Attachment_2_-_PWS_for_Musculoskeletal_Task_Order.pdf

MILITARY HEALTH SYSTEM (MHS)

NEXT GENERATION TRI-SERVICE WORKFLOW SERVICES

SAMPLE TASK ORDER 2: MUSCULOSKELETAL MEDICINE WORKFLOW

Defense Health Agency, Falls Church

Part 1

General Information

1. General: This is a non-personal services contract to provide Subject Manner Experts (SMEs) comprised of Senior

Physicians, Senior Physician Assistants/Nurse Practitioners and Junior Physicians, Training Manager and Program

Managers for the Military Health System (MHS), Defense Health Headquarters (DHHQ), and Falls Church, VA.

The Government shall not exercise any supervision or control over the contract service providers meaning the employees performing the services herein with regards to the contract. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government.

1.1 Description of Services/Introduction: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to create, edit, monitor, and perform services on clinical workflows as it pertains to this statement of work. The aforementioned services will be referred to as Next Generation Workflow Services perform experienced Next Generation Workflow

Services. Workflow is defined as the sequence of operational, administrative, or clinical processes through which a piece of work passes from initiation to completion. The contractor shall provide medical information technology

(IT) services of the nature and scope described in the paragraphs below. This Performance Work Statement except for those items specified as government furnished property and services, the contractor shall perform to the standards therein

1.2 Background: In 2009 the Air Force Medical Support Agency (AFMSA)/SG6 realized the difficulty of deploying and integrating IT products in the MHS. Armed Forces Health Longitudinal Technology Application

(AHLTA) was and is the electronic medical record for the MHS, and had low user satisfaction. There was no clinical decision support in AHLTA, nor were the evidence based screening or severity measures. Compliance with clinical practice guidelines (CPG’s) was erratic and often had a low penetrance into the clinical setting. Policy, IT services, workflow, education and clinical operations were all parts of a successful IT integration, yet these were

“stove-piped” across various Air Force Medical Agencies. To address this issue and cut across these barriers, AFMSA created the Workflow Division. This group of clinicians with IT expertise was able to create programs that included all of the fore mentioned components and empowered clinicians at the point of care. Seeing the importance of working across the MHS, the AFMSA Workflow Division reached out to the Army and the Navy and formed the

Tri-Service Workflow Team (TSWF team). This group of clinicians from all three services work together to create

IT solutions in a standardized manner to actualize evidence based medicine at the point of care. The TSWF Aim form Templates are the standard documentation tool for primary care across all three services. It is the only group who delivers evidenced based clinical decision support at the point of care in AHLTA. Research on the TSWF group has shown that it has effectively increased rates of screening for depression in the clinical setting, coding accuracy, compliance with Joint Commission inspection items, reimbursement and readability of notes.

With the increasing amount of clinical data that is available through health information systems, caring for patients has become dependent on being able to utilize vast amount of information in a useful way. Clinicians must not only be able to utilize new information systems, but engage the patient in data capture and integrate their clinical team to perform at the highest level of their licensure. For the purposes of this contract, making data available in a meaningful way at the point of care is a difficult task, and is what is referred to as “Workflow.” It is Workflow that allows us to maximize the talents of every member of the medical team and deliver world class care to our patients.

Workflow is the “how, who, when and where” of data management. Commanders on the battlefield know the importance of having the right intelligence at the right time. Medical providers need the same to deliver optimal care for our patients. The Tri-Service Workflow (TSWF) team has developed programs and methodologies that apply state of the art Workflow principles into military medicine.

1.3 Objectives: DEVELOPMENT AND DISSEMINATION OF CLINICAL WORKFLOWS: The contractor shall provide Subject Matter Experts, training managers, programmers and program management support for the sustainment of the TSWF Suite of Products. Efforts will be in coordination of the DEVELOPMENT of a clinical workflow for the electronic medical record system, in providing evaluations and recommendations on clinician-focused IT systems, in support of the Military Health Service (MHS). This includes:

a. AHLTA

b. Milsuite or other communication platforms

1.4 Scope: The Contractor shall provide qualified personnel as described in section 1.5.11 of this document to perform medical and information technology (IT) Workflow support, TSWF specifically leverages enterprise DoD

IT solutions to help standardize functionally directed clinical workflows at every military treatment facility. The most common current solution is the AHLTA TSWF Alternate Input Method (AIM) forms (though the team is transitioning to support of the future electronic health record). Functionally directed clinical workflows are difficult to anticipate, and have varying levels of effort. Effort is dictated by clinical needs, policy and IT limitations.

Creation of workflow forms is usually technically simple; the challenge lies in identifying and standardizing the clinical content of the form while balancing usability needs of a wide population of physicians. Proper training is necessary to ensure success of these workflows. Likewise, analysis of effort (i.e. metrics, both internal to the project

– i.e. project process improvement, and external to the project – i.e. clinical process or patient outcomes) is just as important to the success of the project. Future workflows will require varying technical needs, based on the system at hand. This contract encompasses the entirety of the development lifecycle (planning, implementation, testing, documentation, deployment/training, analysis, and eventual closure) of workflow solutions across the enterprise.

