SOW - OCAO RPMS GUI Services.docx

STATEMENT OF WORK – RPMS GRAPHICAL USER INTERFACE

I. General:

This Statement of Work describes the requirement for the maintenance of the graphical user interface (GUI) product that interfaces with the Indian Health Service’s Resource and Patient Management System (RPMS) software program. This requirement shall be for all federal hospitals and health centers within the Oklahoma City Area (OCA). This product is HealthPic and is a proprietary product managed by Sovereign Technologies Solution, LLC that has been customized to meet OCA’s specific needs and requirements.

II. Background:

The RPMS system is a decentralized integrated solution for management of both clinical and administrative information for healthcare facilities. Flexible hardware configurations, over 50 software applications, and network communication components combine to create a comprehensive clinical, financial, and administrative solution; a solution that can stand alone or function in concert with other components as needed. RPMS is used every day to efficiently manage programs, maximize revenue generation, and most important, to provide high-quality care for patients.

RPMS software applications have been, and continue to be, customized and enhanced based on requests and input from users throughout the entire Indian Healthcare system. As the foundation of the Indian Health information technology support system, RPMS is mission critical in providing healthcare within the IHS health system. Over the past ten years, this mission critical system has been enhanced by the development of a GUI electronic health record in order to provide a resource for full documentation of direct patient activities. To date, limited GUIs have been developed to support non-direct patient care activities such as quality assurance/performance improvement, reporting of patient outcomes, clinical quality measures, purchased referred care, business office, health information management, 3rd party internal control requirements, etc. Thus, HealthPic was developed and implemented within OCA as a RPMS GUI solution and it has dramatically assisted each facility in extracting, analyzing and management of critical business information to support their healthcare operations. The personnel at the facilities have embedded this solution into many of their workflows. In order to maintain this important tool, OCA has a requirement to maintain and provide optimization to the existing tool.

III. Scope:

The primary need is for maintenance and troubleshooting of the existing RPMS GUI reporting tool, HealthPic. Secondary goal is to continue development and optimization of the tool. The continued GUI development shall be founded upon existing reporting mechanisms currently available within RPMS thereby allowing for real-time data extraction, analysis and management to allow consistent analysis at each service unit and throughout the OCA.

Project development and enhancement requests are outlined below and shall be adhered to unless other directed otherwise. The government reserves the right to modify requirements and reprioritize development/enhancement requests based upon circumstances beyond control or external factors/directives not yet known or forecasted. All such requests will be at the direction of the CO or COR.

Overall, the RPMS GUI shall include the following concepts:

· Reporting shall have the capability to run data by day, month, quarter and calendar/fiscal year while allowing the figures to be linked to the original data, thereby allowing a drill down capability to identify and review the raw data.

· Development of a reporting tool to allow for selection of date ranges in addition to standard “canned” reports.

· Source of extracted data shall be clearly identifiable with notation of inclusion and exclusion criteria on generated report in both viewing and printing functions.

· Allowance for multi-divisional site’s data to be separated by facility but also creation of one overall service unit wide report that incorporates the individual sites data to an aggregate total.

· Data shall be displayed in a chart-based format with development of additional reporting formats (i.e. pie charts, run charts, variances, etc.) as applicable.

· Data shall include current fiscal year data and at minimum two prior fiscal years for historical comparisons.

· Data to be downloaded and imported into excel (xls), comma delimited (CSV), tab delimited (text) and PDF formats.

· Establish key performance indexes with ability to directly input data goal (i.e. goals for 3rd party collections, weekly PRC spending, etc.) for all monitoring tools deemed necessary.

· Possess ability to generate a daily synopsis email report(s) of selected data and data points.

Specific Requirements:

The Contractor shall provide ongoing maintenance, support and troubleshooting of all existing functionality and reporting options within the current infrastructure.

The Contractor shall incorporate below outlined defined reports and requirements into existing infrastructure.

