PWS - Teleradiology.docx

PERFORMANCE WORK STATEMENT

Tele-Radiology Service

C-1 GENERAL

To provide Radiographic Interpretation Service for the CHEYENNE RIVER HEALTH CENTER FACILITY Eagle Butte, South Dakota. The mission of Indian Health Service (IHS) is to provide the best possible Health Care services to the Native American population. To meet the mission of the Indian Health Service, the Cheyenne River Service Unit requires contractor support to assist with Radiographic Interpretation Services.

The Contract resulting from this solicitation shall:

a.) Be a fixed-price non-personal health care service contract under which the Contractor is an independent contractor that will result in a Base, plus four (4) Option years.

b.) Allow the Government to evaluate the quality of professional and administrative services provided.

1.1 Scope of Work

The Contractor shall provide Radiographic interpretation services using a teleradiology system, in the following estimated proportions per year:

The government reserves the right to accept or reject services if the level of performance is unsatisfactory to I.H.S.

The Joint Commission on Accreditation of Health Care Organizations (JCAHO) and AAAHC standards must be considered and adhered to at all times on order to be compliant. All Medical Record Information generated in the performance of this contract shall remain the property of and subject to the exclusive control of the Indian Health Service (I.H.S). The Contractor is responsible for maintaining Patient Confidentiality and adhering to the Privacy Act of 1974 and the Health Insurance Portability & Accountability Act (HIPAA) of 1996.

The Contractor shall provide telephone consultations with the Indian Health Service attending clinician concerning their patients' medical images as medically indicated.

The Contractors viewing equipment shall interface with the Service Units teleradiology platform. The successful offeror shall possess a teleradiology system that is compatible with the Service Units Imaging Network, capable of receiving/transmitting a 14X17, 2kb chest film within 4 minutes. In addition, the Contractors computer system must be compatible with the Service Unit's PACS software. The Contractor must be able to provide compression software to ensure timely transmission times of images.

All interpretations shall be performed on diagnostic, medical-grade, high resolution monitors. All monitors shall be calibrated at least semi-annually, or consistent with proper quality control procedures at the interpretation sites.

The Contractor's network shall have established firewalls and procedures to ensure patient confidentiality and security compliant with The Health Insurance Accountability and Portability Act of 1996 (HIPAA) and IHS security Standards.

1.2 Personnel

The Contractors facilities shall be compliant with any applicable Medicare (CMS) requirements and Health Insurance Portability and Accountability Act (HIPAA) requirements.

The Contractor shall maintain appropriate certification and licensing for Contractors work facilities and will assure appropriate certification and licensing for all Radiologists providing services.

The Contractor and any subcontractors who interpret studies must use Board Certified or Board Eligible Radiologists who possess an unrestricted license to practice medicine in the United States. The Contractor must provide a current and up-to-date copy of professional Credentials to the Service Unit, and must be appointed to the each Service Unit’s Medical Staff.

The contracting Radiologist must maintain MQSA certification The Contractor and any subcontractors must be physically practicing medicine in the United States. The Contractor shall furnish proof of a minimum of 12 peer review (over- reads) annually.

1.2.1.1 Contractor Representative

The contractor shall designate a representative in accordance with FAR 52.236-6 included in section 1 of this contract. The name of this person shall be designated in writing and provided to the CO.

1.2.1.2 Response Time

The contractor representative shall be available during normal duty hours within 30 minutes to meet with government personnel designated by the CO to discuss and resolve performance issues. After normal duty hours the representative shall be available within 1 hour.

1.2.1.3 Reports

The contractor representative shall provide weekly (or other frequency) accomplishment reports to the designated government representative. Reports shall be in writing and provided within three days following the workweek.

1.2.1.4 Language

The contractor representative must be able to read, write, speak and understand English.

1.2.2 Employees

The contractor shall provide Radiology services by a board certified, currently licensed Radiologist to the Indian Health Service staff. The Indian Health Center staff and radiologist shall work in close cooperation in order to meet the needs of the patient.

1.3 Quality Control

1.3.1 Quality Control Plan

The contractor shall establish and maintain a quality control (QC) program/plan to ensure the requirements of the contract are achieved. One copy of the contractor’s QC plan shall be furnished to the CO (mark appropriate item):

______ Prior to the start of contract work.

______ Prior to issuance of the Notice to Proceed.

__X___ With the initial proposal.

Revisions or updates to the submitted QC plan must be submitted in the same manner as the original plan.

1.3.2 Plan Contents

1.3.2.1 Inspection System

An inspection system must cover all the services listed on the performance requirements summary (PRS). It must specify the areas to be inspected on either a scheduled or unscheduled basis, how frequently inspections will be accomplished, and the title of the individual(s) who will perform the inspection. The inspection system must provide for a written record of inspections and results.

