PWS Questions (Final) SAM.GOV.xlsx
XLSX spreadsheet 45 KB Posted
- Attached to
- GLOBAL NURSE ADVICE LINE RFI/ INDUSTRY DAY
- Solicitation number
- HT0011-24-RFI-0196
- Issued by
-
Defense Health Agency
About this file
This document is a Draft Performance Work Statement (PWS) for the Global Nurse Advice Line (GNAL) contract opportunity. The key objectives include providing multimodal call center operations, telehealth registered nurse triage, medical care coordination, appointment scheduling through the MHS GENESIS electronic health record, and medical administrative capabilities. The contractor will be required to establish integrations with existing military systems such as DEERS and MHS GENESIS. The PWS provides detailed requirements for services like automated triage, reporting, security protocols, and staffing. The Defense Health Agency (DHA) is conducting market research through this Request for Information (RFI) and plans to hold an industry day. DHA anticipates issuing a solicitation for the GNAL contract in the future, but this RFI is not a request for proposals and participation does not guarantee a future contract award. Contractors are advised to provide information about their qualifications and ability to meet the GNAL requirements.
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Other files
| File | Type | Posted |
|---|---|---|
| GNAL PWS Draft 20240813.pdf | ||
| GNAL RFI Comment Matrix.xlsx | XLSX spreadsheet | |
| DRAFT PWS INSTRUCTIONS .docx | DOCX document | |
| RFI-ROM GNAL RFI-24-0196.docx | DOCX document | |
| Reverse Industry Day Slide Deck 4 Jun 24 - FINAL.pptx | PPTX presentation | |
| Nurse Advice Line_QA_Industry Day.xlsx | XLSX spreadsheet | |
| GNAL Virtual Industry Day Agenda - SAM POSTING.docx | DOCX document | |
| GNAL_ReverseIndustryDay_Announcement_9MAY.docx | DOCX document | |
| Att 1 - PWS GNAL Bridge Final Revised 20240311.docx | DOCX document | |
| HT0011-24-RFI-0196 GNAL .docx | DOCX document |
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Sheet1
| PWS REFERENCE (SECTION #) | QUESTION | Government Response | |
| Section(s) 5.15 and 5.16 | Overall Questions concerning these questions for section 5.15 &5.15 | Pending revision and or deletion, final PWS will address these questions. | |
| OVERALL MHS GENESIS INTERFACE | All questions concerning MHS GENESIS INTERFACE & INPUT WILL BE CLARIFIED IN THE REVISED PWS. | The Government is still in the process of defining MHS GENESIS INTERFACE & INPUT within the PWS. This section will be revised in its entirety to clarify the timeline and expectations for MHS GENESIS. This revision will include expectations for live calls, chatbot, and AI features. | |
| 1.3 | We recommend Government provide more specific details on the level of access required for DEERS, MHS GENESIS, and DFD platforms. This should include any API and/or application functions/regions within these systems that the contractor is required to access (or modify) and what security protocols must be followed to ensure compliance with DoD standards? | The Government will provide additional details in the PWS or elsewhere in the final RFP regarding requirements for accessing Government systems. | |
| 1.3 | We recommend Government provide industry with the appropriate systems and change management schedule for planned updates/releases for these military systems in order to align transition schedules. Additionally, please include information on how the awardee would integrate with the change management processes for these systems? | The Government will take this under consideration. | |
| 1.5.4 | We understand the importance of data interoperability across DHA platforms. We recommend the GNAL-NG Program Office provides bidders with information and/or references to applicable polices, data definitions, data plans related to GNAL-NG and the related systems. This would enhance contractor solutions in support of DHA’s goals for improved data management. | The Government will take this under consideration. | |
| 1.6.1.1 | We recommend Government include reference to the current/relevant DoD directives on zero-trust architecture and cybersecurity maturity model certification (CMMC) required for the GNAL-NG. It would also be helpful to include narrative on how/if these frameworks influence the cybersecurity posture required for GNAL-NG. Government would additionally help industry by providing any specific tools (i.e.: DHA J-6 Enterprise-approved tools) or protocols that should be prioritized to align with/interoperate with DHA's cybersecurity strategy, particularly in securing telehealth communications and data storage? | The contractor will work with the Government to identify, gain approval of, and implement a strategy and tasks in alignment with Zero Trust Architecture. The DoD Zero Trust Capability Roadmap can be found here: https://dodcio.defense.gov/Portals/0/Documents/Library/ZTCapabilitiesActivities.pdf | |
| 1.7.1 | We recommend Government clarify whether bidders are required to have nurses and appointers (i.e.: the GNAL-NG contractor workforce) operating out of contractor offices (i.e.: a contractor call center/office faculty) or if the workforce can be remote. Please clarify if remote workforce are subject to telework requests. Include any specific conditions by which telework requests might be denied by the COR. Provide the criteria that will be used to evaluate telework requests, and how will the contractor be informed of these criteria to ensure compliance with government expectations. | The Government will revise PWS paragraph 1.7.1 to more clearly describe the workplace/place of performance requirement. Remote workstations will be permitted. | |
| 1.10.1.3 | Please include specific data and/or metrics that are required for real-time information sharing. Please include the preferred format for this reporting, and what systems or platforms should be used to ensure secure and efficient data exchange between the contractor and the government. | The Government will revise the PWS to clarify this requirement. | |
| 1.18.6 | We recommend Government include virtual hold (callback requests) functionality within the GNAL-NG solution as this will improve customer experience, call handling and prioritization during anomalous or unexpected surge periods. | The Government will take this under consideration. | |
| 1.18.6 | We recommend Government include dynamic routing functionality as it is proven to improve customer experience via targeted call flows. | The Government will take this under consideration. | |
