Questions Answers Soldiers Homes EMR RFRfinal07320.docx

Commonwealth of Massachusetts Executive Office of Health and Human Services (EOHHS) Massachusetts Department of Veterans’ Services Soldiers’ Home in Chelsea & Soldiers’ Home in Holyoke

QUESTIONS AND ANSWERS

regarding the Request for Responses for the Soldiers’ Homes Electronic Medical Record (EMR) System Document Number: 21EHSKAEMRSYSTEM COMMBUYS Bid Number: BD-20-1039-EHS01-EHS01-49184

Q&A Issue Date: July 31, 2020

This document contains responses to questions received regarding the Request for Responses for the Soldiers’ Homes Electronic Medical Record (EMR) System issued on June 23, 2020, by the Executive Office of Health and Human Services (EOHHS) and the Massachusetts Department of Veterans’ Services (DVS) Soldiers’ Home in Chelsea & Soldiers’ Home in Holyoke, including questions asked at the Bidder’s Conference on July 9, 2020. Answers have been provided to those questions which are of general interest and relevant to the preparation of a response to the RFR.

Q1. Can the Soldiers’ Homes supply additional information on the current volume of services including number of providers, hospice care, pharmacy, and radiology?

A1. Existing service volumes are set forth in Section 1.3 of the RFR, but are not predictive of future activity. The new system must handle increased billing for outpatient services as well as additional increased acuity services to be provided by the new CLC. The new system must also be able to accommodate billing for long term care (LTC), skilled nursing facility (SNF), and outpatient services.

Patients currently receive an estimated 7-8 medications daily, and the new system should be able to accommodate this volume, as well as variants in volume.

Q2. Would EOHHS be willing to sign a Non-Disclosure Agreement (NDA) in order for our company to submit financials as required under Section 3.2.5.2 (Financial Information) of the RFR? Alternatively, can financial information be provided under separate cover, password protected and marked as private and confidential?

A2. Although proposals will not be made publicly available as a matter of course, the proposals are public records and may be produced to the extent they are responsive to a request, in accordance with M.G.L. c. 66, s. 10 and M.G.L. c. 4, s. 7, ss. 26. EOHHS is unable to sign a nondisclosure agreement that is contrary to these statutes. Any statements in submitted responses that are inconsistent with these statutes, including marking by bidders of information as confidential or proprietary, will be disregarded. All Responses should be submitted in accordance with the instructions set forth in Section 3.1 of the RFR.

Q3. Are the Soldiers’ Homes seeking an OTC solution, or would the Soldiers’ Homes consider a fully customized solution offered by a technology services company?

A3. The Soldiers’ Homes seek a system that meets the requirements as set forth in the RFR and provides best value to the Commonwealth.

Q4. Do the Soldiers’ Homes plan to allocate staff to participate in the EMR system build and implementation, or is the expectation that the vendor take responsibility for building out and testing phase of the implementation?

A4. Further to Sections 1.1 and 2.1 of the RFR, the Soldiers’ Homes expects the vendor to support the EMR system through implementation, including testing.

Please see requirement instructions for vendor to answer build vs configure. As stated under Section 4 of the SOW regarding project management, Soldiers’ Homes will have teams to support change management and interface with Commonwealth systems. However, the Soldiers’ Homes has not allocated resources to perform vendor deliverables.

Q5. Are you planning a central training center for both Soldiers’ Homes? Where would you like the training performed at both sites?

A5. The Soldiers’ Homes look forward to bidder suggestions of training approaches. Any in-person training will need to occur at both facilities given their geographic distance, however bidders may suggest alternatives in their Response, in particular given the current COVID pandemic.

Q6. In the RFR, a Database Administrator (DBA) is listed as part of the Key Personnel required. Can the Soldiers’ Homes provide additional details into this role and core responsibilities for this role in a subscription, cloud hosted model?

A6. Given the importance of systems integration identified in the RFR (including, without limitation, Sections 1.1, 1.3 and 2.1), the Soldiers’ Homes view the DBA as a critical resource to support the systems integration work. However, the Soldiers’ Homes are open to bidders providing alternative approaches or roles to meet the needs specified.

Q7. Can the Soldiers’ Homes’ identify additional information on lab services provision including estimated volume, in-house capabilities, and external contracts?

A7. Currently all lab testing is sent offsite; the Soldiers’ Homes do not expect a high per patient lab testing volume.

Q8. How many instruments does the customer plan to interface?

A8. The Soldiers’ Homes’ preference is for a system that allows ongoing interfacing that can be expanded over time, as set forth in Sections 1.1 and 2.1 of the RFR.

Q9. How many scheduling departments do you anticipate needing to be built and tested?

A9. The two Soldiers’ Homes schedule independently.