1.4.1 The Contractor shall comply with all applicable laws, rules and regulations, including but not limited to those included in Section 4 of the PWS

1.5 Period of Performance: The Musculoskeletal workflow will be "folded" into the sustainment vehicle after the base period with 1-2 option periods, based on completion of development and deployment.

1.5.1 Quality Control: The contractor shall develop and maintain an effective quality control program to ensure services are performed in accordance with this PWS.

1.5.2 Quality Assurance: The government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan.

1.5.3 Recognized Holidays:

New Year’s Day Labor Day

Martin Luther King Jr.’s Birthday Columbus Day

President’s Day Veteran’s Day

Memorial Day Thanksgiving Day

Independence Day Christmas Day

1.5.4 Hours of Operation: The contractor is responsible for conducting business, between the hours of 0800 to 1600

Monday thru Friday except Federal holidays or when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings. For other than firm fixed price contracts, the contractor will not be reimbursed when the government facility is closed for the above reasons.

The Contractor must at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS when the Government facility is not closed for the above reasons. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential.

1.5.5 Place of Performance: The place of performance for the main members of the team which includes the program manager and the majority of the SME’s which will be referred to here on out as the Core Team will be the

National Capital Area (NCA) to include Walter Reed National Military Medical Center/National Intrepid Center of

Excellence, Fort Belvoir, Defense Health Agency Headquarters, Uniformed Services University, and Joint Base

Andrews ; however the team deploys products throughout the MHS at Continental United States (CONUS) and

Outside the Continental United States (OCONUS) sites. Selection criteria for visits at sites that have a need for standardization, implementation of new or current tools into their workflow, or require refresher training is typical.

New development of products and periodic data pulls many be conducted at, but not limited to, some or all of the recognized pilot sites. The pilot sites selected are variable, and the days at each pilot are notional estimates of time required, and in this case, are based on previous performance.

Examples of pilot sites requiring sustainment training, and previous amount of time spent at these sites:

Army:

Joint Base Lewis-McChord, WA 4 days

Ft Sam-Houston, TX 4 days

Tripler, HI 4 days

Navy:

San Diego Naval Station, CA 4 days

NSA Bethesda, MD 4 days

Air Force:

Eglin AFB, FL 4 days

Lackland AFB, TX 4 days

Travis AFB, CA 4 days

1.5.6 Type of Task Order: The government will award a firm fixed price line item task order on the Next

Generation Tri-Service Workflow Services contract.

1.5.7 Security Requirements: The MTFs are restricted access military installations. A personnel background check will be processed. An ID, the common access card (CAC), and the vehicle registration will not be issued until the background checks are completed and approved the installation security manager. The CAC card is required for access to government computer data bases and also is given to the security guards when entering military installations.

1.5.7.1 Security Identification badges: Contractor personnel shall comply with the local installation and MTF personnel identification requirements. The contractor is responsible for absences of contractor personnel due to expired identification and access documents.

1.5.7.2 Contractor Personnel has turn in the MTF badge and common access card to the COR upon termination of their services under this contract.

1.5.7.3 Physical Security: The contractor shall be responsible for safeguarding all government equipment, information and property provided for contractor use. At the close of each work period, government facilities, equipment, and materials shall be secured.

1.5.8 Key Control: The Contractor shall establish and implement methods of making sure all keys/key cards issued to the Contractor by the Government are not lost or misplaced and are not used by unauthorized persons. NOTE:

All references to keys include key cards. No keys issued to the Contractor by the Government shall be duplicated.

The Contractor shall develop procedures covering key control that shall be included in the Quality Control Plan.

Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas.

The Contractor shall immediately report any occurrences of lost or duplicate keys/key cards to the Contracting

Officer.

1.5.8.1 In the event keys, other than master keys, are lost or duplicated, the Contractor shall, upon direction of the

Contracting Officer, re-key or replace the affected lock or locks; however, the Government, at its option, may replace the affected lock or locks or perform re-keying. When the replacement of locks or re-keying is performed by the Government, the total cost of re-keying or the replacement of the lock or locks shall be deducted from the monthly payment due the Contractor. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the Government and the total cost deducted from the monthly payment due the

Contractor.

1.5.8.2 The Contractor shall prohibit the use of Government issued keys/key cards by any persons other than the

Contractor’s employees. The Contractor shall prohibit the opening of locked areas by Contractor employees to permit entrance of persons other than Contractor employees engaged in the performance of assigned work in those areas, or personnel authorized entrance by the Contracting Officer.

1.5.9 Government Training / Orientation.

1.5.9.1 Staff Orientation - New Employee. Contract employees shall participate in all staff orientation and/or training. Contract employees will attend a contractor provided initial orientation to familiarize themselves with policies and procedures of the MTF. All training must be updated on a quarterly basis and initial and updates must be approved by the COR (s). Such orientation may include instruction on automated processing, standard operating procedures, local in-services, quality improvement policies, communications, and occupational exposure to blood borne pathogens, safety programs, etc.