| 3.1 | Please clarify the process for updating MTF instructions? Will there be a formal review process for these updates, and will the contractor be involved in proposing or implementing changes to ensure that instructions remain relevant and effective? | The Government will establish the process for updating MTF instructions (which will involve formal review) after award. Yes, the contractor will be involved in ensuring that the instructions are relevant and effective. | |
| 5.1.3 | What is the expected timeline for the contractor to obtain the URAC Telehealth Accreditation and URAC Health Website Accreditation? Is there a grace period after the contract award for obtaining these accreditations, or must they be in place immediately upon the start of the contract? | The contractor must have have the appropriate accreditations at the time of award. | |
| 5.1.3 | We recommend government accepts accreditation from The Joint Commission (TJC) and the National Committee for Quality Assurance (NCQA) in addition to the stated URAC standards. Each of these standards provide equivalent accreditations and specific ying just one is limiting to industry. | The Government will take this under consideration. | |
| 5.1.3 | Can the government provide more details on the expectations for ensuring that technology-based applications, such as chat and portals, meet industry standards for quality, safety, and performance? Are there specific guidelines or best practices that the government expects the contractor to follow in this area? | Yes, the Government has revised the PWS to provide more details regarding the technology-based application requirements. | |
| 5.1.14 | What are the specific security protocols and standards that the data repository must adhere to? Is there a preference for certain cloud providers or technologies that have already been approved for use within DHA? | The security protocols and standards are described in NIST SP 800-53. See new PWS paragraph 5.1.4. Several commercial cloud platforms currently exist in the DHA ecosystem. | |
| 5.3.3.1 | How will success be measured for automated care and self-triage? | The Government has updated the PWS to reflect the measures of success for automated care and self-triage. | |
| 5.3.9 | We recommend government includes the use of ambient dictation technology as a feature to automatically document nurse triage encounters, ensuring accurate and real-time record-keeping. This is proven to minimize the administrative burden on healthcare providers and increases provider satisfaction. | The Government will not prescribe a methodology but will leave it to the Offerors to propose an appropriate solution. | |
| 5.16.2 | The PWS references the importance of data security, but it could be enhanced by specifying the data governance framework that the DHA expects the contractor to follow. This might include data lineage tracking, data stewardship roles, and data quality metrics. | The Government has revised the PWS to provide additional information regarding the data security requirement. | |
| 1.5.1 | The DPWS states, "The contractor shall provide optional services capabilities, including virtual scheduling, AI-driven patient triage, and diagnostic support solutions. These services shall be integrated through a platform that connects with MHS GENESIS, allowing seamless access to DHA platforms." | ||
| Question: Can the Government please identify all existing technologies which maintain a current integration with MHS GENESIS with respect to this effort? Can the Government please explain why a new or external platform is necessary as opposed to granting the Contractor access to MHS GENESIS directly? Is the intent for beneficiaries to access the external platform? | The Government has revised the PWS to provide additional information regarding the requirement to connect and integrate with MHS GENESIS. The contractor will have direct access to MHS GENESIS, but the contractor will also need to develop its own platform to deliver other PWS requirements. | ||
| 1.5.1 | The DPWS states, "The contractor shall provide optional services capabilities, including virtual scheduling, AI-driven patient triage, and diagnostic support solutions. These services shall be integrated through a platform that connects with MHS GENESIS, allowing seamless access to DHA platforms." | ||
| Question: Since the services identified in this paragraph are labeled as "optional," can the Government provide a guideline on how/whether an offeror's proposed optional services will or will not impact their overall weighting/scoring during proposal evaluation? | The Government has revised the PWS to remove the reference to "optional" services. | ||
| 1.17.1.1 | The DPWS makes reference to following "DHA Personnel Security Office guidelines for submittal of security clearances." Also, DPWS Sec. 4.3 is titled, "Secret Facility Clearance: Reserved." | ||
| Question: Can the Government please clarify whether this contract will require access to and/or handling of Classified materials? Does the Government anticipate requiring a DD254 from the prime contractor? What is the highest expected security level required by any individual contractor for this effort? | The Government has revised the PWS to remove the reference to classified materials. The contractor will not handle classified materials and will not be required to submit a DD254. | ||
| 3 | Part 3 (Government Furnished Property) makes no mention of any existing technologies enabling interoperability with the required Government systems such as DEERS and MHS GENESIS. | ||
| Question: Are offerors meant to assume there are no existing systems enabling interoperability with the required Government systems? Are we further to assume that the Contractor shall be responsible for developing, implementing, and maintaining any and all such systems? If so, is the Government looking for these systems to be developed, tested, and deployed within the 60-day phase-in period, or was this meant as the timeframe for the awardee to take ownership of the existing systems? | The Government has revised the PWS to provide for a longer transition-in period. | ||
| 5.1.6 | Question: Please provide historical workload/incoming calls data for overseas locations. We request this data be provided at minimum expressed as a percentage of the total incoming calls volume and also provide the countries of origin for overseas calls expressed as a percentage for OCONUS calls. | The Government will provide historical workload information with the release of the final RFP. | |
