SOW - Enterprise-Wide Online Evidence-Based Clinical Decision Support Resource.pdf

Statement of Work (SOW)

Enterprise-Wide Online Evidence-Based Clinical Decision Support Resource

Indian Health Service (IHS)

I. Introduction The Indian Health Service (IHS) requires an enterprise-wide license subscription for an online, evidence-based clinical decision support resource that provides continuously updated medical and drug information. The subscription will support site-level access at hospitals, clinics, and ambulatory healthcare centers across all nine IHS Area Offices.

UpToDate provides 24/7 access to clinical guidance, supporting providers at the point of care and enabling informed decision-making, ultimately improving patient safety and outcomes. It also serves as a key educational resource by providing continuing medical education (CME) credits to licensed healthcare providers.

II. Objectives The objective of this SOW is to ensure comprehensive, real-time access to trusted clinical and pharmaceutical information, authenticated seamlessly through IHS network IPs, and accessible from any IHS facility or remote location. Key goals include:

• Providing instant, evidence-based information to support clinical decision-making at the point of care.

• Offering built-in CME/CE/CPD credits for providers through AMA- and ACCME-accredited content by automatically tracking learning activity in the background. Any time you open, read, or search for clinical topics, this resource logs the activity to make it eligible for credits.

• Ensuring enterprise-level integration and secure authentication through IP-based access and mobile support.

• Maintaining a high-availability platform with robust customer and technical support.

III. Period of Performance Base Year: July 1, 2026 – June 30, 2027 Option Year 1: July 1, 2027 – June 30, 2028 Option Year 2: July 1, 2028 – June 31, 2029 Option Year 3: July 1, 2029 – June 31, 2030 Option Year 4: July 1, 2030– June 31, 2031

Place of Performance: Onsite and Remote (accessible from IHS facilities, VPN, and authorized mobile devices).

IV. Contract Type The contract will be a Firm Fixed-Price (FFP) agreement, subject to the Contracting Officer’s discretion and determination of the most advantageous structure for the Government.

V. Scope of Work

The contractor shall provide a comprehensive, evidence-based clinical information and decision-support platform to authorized Indian Health Service (IHS) personnel nationwide. The platform must ensure quality access for clinical and non-clinical users across hospitals, clinics, and remote field sites.

A. General Requirements:

1. Enterprise-Level Licensing: Provide an agency-wide license that allows unlimited, concurrent access for all IHS health programs. The license must include users such as physicians, nurses, pharmacists, physician assistants, and allied health professionals.

2. IP-Based and Federated Authentication: Configure seamless access through IP authentication for all IHS networks, including VPN users, while also supporting remote logins via Single Sign-On (SSO) or secure credentials.

3. Multi-Platform Accessibility: Ensure access from desktops, tablets, and mobile devices using standard browsers or vendor applications on iOS and Android.

4. High Availability: The system must be hosted on redundant, fault-tolerant infrastructure, with uptime of at least 99.5%, excluding scheduled maintenance.

B. Functional Requirements:

1. Comprehensive Clinical Content: Provide continuously updated, peer-reviewed clinical topics across all major specialties, including but not limited to internal medicine, pediatrics, psychiatry, cardiology, dermatology, infectious diseases, oncology, and hospital medicine. Each topic must include diagnostic criteria, differential diagnoses, and treatment options supported by evidence-based rationales, along with interactive care pathways that facilitate clinical decision-making.

o The content must be authored, reviewed, and updated by a large network of clinical experts, with transparent sources and references.

o The solution shall state who authored and edited each topic.

o The lead or primary author/writer of each topic shall be an expert in the clinical subspecialty. Each topic will be peer-reviewed by experts in the relevant clinical subspecialty.

o Author and editor credentials and affiliations shall be included in the topic.

Credentials and affiliations shall clearly demonstrate specific relevance to the topic subspecialty.

o Author, editors, and reviewers' clinical subspecialties must match the clinical topic.

o Authors and reviewers with an academic appointment must, at least 75% of the time, be at the associate professorship level or higher in the clinical subspecialty.

o Authors and reviewers with an academic appointment must, at least 50% of the time, be at the Professor level, as they are the most experienced.

o Recommendations must include a distinction between expert opinion and scientific evidence, and consideration of patient preferences in cases of limited documentation.

o Recommendations must use only the GRADE system.

o Provide an AI natural language tool for rapid retrieval of answers to clinical questions. The AI must be a closed system, only surfacing clinical content from the clinical reference. The AI tool must be able to answer clinical and drug-related questions. Clinical “nudges” must be provided in the AI response. The AI must provide references to the clinical content.

