific documentation tools.x
Behavioral Health
22Provides specific documentation tools.x
23Provides specialty specific role based security.x
Occupational Health
24Provides specialty specific documentation tools.x
Immunizations
25Provides specialty specific documentation tools.x
Audiology
26Provides specialty specific documentation tools.x
Radiology
27Provides specialty specific documentation tools.x
Ambulatory Pharmacy
28Provides check-in functionality.x
29Incorporates the FDA mandated "Medication Guides" into the patient information sheets.x
30Incorporates the new DEA Controlled Substance Ordering System (CSOS).X - TBD
31Provides customized drug lists to provide clinics with only medications that are carried at that facility, providing the provider with an accurate pick list (e.g. buildable not imported).x
32Provides pharmacy label customizable, for example be able to add the expiration date of the drug for each prescription.x
33Provides the ability to load "controlled substance vault" for use at specific locations and track inventory (inventory management component for controlled substances) for all drugs.x
34Provides ability to create multiple formularies.x
35Provides integrated drug inventory system.x
36Provides all order-related information to pharmacists including comments from the physician, alerts that were seen by physician, and override reasons given for those alerts. All of this data should be available for all patients system wide.x
37Provides pharmacist/technicians with the ability to access the provider’s notes to see why the medication is being prescribed.x
38Provides pharmacist/technician with ability to review medication allergies.x
39Allows pharmacist/technician to add medication allergies.x
40Provides complete dispense and refill history (compliance) information to pharmacists, physicians, and nurses for orders dispensed by ambulatory pharmacy.x
41Allows for multiple prescriptions for a patient to be adjudicated in real time in a single transaction.x
42Allows for a prescription (that does not have refills remaining) to generate an electronic message to a physician requesting approval of a new prescription.x
43Provides for refill requests with physician approval in a single click, automatically initiating the fill processing in pharmacy.x
44Allows for refill requests submitted via the web patient portal and routed directly to pharmacy for processing (if refills remaining).x
45Provides pharmacists/technicians the ability to modify prescriptions within the pharmacy system, and those modifications do not need to be replicated in any other system (i.e., pharmacists do not need to go into the ordering system to make sure the prescription is updated to reflect what pharmacy is actually dispensing).x
46Provides warnings/ alerts to providers about contraindications, refills remaining/ refills too soon, etc. (via interface with PDTS).x
47Allows the ability for prescriptions for network formularies to be sent electronically to E-scripts network pharmacies.x
48Allows when a prescription order in the ambulatory system is stopped (i.e., discontinued or expired), the prescription will be stopped in the pharmacy. (i.e. information regarding prescription will be relayed to pharmacy system so that prescription is not filled)x
Laboratory
49Allows lab users to manage specimen collection.x
50Allows lab users to manage specimen tracking.x
51Allows lab users to manage specimen testing.x
52Allows lab users to manage specimen reporting.x
53Allows lab users to track and report quality control to help ensure that patients’ results are accurate.x
54Provides a lab system that has the ability to see all outstanding orders for a patient from a single screen, regardless of the source of the order.x
55Provides a lab system that has the ability to act on all outstanding orders for a patient from a single screen, regardless of the source of the order.x
56Provides dynamic work lists that allow real-time view of testing in progress without pulling up separate reports. (e.g. occur at time of order)x
Patient Portal
57Provides Integrated Patient portal with web interface.x
58Provides ability to export PHR.x
59Provides Personal Health Record that interacts with patient portal.x
60Provides a patient portal that grants patients web access to the same information their physicians use.x
61Provides patients with web access to review their medical history.x
62Provides patients with web access to medical history to submit changes for their provider to review.x
63Provides a patient tracking mechanism that would administer questionnaires to patients via a patient portal.x
64Provides customizable settings that would allow the health care team and the patient to modify certain aspects and features of the PHR, based on updated requirements.x
65Provides a patient tracking mechanism that would allow the healthcare team to coordinate between multiple medical systems ( civilian, military) and settings (outpatient and consultative services).x
66Provides the capability to allow proxy access. (e.g. for children and for elderly parents)x
67Provides a patient portal for patients and their proxies:x
68a. View patient medical profile (demographic information, contact information, problem summary list, all prescribed and over the counter medications, drug and food allergies, past surgical history, family history, social history).x
69b. Request prescription renewals.x
70c. Schedule appointments (search for available appointments).x
71d. Receive/review test results including viewing a history of result components.x
72e. Receive/review test results including viewing a history of result components in a graph.x
73f. Review their medical history including current conditions, medications, a summary of their visit, view health summaries and read targeted medical content.x
74g. Record data — e.g. blood pressures that automatically alert their physician of abnormal results.x