| All | Question: Would the Government consider splitting the systems testing & development portion of this requirement out separately from the GNAL Call Center staffing/ops/maintenance portions? | No, not at this time. It is the Government's intent for a single award contract. | |
| 5.1.4 | Is there current AI technology being used for call transcription? If so, what is being used? | No. The Offerors will be expected to propose a transcription solution. | |
| 5.1.6 | Is there a current mobile application that beneficiaries use to access telehealth? If so, what is it? Is it a Commercial-Off-the-Shelf (COTS) application, or custom developed? | No, there currently is no GNAL mobile application for accessing telehealth. | |
| 5.1.3 | URAC Health Call Center accreditation mentioned in 5.1.3 is no longer being offered as an accreditation. Going forward it is Health Contract Center accreditation and has two focus areas clinical and non-clinical. Will the URAC Health Contact Center accreditation for clinical be allowed and what is expected to be maintained in the future? | The Government has revised the PWS to correct the nomenclature for the URAC accreditation standards. | |
| Part 7, Attachment 1 (table) / PRS 6 | Need clarification as this notates the ASA SLA as being 90 seconds, 95% of the time and references the "URAC Health Call Center Accreditation Standard", but the URAC standard is 30 seconds, 80% of the time. If the correct ASA SLA is 30 seconds, 95% , this also does not match URAC Standards, so the “URAC” reference is confusing. | The Government has revised the PWS to update the language. ASA standards are commercial practice however the government metric could/may be higher. | |
| Part 7 Attachment 2 | Please provide additional workload data, so we can properly model the program and estimate the personnel needs. We request you provide the current average handle time for a nurse call and for a care coordinator call. | The government will provide historical workload data to industry when it issues the final RFP. | |
| Part 7 Attachment 2 | Please provide the average number of calls over the past year. To include the distribution of calls across the week and time of day. This data is needed to properly estimate how many nurses and call center coordinators are needed. | The government will provide historical workload data to industry when it issues the final RFP. | |
| 1.4.5 | PWS item 1.4.5 references a list of MHS directives, DHA policies and DOD policies the contractor needs to comply with? Are these the documents listed in 2.3 or are there more? | The Government has removed PWS paragraph 1.4.5. | |
| 1.4.8 | PWS item 1.4.5 references generally accepted private sector business practices and DoD policies and regulations the contractor needs to keep up with. Are these the documents listed in 2.3 or are there more? | The Government has removed PWS paragraph 1.4.5. | |
| 1.5.2 | 1.5.2 references a chart, but no chart is included. Please provide the chart. | The Government has removed PWS paragraph 1.5.2. | |
| 1.7.1 |
| Can an offeror propose remote workstations? PWS 1.7.1 states that remote workstations can be used, but as approved by the government. | The Government has revised the PWS to clarify this requirement. Remote work will be permitted. | ||
| 5.1.5 | Please clarify the use case or requirement for a Board Certified physician. In 5.1.5 you state that the Board Certified Physician (key person) shall be available 24x7 to provide on-call support. Is it really expected that 1 person be available 24x7x365? In part 7 attachment 2 you estimate that only 1,920 hours are needed for the board certified physician, which is not 24x7. | The Government has revised the PWS to remove the 24x7 requirement. | |
| 1.12 | Please clarify the Board Certified Physician minimum requirement to possesses an active, unrestricted medical license in the relevant state or jurisdiction where services will be performed. With GNAL being across 50 states is it expected that the board certified physician have multiple state licenses or only the state that he or she resides in? | The Board Certified Physician merely needs to be licensed in the physician's state of residence. | |
| 1.5.1 | Please describe how the Government will maintain provider appointment availability in MHS GENESIS so that GNAL-NG self-service and customer service representatives can book their appointments online. | The contractor will be required to establish, during the transition-in period, an interface with MHS GENESIS; with that interface, the contractor will be able to see and book appointments. | |
| 1.5.4 | Will the Government please define what type of access nurses will have for the purpose of fielding calls. | The contractor will be required to establish, during the transition-in period, an interface with MHS GENESIS; through that interface, the contractor will be able to book appointments, document GNAL-NG encounters, and access/review patient medical information. | |
| 1.10.1.5 | Will the Government define what onboarding and offboarding members means. | The Government has revised the PWS to better define onboarding and offboarding. | |
| 1.11.2.2 | Will the Government provide an Industry reading library? There is information within the PWS that the Government asks Industry to access for the response that are not available without a Government Common Access Card. | The Government will provide the Onboarding Checklist for Contractor Employees as an exhibit to the RFP. | |
| 5.1.27 | Will the Government please provide confirmation of an existing NLMS database available at contract start. | The existing NLMS database will not be passed to the new contractor. The contractor will be required to develop its own web-based platform/portal and database. | |
| Digital Front Door | There are several requirements within the scope and task areas of the Draft PWS that reference the Digital Front Door (DFD). As we understand it, the DFD procurement is still pending. |
On a Firm Fixed Price (FFP) bid, requirements to align with, integrate with, or use a system without technical details will drive increased costs across the field of bidders as those unknown elements add significant development risk to the offerors and ultimately increase the price to the Government.