1.5.9.2 Annual Training Updates. Contract employees shall be required to complete an annual training update at the

MTF Annual training updates may be accomplished via video or classroom instruction, computer-based instruction, or review of written materials.

1.5.9.3 Armed Forces Health Longitudinal Technology Application (AHLTA) Training (formerly known as

CHCSII). Contract employees shall attend training in the use of AHLTA. The length of training will depend upon the computer skills of the individual contract employee. This training will be coordinated and scheduled by the

COR. (Access to such patient data systems is an “Automated Data Processing Sensitive” position requiring compliance with AR 25-2 and AR 380-67.)

1.5.9.4 HIPAA Privacy and Security Training (HIPAA 101). Contract employees shall be required to complete the

On-Line Web-based Training Modules within the first 30 days of employment.

1.5.9.5 In addition to the specified courses listed above, contract employees are required to attend or complete on-line any Department of Defense, Army, or Federal Government directed courses, which are not available to contract employee outside of the MTF. Contract employees will participate in all mandatory training.

1.5.9.6 Government unique training. The government may elect to provide unique government training to contract employees who are performing services under this contract. If the government elects to provide such training, the government will provide such training at no additional expense to the contractor or to the contract employee. When directed by the contracting officer, contract employees shall attend all such training in a paid status as part of the normal services required and billed under the contract. Such training shall require a performance commitment by the contractor and the contractor shall reimburse the government (by means of a reduction in an invoice) if a contract employee fails to satisfy the performance commitment after the contract employee receives the unique government training. The amount of the reimbursement shall be the prorated cost of training, calculated based on the total cost of the training and the number of months by which the contract employee fails to complete the performance commitment. The length of the performance commitment shall be 12 months or until the end of all performance under this contract, whichever occurs first.

1.5.9.7 AT Level I Training. All Contract Service Providers (CSPs), to include subcontractor CSPs, requiring access to Army installations, facilities and controlled access areas shall complete AT Level I awareness training within 90 calendar days after contract start date. The contractor shall submit certificates of completion for each affected CSP and subcontractor CSP, to the COR or to the contracting officer, if a COR is not assigned, within 30 calendar days after completion of training by all CSPs and subcontractor CSP. AT Level I awareness training is available at the following website: https://atlevel1.dtic.mil/at.

1.5.9.2.8 CSPs Who Require Access to Government Information Systems. All CSPs with access to a government information system must successfully complete the DOD Information Assurance Awareness training prior to access to the information systems and then annually thereafter.

1.5.9.2.9 For Contracts that Require OPSEC Training. Per AR 530-1, Operations Security (OPSEC), new contractor employees must complete Level I OPSEC training within 30 calendar days of their reporting for duty. All contractor employees must complete annual OPSEC awareness training.

https://atlevel1.dtic.mil/at

1.5.10 Post Award Conference/Periodic Progress Meetings: The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal

Acquisition Regulation Subpart 42.5. The contracting officer, Contracting Officers Representative (COR), and other

Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the contracting officer will apprise the contractor of how the government views the contractor's performance and the contractor will apprise the Government of problems, if any, being experienced.

Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the government.

1.5.11 Key Personnel: The follow personnel are considered key personnel by the government: 1 Lead Trainers, and

1 Program Managers. These personnel shall work onsite in government facilities, aiding government/military members.

Program Manager (Key Personnel) - These personnel shall work onsite in government facilities, aiding government/military members. Program

Management Professional Certification (Portfolio and Program

Management Certification) is highly preferable.

Training Manager (Key Personnel)- Training Managers shall have a minimum of 3 years’ experience using AHLTA in a clinical setting and have experience in a training role. Managers should have experience as medical support staff in a Military Treatment Facility.

1.5.11.1 The contractor shall provide a contract manager who shall be responsible for the performance of the work.

The name of this person and an alternate who shall act for the contractor when the manager is absent shall be designated in writing to the contracting officer. The contract manager or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The contract manager or alternate shall be available between 8:00 a.m. to 4:30p.m., Monday thru Friday except Federal holidays or when the government facility is closed for administrative reasons.

1.5.12 The Contract Manager and Alternate must have 24 semester hours in mathematical, engineering, and/or quantitative analysis courses; 15 or more years cost analysis experience; and familiarity with Defense Department

Data Sources (e.g. cost and software data reporting, EVM). Program Management Professional Certification

(Portfolio and Program Management Certification) is highly preferable.

1.5.12.1 Identification of Contractor Employees: All contract personnel attending meetings, answering Government telephones, and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are

Government officials. They must also ensure that all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed. Contractor personnel will be required to display badges displaying contractor status when in a military working environment.

