Sample SOW.docx

Sample: STATEMENT OF WORK

MEDICOM IMAGEX VISN21

INTRODUCTION:

This requirement is for a system which enables electronic, bi-directional exchange of radiology imaging exams and reports with commercial healthcare facilities providing services to VA patients.

BACKGROUND:

The Mission Act has made it possible for Veterans to seek diagnostic imaging services outside of the VA. As a result, diagnostic results, which are in the form of DICOM images and textual reports, need to be couriered back to the VA for further patient care. As it exists currently, CD-ROMs and DVD-ROMs are hand-carried or mailed to and from the VA at the completion of a diagnostic test; this causes bottlenecks and delays in the continuity of Veteran care. There has also been a delay in archiving the images, delivered to the ordering provider by the patient who diligently obtains the requested images from the outside provider on a CD-ROM. The VA relies on CDs to share imaging examinations with community care providers, but examinations are often repeated when CDs are not requested, get misplaced, or are not “readable” due to software incompatibility. CDs and repeat imaging cost the VA an estimated $163-181 million per year, nationally. But more importantly, the Veteran can be harmed when previous examinations are not available: delayed diagnosis of cancer, aggressive and needless workups, and increased radiation exposure.

Medicom’s Imagex transforms this physical-media dependent process of sharing imaging and associated data with the private sector into an easy-to-use electronic process that eliminates CD-ROMs and associated delays in care. Medicom’s proprietary peer-to-peer network gives the VHA the ability to bi-directionally exchange medical images and diagnostic reports with private sector facilities at no cost to the private sector facilities. Medicom’s search engine gives the VA the ability to locate, access, and use medical images and reports even when the Care in the Community location is unknown.

Medicom is the only platform with a vendor-agnostic patient record locator service, which allows clinicians to locate patient information without calling and waiting for private sector facilities to send information. Immediate access to patient data performed under the Mission Act is a specific need for VHA timeliness of care, care quality, and patient safety and Medicom is the only vendor able to provide this timesaving solution. Medicom is the only vendor to offer an automated patient record retrieval service, which is a specific requirement for achieving the VHAs cost-savings goals associated with an electronic DICOM image sharing service.

Medicom’s proprietary peer-to-peer network would give the United States Department of Veterans Affairs Hospitals in VISN 21 the ability to electronically exchange data with private sector healthcare providers. In so doing, Medicom’s Imagex would minimize delays in the delivery of care and reduce the operational costs associated with Veterans seeking imaging under the Mission Act or through the Veterans’ Choice Program. Medicom’s proprietary peer-to-peer network technology enables VISN 21 staff to retrieve the requested images and diagnostic reports from private sector facilities electronically. Medicom’s technology saves VA the time and cost of using courier services to transport CD-ROMs and faxing requests to and from the Radiology File Room and Care in the Community (CITC) Office. In addition, automated processes for importing images and reports reduce the burden imposed on VA personnel across the Imaging Services Lines in VISN 21. Medicom is the only vendor to provide this fully federated image sharing architecture, which allows the VA to:

· Broadcast queries to the community to locate VA patients’ prior images in the private sector. Without a fully federated approach, the VA would have to continue calling and faxing outside facilities to locate prior images.

· Medicom’s fully federated model means that data sent from the private sector to the VA is sent through a secure conduit by way of a FIPS 140-2 validated connection with the VA TIC.

· The Medicom Imagex architecture, which takes a security-first approach, also allows the VA to instantly locate and access prior clinical information through a federated search function. This functionality is unique to Medicom and leads to significant cost savings for the VA.

· In addition, Medicom’s Imagex is the only solution to provide advanced automation features that improve patient safety through consistent access to information and reduce operational overhead for the VA with expected savings of roughly $1,000,000/year/VA Medical Center.

The following items below are protected by US Patents with registration number US 10,305,869 and US 10,257,174:

· Patient Matching: Patient Matching allows Medicom to update DICOM images and reports as they arrive from the private sector so Medicom can automatically add the information to the patient’s chart in CPRS and jacket in Commercial PACS. If a distinct match is not found, the outside data can be held for manual review by staff in Medicom’s Checkpoint worklist.

· Outside Order Generation: When outside images are received, Imagex can automatically generate an ‘outside’ order in VistA so that the data is associated properly between the DICOM archives and VistA/CPRS through a Class 2 Interface.