Will the Government provide additional details on the technical specifications of the DFD in the GNAL-NG solicitation?
| Or as an alternative, will the government include the DFD-associated tasks as optional services tasks/CLINs to be negotiated post award with the appropriate level of technical discovery and specification. | The RFP will provide offerors with all system specifications necessary to establish required interfaces and to integrate with Government systems. | ||
| Artificial Intelligence (AI) | Can the Government provide a list of, or further detail on, the AI, Generative AI, or Large Language Models (LLM) and/or protocols anticipated under this contract? | No. The contractor will propose its own AI, Generative AI, and LLM solutions. | |
| PWS Ref Section 1.3--GNAL-NG contractor must have access to and interoperability with existing military applications and systems including, but not limited to, the Defense Enrollment Eligibility Reporting System (DEERS); the MHS electronic health record (MHS GENESIS); patient portals; and any Digital Front Door (DFD) platforms (e.g., Amwell's platforms) | Can the Government provide a full list of platforms (and the technical specifications and integration requirements) to which the GNAL vendor will be required to connect? | ||
| The RFP will provide offerors with all system specifications necessary to establish required interfaces and to integrate with Government systems. | |||
| PWS Ref Section 1.11.1--All contractors, whether working in Government facilities or from home, are required to obtain a CAC. | Do contractors working on the program who do not connect to government systems have to obtain a CAC in order to reduce cost impact? | CACs are required only for contractor personnel who will need access to Government systems (e.g., MHS GENESIS). | |
| PWS Ref Section 1.5.1--The contractor shall provide optional services capabilities, including virtual scheduling, AI driven patient triage, and diagnostic support solutions. These services shall be integrated through a platform that connects with MHS GENESIS, allowing seamless access to DHA platforms. The platform shall facilitate access, enabling beneficiaries to schedule appointments, receive automated triage and diagnostic support, and access their records. | Please confirm the "platform that connects with MHS GENESIS, allowing seamless access to DHA platforms" is intended to be the DFD. Or, does "the platform" reference the contractors system? | ||
| The Government has revised the PWS to remove the reference to "optional" services. | |||
| PWS Ref Section 1.5.1--The contractor shall provide optional services capabilities, including virtual scheduling, AI- driven patient triage, and diagnostic support solutions. These services shall be integrated through a platform that connects with MHS GENESIS, allowing seamless access to DHA platforms. The platform shall facilitate access, enabling beneficiaries to schedule appointments, receive automated triage and diagnostic support, and access their records. The integration with MHS GENESIS must ensure that all interactions are securely documented and synchronized with the patient’s medical history, providing comprehensive and coordinated care. | It appears as though “optional services capabilities” refers to optional support outside the current tasks identified. Will the Government consider constructing the GNAL-NG contract to allow for base-level requirements under the FFP with optional CLINs to support the "optional services capabilities" that can be exercised when needed with discovery and requirements validation? | The Government has revised the PWS to remove the reference to "optional" services. | |
| PWS Ref Section 5.3--Telehealth RN Triage and Intelligent patient triage and diagnostic support | Please confirm that dispositioning via AI-self triage is only permissible when the beneficiary is asymptomatic. Please confirm the government is anticipating use of AI in voice channels to supplement caller intake and support services. | Correct. The Government has revised the PWS to more clearly address this topic. The contractor's AI-supported triage system would need to connect patients who are symptomatic to a telehealth RN for appropriate triage (see revised PWS paragraph 5.3.6.1). AI should supplement intake, triage, and support. | |
| Draft L&M | Will DHA provide a Draft L&M for vendors to review/ask questions on in advance of the Final RFP release for GNAL-NG? | No, the Government will not be providing a draft of RFP sections L&M for industry comment. | |
| 1.3 Background: The Global Nurse Advice Line (GNAL)-NG is a continued an available service to the Military Health System’s (MHS) eligible beneficiaries. The GNAL will provide-NG contractor provides access to telehealth registered nurses for triage services, self-care advice, and general health inquiries 24 hours a day, 7 days a week. The GNAL also offers-NG contractor provides customer service and care coordination services to include, provider locator support, specified Military Medical Treatment Facility (MTF) appointing services, Active Duty Service Member (ADSM) urgent care referral submissions, and customized MTF transfers to support the MTF’s capability for eligible MHS beneficiaries.. In order to successfully perform, the GNAL requires-NG contractor must have access to and interoperability with existing military applications and systems including, but not limited to, the Defense Enrollment Eligibility Reporting System (DEERS) and); the MHS electronic health record (MHS GENESIS.); patient portals; and any Digital Front Door (DFD) platforms (e.g., Amwell's platforms). Such access and interoperability will allow for the contractor to conduct eligibility verification of NAL callers, GNAL-NG contacts and the ability to book primary care appointments, submit urgent care referrals for ADSMs, and document the GNAL-NG encounters., and review past medical information. The contractor must also deliver other capabilities include the ability to provide, including providing real-time information sharing, business intelligence, reporting, and archiving of documented call encounters at a corporate, regional, and local level | Is the transition timeline predicated on Amwell being fully deployed? | No. The Government has revised the PWS to extend the transition period. | |
| The contractor shall provide optional services capabilities including virtual scheduling, AI-driven patient triage, and diagnostic support solutions. | Will the Government please define the "diagnostic" support solutions? | The Government has revised the PWS to remove the reference to "optional" services. The term "diagnostic" (as used elsewhere in the PWS) carries its normal meaning: "concerned with the diagnosis of illness or other problems." | |