1.5.13 Contractor Travel: Contractor will be required to travel CONUS and within the NCR during the performance of this contract to attend meetings, conferences, and training. The contractor may be required to travel to off-site training locations and to ship training aids to these locations in support of this PWS. Contractor will be authorized travel expenses consistent with the substantive provisions of the Joint Travel Regulation (JTR) and the limitation of funds specified in this contract. All travel requires Government approval/authorization and notification to the COR.

1.5.14 Other Direct Costs: ODCs consist of travel, government directed training and other ODCs and is required in order to provide IT Professional Non-Personal Services to support the JTF CAPMED and MHS. The work will be performed mainly in MHS facilities, both CONUS and OCONUS. The number and frequency of travel is unknown, but would not exceed the travel budget allotted. This category includes travel (outlined in 1.6.13), reproduction, and shipping expenses associated with training activities and visits to contractor facilities. It could also entail the renting of suitable training venues.

1.5.15 Data Rights: The Government has unlimited rights to all documents/material produced under this contract.

All documents and materials, to include the source codes of any software, produced under this contract shall be

Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government. These documents and materials may not be used or sold by the contractor without written permission from the Contracting Officer. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other

Government rights.

1.5.16 Reserved

1.5.17 Transition-In/Transition-Out: To minimize any decreases in productivity and to prevent possible negative impacts on additional services, the Contractor shall have personnel on-board, completing the stated required training, doing the appropriate background checks, during the twenty day Transition-In/Transition-Out periods.

During the Transition-In period, the Contractor shall become familiar with performance requirements in order to commence full performance of services.

1.5.17.1 During the thirty day Transition -In Period, the contractor shall ensure that all mandatory training, all needed security clearances and all contractors direct training is complete. During the Transition-in period, the contractor shall identify key-personnel (i.e. program, manager and government office personnel), and decide who is to be working in government offices. The contractor shall ensure that the key personnel have met requirements to work at the aforementioned government offices (i.e. badging, mandatory training). It is highly preferable that project sustainment is evaluated – specifically, the current status and needs of each project – in order to ensure the workflows are as up to date as possible.

1.5.17.2 During the thirty day Transition-Out Period, the contractor shall ensure that all Common Access Cards are returned. Likewise, the contractor shall ensure all government furnished equipment is returned. Further, the contractor shall ensure that a transition plan summarizing the state of any open projects are to be created and issued to the government.

PART 2

DEFINITIONS & ACRONYMS

2. Definitions and Acronyms:

2.1 DEFINITIONS

2.1.1 ARMED FORCES HEALTH LONGITUDINAL TECHNOLOGY APPLICATION (AHLTA): An automated medical information system that provides integrated support for the functional work centers of inpatient and outpatient care facilities, patient administration, patient appointments and scheduling, nursing, laboratory, pharmacy, radiology, and clinical dietetics.

2.1.2 BENEFICIARIES OF THE MILITARY HEALTHCARE SYSTEM: Those individuals entitled to care at the

MTF IAW AR 40-3.

2.1.3 BACKUP PERSONNEL: Pre-approved contract personnel designated to move into the position of the primary contract personnel to perform required services for the duration of his/her absence.

2.1.4 CLINICAL PRIVILEGES: Authorization by the government body to provide specific patient care and treatment services in the organization, within well-defined limits, based on the individual’s license, education, training, experience, competence, judgment, and physical and mental health.\

2.1.5 CONTINUING EDUCATION: Education beyond initial professional preparation that is relevant to the type of patient care delivered in the organization, that provides current knowledge relevant to the individual’s field of practice, and that is related to findings from quality assurance activities.

2.1.6 CONTRACTING OFFICER. A person with authority to enter into contracts; administer, or terminate contracts. Make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.7 CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the contracting officer to monitor contractor performance. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.8 CONTRACTOR. The term as used in this contract refers to the prime.

2.1.9 CONTRACTOR VERIFICATION SYSTEM (CVS): A web based application hosted on a DMDC (Defense

Manpower Data Center) server that allows for updating DEERS with DoD contractor personnel data.

2.1.10 DEFENSE ENROLLMENT ELIGIBILITY REPORTING SYSTEM (DEERS): A computerized system that maintains current eligibility status for all eligible health care beneficiaries.

2.1.11 MILITARY TREATMENT FACILITIES (MTF): Military hospital or clinic.

2.1.12 MILITARY TIME is on a 24-hour clock, i.e.

8:00 a.m.-0800

9:10 a.m.-0910

Noon -1200

8:00 p.m.-2000

9:10 p.m.-2110

Midnight-2400

12:01 a.m.-0001

2.1.13 MILITARY DATES are written by placing the day of the month, followed by the first three letters of the month, followed by the last two digits of the year, i.e., September 02, 2001 - 02 Sep 01

November 10, 2004 - 10 Nov 04

May 1, 2005 - 01 May 05

2.1.14 PRIME SOURCE VERIFICATION: Confirmation from a primary source (granting agency) or a service that confirms credentials from a primary source that the information provided by the health care provider is current, correct, and substantiates qualifications.