Q10. Are you expecting an onsite resource to work on the mapping conversions stated in RFR?

A10. Commonwealth IT resources will be available but may not be onsite. See Sections 3.2.5.12 and 4 of the RFR for vendor expectations.

Q11. Is the existing HR/Payroll solution being retained or being replaced by a new EMR HRP product suite?

A11. The Commonwealth’s existing payroll system is being retained. The vendor’s EMR system will need to work with the Commonwealth’s payroll system.

Q12. Would the Soldiers’ Homes please provide the number of beds for each facility by level of care?

A12. Please see the below information as of October 2019. Note: the COVID response has impacted the number of beds available.

Core Service Offering

Q13. Please provide user counts for those users that will be accessing the system.

A13. Please see Section 1.3 of the RFR, which states the vendor should plan to initially accommodate approximately 400 users accessing the EMR system, inclusive of onsite vendors.

Q14. Regarding Section 4.13 (Supplier Diversity Program) of the RFR:

a. Do these business enterprises have to be certified and listed on the Supplier Diversity Office (SDO) site? Yes.

b. If vendor has an existing relationship with a qualifying enterprise that is not currently certified in the Commonwealth, can they be listed in the RFP response as the potential partner completes the certification process with the Commonwealth? The RFR does not ask prospective Bidders to identify their SDP partners in their RFR Response. Only the newly awarded Contractor(s) must complete SDP Plan Form #2 – Declaration of SDP Partners within 30 days of contract execution.

c. Is there a required percentage of contract revenues that must be met in the SDP commitment? No.

d. Would the Commonwealth provide any recommendations for business enterprises that have worked with EOHHS and/or the Department of Veterans’ Services in order for the vendor to meet this requirement? No, EOHHSS/DVS cannot provide recommendations. Section 4.13 of the RFR contains hyperlinks to Supplier Diversity Program (SDP) Resources.

A14. See answers noted above in bold.

Q15. In RFR Attachment A, Section B, for the below requirement, please advise where the reference to Section I5.3 can be found:

B9.60

A15. The “Section I5.3” reference is a typo. The requirement B9.60 is referring to the above requirement, B9.59. The same correction applies to requirements B9.62 and B9.63.

Q16. In RFR Attachment B, Section A, please provide more information on the Caregiver Direct system to which integration would be needed in the below requirement. What kind of data is the Commonwealth seeking to integrate?

A6.8

A16. Specific data for exchange will be discussed during configuration discussions with the selected vendor.

Q17. Please specify which tools the EMR system should integrate with, as noted in the below requirement in RFR Attachment B, Section B:

B3.2

A17. The RFR seeks the vendor’s current and/or planned capability. The Soldiers’ Homes’ have not yet identified the specific tools, however the EMR system should have multi-functional integration capabilities.

Q18. Please clarify what is meant by ‘seniority’ in the below requirement in RFR Attachment B, Section E:

E2.2

A18. The seniority date refers to the date entered into active duty and discharge of a respective resident or patient.

Q19. Can you please provide a list of your lab, radiology, and other external vendors so we can determine if they are already someone we can integrate with?

A19. The Soldiers’ Homes are not able to identify specific vendors at this time, however, as set forth in Section 1.3 of the RFR, the EMR system should be capable of integrating with myriad third party vendors.

Q20. Can you please provide a list of pharmacies used? Will bi-directional pharmacy workflow be used? What is the medication management dispensing software in use?

A20. The Homes have in-house pharmacy services provided by the State Office of Pharmacy Services (SOPS). The vendor solution will need to integrate with the SOPS record system. The Holyoke Soldiers’ Home is in the process of implementing the Omnicell solution.

Q21. Name any third party that you would like to gather data from (i.e. Health Care Providers, Community Partners, Referral Management systems, Therapy systems, etc.).

A21. A list of community partners is provided in Section 1.3. of the RFR, although the EMR system should be capable of integrating with myriad data sources.

Q22. Who do you use for Customer Relationship Management? Do you have Customer Relationship Management needs?

A22. The Soldiers’ Homes do not currently have a CRM system installed.

Q23. Do you require a solution for the pre-admission process (i.e., wait lists, accepting referrals, tracking referral sources, admission paperwork)?

A23. Yes, please refer to RFR Attachment A, B1 requirements.

Q24. Regarding RFR Attachment A, Section F, Ancillary Services, where are in-house Hospice services provided?

A24. The Soldiers’ Homes provide hospice care at the respective facility for residents as appropriate. The Soldiers’ Homes do not provide hospice care offsite.

Q25. How many calls per month are being made at the point of scheduling appointments?

A25. The Holyoke Soldiers’ Home hosts an outpatient department that receives more than 5,000 visits per year and a dental facility that receives more than 3,000 visits per year.