In addition to the defined reports and requirements listed below, two report enhancement/modification requests shall be permitted per quarter.

· Display and Information:

· The Contractor shall update names of sections/tabs to reflect accurate descriptions of information that will be intuitive to the end-user.

· The Contractor shall provide system, training, and user documentation for each application and upgrades/updates in a format editable by the Government.

· The Contractor shall provide information on each section/tab to indicate the source of the information and attributes of the information displayed.

· Patient Demographics:

· Reporting shall assess year to date patient demographics with drill down capabilities to the month/day for active user population for the following: age breakout for 0-4, 5-12, 13-19, 19-21, 22-49, 50-64, 65 and older; facility, gender to include gender identity; 3rd party status, community breakdown; tribal affiliation; births; veterans’ status; active charts; deaths; and visits. 3rd Party status shall be calculated as an individual percentage of Medicare, Medicaid, Private Insurance, and Veterans Affairs with summation of an overall 3rd Party percentage and shall be done year to date and by fiscal year Data shall be displayed in graph depicting current/real-time data and run-chart based format for tracking over time.

· Visit/PCC Activity including Provider Practice Description Report (PPDS):

· Provider Empanelment calculation should be enhanced to correct calculations by month and year and to be updated nightly.

· Patient Care Component (PCC)/Active Patient Count (APC) Report including 1-A, Visit Count by Individual Provider (APRV):

· Reporting shall assess year to date and by fiscal year and by facility: updates to include addition of number of secondary provider visits, ability to drill down within and to sum by or remove select clinic stop codes and service category.

· Facility Summary:

· Report shall include the PCC facility summary: updates to include addition of year to date totals for current fiscal year and top 20 injuries.

· Scheduling

· Appointment Activity by Month Year

· Add a key on the page to indicate what the colors mean.

· Appointment Scheduling Time to Appointment

· Report shall track time between date and time of scheduling appointment to actual appointment date and time. Data shall be presented by each individual provider/clinic stop code and hospital location with summary by clinic type, facility and service unit. Sub-analysis of type of appointment (same day/urgent, pre-book/routine and wellness) shall be created for differentiation and analysis.

· Report shall also analyze RPMS waiting list and incorporate data from RPMS waiting list if patient is on waiting list and receives subsequent appointment.

· Outpatient Cycle Times

· Updates to report shall include the ability with drill down capabilities by appointment time to check-out, start (date and time) of note completion/signature (date and time) and addition of presentation by provider and by evaluation and management codes.

· Emergency Department (ED): The Contractor shall provide the following enhancements to this section:

· Number of patients seen per year by ED doctor (same timeframe) with line graph demonstrating comparison of previous calendar year.

· Cycle Time from ED arrival to treatment and discharge or admission

· Median Time from ED arrival to ED departure for admitted patients

· Median Time from Decision to Admit to ED Departure for Admitted Patients

· Number of left against medical advice (AMA) per day/month/year (same timeframe)

· Number of patients seen per hour (same timeframe) with a run graph for the month/year

· Daily/monthly/yearly acuity report for the ED with a bar graph - by day of the month

· Line graph for number seen per each ED physician by month and year

· Average turn-around-time per provider by month and year

· Average time for door to provider by ED physician by month and year

· Left without being seen per ED provider by month and year

· Number of Admits per ED provider by month and year

· Number of Transfers per ED provider by month and year

· Number of left against medical advice (AMA) per ED provider by day, month and year

· Surgery Department

· Total number of endoscopy procedures per day/month/year – broke down by inpatient and outpatient

· Total number of surgical procedures per/day/month/year – broke down by procedure and surgeon

· Number of procedures performed in Surgery Clinic per day/month/year – broke down by procedure and provider

· Inpatient

· Number of admissions per day broke out by service line/unit and provider

· Number of left against medical advice (AMA) per unit & provider by day/month and year

· Number of patient days per unit & provider by month and year

· Number of transfers out of the facility per unit & provider by day

· Number of unit-to-unit transfers per unit & provider by day

· Average daily patient load (ADPL)

· Number of discharges per day broke out by service line/unit and provider

· Number of observation admissions per day/year broke out by service line/unit and provider

· Number of observation admissions that were not discharged or converted to inpatient in the first twenty –four (24) and forty-eight (48) hours.