1.3.2.2 Methods

The methods for identifying and preventing defectives in the quality of service performed before the level of performance becomes unacceptable.

1.3.2.3 Records

On-site records of all inspections conducted by the contractor and necessary corrective action taken. This documentation shall be made available to the CO, as requested, during the term of the contract.

1.3.3 Government Review

The government may review the contractor’s QC plan to determine if it is adequate. If the plan is found to be adequate, a government will authorize the plan. If the plan is not adequate as submitted, the deficiencies will be identified to the contractor in writing. The contractor shall correct all identified deficiencies and submit a corrected QC plan within 10 working days or by contract start date whichever is sooner. Contractor-performed work that fails to conform to standards when this CO performs quality assurance (QA) work will serve as an indicator at the contractor is QC system is not adequate.

1.4 Quality Assurance

1.4.1 Contracting Officer’s Representative responsible for:

· Monitoring the Contractor’s technical progress

· Interpreting the statement of work

· Technical evaluation as required

· Technical inspections and acceptance required by this contract

· Assisting in the resolution of technical problems encountered during performance of this contract

1.4.2 Government Monitoring

A government will monitor the contractor’s performance under this contract using the method(s) of surveillance specified in that PRS. All monitoring observation will be recorded by the government. When and observation indicates defective performance, this COR will request the contractor’s representative to confirm defective work and perform corrective action.

1.4.3 Performance Evaluation Meetings

The contract manager may be required to meet weekly with that COR or others during the first month of the contract meeting shall be as often as necessary thereafter as determined by this CO. However, if the contractor requests, a meeting will be held whenever a contract discrepancy report is issued. The meetings shall focus on contractor performance and actual or potential problems. A mutual good faith effort shall be made by all parties to resolve all issues. The written minutes of these meetings shall be signed by the parties to the discussion. Should the contractor not concur with the minutes, the contractor shall state any areas of nonoccurrence in writing to the CO within 7 work days of the minutes.

1.5 Physical Security

The contractor shall be responsible for safe guarding all government property provided for contractor use in accordance with the government property (GP) clause, FAR 52.245.1

1.6 Hours of Operation

1.6.1 Normal Hours

1.6.1.1 Contractor must provide 24/7 coverage.

Federal Government Holidays, weekends and overtime are included in the base price. GOVERNMENT HOLIDAYS

1.6.2 Emergency Services

On occasion, services may be required to support an activation or exercise of contingency plans outside the normal duty hours described above. The contractor’s responsibilities for emergency support are described in section C-5.

Documentation and Records All documentation, records, and schedules as described in the PWS that are the responsibility of the contractor are the property of the government and shall be turned over to the government upon completion or termination of the contract. All records are subject to the Freedom of Information and/or Privacy Acts and any request for release of any records shall be handled accordingly.

C-2 DEFINITIONS

2.1 Standard Definitions

2.1.1 Acceptable Quality Level (AQL)

The maximum percent defective (or the maximum number of defects per 100 units) that, for purposes of random sampling, may occur before the government will affect the price computation system in accordance with that PRS and the Inspection of Services clause. When the method of surveillance is other than random sampling, the AQL is defined as the number of defects or maximum percentage of defects and a lot that may occur before the government will affect the price computation system in accordance with the PRS and the Inspection of Services clause. An AQL does not allow a contractor to knowingly offer defective service but limits reduced payment to circumstances in which defective performance results in a measurable reduction in the value of services rendered.

2.1.2 Defective Service

A unit of service that contains one or more defects or nonconformance with specified requirements.

2.1.3 Lot

The total number of service outputs in a surveillance period, as defined in the AQL column of the PRS.

2.1.4 Performance Requirements Summary (PRS)

Identifies the key service outputs of the contract that will be evaluated by the Government to ensure contract performance standards are met by the contractor.

2.1.5 Quality Assurance (QA)

The actions taken by the Government to ensure that services meet the requirements of the PWS.

2.1.6 Contracting Officer’s Representative

A Government person designated by the CO with authority to act within the scope of the delegated authority.

2.1.7 Quality Assurance Surveillance Plan (QASP)

The purpose of the QASP is to describe the systematic methods used to monitor performance and to identify the required documentation and the resources to be employed. The QASP provides a means for evaluating whether the contractor is meeting the performance standards/quality levels identified in the PWS and the contractor’s quality control plan (QCP), and to ensure that the government pays only for the level of services received.

100%

Positive contract evaluations.

2.1.8 Quality Control (QC)

Those actions taken by contractor to control the performance of services so that services meet the requirements of the PWS.