Q26. How many provider licenses are needed for Voice Recognition?

A26. The Soldiers’ Homes anticipate approximately 400 users; it has not been determined the percentage of those users who may need voice recognition. As stated in Section 2.3.2 of the RFR, the EMR system should be compliant with applicable accessibility requirements.

Q27. In order to process online credit card portal payments, what is the expected monthly credit transactions and the average sale amount for a transaction to produce a quote.

A27. Credit card processing fees are not included in this procurement.

Q28. What system is currently in place at the Soldier’s Homes’ and what besides a paper-based system is being replaced?

A28. Due to the age and level of functionality being utilized in the current system, and further to Section 2.1 of the RFR, the Soldiers’ Homes suggest vendors assume a fully paper-based record system is currently in use.

Q29. Is the onsite pharmacy an inpatient licensed pharmacy, or a retail licensed pharmacy?

A29. Both facilities have inpatient pharmacies run by the State Office of Pharmacy Services (SOPS). See Section 1.3.

Q30. Does your pharmacy electronically verify medication orders before nursing can administer them on the MAR? Are you using bar code med admin today?

A30. Current medication is verified manually. One facility has limited use of bar-coded medication. The Holyoke Soldiers’ Home is in the process of implementing Omnicell medication system.

Q31. Are you doing any electronic ordering, resupply, renewals, on hold notifications, etc. today?

A31. The Soldiers’ Homes currently use SOPS (State Office of Pharmacy Services) for its pharmacy services which does not support electronic transactions.

Q32. What system is the SOPS (State Office of Pharmacy Services) currently running? Would that system migrate to the EMR vendor system as well? Or would the EMR system be required to interface to the SOPS current system?

A32. The EMR system will be required to integrate with the SOPS system. The SOPS system may be a source of data migration information. The Soldiers’ Homes utilize SOPS services, and currently the systems don’t integrate. The goal with the Homes’ EMR system is to have all services occurring at the Homes to use the single EMR system but to integrate with the SOPS system on the back end to maintain the SOPS record.

Q33. Do the Soldiers’ Homes receive federal funding? If yes, will these funds be used to fund the purchase of the requested EMR system?

A33. Please RFR Section 1.3 for information regarding any federal funding.

Q34. May vendors negotiate exceptions to the Commonwealth Terms and Conditions for Information Technology Contracts at any point in the procurement process?

A34. Further to Sections 3.4.4 and 4.1 of the RFR, the Commonwealth Terms and Conditions for IT Contracts are non-negotiable for any vendor selected for this procurement.

Q35. Vendor is presently operating under a Stay at Home Policy due to the COVID-19 pandemic in order to protect the health of our associates, clients, and communities. Therefore, we are unable to process "wet" signatures at this time. Rather, we will submit digitally certified signatures. Is this acceptable?

A35. Further to Section 3.1 of the RFR, Responses are required to be uploaded via COMMBUYS with all completed materials. Any resulting contract, and the resulting signature requirements, will be subject to the policies of the Office of the Comptroller in effect at the time of contracting.

Q36. The RFR text in Section 3.2.3 (functional requirements) states: “When additional space is required, the narrative response must be included in the main RFR document using the format in Table 9 below.” It is our understanding that the final submission will consist of 5 files per RFR Section 3.1.7.

Please confirm that the "main RFR document" indicated in this instruction is Attachment C - Business Response and that any additional narrative responses should be included in Section 20 Supplemental Information (3.2.5.20) of the Business Proposal.

A36. Yes, that is correct.

Q37. Please confirm that the Mandatory Response Forms (See Attachment E) may be provided as individual electronic files in COMMBUYS.

A37. Yes, that is correct.

Q38. Please confirm that it is not necessary to return the RFR text found in Sections 3.2.5.1 through 3.2.5.20 with our response so long as all requested information is provided and in the order outlined in Attachment C. In other words, it is only necessary to include the RFR section numbering and headings in the order indicated in Attachment C.

A38. Yes, that is correct.

Q39. The RFR text in Section 3.2.4 (Technical Requirements – Attachment B) states:

“Use the following naming convention for the file name (Note that the date should be the date the response is submitted):

Bidder Name_ Technical Requirements_mm_dd_yyyy.docx”

Please confirm that the Soldiers’ Homes want this document returned in Excel format.

A39. Yes, that is correct.

Q40. Please confirm if it is necessary to provide named staff for all positions mentioned in the list of Key Personnel provided in Section 3.2.5.5 of the RFR or if it is acceptable for bidders to provide names for only those positions that are key for its proposed delivery model.

A40. The bidder should answer consistent with their proposed delivery model.