75System notifies patients via email when they have new information available to view in the patient web portal and notifies parents when there is new information regarding their children.x
76Physician can control which test results the patient can see or receive automatically or allow clinicians to control which test results to send to a patient.x
77Physician can control which problems appear in the patient web portal and can set patient-friendly names for problems that patients see when reviewing their chart in the patient portal.x
Allows the organization to:
78a. Allow physicians to add a message to the patient when making a result available in the portal.x
79b. Prevent certain sensitive or legally mandated diagnoses from being shared with the patient via the portal.x
80c. Control what a parent can see when accessing the record of a child including the ability to automatically transition what parent sees as child ages and ultimately end the parent’s access when child reaches adulthood.x
81Provides patient with the ability to modify only selected data on his / her respective profile.x
82Provides the patient with the ability to print his/ her current medical information in a presentable, printer friendly format.x
83Provides secure electronic messaging:x
84a. Two way secure communication between the patient and the healthcare team.x
85b. Allow the patient to select the level of urgency for their message. (e.g. red, yellow, green)x
86c. Patients should be able to attach/ send medical information to their providers. (e.g. medical documents, laboratory tests results, radiology test results, disease specific data, data and notes from civilian consultative services)x
87Provides alert capabilities:x
88a. An alert icon available on the patient home page.x
89b. All alerts would automatically generate and send an email to the patient to check his/her PHR.x
90c. Alerts would be cleared once the task is completed or in cases when a task is not required, at the time the alert is reviewed.x
91Provides preventive health alerts.x
92Provides appointment alerts.x
93Provides an educational component that would be accessible for chronic disease process that is listed in the patient profile.x
94Provides the educational modules that contain components for each disease state:x
95a. Definition.x
96b. Risk Factors.x
97c. Self Management Strategies.x
98d. Preventive Factors.x
99e. Signs and Symptoms of Disease Process.x
100f. Disease Monitoring for Chronic Conditions.x
101g. Diagnosis.x
102h. Treatment.x
103Provides the ability to have medical information and self-management tools linked to the educational module.x
104Provides the ability to have medical information and self-management tools customizable for the educational module.x
105Provides a component that would include tracking:x
106a. Laboratory/ Radiology tests and their status.x
107b. Ordered and completed procedures.x
108c. Inpatient services.x
109d. Consultative requests and their appointment status.x
110e. A function by which patients could send data from civilian consultative services.x
111f. Emergency room visits.x
112g. Hospitalizations.x
PATIENT CARE AND DOCUMENTATION
Clinical Content and Decision Support
113Provides a pre-populated system with clinical and administrative content:x
114a. Templates with orders and documentation elements for routine visit types.x
115b. Outpatient medications configured with suggested discrete doses.x
116c. Warnings based on protocols validated by live users of the system.x
117d. Analytical and operational reports, including reporting home pages for users.x
118Provides access to a library of clinical and administrative content provided by healthcare organizations:x
119a. Order sets containing medications, labs and procedure orders.x
120b. Documentation templates for notes.x
121Provides advanced clinical decision support tools (CPGs).x
122Provides decision support features with alerts.x
123Provides actionable alert windows driven by patient data that let providers take recommended actions such as reviewing lab results and placing orders or sending messages directly from the alert window without having to change screens.x
Demographics
124Provides the ability to maintain demographic information on patients (e.g. Record the demographics of: preferred language, insurance type, gender, race and ethnicity, and date of birth).x
125Provides the ability to receive updates on demographic information patients.x
126Provides the ability to lock demographic information as needed.x
127Provides the ability to house free form comments field for demographic data.x
128Provides the ability to maintain alternate demographic information for patients. (e.g. alternate contact information)x
Patient Problems, History and Laboratory Tests
129Allows tools to increase caregiver efficiency in reviewing patient medical history including graphics.x
130Allows users navigate to specific labs and medications from the problem list.x
131Allows users to set patient-specific goals in the problem list.x
132Allows a specialist, such as an optometrist, to view the patient’s record in which the problem list items for that specialty are automatically at the top of the list.x
Charting and Drawing
133Ability for scanned notes to reside in the DINPACS.x
134Ability to scan notes.x
135Allows role-based security. (e.g. Behavioral Health Charting)x
136Allows providers to take notes using free text, speech recognition tools, or point-and-click list options that generate narrative notes.x
137Provides ability to submit "telecons".x
138Ability to create mini encounter (date, time, encounter provider, address, encounter type, etc) that would become apart of medical record and associated with the appropriate ICD-9 codes. (e.g. used to capture care provided by TRICARE providers)x
139Provides documentation efficiency capabilities:x
140a. Users can copy notes forward from a previous encounter.x