| 1.6.1.1.2 The contractor, within 60 days after contract award, shall build and deploy a system-to- system interface, as working software, that would query DEERS and save the data received into the contractor’s system within six months after contract award. DEERS is the system of record for eligibility; the contractor shall always make eligibility determinations based on what is returned in Defense Manpower Data Center’s (DMDC's) web and system to system interfaces. The contractor shall use the General Inquiry of DEERS (GIQD) system until the automated integrated system is fully operational | If there is an API please confirm the Government will provide the API in the first week of transition. | ||
| There is no API for DEERS. The Government will provide the draft DEERS technical specifications with the RFP. | |||
| Contingency for Surges | Please provide the number of times surges have occurred in the last 4 years. | There was a lengthy surge period during the COVID-19 pandemic. Surges otherwise have been rare. | |
| GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES | Is the Nurse Advice Line Management System (NALMS) considered GFE and will be made available to the incoming contractor, or will the incoming contractor be required to replace the system? | No. The contractor will be required to provide its own system. | |
| The use of AI technology is required to transcribe nurse-patient interactions into clinical notes accurately. This transcription should include structured data elements that can support ongoing care and facilitate machine learning applications for continuous improvement of the GNAL-NG. | Please clarify if DHA PWS 5.1.4 requires that only AI be used to provide this capability and only structured data elements be used to store data here? |
| Would other automated methods or other data structures be acceptable to meet this requirement? | It will be up to the contractor to propose an appropriate solution. | |||
| The contractor shall ensure constant, secure connectivity to MHS GENESIS | Given that consistent connectivity to MHS Genesis is required to achieve the established Performance Requirements and AQLs, would the government consider removing the word "constant" connectivity? This adjustment could allow for more flexible solutions that meet all performance and security standards while potentially reducing unnecessary costs. | The Government will take this under consideration. | ||
| 5.1 Basic Services | Currently, the chat platform is available via mhsnurseadviceline.com, a web portal that is provided by OptumHealth Care Solutions, LLC. Will the new contractor be able to use mhsnurseadviceline.com or will the contractor be required to create a new portal? | The contractor will be required to deliver a new portal. | ||
| 5.1. Basic Services | Does the MHS Genesis system have a portal that can be utilized by the contractor to ensure that all chats can be added to the patient record if clinical triage is provided? | The Government expects the contractor to provide a solution that ensures encounter information is recorded in the patient's medical record in MHS GENESIS. | ||
| 1.5 Scope | 1.5.1 begins with "The contractor shall provide optional services capabilities, including virtual scheduling, AI- driven patient triage, and diagnostic support solutions. These services shall be integrated through a platform that connects with MHS GENESIS, allowing seamless access to DHA platforms. The platform shall facilitate access, enabling beneficiaries to schedule appointments, receive automated triage and diagnostic support, and access their records. The integration with MHS GENESIS must ensure that all interactions are securely documented and synchronized with the patient's medical history, providing comprehensive and coordinated care." Is the contractor responsible for integrating the optional services into MHS Genesis, or will the MHS Genesis systems integrator support the contractor on this effort? | The Government has revised the PWS to remove the reference to "optional" services. However, the contractor will be required to establish necessary connections between its portal and the Government's systems. The Government will provide in the RFP necessary system specifications in order to facilitate establishing these connections. | ||
| 1.5 Scope | The third sentence in this section reads: " In addition to telephonic access, the GNAL-NG shall offer multiple technology and web-based options, including but not limited to mobile applications, web portals, and computer-based platforms. These options will enable beneficiaries to access services via various modalities such as video calls, chat, email, ensuring comprehensive access to telehealth solutions, regardless of location as provided by the contractor." Is the government expecting the contractor to create a new mobile application and computer-based platform? Does the government already have these options that we can connect into? What is the timeframe for completion of these options? | The contractor will be required to provide a portal and deliver a solution that enables beneficiaries to access services through the identified modalities. | ||
| 1.6 Period of Performance | How long will it take for the government to issue Common Access Cards (CAC)? What are the equipment requirements to use the CAC? Can the government provide the brand/model number of CAC readers to access DHA applications? | This is expected to take place during the transition in phase. Obtaining a CAC typically takes 60-days. The Government will not specify CAC equipment requirements. | ||
| 1.13 Data Rights | The section refers that all documents and materials shall become the property of the US Government. Does this apply to the mobile application, data platform, and web portal? Is this part of the incumbent's contract and therefore can be transferrable to the government to provide cost efficiencies and continuity of care? | The Government will include the appropriate data rights clauses in the contract and will also expect the contractor to deliver commercial licenses and license rights necessary to permit the Government, at its option, to transfer the GNAL-NG system to a follow-on contractor. | ||