2. Pharmacology and Drug Database: Include a fully integrated drug reference database providing FDA-approved indications, dosing, contraindications, and drug interaction data, including cross-linking to relevant clinical topics. Provide a mental health drug tool to ensure safe dosing regimens when switching antidepressant drugs.

o The solution must include expansive dosing for patients with:

o Altered kidney function (chronic kidney disease, dialysis, peritoneal dialysis) o Hepatic impairment o Enteral tubes o Bariatric (obesity) o Authors must recommend drug dosages or therapeutic regimens in the absence of practice guidelines, algorithms, and published evidence.

o RX Transitions for Mental Health to assist clinicians with guidance when switching antidepressant medications o Gene test interpretation

3. Patient Education Materials: Supply printable and digital handouts suitable for patient counseling and written at appropriate literacy levels. Materials must align with and follow similar editorial policies as the clinical and drug content.

4. CME and Continuing Education: Support automatic tracking and documentation of ACCME-accredited CME/CE/CPD credits for licensed providers. Reports shall include user activity, topics accessed, and CME credits earned. CME will meet MATE Act requirements and be eligible for Maintenance of Certification (MOC) requirements.

5. Integration and Interoperability: Contractor to provide integration options with IHS Electronic Health Record (EHR) systems (e.g., RPMS, Cerner, or other federally approved EHR platforms) for point-of-care access. Offer technical assistance for embedding the solution into clinical workflows.

6. Reporting and Analytics: Generate detailed monthly and quarterly reports showing total sessions, user counts, CME activity, and access by IP and device type, as well as trends by Area Office and facility.

7. Content Updates: Ensure continuous and ongoing literature surveillance and update clinical topics.

C. Technical Requirements:

1. System Performance: Ensure page load times are efficient for standard broadband users.

Guarantee regular updates for mobile app security and compatibility.

2. Helpdesk and Support: Provide 24/7 customer and technical support accessible via phone, email, and web portal. Establish an escalation protocol and assign a dedicated account manager. Receive requests for Care Pathway updates from dedicated IHS SMEs.

Consider hosting static IHS Care Pathways in a separate designated ‘IHS’ folder.

3. Training and Onboarding: Conduct initial and refresher training sessions for staff, including webinars, tutorials, and user guides. Provide an implementation schedule and progress updates to the COR.

D. Compliance Requirements:

1. Section 508 Accessibility: The system must meet Section 508 standards for accessibility.

If full compliance is not achieved at award, the vendor must provide a remediation plan with milestones and achieve compliance within 12 months.

2. Data Security and Privacy: Adhere to HHS, IHS, and federal IT security policies, including HIPAA. All data transmissions must use TLS 1.2 or higher encryption, and no PHI or PII may be stored or transmitted outside U.S.-based servers.

3. Quality Assurance: Implement a quality management process to ensure accuracy, timeliness, and reliability of content and services. Provide quality control documentation upon request.

E. Deliverables Related to Scope:

• Fully operational enterprise subscription platform within 60 days of contract award.

• IP-based access verification and functionality report within 30 days post-launch.

• Monthly usage analytics and technical performance summaries.

• Annual content update certification and CME report submission.

The contractor shall provide a comprehensive evidence-based online medical and drug information resource with the following capabilities:

A. Functional Requirements:

1. Enterprise Access: IP-authenticated access for all IHS facilities and VPN users.

2. Comprehensive Content: Must include all major clinical specialties and patient education materials.

3. Clinical Decision Support: Provide concise, evidence-based summaries to guide clinical decisions.

4. CME Functionality: ACCME-accredited, allowing tracking and claiming of credits, along with direct submission to state boards

5. Reporting and Analytics: Provide detailed monthly and ad-hoc usage reports.

6. System Reliability: Minimum uptime of 99.5% and 24/7 technical support.

7. 508 Compliance: Must comply with Section 508 or provide remediation.