2.1.15 PHYSICAL SECURITY. Actions that prevent the loss or damage of government property.

2.1.16 QUALITY ASSURANCE. The government procedures to verify that services being performed by the

Contractor are performed according to acceptable standards.

2.1.17 QUALITY ASSESSMENT AND IMPROVEMENT (QA& I): An ongoing program designed to objectively and systematically monitor and evaluate the quality and appropriateness of patient care, to pursue opportunities to improve patient care, and to resolve identified problems.

2.1.18 QUALITY CONTROL (QC): Those actions taken by the Contractor to control and ensure that performance of duties meet the requirements of the contract.

2.1.19 SUBCONTRACTOR. One that enters into a subcontract and assumes some of the obligations of the primary

Contractor.

2.1.20 TRAINING HOLIDAYS: Training holidays are days designated by the MTF Commander either the workday preceding or following a legal public holiday. The number of training holidays may vary from year to year.

2.1.21 WORK DAY. The number of hours per day the Contractor EMPLOYEE provides services.

2.1.22 WORK WEEK. Is defined as Monday through Sunday (dependent on workload and mobilization requirements).

2.2. ACRONYMS.

ACOR - Alternate Contracting Officer's Representative

ADP - Automated Data Processing

AHA - American Hospital Association

AHLTA - Armed Forces Health Longitudinal Technology Application

AR - Army Regulation

AMA - American Medical Association

AOD - Administrative Officer of the Day

BCLS - Basic Cardiac Life Support

BLS - Basic Life Support

CFR - Code of Federal Regulations

CHAMPUS - Civilian Health and Medical Program of the Uniformed Services

CHCS - Composite Health Care System

CLIN - Contract Line Item Number

CME - Continuing Medical Education

CONUS - Continental United States (excludes Alaska and Hawaii)

COR - Contracting Officer’s Represent

COTS - Commercial Off the Shelf

CPGs - Clinical Practice Guidelines

DA - Department of Army

DEA - Drug Enforcement Administration

DA - Department of the Army

DMHRSi - Defense Medical Human Resources System Internet

DMRC - Deployment Medical Readiness Clinic

DOD - Department of Defense

DODI - Department of Defense Instruction

ECFMG - Educational Commission for Foreign medical Graduates

EFT - Electronic Funds Transfer

FAR - Federal Acquisition Regulation

FIPS PUB - Federal Information Processing Standards Publication

FSO - Facility Security Officer

FTE - Full Time Equivalent

GS - General Schedule

HCAA - Health Care Acquisition Activity

HCP - Health Care Provider

HIPAA - Health Insurance Portability & Accountability Act of 1996

HSPD - Homeland Security Presidential Directive

JC - Joint Commission

KO - Contracting Officer

MEDCEN - Medical Center

MEDCOM - Medical Command

MEDDAC - Medical Department Activity

MHS - Military Health System

MTF - Military Treatment Facility

NACI - National Agency Check with Inquiries

NASW - National Association of Social Workers

NCOIC - Noncommissioned Officer in Charge

OCONUS - Outside Continental United States (includes Alaska and Hawaii)

OIC - Officer-in-Charge

OMB - Office of Management and Budget

OTSG - Office of The Surgeon General, U.S. Army

OSHA - Occupational Safety & Health Association

PAD - Patient Administration Division

PWS - Performance Work Statement

PIPO - Phase In/Phase Out

PL - Public Law

POC - Point of Contact

PPIMS - Past Performance Information Management System

QA&I - Quality Assessment & Improvement

QA - Quality Assurance

QC - Quality Control

QAP - Quality Assurance Program

QASP - Quality Assurance Surveillance Plan

QCP - Quality Control Program

RFP - Request for Proposal

RMC - Regional Medical Command

SF - Standard Form

SRP - Soldier Readiness Processing

TA - Trusted Agent

TAB - Therapeutic Agents Board

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1 GOVERNMENT FURNISHED SUPPLIES.

3.1.1 The Government will provide the use of all available MTF facilities and support services, materials, publications and forms, and equipment required for contract performance (except as designated). Contract employees shall keep Government furnished supplies, equipment and work areas in a safe, orderly and clean condition. Contract employees shall notify the Government whenever maintenance of equipment is required.

Contract employees shall abide by all MTF and Army requirements for physical security of Army property and equipment.

3.1.2 Telephones, facsimile machines, copiers and computer equipment are authorized for transaction of official Government business only and shall not be used for personal business. Personal long distance calls are not authorized. Telephones, facsimile machines and computer equipment are subject to communications security monitoring at all times.

3.1.3 Space used by contract employees in performance of services may be used for other purposes during their absence. Items of clothing, personal effects, or equipment cannot be secured during their absence. The Government will not incur any liability for theft, damage to, or loss of such personal items.

3.1.4 Items issued will remain the property of the Government and will not be removed from the hospital unless used for authorized travel for the training mission. They are to be used, turned in, or disposed of as directed.