| 5.1 Basic Services | 5.1.4 includes "The use of AI technology is required to transcribe nurse-patient interactions into clinical notes accurately. This transcription should include structured data elements that can support ongoing care and facilitate machine learning applications for continuous improvement of the GNAL-NG. The documentation must be clear, consistent, and sufficiently detailed to provide a comprehensive record of each interaction." Will the government provide the contractor with read/write capabilities into the MHS Genesis clinical notes? Will the government determine which AI technology preference to ensure compatibility? Will the contractor be liable for any misinformation generated by the AI technology used? | Yes, the contractor will have read/write access to MHS GENESIS clinical notes. Regarding AI technology, the Government expects the contractor to propose an appropriate solution. | ||
| 5.1 Basic Services | Regarding chat, is this regarding the current website environment or a net new environment? Will the SLA for 30 seconds happen post the beneficiary post-DEERS? | The Government has substantially revised the performance metrics for all modalities. For chat, the clock will start after the system has verified the patient's eligibility. | ||
| 5.1 Basic Services | Can the contractor utilize the existing website for chat and video (mhsglobalnurseadviceline.com)? If a new website required, beneficiaries who may have bookmarked the existing will not be able to access the new website unless DHA provides a campaign around the new contractor and new website. | No, the contractor will be required to provide its own portal/website and other GNAL-NG required functionalities. | ||
| 5.35.3 | Telehealth RN Triage and Intelligent patient triage and diagnostic support | AI conversational agent. Does the government require the contractor to enter into a software license on behalf of DHA for AI technology? Will the government provide AI technology vendors that have been vetted by DHA? Will the contractor be required to submit the AI software for review (compliance and security)? | The Government expects the contractor to propose an appropriate AI technology solution. The Government will review the proposed AI solution for compliance with DoD cybersecurity requirements. | |
| 5.1 Basic Services | The government has replaced the word "caller" with "contact" beginning in this section and subsequently throughout the document. Can the government provide its definition of contact? | The term "contact" means any person who encounters the GNAL-NG though voice, chat or other means of communication. In the vast majority of cases, these will be TRICARE beneficiaries. | ||
| 5.4 Care Coordination | The section has new language that instructs GNAL-NG to create a message in MHS Genesis. Please provide the section within MHS Genesis to do this message creation. | The section is called the MHS GENESIS Message Center | ||
| N/A | Can the government provide the average duration of telehealth triage calls? | The government will provide historical workload data to industry with the release of the final RFP. | ||
| Cybersecurity Requirements for Non-DoD IT or Covered Contractor IS | 6.5.1.2 reads "The contractor shall submit a signed and completed system security plan (SSP) or extract thereof) and any associated plans of action to self-certify compliance to implementing the NIST SP 800-171 requirements. For reporting requirements, (CDRL 23 – System Security Plan (SSP), See Part 7, Technical Exhibit 1: Deliverables Table.) " Is compliance with 800-171 required at the time of our RFP response? | Yes. The contractor shall, at time of award, have implemented the security requirements prescribed in the NIST SP 800-171. | ||
| 1.6.1.1 | To promote competition and ensure non-incumbent vendors have adequate time to coordinate ATO interface and completion, would the Government consider extending the timeline for ATO go live? | No ATO is required for COTS products not operating within the Government domain. However, a security assessment will be required. Regardless, the Government has extended the transition timeline from 60 days to 6 months. | ||
| 1.6.1.1 | Has the ATO go live timeline been coordinated with and agreed upon by the DHA Information Security leadership? If not, how does the Government plan to mitigate timeline risks and reduce favoritism towards vendors who are already under contract with DHA and may already have ATOs established? | No ATO is required for COTS products not operating within the Government domain. However, a security assessment will be required. Regardless, the Government has extended the transition timeline from 60 days to 6 months. | ||
| 1.5.1 | Can the Government clarify the expected timeline for GNAL integration with MHS GENESIS? | The Government has revised the PWS to provide for a longer transition-in period. | ||
| 1.17.1.1 & 1.17.1.2 | What clearance level will contractor personnel (nurses, care coordinators, and other supporting personnel) require under the program? (i.e. Public Trust?, Secret? Etc) | TIER 1 NACI | ||
| 5.1.7 & 5.1.10 | Will the Government provide the current ASA and abandonment performance measures of the current operation for the preceding year leading up to RFP release? Will the government provide the current Chat performance measures of the current GNAL program. This includes all segments measured, both incoming calls and transferred calls that are subject to the SLA performance measures. | The government will provide historical workload data to industry with the release of the final RFP. The Government will not provide information regarding the current contractor's performance against contract standards. | ||
| 5.1.17 | What standard of beneficiary satisfaction does the Government deem as satisfactory (i.e. measure of 4.0 out of 5?) | The PWS now provides that the Government and contractor will collaborate to establish an agreed upon process for measuring beneficiary satisfaction. Specifically, PWS paragraph 5.1.17.1 provides as follows: "the contractor shall collaborate with the Government, during the contract transition period and before the full performance start date, to establish an agreed-upon process for measuring beneficiary satisfaction. This collaboration shall include working with the Government to define specific metrics, measurement methods, and measurement frequency. " | ||
| 5.4.9 | Will the Government provide an estimate as to the number of MOUs that may be necessary to satisfy CDRL 14 - Deliverable 14? | The contractor will need to prepare 3 MOUs. | ||
| 5.11.1 | As noted in this clause, international toll-free numbers are to be transferred to the Government at the completion of the contract. Can we therefore assume that these same phone numbers will be transferred to the new contractor from the Government (assuming the incumbent contractor is not awarded a follow on contract)? | Yes | ||
| 5.4.9 | Can the government provide the expiration of the current Memorandum of Understanding (MOU) with the TRICARE MCSCs and TRICARE Overseas Program contractors ? | The contractor will be required to establish its own/new MOUs with the specified contractors. | ||