· Number of readmissions per provider and unit by day

· Number of newborns

· Number of elective deliveries based on CMS criteria by month and year

· Number of newborn hearing screening prior to hospital discharge by month and year

· Business Office:

· Accounts receivable adjustment & refund report to include each adjustment reason by each fiscal year visit type, clinic type and estimated charges.

· Accounts receivable top 10 payor analysis by month/year

· Accounts receivable billing list by month/year, payor, provider, outstanding balance, billed amount, paid amount (with drill down capability), co-insurance, deductible, write-off amount (with drill down capability), non-covered charges (with drill down capability) and bill count.

· Dashboard shall include the following updates: The dashboard elements below with the ability to click on each total to view by month and the ability to drill down to see the breakdown behind the numbers by payer category.

· Total # of New Charts

· Total # Reactivated Charts

· Total # Visits

· Clinical Visits

· Pharmacy Visits

· # Visits w/3rd party

· Total # of Claims Coded

· Total $ Billed

· Total $ Posted

· AR 60+ %

· AR 90+ %

· AR 120+ %

· Total A/R

· Reporting shall assess year to date and by fiscal year, quarter and date if available with drill down capabilities to the month/day

· Benefit Coordinator Productivity Report

· Exception Report of Patients under 18 without 3rd Party coverage for patients with a visit within the last two years

· Exception Report of Patients over 65 without 3rd part coverage for patients with a visit within the last two years

· Days to A/R Report

· Aged Summary Report

· Patient Registration Error report

· BRRP (Brief Claims Listing)

· Cancelled Claims Report

· Pended Claims Report

· Bills Awaiting Export

· Auto Sync Report

· PRC Management:

· Referrals:

· Report shall include the following updates: referrals by month with referral count. This shall include the capability to drill down: by purchase order, number of visits, and days outstanding from referral date to current date for those without an approved purchase order.

· Incorporation of PRC open vendor purchase order data to track and trend with sorted data by fiscal year and vendor.

· Develop cycle time analysis for tracking of denials to track the date and time of denial to issuance of denial letter.

· PRC cycle time by both clinic-initiated referrals and self-referrals with an overall cycle time summary, cycle time summary by specialty/vendor and subgroup average of the following benchmark dates:

· Date of referral

· Date approved

· Date scheduled (based upon date and time of entry of referral date of service)

· Date of appointment

· Date of Issuance of purchase order

· Date of receipt of medical records from vendor (closing the loop)

· Date of payment by fiscal intermediary

· Add Clinical Consultation tab/report that includes both Awaiting and Completed Clinical Consultation that is broken down by month and display rate of completion.

· Provider Analysis Reports

· Report shall include the ability with drill down capabilities for providers by specialty and include encounter provider outpatient visits, inpatient admit totals and encounter provider inpatient visits.

· Laboratory:

· Report shall include the ability with drill down capabilities by billable visit count, total patient costs, billable costs and payments. Drill down capabilities shall be accessible by using lab utilization by CPT by frequency lab report for identification of orders by each provider. Lab data should be summarized by totals under each chart and in the CEO Dashboard.

· Radiology:

· Report shall include the ability with drill down capabilities by billable visit count, total patient costs, billable costs and payments. Drill down capabilities shall be accessible by using radiology utilization by CPT by frequency lab report for identification of orders by each provider. Data should be summarized in each chart/table and in CEO Dashboard.

· Operational Summary:

· Report shall include the patient registration, outpatient appointment activity, outpatient appointment by 3rd party payor mix, emergency department including urgent care, hospital inpatient by ward, purchased referred care, visit (patient encounter) activity. Report shall be accessible by each month, fiscal year or specified date range.