PART 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1 General: The Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this contract that are not listed under Section 3 of this PWS.

4.2. Materials: The Contractor shall furnish all materials, supplies, and equipment necessary to meet the requirements under this PWS.

4.3. Equipment: The Contractor shall provide all laptops needed for development, and training of workflows. The contractor shall provide all non-military software needed on the laptop. The contractor shall provide all equipment needed for maintenance of the TSWF website. Government Furnished Equipment (GFE) with regards to laptops will be broken into two categories Training Laptops and Key Personnel Laptops.

Training Laptops: It is anticipated that the contractor will purchase laptops specifically for use to meet the training requirement. These training laptops will be purchased by the contractor using ODC funds. Upon purchase of the laptops they will become property of the Government. The contractor is advised to choose a laptop optimized for a mobile training mission (i.e. lightweight, large screen). These laptops will be returned to the government on completion of contract.

Key Personnel Laptops: It is anticipated that Government Furnished Equipment (GFE), material, and facilities will be required for contractor performance of this requirement. The required GFE has been reviewed and it has been determined that no apparent problems exist that will hinder successful performance by the prospective contractor. The government will provide four network laptops to key personnel working at the DHA.

PART 5

SPECIFIC TASKS

5.1 Project/Program Management: The contractor shall provide a program manager.

5.1.1 The contractor shall create a Master Project Schedule and Program Execution Plan within 30 days of start of contract and quarterly thereafter. Success is measured by COR acceptance of this. COR can direct renewal of this quarterly.

5.1.2 The contractor shall complete a monthly Status Report – 10th business day of every month electronically. This includes, but is not limited to:

Program status, to include objectives met, work completed and works outstanding

Issues or obstacles impeding progress and recommended solutions

Status of deliverables/milestones

Resource planning/status

Topics or issues identified by the Government QAP

Description of work completed and plans for next month

Summarize the efforts of each primary task

Enterprise-wide Contractor Manpower Reporting Application, Policy Alert 13-38 dated 13 May 2013, DPAP

Memorandum dated 28 November 2012 and Policy Alert 13-59 dated 14 Aug 2013.

5.1.3 The Contractor shall create a comprehensive and granular communication plan for all stakeholders in TSWF.

This communication plan must be in alignment with existing DoD Change Management and Communication plans.

This communication plan will be delivered to the COR.

5.1.4 The Contractor shall create and maintain internet and social media resources applicable to the team for this project (Twitter, Facebook, Milsuite; TSWF website), monitor and disposition questions from those sites. All log-in information and databases applicable to this (post-banks, etc…) will be delivered to the COR upon cessation of contract. This shall be logged and given to COR quarterly.

5.1.4.1 All functional comments to social media sites/internet sites must have a reply from the contractor within three days. All comments must have Government approval prior to posting.

5.1.4.2 All content on the TSWF website shall be updated by the contractor on a monthly basis or as directed by the

COR(s).

5.1.5 The Contractor shall create a Change Management Plan development and deployment of products. This shall be logged and given to COR quarterly.

5.1.5.1 The contractor shall maintain a database of all site pocs, site relevant information that is obtained from beta testing and pilot visits.

5.1.5.2 The contractor shall also maintain a log and database of training abilities when deploying to each site (this includes, but is not limited to, training room size, number training room can accommodate). This shall be logged and given to COR quarterly.

5.1.5.3 The contractor shall prepare a communication plan customized for each site; also pre-visit and post visit checklists and strategy to monitor adoption at the end user level.

5.1.5.4 The contractor shall track return on investment, end-user adoption and report best practices and lessons learned and maintain a database with this information.

5.1.6 The contractor shall submit reports to the COR and/or the Contracting Officer as requested for use in monitoring contract employee’s performance. Such reports will include, but are not limited to, initial and/or monthly/annually immunizations, and monthly schedule.

5.1.6.1 The contractor shall maintain a database of all site pocs, site relevant information that is obtained from beta testing and pilot visits.

5.1.6.2 The contractor shall also maintain a log and database of training abilities when deploying to each site (this includes, but is not limited to, training room size, number training room can accommodate). This shall be logged and given to COR quarterly.

5.1.6.3 The contractor shall prepare a communication plan customized for each site; also pre-visit and post visit checklists and strategy to monitor adoption at the end user level.

5.1.6.4 The contractor shall track return on investment, end-user adoption and report best practices and lessons learned and maintain a database with this information.

5.2 Workflow Development:

5.2.1 Development of New Tri-Service Workflows: as a baseline, the contractor shall develop and sustain a minimum of one new workflow per year (with AHLTA forms as appropriate). The maximum will be dictated as in base PWS section 1.6.6. There are usually anywhere between 3-7 workflows created per year.