Q41. Further to Attachment A Section F - Ancillary Services, which requests bidders describe your module's features for in-house Hospice, are the hospice services provided by a community partner? How do you currently provide information to and receive data from this hospice provider?

A41. Hospice services are delivered both by facility staff and by community partners. Existing record data sharing is done with paper.

Q42. Further to RFR Attachment A Section B – Care Management, the system shall capture information needed and support submission (scan/email/online) of the VA Form 1010 EZ. This is an application for VA benefits. For specific data fields please refer to 1010 EZ form in Appendix E. The 1010EZ is required for the LTC and Dorm services. This appears to be an application for services – please clarify the functional expectations with respect to this form and the EMR system?

A42. The EMR system must capture data that will be submitted on the VA Form 1010EZ.

Q43. Further to RFR Attachment A Section B – Care Management, the system shall capture information needed and support submission (online) of the VA Form 1010 SH. This is a State Home Program Application For Veteran Care Medical Certification. For specific data fields please refer to 1010 SH form in Appendix F. The 1010SH is required for the LTC and Dorm services. This appears to be an application for housing – please clarify the functional expectations with respect to this form and the EMR system?

A43. The EMR system must capture data that will be submitted on the VA Form 1010SH.

Q44. Further to RFR Attachment A Section B – Care Management, please clarify the meaning of the acronym CSU.

A44. CSU refers to Crisis Stabilization Unit (short-term intervention).

Q45. Further to Section 4.1 of the RFR, does the Commonwealth want a fee-for-service model of a fixed-fee/all-in price for the term?

A45. “Fee for service” as used in Section 4.1 of the RFR refers generally to a service contract, which may be unit based or project based. Please see Attachment D for the format of a bidder’s Cost Response and required information.

Q46. The documented listing for web browser versions as well workstations OSs in Appendix A seems to be dated (from 2015) with many no longer supported. Is there a more current listing available?

A46. No, there is not a more current listing available. The project assumes a hardware technology upgrade, including vendor guidance at the time of additional hardware procurement.

Q47. Is the Commonwealth willing to accept a vendor proposed alternative to the requirements for security and security audit if it follows the intent of the procurement and achieves an equal or greater level of security and confidence?

A47. Further to Attachment B of the RFR, required security controls are NIST 800-53, and cloud solution should be FedRAMP Moderate.

Audit compliance under NIST generally requires the following:

i. Security & Vulnerability Testing: Quarterly

ii. Security & Vulnerability Testing, external 3rd party: Annually

iii. HIPAA/HITECH Audit, external 3rd party: Annual

iv. SOC 2 audit report (Type II or Type I Annual) negotiable

v. Security Policy and Standards, Annual Review - negotiable Q48. Attachment A – Tab Section E - Other Business Req. states the following: “Daily Report Log: The system shall track daily events. This information is shared between shifts daily. Please see currently used forms in Appendix XYZ.” We are unable to locate Appendix XYZ. Where can we obtain this document?

A48. Examples of the dormitory forms are not provided in the RFR. Please disregard the reference to the Appendix XYZ.

Q49. For the below requirement on RFR Attachment A, Section B, please provide the information to be captured and displayed for each audience listed in the requirement:

B9.54

a

Client/patient b

Guardians c

Other agency

A49. The Soldiers’ Homes have not specified reports for Guardians and Other agencies. These examples are included because often additional parties are involved in treatment decisions.

Q50. Do the Soldiers’ Homes plan to use masked production data in non-production environments?

A50. No.

Q51. Will the Soldiers’ Homes be processing payments from patients by credit card?

A51. Yes, see Attachment A of the RFR, Requirement C3.4.

Q52. Is the Soldiers’ Homes willing to accept authentication and identity management processes that are regularly audited and reported on and maintain encryption key management as a responsibility of hosting?

A52. Bidders should propose their best solution to meet the Soldiers’ Homes’ identified needs as set forth in the RFR.

Q53. Can you confirm the appropriate Commonwealth standard contracting documents that should be reviewed?

A53. Please see Amendment 2 to the RFR, dated July 10, 2020, which clarifies the Commonwealth standard contracting documents applicable to this RFR and the resulting contract.

Q54. Is it the expectation that the vendor/external contract HC providers will have or need to provide the access to the EMR system?

A54. As further set forth in the RFR (including, without limitation, Section 1.1, 1.3 and 2.1), the Soldiers’ Homes are seeking an interoperable system to be able to connect with other systems so readily able to exchange information in compline with all applicable laws, including without limitation, privacy. In Attachment A of the RFR, the modalities of treatment type are outlined, and the Soldiers’ Homes expects all modalities in Attachment A would have the same level of access within the EMR system.

Q&A RFR for the Soldiers’ Homes EMR System 1

Q&A RFR for the Soldiers’ Homes EMR System 2