· Consult (internal) Management:

· Reports shall include the ability to track all pending consults by department (i.e. physical therapy, optometry, etc.). Data shall consist of the number of pending consults, average days pending calculated by date of consult to current date, and average day scheduled calculated by date of consult to scheduled appointment.

· Reporting format shall be built upon PRC referral platform.

· Internal Controls Self-Assessment

· Develop full revenue cycle time analysis by the following reporting elements:

· Date of appointment

· Date of signed note by provider

· Date of final coding (exclusion of incomplete notes until released by coding staff)

· Date first noted on BRRP (Brief Claims Listing)

· Date billed

· Date of accounts receivable

IV. Responsibilities:

a. The Contractor shall maintain and incorporate above requirements into the RPMS GUI.

b. All development efforts must adhere to 508 compliance regulations.

c. IT security requirements must be incorporated into all phases of program planning and execution, from budgeting to close-out and the implementation of those requirements should align with the HHS Enterprise Performance Life Cycle (EPLC). The Contractor shall comply with security requirements, EPLC processes, and Enterprise Architecture, to ensure proper and confidential handling of data and information.

d. The Contractor shall refer to the HHS-OCIO Policy for Information Systems Security and Privacy, dated July 7, 2011. The Contractor shall become familiar with the HHS Departmental Information Security Policies, which may be found at http://www.hhs.gov/ocio/policy/. The HHS Cybersecurity Program develops policies, procedures, and guidance to serve as a foundation for the HHS information security program. These documents implement relevant Federal laws, regulations, standards, and guidelines that provide a basis for the information security program at the Department. The Contractor must become familiar with HHS Cybersecurity Program guidelines as presented at http://www.hhs.gov/ocio/policy/index.html#Security

e. Contractors must follow and adhere to National Institute of Standards and Technology (NIST) Special Publication (SP) 800-64 Security Considerations in the System Development Life Cyclehttp://csrc.nist.gov/publications/nistpubs/800-64-Rev2/SP800-64-Revision2.pdf, at a minimum, for system development. This requirement may include providing system documentation at designated intervals within the EPLC that require artifact review.

f. The Contractor shall protect information that is deemed sensitive from unauthorized disclosure to persons, organizations or subcontractors who do not have a need to know the information. Information which, either alone or in aggregate, is deemed sensitive or proprietary by the Government shall be protected as instructed in accordance with the magnitude of the loss or harm that could result from inadvertent or deliberate disclosure, alteration, or destruction of the data. This language also applies to all subcontractors that are performing under this contract.

g. The Contractor shall ensure that computer software operated on behalf of the Government is fully functional and operates correctly on systems configured in accordance with government policy regarding configuration requirements. The Contractor shall test applicable products and versions with all relevant and current updates and patches updated prior to installing in the government environment.

h. The Contractor shall provide an estimated timeline for the development for the above outlined requirements at the start of the performance period. A percentage of completion report/analysis shall be provided monthly until such work is satisfactorily completed according to Contracting Officer Representative (COR). Any delay shall be communicated, in a timely fashion, to the COR and CO accordingly.

i. The Contractor shall provide a maintenance program with notation of system upgrades/updates to ensure system remains current and up to date.

j. The Contractor shall provide system, training, and user documentation for each application and upgrades/updates in a format editable by the Government.

k. The Contractor shall provide information on each section/tab to indicate the source of the information and attributes of the information displayed.

l. Failure, on the part of the Contractor, to provide service as identified may result in the suspension of contract.

V. Suggested Vendor:

Sovereign Technology Solutions, LLC

VI. Period of Performance:

The period of performance shall be one year from beginning date, with 2 yearly option years thereafter.

VII. Contractor Qualification Requirements:

The Contractor is responsible for providing personnel with the necessary level of expertise to support the task activities and requirements in this SOW. The Contractor shall provide a single point of contact that shall serve as the project manager for the life of the contract.