141b. Individual note templates are preselected to default to a user’s most common review of systems and physical exam.x
142c. Organization can create templates that include customized sets. (orders, notes, level of service, follow up and patient instructions)x
143d. A WYSIWYG designer allows users to create and modify visual forms.x
144e. Includes pre-written and formatted notes and text shortcuts that clinicians and other users can use as templates to create documentation.x
145f. End-users can create their own templates and share them with other users.x
146g. Users can select values from lists to include in notes.x
147h. Drawing tools including provider ability to customize stencils.x
148i. Users can embed a drawing within a note.x
149j. Users can use templates (free text of dictation)for parts of the note and can record dictation for other parts.x
150Allows users to use speech recognition with the system for free-form note taking.x
151Allows users to use speech recognition with the system in some cases for navigating the system including signing notes and opening and closing workspaces.x
152Provides reminders to clinicians.x
153Provides patient treatment plan or after visit summary.x
154Provides patient education materials.x
155Provides user editable patient education materials.x
156Provides electronic document signing functionality. (e.g. patient privacy, consent for treatment forms)x
157Allows users can use speech recognition with the system for embedding macros into notes. For example, a provider could insert a full list of a patient’s current medications or problems with a short verbal command.x
Medications
158Provides ability to perform drug-drug checks.x
159Provides ability to perform drug-allergy checks.x
160Provides ability to perform drug-formulary checks.x
161Provides tools for providers to reconcile medications and to document medication administrations:x
162a. Users can document patient reported medications and place new orders within the same screen.x
163b. System warns providers about duplicates (including across brand name and generic equivalents) and recommends action before orders are signed.x
164c. System provides a method for documenting facility administered (in the clinic) medications on select schedules for administration.x
165d. System warns/ alerts providers about contraindications, refills remaining/ refills too soon, etc. (via interface with PDTS).x
Sick Call / Triage Center
166Allows the use of custom clinical protocols to help guide corpsmen and nurses through the triage process.x
167Provides support of documentation workflows.x
168Provides support of evaluation workflows.x
169Provides support of triage sick call workflows.x
INFRASTRUCTURE / FRAMEWORKx
Architecture
170Provides Citrix Client architecture.x
171Allows system to operate across 6 time zones.x
172Provides integrated patient portal with web interface.x
173HIPAA Compliant.x
174FISMA Compliant.x
175508 Compliant.x
176Provides support for at least 300 providers.x
177Provides support for at least 1200 users.x
178Provides support for at least 500 concurrent users.x
179Provides intended redundancy with workload sharing.x
External Interfaces
180Provides Plug-in (Portlet) to MHS SSO/CM Interface. (uses CareFx)x
181Provides NHIN compliant data exchange with DoD, VA, and Private Sector.x
182Uses implementation of HIE standards in data exchange.x
183Uses implementation of C32 and CCR for health information exchange.x
184Currently Ambulatory CCHIT Certified.x
185Maintains a plan and associated process for continuous CCHIT certification.x
186Maintains a plan and associated process for continuous adaptation to changing electronic data exchange requirements.x
187Provides MHS pharmacy interface. (e.g. TRICARE Retail Pharmacy interface)x
188Provides MHS pharmacy interface. (e.g. PDTS)x
189Provides Quest Laboratory Interface.x
190Provides Data exports (secure FTP-delimited text) to DoD data warehouses.x
191Provides the ability to export data to external databases. (e.g. CGBI and other medical/personnel databases)x
192Provides for automated data export.x
193Provides DINPACS interface. (vendor TBD)x
194Provides unidirectional interface to update information with DEERS demographics.x
195Provides eligibility verification through DEERs.x
196Ability to receive ICD-9 codes from financial intermediary.x
197Ability to create mini encounter (date, time, encounter provider, address, encounter type, etc) that would become apart of medical record and associated with the appropriate ICD-9 codes.x
198Dental - Ability to receive healthcare treatment data from financial intermediaries (e.g. United Concordia) data.x
199Dental - Ability to create mini encounter (date, time, encounter provider, address, encounter type, etc) that would become apart of medical record and associated with the appropriate ADA codes.x
200Dental - Ability to have problem list updated with CDT codes.x
201Provides interface engines.x
System Integration
202Provides a system that supports context management. (e.g. The patient that the user accesses in one module is automatically the same patient as the user moves to another module.)x
203Allows registration data to be only entered once, and passed to each of the EHR modules as appropriate.x
204Provides scheduling for ambulatory, laboratory, optometry, and physical therapy appointments that is processed through a single user view across all appointment areas.x
205Provides scheduling for dental that is processed through a single user view across all appointment areas.x
206Allows problem lists, once entered into the system, (i.e. allergies, medications, and medical history) to be available without re-entry to all other modules.x
207Allows for all billing to be processed by a centralized billing module, with data passed from the other modules (e.g. ambulatory, laboratory optometry, or physical therapy) as required.x

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