· Automated Federated Search: Automated Federated Search ensures that a patient’s outside priors are available for comparison. Imagex searches based on an upcoming appointment/procedure using an HL7 order (ORM) or scheduling (SIU) message from VistA. Once a patient event is received, Imagex will search private sector facilities on the Medicom’s proprietary peer-to-peer network for the patient, retrieve clinically relevant prior images and reports, reconcile the prior information, and store the prior information in VistA Imaging and Commercial PACS.

· Automated Internal Prefetch: Automated Internal Prefetch ensures that a patient’s internal priors are available for comparison. Imagex locates and moves a patient’s clinically relevant prior images within an organization to a specified location (like a reading workstation or a radiation therapy planning system) based on an upcoming appointment/procedure using an HL7 order (ORM) or scheduling (SIU) message.

· Electronic Requests: Electronic Requests enable VA employees to request and search for patient information at facilities participating and not participating on Medicom’s proprietary peer-to-peer network.

In addition to the automated features, Medicom offers a web-portal to VHA end-users. Some of the key actions an end-user can take in the Medicom Web Portal are:

· Checkpoint: View and manage inbound data that was held for review.

· Requests: View and manage electronic requests for prior patient images from private sector providers or send electronic requests for prior patient images to private sector facilities.

· Internal Pre-Fetch: View scheduled appointments and the status of the automated retrieval of priors from local information systems.

· Federated Search: View scheduled appointments and the status of the automated retrieval of priors from private sector information systems.

· Web-Initiated Sharing: At any time, staff can click a shortcut to send, retrieve, or request data using the persistent quick action menu bar on the left-hand side of the screen.

· Administrative Management: For IT and PACS administrators, the web portal contains configuration options for the entire suite of products, allows for the creation of rules to modify and route data automatically, and maintains an audit trail of all transfers for compliance.

Medicom has demonstrated repeatable performance and processes for successfully deploying its Imagex service within the VHA. Medicom conducts its delivery and deployment process through three concurrent workstreams:

· Information Technology Pathway

· Medicom will work with VISN 21 to deploy a virtual machine to host the Medicom Imagex service. The software to be installed is TRM Approved (please reference https://www.oit.va.gov/Services/TRM/ToolPage.aspx?tid=11612).

· Medicom has an established National BAA and National MoU-ISA with the VA (please reference National MoU-ISA record E-2247).

· VISN 21 submits a site-to-site Add Request for the virtual machine hosting the Medicom software to be added into Medicom’s National Site-to-Site Connection with the VA (please reference Connection Identification (CID) #0584).

· Upon completion of the above tasks, the VA will have completed the IT implementation path.

· Application Configuration Pathway

· Medicom conducts workflow demonstrations for Cardiology, Mammography, Radiology, Radiation Oncology, and Care in the Community Departments and consults with end-users regarding their desired workflows.

· Upon determination of the desired workflows, Medicom produces a configuration document, and the workflows are implemented through the deployment of DICOM and HL7 interfaces along with deployment of Medicom’s Class 2 Interface with VistA.

· Upon completion of implementation and end-user training, Medicom provides ongoing support.

· Outreach Pathway

· Medicom deploys extensive resources to ensure the VA can quickly and efficiently establish connectivity with private sector facilities.

· The VA will be able to provide Medicom a list of requested private sector facilities to connect with at no additional cost to the private sector facilities.

· Medicom’s outreach team will coordinate and establish connectivity to these community partners on behalf of the VA.

· In addition, there will be no limit to the number of connections that the VA may have with private sector facilities and there will not be any volume limit for the VA as well.

Medicom’s Imagex will allow the Radiology Department to do the following:

· To search private sector healthcare providers serving VISN 21 patients.

· Locate and retrieve prior medical images and reports.

· Induct outside prior medical images and reports to VA systems using a quality assurance step.

SCOPE:

Medicom’s Imagex deploys a proprietary peer-to-peer network that would give the United States Department of Veterans Affairs Hospitals the ability to electronically exchange data with the community. In so doing, Medicom’s Imagex would minimize delays in the delivery of care and reduce the operational costs associated with seeing a Veteran imaged outside of VA under the Mission Act. By using the unique peer-to-peer secure network technology provided by Medicom, the VA Southern Nevada Healthcare System would be able to, in effect, retrieve the requested images from our community providers electronically, saving the time and cost of using courier services to transport the CD-ROMs to the Radiology File Room.