VIII. Special Terms and Conditions:

Commercial Computer Software License:

(a) Notwithstanding any contrary provisions contained in the Contractor’s standard commercial license or lease agreement, the Contractor agrees that the Government will have the rights that are set forth in paragraph (b) of this clause to use, duplicate or disclose any commercial computer software delivered under this contract. The terms and provisions of this contract shall comply with Federal laws and the Federal Acquisition Regulation.

(b)

(1) The commercial computer software delivered under this contract may not be used, reproduced, or disclosed by the Government except as provided in paragraph (b)(2) of this clause or as expressly stated otherwise in this contract.

(2) The commercial computer software may be—

(i) Used or copied for use with the computer(s) for which it was acquired, including use at any Government installation to which the computer(s) may be transferred;

(ii) Used or copied for use with a backup computer if any computer for which it was acquired is inoperative;

(iii) Reproduced for safekeeping (archives) or backup purposes;

(iv) Modified, adapted, or combined with other computer software, provided that the modified, adapted, or combined portions of the derivative software incorporating any of the delivered, commercial computer software shall be subject to same restrictions set forth in this contract;

(v) Disclosed to and reproduced for use by support service Contractors or their subcontractors, subject to the same restrictions set forth in this contract;

(vi) Used or copied for use with a replacement computer; and

(vii) Be accessible via network and licensed for use by any number of concurrent users.

(3) If the commercial computer software is otherwise available without disclosure restrictions, the Contractor licenses it to the Government without disclosure restrictions.

(c) The Contractor shall affix a notice substantially as follows to any commercial computer software delivered under this contract:

Notice--Notwithstanding any other lease or license agreement that may pertain to, or accompany the delivery of, this computer software, the rights of the Government regarding its use, reproduction and disclosure are as set forth in Government Contract No. ________________.

(d) The Contractor shall not, without the written approval of the Contracting Officer, incorporate any copyrighted data in the data to be delivered under this contract unless the Contractor is the copyright owner or has obtained for the Government the license rights necessary to perfect a license or licenses in the deliverable data within the defined scope of work.

Section 508 Program Need Requirements for accessibility based on Section 508 of the Rehabilitation Act of 1973 (29 U.S.C. 794d) are determined to be relevant for the following program need: "Application/Operating System Software."

Section 508 Product Requirements Technical standards from 36 CFR part 1194 Subpart B have been determined to apply to this acquisition. Solicitation respondents must describe how their proposed Electronic and Information Technology (EIT) deliverables meet at least those technical provisions identified as applicable in the attached Government Product/Service Accessibility Template (GPAT).

Functional performance criteria from 36 CFR part 1194 Subpart C have been determined to apply to this acquisition. Solicitation respondents must describe how their proposed Electronic and Information Technology (EIT) deliverables meet at least those functional performance criteria identified as applicable in the attached Government Product/Service Accessibility Template (GPAT).

Information, documentation, and support requirements from 36 CFR part 1194 Subpart D have been determined to apply to this acquisition. Solicitation respondents must describe how the information, documentation, and support proposed for Electronic and Information Technology (EIT) deliverables meet at least those information, documentation, and support requirements identified as applicable in the attached Government Product/Service Accessibility Template (GPAT).

Section 508 Evaluation Factors Responses to this solicitation will only be considered for award after it has been determined that the proposal adequately addresses the requirements for Section 508. Only proposals which contain adequate information to document their responsiveness to the Section 508 requirements (e.g. a completed GPAT, VPAT or equivalent and supporting documentation) will be eligible for any additional merit consideration.

Section 508 Acceptance Criteria Software Application delivered as a result of this solicitation will be accepted based in part on satisfaction of identified Section 508 requirements for accessibility. Application/Operating System Software delivered must include a completed GPAT, a sample of which is included as a part of this solicitation.

IX.

X. Schedule of Work:

To be determined by vendor according to each as agreed upon by vendor and Contracting Officer.