| 5.1.12 | Can the government provide estimated number of users that will need to access the Real Time Database ? | The contractor's database will be required to support 750 simultaneous users. This requirement is addressed in PWS paragraph 5.12.4. | ||
| 5.1.17 | Can the government provide the current beneficiary satisfaction rate for the GNAL program? | No. | ||
| 5.1.19 | Can the government clarify if this consent and documentation need to be stored in the MHS Genesis along with the encounter data? | |||
| This is to address PWS 5.1.19 The contractor is responsible for obtaining and documenting the beneficiary’s consent to provide PHI and PII to the GNAL contracting staff either through the telephone, secure webchat, or video conferencing communication channels prior to the connection. The GNAL contractor is also responsible for obtaining and documenting consent to email or text message the MHS eligible beneficiary directly their general self-care and/or watch out conditions. | Yes, documentation of the patient's consent must be stored in the patient's medical record. | |||
| 5.1.15 and 5.12.16 | Can government provide estimated number of attendees for each session for government end users. | |||
| (PWS 5.1.15 | The contractor shall provide 24 sessions of GNAL-NG sustainment training on a yearly basis to the government. This training will be interactive and conducted online and/or over the phone. Training will be adjusted as the program develops. and PWS 5.12.16. The contractor shall provide initial and sustainment training to government end users on the real time database system and as needed, which shall be determined by the GNAL PMO. ) | The contractor should be prepared to provide training for an average of 32 users per session. | ||
| 5.13.2, 5.13.2.2 | Can the government provide an estimated average number of push (MTF, Aggregate, etc.) and ad hoc reports for a month to address PWS 5.13.2? The contractor is required to set-up multiple types of push and ad hoc reports at the request of the government, providing specified data elements of GNAL services rendered to eligible MHS beneficiaries. | The Government has revised the PWS to provide an outline of reports. | ||
| 5.13.7 | ||||
| Can the government specify the format and frequency for the predictive analytics to report service/MTF trends? PWS 5.13.7. The contractor shall provide integrated predictive analytics to report Service / MTF trends on high volume symptoms, patients, unsuccessful warm transfers, and lack of appointment availability. | The Government has revised the PWS to include this information. | |||
| 5.1.24 (Removed) and 5.1.25 (Removed) | Can the government provide if the intent was to remove access to the contractor to the MHS scheduling and order-entry systems for real-time MTF appointing services and referrals and providing call encounter data updates within the MHS Genesis? | The Government has revised the PWS to remove this requirement. | ||
| Part 7, Attachment 1 PRS 2 | PRS2 performance objective regarding beneficiary satisfaction references PWS reference section 5.1.15, which pertains to training. Can the government clarify if the PWS reference should be 5.1.17? | The Government has revised the PWS to correct the reference. | ||
| 3.1 | Can the government elaborate on the delivery of media i.e. format, system(s), and access rights for this data? | Revisions have been made to the PWS to clarify. | ||
| 3.1 | Is the contractor expected to host this data? | Yes. | ||
| 5.2.2.2 | Can the government describe what plans are on the horizon, especially concerning demonstration projects? | No. | ||
| 5.2.13 | Can the government identify what DB or systems in use at the MTF's? Would calling the MTF patient administration be a better choice? | The Government is not able to provide the database information. Calling MTF patient administration is a permissible option. | ||
| 5.4.1 | Did the government intend to offer regular patient appointing services? Given the current call volume and delays of 1-800 TRICARE contractor appointing services booking, the GNAL-NG services call volume would be significantly higher requiring more resources to fulfill at the current SLA's. Recommend continue with canceling, rescheduling, and new appointing as a result of a Triage requirement. | GNAL-NG will not be a patient appointing service (i.e., in lieu of MTF central appointing offices); therefore, the Government does not intend to support "regular" (or primary) appointing services through GNAL-NG. | ||
| 5.12.6 | Please clarify the access, utilization rates, and CRUDE requirements? This statement appears to be referencing two database's (1) the official GNAL-NG triage record for metrics, etc., and (2) the GFI provided data set of MTF/Clinic operating instructions (i.e. NALMS) | The Government has revised the PWS and removed this paragraph. | ||
| 5.15.5 | Please verify the ZTA/MFA requirements of this statement is required for GNAL-NG users, and government access only and not the general beneficiary public? | The Government has revised the PWS to include this information. | ||
| 1.17.1.1 | What is the location (State, for licensing requirements) of each of the Key Personnel positions? | There is no location requirement for the key personnel. | ||
| 5.13.1 | Is there an anticipated choice of BI Tool at this time? | The Government expects the contractor to propose an appropriate business intelligence solution. | ||
| 5.1.17.1 Japanese |
5.1.17.2 German
5.1.17.3 Filipino (Philippines)
5.1.17.4 Korean
5.1.17.5 Italian
5.1.17.6 Chamorro (Guam)
5.1.17.7 Arabic
5.1.17.8 Turkish
5.1.17.9 Dutch
5.1.17.10 French
| 5.1.17.11 Greek | Is support in these languages expected across all channels (chat, email, SMS, etc.) or voice only? | No. For voice and chat, the contractor is required only to provide support in English and Spanish. The Government has addressed this topic in PWS paragraph 5.1.19. | |
| 1.3 Background | The draft PWS indicates access to and interoperability with "any Digital Front Door (DFD) platforms (e.g., Amwell's platforms)." Is Amwell's Converge the Government's preferred DFD platform for GNAL-NG? | The Government has revised the PWS to better define the DFD initiative and to clarify expectations regarding interoperability with DFD platforms. The Government will provide necessary system specifications information in the RFP. | |
| 1.17.1 Personnel Security - 1.17.1 and |
2.3.1 #25 and
6.4 Training - 6.4.1.1 Does the requirement to meet DoD 8570.01-M apply to contractor personnel working on contractor systems? Yes. GNAL-NG interfaces with health data in MHS GENESIS and would comply with DoD 8570.01-M