5.2.2 The contractor shall engage in stakeholder analysis, coordinate meetings, produce flow charts mapping out the “as is” and “to be” high level workflows as directed by COR (s), as well as conduct research, analyze current literature and produce white papers when required. The contractor may need to observe stakeholders in their clinical settings to gather needed information on clinical processes, analyze IT systems, and generate or maintain high-level requirements for the new workflows. The TSWF team will then create a gap analysis; gauging what measures the form will improve (i.e. user satisfaction). After initial analysis is completed within 30 days of project start, coordination is accomplished among stakeholders in the three services. The contractor shall identify additional subject matter experts needed by the project. Success of this will be measured by 75% acceptance of the initial workflow analysis by each service workflow lead (i.e. cardiovascular army/air-force/navy lead); documentation of acceptance shall be provided to the COR.

5.2.3 The contractor shall provide a staffing plan, specifying subject matter experts as “Project Leads” for all sustainment workflows. Project Leads are to be proposed by the Contractor, but must be approved by the COR. All

Contractors shall meet the qualifications for their specialty, maintain certifications/qualifications within the scope acceptable for their technical professional discipline and standards, as would be required by government service technical professionals of similar experience and in similar duty assignments.

All personnel will have experience either using or training Tri-Service Workflow products/AIM forms in a clinical setting. Personnel must show understanding of/ or experience with TSWF principles and workflow concepts. (i.e.

embedding evidence based medicine/ clinical practice guidelines into standardized documentation templates to complement the clinical workflow.

5.2.3.1 Minimum requirements for SME are as follows:

5.2.3.1.1 Subject Matter Expert Level 1 Functional

Functional shall be a minimum of a physician assistant (PA) or nurse practitioner (NP) , have at least 3 years of experience in the military health system, shall possess experience functioning in a teaching role (>1 yr experience as an Advanced Practice Nurse or Physician Assistant supervisor; or experience as an instructor as demonstrated by

Associate Professorship at USUHS, Advanced Cardiac Life Support class instructor or similar class, such as Basic

Life Support), shall have had at least 1 year of leadership experience in a clinical setting.

5.2.3.1.2 Subject Matter Expert Level 2 Functional

Functional shall be a junior physician (MD/ DO) or senior physician assistant (PA) or nurse practitioner (NP), have at least 3 years of experience in the military health system (>1 yr experience as an Advanced Practice Nurse or

Physician Assistant supervisor; or experience as an instructor as demonstrated by Associate Professorship at USUHS, Advanced Cardiac Life Support class instructor or similar class, such as Basic Life Support), have experience functioning in a teaching role, excellent organizational and communication skills, and at least 1 year of leadership experience/team leadership skills.

5.2.3.1.3 Subject Matter Expert Level 3 Functional

Functional shall be a senior physician (MD/ DO), have at least 3 years of experience in the military health system, have experience functioning in a teaching role (>1 yr experience as an Advanced Practice Nurse or Physician

Assistant supervisor; or experience as an instructor as demonstrated by Associate Professorship at USUHS, Advanced

Cardiac Life Support class instructor or similar class, such as Basic Life Support), excellent organizational and communication skills, have had at least 1 year of leadership experience in a clinical setting.

5.2.3.1.4 Subject Matter Expert Level 3 Technical

Technical Expert with at least 3 years of experience in the military health system, bachelor in information technology.

5.2.3.1.5 Functional Subject Matter Experts must have demonstrable knowledge (degree, fellowship, and certification) at some, but not limited to, the following fields as they apply to their assigned workflows.

Demonstrable knowledge must be accepted for each workflow by the COR. The following fields will be in sustainment:

Sports Medicine

Musculoskeletal Medicine

5.2.3.1.6 All members of the team have three years of experience in the field of EHR form development/usability.

5.2.3.1.7 The staffing plan shall include ancillary credentials for team members. Ancillary credentials include, but are not limited to:

Master’s Degree in Informatics

Board Certification in their specialty and/or Informatics

Six-Sigma Green Belt or Black Belt

Lean Certification

Project Management Professional Certificate

Capability Maturity Model Integration (CMMI)

Agile Development Certificate

Change Management Certificate Program

Master’s Degree Health Science

Master’s Degree in Health Administration

Master’s Degree in Informatics or Health Information Technology

Bachelors in Information Technology or Health Information Technology

American Medical Informatics Association (AMIA) 10x10

Nursing Informatics Certificate Program

Certified Associate in Healthcare Information and Management Services (CAHIMS)

Certified Professional in Healthcare Information and Management Services (CPHIMS)

5.2.3.1.8 The staffing plan shall include if the individual has been in a deployed setting.

5.2.4 The contractor shall hold a conclave meeting, unless deemed unnecessary by the COR. A conclave meeting with subject matter experts (either live or via internet) will be held in the first three months following initial workflow analysis acceptance, with the service representatives for the workflow, DHA Workflow and the contractor to build the initial beta workflow and IT tools. A follow-up conclave may be utilized if needed for project success, to be deemed by the COR. Success of the conclave will be measured by completion of draft form/tool for pilot program; the draft form/tool must be accepted by the COR.