8. Training and Support: Offer live or web-based training sessions and user documentation.

VI. Security and Privacy The contractor must ensure data confidentiality and user privacy, consistent with HHS and IHS IT security policies, including adherence to HIPAA. No PII or PHI shall be stored or transmitted by the system. A Security Plan and supporting documentation will be requested. The contractor must adhere to Federal security policies. The system shall not store or transmit PII or PHI. A Security Plan and supporting documentation will be requested. The contractor must adhere to federally compliant terms of service and indemnification clauses.

VII. Roles and Responsibilities Contracting Officer (CO): Overall contract authority, executes options, ensures compliance.

Contracting Officer’s Representative (COR): Liaison between CO and contractor, reviews deliverables.

Vendor Project Manager: Coordinates implementation, training, and support.

IHS Project Manager: Oversees deployment and verifies performance compliance.

VIII. Deliverables and Milestones Within 2 weeks post-award: Kick-off meeting coordination (COR) Within 2 weeks post-kickoff: Meeting notes and action plan (COR) Within 1-month post-award: List of participating sites (COR) Within 1-month post-award: Submit Interconnect Security Agreement and network diagram (vendor) Within 2 months post-award: Subscription implementation (COR) Monthly: Usage reports and performance metrics (COR) Ongoing: Add/edit/remove access requests within 3–5 business days (COR) Quarterly: Progress summary and technical issue log (COR) Annually: Year-end report with evaluation and impact summary (COR)

IX. Performance Metrics System Uptime: ≥99.5% (Monthly Monitoring Reports) Issue Response: ≤24 hours (Helpdesk Logs) Training Delivery: Within 30 days of request (COR verification) Usage Data: Delivered monthly (COR acceptance) 508 Compliance: (Vendor Certification)

X. Invoicing and Payment Invoices must be submitted monthly, quarterly, or a reasonable timeframe requested by the contractor and include the contract number, description of services, and COR certification.

Payments are contingent on COR acceptance of deliverables.

XI. Special Requirements This contract supports IHS healthcare facilities serving American Indian and Alaska Native populations. The vendor shall ensure equitable access and consistent support across all eligible sites.

XII. Appendices Appendix A: Section 508 Compliance Appendix B: Sample Usage Report Template Appendix C: Security and Privacy Clauses Appendix D: Training and Implementation Schedule

XIII. Deliverables and Deadlines Deliverable Description Due Date /

Frequency Submitted To

Kick-off Meeting Coordinate and conduct project kick-off meeting to review objectives, roles, and implementation schedule.

Within 2 weeks after contract award

COR

Kick-off Summary Report

Provide meeting notes, attendee list, and action items from the kick-off meeting.

Within 5 business days after kick-off

COR

Implementation Plan

Submit detailed plan for site activation, IP authentication, and training rollout.

Within 1 month after contract award

COR

Interconnect Security Agreement and network diagram

Submit a detailed Interconnect Security Agreement and network diagram (vendor)

Within 1 month after contract award

COR

Subscription Activation

Activate support resource solution’s enterprise access for all IHS, Tribal, and Urban sites.

Within 60 days after contract award

COR

Training Sessions Conduct web-based or on-site training for clinical and technical users.

As requested, initial training within 60 days after award

COR

Monthly Usage Reports

Provide monthly analytics of user activity, CME credits, and site engagement metrics.

Monthly COR

Quarterly Performance Review

Summarize key accomplishments, challenges, and recommendations for improvement.

Quarterly COR

508 Compliance Plan

Provide accessibility compliance certification or a remediation plan.

Within 90 days of contract award

COR

Content Update Confirmation

Certify continuous literature updates

Annually COR and content accuracy.

Annual Impact Report

Provide annual evaluation of outcomes, usage trends, and CME engagement.

Expected outcomes include:

o Measurable value o Effectiveness o Program

Impact

30 days before the end of each option year

COR

Ad Hoc Access Changes

Add, remove, or edit user/site subscriptions upon request.

Within 3–5 business days of the request

COR

Final Project Summary

Submit final year-end summary of contract activities, performance metrics, and lessons learned.

30 days before the contract end date

COR