| 1.19 Interactive Voice Recording (IVR) | |||
| 1.19.1 and 1.19.3 | The draft PWS states, "The contractor shall make changes to the IVR tree and messaging to accommodate mission needs." It further states, "The IVR tree should integrate with GNAL-NG's other systems, such as patient records and scheduling, to provide accurate and seamless service." Please confirm that the contractor owns and maintains the IVR. Also, please confirm the GNAL-NG systems with which the IVR should integrate(i.e., DEERS, MHS GENESIS, others). | Yes, the contractor will own and maintain the IVR and it must be capable of integration with Government systems. | |
| 1.7.3 Hours of Operation | |||
| 2.1.17 Work Week | The draft PWS states, "The contractor must always maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS, to include but not limited to when Government facilities are closed for the above reasons." It goes on to say, "The contractor shall ensure that all services provided under the GNAL-NG are available 24 hours a day, 7 days a week, without interruption." Could the Government provide call volumes by the hour or half hour to assist contractors forecast staffing levels necessary to maintain 24/7 coverage. | The RFP will provide offerors with historical data. | |
| 1.4.3 and 1.4.4 | If there is no availability in MTF networks to support urgent care matters, can contractors reference to urgent care solutions incorporated within a contractor's GNAL bid solution (i.e. a TRICARE supported telehealth solution)? A number of the issues GNAL nurses manage can be resolved via a telehealth appointment post consult with telehealth nurse. | Yes, the contractor may utilize all telehealth/virtual health options available through the program--as long as doing so is consistent with the terms of the PWS, any MTF instructions, and governing TRICARE Program/Benefit requirements (as described in the TRICARE regulation and TRICARE Manuals). | |
| 1.3 | The draft PWS explains, "The GNAL-NG contractor provides access to telehealth registered nurses for triage services, self-care advice, and general health inquiries 24 hours a day, 7 days a week" to MHS beneficiaries enrolled to both CONUS and OCONUS MTF and TRICARE Prime beneficiaries enrolled to CONUS Managed Care Support Contractors. Please confirm that RNs providing telehealth services in CONUS locations must be credentialed in the state of the caller or hold multi-state licenses. | Yes. The contractor will be required to ensure that RNs providing triage services and care advice are properly licensed and credentialed, consistence with applicable state laws. In most cases, this means the RN must be licensed and credentialed both in the state where the RN is practicing and the state where the patient is receiving care. The Government has addressed this matter in a revised PWS paragraph 5.3.1. | |
| 5.1.19 | Is the expectation to have a subset of Spanish speaking staff? Could this also be met by interpreter services? | Yes to both. |
| 5.2.7.2 | Questioning why mental health is excluded. There may be a contradiction in section 5.4.1.2 | Behavioral health is not an excluded service. PWS paragraph 5.2.4.1.1 specifically provides that "the contractor’s system shall ensure that patients requiring specialized care, such as pediatric, mental health, or obstetric care are connected to a telehealth RN with the appropriate expertise." |
| 1.6.1.1 | Will the incumbent be providing any assets or intelligence to support the Transition-in/transition-out period? | The incumbent contractor will be required to support the transition in/out process to ensure a smooth hand off between contractors. |
| 5.3.3 | The bullet reads “System must be at least 90% accurate in assigning differential diagnoses: Workflow, Reason for patient encounter…etc.". Perhaps the meaning is unclear to the reader, or perhaps the metric "90% accurate" is misunderstood. How would this be measured? | The contractor's system should provide the functionality/capability to measure these outcomes. |
| 5.3.3.1 | Would the "Automated Care Recommendations" apply to web/mobile application users or to phone users as well? If to phone users, how is that workflow envisioned? | Yes, it will apply to all modalities. The contractor will structure the workflows as they deem appropriate. |
| 5.4.1.6 | The meaning is unclear. If the contractor cannot transfer the caller to the MTF successfully, to whom should the contract initiate a "warm handoff"? Where does the chatbot come into the process? | The Government has revised the PWS to more clearly describe the hand-off process (including for cases where the patient has used the chatbot) and the steps the contractor will take to find the appropriate hand-off resource. The hand-off will be based on appropriate level of care and directed provider. |
| 5.8.5 | Does "Post-triage reporting" in this section refer to a follow-up message to the beneficiary? | The Government has revised the PWS. Reporting will be through MHS GENESIS, which will be accessible by both the patient and PCM, as appropriate. |
| Part 3 - pg 23 | In what format will the Government "provide customized MTF instructions for care coordination, which will be updated on a regular basis"? | There is no particular format requirement. |
1.4.2 The PWS requirement states "1.4.2 The contractor’s telehealth qualified RNs shall provide all eligible MHS beneficiaries with clinical advice based on the Schmitt-Thompson Protocols or equivalent telehealth nursing standards, protocols, or guidelines, coupled with each RN’s professional experience and judgment, to ensure MHS beneficiaries receive high quality nurse triage services."
| Can the government elaborate on the statement "Schmitt Thomson Protocols or equivalent?" Schmitt Thompson protocols are the gold standard in clinical protocols due to their rigorous validation and methodology. If alternative and potentially lower cost decision support protocols are being considered, what measures are in place to ensure the accuracy and quality of care is not compromised? To ensure the government is provided with equal solutions we believe the wording "or equivalent" should be removed. | The Government has revised the PWS to Schmitt-Thompson standards only. | |
| 1.5.1 | The PWS requirement states "1.5.1 The contractor shall provide optional services capabilities, including virtual scheduling, AI- |
driven patient triage, and diagnostic support solutions. These services shall be integrated through a platform that connects with MHS GENESIS, allowing seamless access to DHA platforms.
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