XI. Rates of Payment:

Contracted rates shall be established as an all-inclusive monthly fee that includes all enhancement/development requests and ongoing maintenance. Payment shall be made upon successful completion of each month and shall be invoiced on a totaled, completed service submitted to as identified in sections IX of this Statement of Work.

XII. Indemnity and Insurance:

The government assumes no responsibility of negligent acts of the Contractor. Therefore, the Contractor is responsible for personal insurance if the Contractor indicates that it is necessary. The Contractor will hold harmless and indemnify the government against any or all loss, cost, damage, claims, expense or liability whatsoever as a result from the performance of the Contractor. The Contractor will hold the Federal Government and its agents including the Clinical Director and the Governing Body immune from civil or professional liability for all acts related to quality care management and enforcement of this contract.

XIII. Government Furnished Information, Property and Services:

The government shall provide user access via VPN to site-specific RPMS databases and non-RPMS software access as required to complete the requirements contained within this scope.

XIV. Invoicing Requirements

a. The Contractor shall be required to provide an original invoice to Oklahoma City Area Indian Health Service, Division of Financial Management, 701 Market Center Drive, OKC, 73114.

b. Each invoice shall include the following information:

i. Contractor’s name and invoice date.

ii. Contract number or authorization for delivery of services.

iii. Description, price and quantity of services actually rendered.

iv. Name, title, phone number, and complete mailing address of official to whom payment is to be sent.

c. Invoice shall be submitted upon successful completion of the development and implementation phase and no later than ten (10) calendar days following last calendar day of the month for the maintenance phase.

XV. Applicable Documents

Joint Commission http://jointcommission.org

IHS RPMS http://www.ihs.gov/RPMS/

Health Insurance Portability and Accountability Act (HIPPA) of 1996 http://www.hhs.gov/ocr/hippa

Privacy Act of 1974 http://www.access.gpo.gov/nara/cfr/waisidx

Indian Health Service (IHS) Information Technology and Records Security and Safeguard Policies http://home.ihs.gov/ITSC-CIO/security/index.asp

Electronic Health Records (EHR) Incentive Programs (Meaningful Use): https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/EHRIncentivePrograms

System for Award Management (SAM) http://www.sam.gov

XVI. Definitions

Contracting Officer (CO) A Government employee authorized and warranted to issue contracts and to make subsequent modification(s). The CO has full authority to make determination on all changes and disputes regarding the contract.

Contractor – The individuals as well as organizations awarded a legal binding contract to provide colonoscopy services and professional consultation services.

Credentialing – The process of verifying provider licensure training and education.

Customer Evaluation – Written comments made to the CO regarding the contractor’s performance. This is one of the criteria used to monitor the contractor’s performance.

Federal Acquisition Regulations (FAR) – The FAR is the primary regulation for use by all Federal Executive agencies in their acquisition of supplies and services with appropriated funds.

Past Performance Information – Information entered into National Institute of Health (NIH) database regarding contractor’s actions under this contract. This includes the contractor’s record of conformance to specifications and to standards of good workmanship; the contractor’s record of containing and forecasting costs on any previously performed cost reimbursable contracts, the contractor’s adherence to contract schedules, including the administrative aspect of performance; the contractor’s history for reasonable and cooperative behavior and commitment to customer satisfaction, and generally, the contractor’s business-like concern for the interest of the customer.

Contracting Officers Representative (COR) – A Government employee who assists the CO in the administration of task orders issued under the contract. The COR is primarily responsible for the day to day program management of ordering activity’s task orders.

Computer Software Means:

a. Computer programs that comprise a series of instructions, rules, routines, or statements, regardless of the media in which recorded that allow or cause a computer to perform a specific operation or series of operations; and

b. Recorded information comprising source code listings, design details, algorithms, processes, flow charts, formulas, and related material that would enable the computer program to be produced, created, or compiled.

OCA RPMS Graphical User Interface SOW