2.1.9 Random Sampling

A sampling method in which each service output in a lot has an equal chance of being selected.

2.1.10 Sample

A sample consists of one or more service outputs drawn from a lot. The number of outputs in the sample is the sample size.

2.1.11 Sampling Guide

The part of the surveillance/monitoring plan that contains all the information needed to perform a random sample.

2.2 Technical Definitions Peculiar to this PWS

C-3 GOVERNMENT-FURNISHED PROPERTY

All unique government information related to the Radiologist service that is necessary for Contractor performance will be made available to the Contractor. The Contracting Officer or COR designee will be the point of contact for identification of any information that is supplied.

The Service Unit will provide the Contractor with an imaging requisition for each patient. This will be transmitted to the Contractor along with the patients imaging files.

The Service Unit is responsible for maintaining patient records.

C-4 CONTRACTOR-FURNISHED PROPERTY/SUPPLIES/MATERIALS/EQUIPMENT/ETC.

4.1 General

The Contractor shall provide a complete written report for each medical imaging study. The Contractor shall have the completed report electronically dictated and signed, via the Contractors voice recognition software, delivered directly into the Service Units Radiology Information System (RIS)/Hospital Information System (HIS).

1. IMAGE/STUDY DELIVERY

The studies will be electronically transmitted from the Service Units PACS system via DICOM using an encrypted, secure method via a persistent LAN to LAN VPN connection. Contractor will need to describe the security/encryption protocols used for retrieving transcribed reports.

To this end, the Contractor must sign a Data Exchange Agreement, or other Interconnection Security Agreement that the Indian Health Service provides to the Contractor in order to establish the VPN connection(s).

4.2 Specific Requirements

The Contractor will have a system that is compatible with the I.H.S. computer system.

This is conditional upon the existence of interfaces between the Contractors software and the Service Units RIS/HIS. This scope of work is not intended to limit the application of technology that improves efficiency in the process. The expense of developing any Contractor dictation software interface with the Service Units RIS/HIS shall be the responsibility of the Contractor.

All Radiology reads will be imported, and verified into RPMS. A 24 hour window from the time report is read to verification is a REQUIREMENT Monday-Sunday. Appropriate personal will have access to Contracting reporting system for READINGS 24/7. In the event a report needs an amendment the reading Radiologist will notify each Service Unit ordering provider/Radiology department.

The Contractor will provide each Service Unit Critical Results policy and procedures, and Protocols for General Xray, Computed Tomography, Ultrasound, and MRI.

The Contractor will provide each Service Unit IV contrast and Hydration policy and protocol along with other imaging protocols.

Unless noted below, the average turnaround time between the initial receipt of the imaging study and delivery of a signed radiologic interpretation shall be (12) hours or less.

The turnaround time for preliminary STAT interpretations shall be (60) minutes or less for STAT CT, and Ultrasound exams and (30) minutes or less for regular STAT x-ray exams. (90%) of preliminary interpretations will be followed up with a telephone call or a written interpretation within (30) minutes of transmission.

2. REPORTS

The Contractor will be required to provide transcription and electronic signatures for all radiology reports. An electronically signed report must be entered by Contract Company directly into RPMS within:

· (12) hours for routine studies

· (60) minutes for STAT studies.

The Contractor is solely responsible for the completeness and accuracy of medical terminology spelling, grammar and punctuation. Corrections will be the responsibility of the Contractor without any additional charge to the IHS facility.

The Contractor shall immediately refer apparent discrepancies or inconsistencies to the appropriate physician for clarification and/or corrections so reports are still transcribed within the required timeframe.

C-5 SPECIFIC TASKS

5.1 Task 1

Connectivity issues that may arise after regular business hours.

5.1.1 Standard

Contractor will provide 24/7 technical IT support for any issues that may arise after regular business hours.

Contracting Officer Daniel Donnell Cheyenne River Health Center 615-977-4957 daniel.donnell@ihs.gov

Authority

0. No person other than the Contracting Officer has authority to bind the Government with respect to this contract.

0. No action or omission of any government employee or representative other than the Contracting Officer shall increase or decrease the scope of this contract or shall otherwise modify the terms and conditions of this contract.

0. In no event shall any of the following be effective or binding on the Government or imputed to the Contracting Officer with respect to this contract:

2. An understanding or agreement between the Contractor and anyone other than the Contracting Officer;

2. A purported modification or change order issued by anyone other than the Contracting Officer;

2. A promise by anyone other than the Contracting Officer to provide additional funding or make payments; or

2. An order, direction, consent, or permission from anyone other than the Contracting Officer to:

3. Incur costs in excess of a specified estimated cost, allotment of funds, or other ceiling; or

3. Expend hours in excess of a specified level of effort.