5.2.5 After COR the draft/form tool is developed, and the COR allows beta testing, the contractor shall train

/implement the workflow in a clinical beta testing environment (unless deemed unnecessary by the COR), providing a summary of the feedback and success or failure of the new workflows, travel to beta or stakeholder sites as needed, producing artifacts to document development processes. Beta testing shall occur within 3 months of the conclave, unless directed otherwise by the COR. Beta testing success will be measured by delivering a document detailing the impact on measures identified in the gap analysis; this document will be accepted by the COR.

5.2.6 After the initial beta testing, the contractor shall train and deploy workflows into the TSWF pilot sites or

MHS/service designated pilot sites. Pilot testing shall occur within 3 months of beta testing, unless directed otherwise by the COR. The contractor shall be required to track workflow and clinical measure data on the pilot bases’ results after implementing the new workflows. This data will be obtained by AFMSA (or appropriate data group), but the analysis will be performed by the contractor in conjunction with the TSWF team. Success will be measured by >50% acceptance of the piloted workflows by the stakeholders; in addition, pilot success will be measured by delivery of the document detailing the impact on measures identified in the gap analysis; this document will be accepted by the COR.

5.2.7 In addition, the contractor shall provide baseline and incremental sustainment data collection to measure the outcomes of the workflow tools (unless deemed unnecessary by the COR). The workflows that are developed must be done in accordance with current TSWF principles and processes. All developed workflows must interact seamlessly with the current suite of TSWF products including using the same “medcin” (a medical ontology) terms, the same organization and graphical user interface style as the TSWF products. The contractor shall coordinate with other TSWF efforts to make sure that behavioral health in primary care tools and processes are included in the current tools in development for the DoD/VA clinical practice guidelines. The contractor must be prepared to brief on studies, analysis and outcomes when requested.

5.2.8 It is highly preferable that metrics created by workflow redesign at pilot and MTF level sites should be research quality, and that the contractor shall publish in journals as appropriate. Publications must be directed by the COR, and cleared by public affairs.

5.3 Training/Implementation: The contractor shall develop the musculoskeletal medicine workflows with associated sustained training – via the government’s current collaboration tool, and/or prepared briefs to clinical system trainers.

5.3.1 Training Managers: The contractor shall provide training managers in support of their workflows.Training

Managers shall have a minimum of 3 years’ experience using AHLTA in a clinical setting and have experience in a training role. Managers should have experience as medical support staff, ideally in a JTF CapMed facility. All training managers must be appointed by the contractor after COR approval.

5.3.1.1 All trainers must work directly with workflow developers’ work in conjunction with the trainers to achieve alignment of efforts.

5.3.2 The contractor shall place training Materials that will be in the DHA/TSWF Format. Training will be made available by the contractor 1 month prior to deployment (unless otherwise directed by the COR) – and will require

COR acceptance prior to pilot. All training will be updated on a quarterly basis by the contractor, and all updated training will also require COR acceptance. All training must be disseminated to Clinical Systems Trainers monthly

(highly preferable to be in a meeting/telephone format). In addition, all training must be disseminated via the appropriate websites (i.e. KX, Milsuite, or TSWF site).

5.3.3 As those training in a clinical setting may be incidentally exposed to infectious disease, all contractors engaged in over the shoulder the training shall have all vaccinations required of healthcare personnel. The immunization records of the team shall be given to the COR on a yearly basis.

5.3.4. Personal Appearance

5.3.4.1 The Contractor shall present a neat and clean appearance.

5.3.4.2. All outer clothing shall be laundered or dry cleaned as appropriate and well-fitting.

5.3.4.3. Shoes shall cover the foot to meet sanitation and safety requirements. Open-toe shoes or sandals shall not be worn.

5.3.4.4. Fingernails shall be clean and not extend one quarter of an inch beyond the flesh tips.

5.3.4.5. Hair shall be neatly groomed. The length and bulk of hair shall not be unkempt, or of extreme appearance.

5.3.4.6. Contractors shall wear dresses, pants or slacks, shirt or blouses with collar and sleeves, shoes and socks.

Tank tops, cut-off pants, shower shoes or similar items of apparel are specifically prohibited. In all cases, contract employees shall conform to the established personal appearance policy of MTF.

5.4 Projects:

5.4.1 The Contractor shall create a Musculoskeletal Medicine workflow.

5.4.2 The Contractor must collaborate with other interest groups (i.e. Uniformed Services Academy of Family

Practitioners), communities of interest (i.e. DoD/Veteran Affairs Clinical Practice Guideline Groups), and divisions

(i.e. Business Process Management) when required to fulfill a tasking. Any new collaboration with an agency requires COR permission.

5.5 Travel: The contractor shall deploy their workflows across the MHS. Standard beta testing, and Standard pilot sites are listed in section 1.6.5. It is highly preferable that training be conducted CONUS. With OCONUS sites trained only as necessary. It is preferable that Clinical Systems Trainers be used for OCONUS training and travel.

OC…