Teleradiology Services Statement of Work.docx

STATEMENT OF WORK PORTLAND AREA INDIAN HEALTH SERVICE

TELERADIOLOGY SERVICES

C-1 PURPOSE OF CONTRACT

The Portland Area Indian Health Service (PAIHS) has a requirement for Teleradiology interpretation services for Indian Health Service facilities. To meet this requirement, the PAIHS requires Virtual Radiologic Professionals of Texas, P.A., (VRPTX), hence known as Contractor, in conjunction with its management partner, Virtual Radiologic Corporation (VRC) support to assist in the interpretation of medical images for X-ray.

IHS facilities provide medical services 8 hours per day, 5 days per week. The purpose of the contract is for the interpretation of electronic images. The Contractor shall furnish the necessary personnel, supplies, materials, and equipment to perform this contract.

C-2 PROFESSIONAL QUALIFICATIONS

Each Physician providing Interpretations under this Agreement shall be:

A. English-Speaking B. Certified by the American Board of Radiology or American Osteopathic Board of Radiology C. Qualified and licensed to practice medicine in the state(s) where the Institutions are located and D. Eligible to participate in the Medicare or Medicaid programs.

C-3 INTERPRETATION REQUIREMENTS

All interpretations, whether preliminary or final, shall be performed on monitors subject to the quality assurance progran1 referenced in C-6.

A. Standard report turnaround time shall be as specified in section C-8, following receipt of electronic images Monday through Friday during regular business hours, i.e., 8:00 A.M. to 5:00 P.M. (Pacific Time).

Reporting Time - Preliminary Interpretations. Estimated Reporting Time for Preliminary Interpretations during the Coverage Periods ordinarily will not exceed 30 minutes, and usually will be less than 30 minutes. If no fax or printed report has arrived within forty five minutes, PAOIHS shall access Contractor's RIS for results or call Contractor to inquire about the status for the requested Interpretation.

All interpretations with critical findings require the Contractor to telephone the requesting clinician and verbally report the study interpretation.

B. Except for interpretations where only hard copy film is available (for primary interpretations or prior study comparisons), the Contractor shall utilize soft copy digital image interpretation. Soft copy is electronic image used for interpretation while hard copy is film processed from computerized image or digitized from x-ray film.

Interpretive reports shall be provided electronically via HL7 format for all participating facilities capable of transmitting study information/receiving study reports in HL 7 format. Reports should also be available via secure facsimile transmission, in the event of problems with electronic transmission or for sending facilities not yet capable of transmitting study information/receiving study reports in HL 7 format.

C. The Contractor shall provide immediate telephone consultation with ordering clinicians requesting it. Contractor shall make telephone contact with the ordering facility to report any critical findings, which will be documented on the report.

D. The Contractor shall have the capability to both receive study order infom1ation and send study report information in HL7 format. For those sending facilities not yet able to send and receive radiology study information in HL7 format, the Contractor Repmi Form shall specify the following information: Reports must be on official Contractor letterhead and specify the physician(s) who perfom1ed the read, the required patient demographics and in accordance with Standard Form 519A: Radiologic Consultation Request/Report Form or equivalent format. The demographics shall include complete patient name; date of Birth, Patient ID number, Type of Study, Accession number, SSN, Reason for request, Date of Examination, and Date of request.

C-4 QUALITY ASSURANCE (QA)

The Contractor shall perform quarterly QA peer review on interpretations from electronic images. A minimum of 20 reports (total) pulled randomly from the facilities covered by this requirement per quarter must have "blinded over-readings" performed as part of the Contractor's quality assurance program. Discordant interpretations must be graded as to their clinical significance (agree, disagree-insignificant, disagree-significant).

In addition, a log quantifying discrepancy rates between preliminary vs. final interpretations must be maintained and reported as part of the quarter quality control report. This log should likewise assess discordant interpretations as to their clinical significance (agree, disagree-insignificant, disagree-significant).

C-5 CUSTOMER SERVICE ASSISTANCE

The Contractor shall provide a customer representative to assist IHS staff with billing or insurance questions during regular business hours 8:00 A.M. to 5:00 P.M. Monday through Friday (Pacific Time). Contractor will maintain an 800 numbers or equivalent telephone service 24 hours per day with an answering service or recording machine.

C-6 COMMUNICATION NETWORK INTERFACE/REQUIREMENTS

Contractor shall interface with Government furnished VistA Imaging/PACS (Picture Archiving and Communication System) communications platforrn(s) at participating IHS facility sites.

Equipment and Protocols:

Equipment and Software. Portland Area Office shall maintain DICOM programming and infrastructure appropriate to transmit orders and images to Contractor's servers including:

A. A broadband internet connection (minimum of Tl, business-type cable or business type digital subscriber line) B. Computer terminals to send orders and images to Contractor's secure server through HIPAA-compliant encrypted communications. Contractor shall only be obligated to provide Services if Portland Area Office's and Institutions' equipment, com1ections and software are in good working order and are HIPAA-compliant.

Encrypted Bridge. Contractor will create and configure, with Portland Area Office's cooperation an encrypted network connection (Virtual Private Network or comparable encrypted connection, each a "VPN") for each Portland Area Office to transmit radiology images to contractor. Contractor will provide all necessary technical support for the VPN (excepting Portland Area Office equipment) upon request to Contractor's call center.

Local Technical Support. Portland Area Office shall obtain as required any technical assistance or maintenance relating to equipment and software located at its premises. If Portland Area Office is unable to provide or arrange for such support, Contractor may agree to provide such support to Portland Area Office at standard industry rates for critical systems emergency support.

Contractor-Provided Equipment. If Contractor provides Portland Area Office with any Contractor-owned equipment or software it will be listed on an addendun1 attached to this Agreement or added by amendment.

The Contractor must utilize a DICOM Tele-radiology System/PACS that is compliant and compatible with the Portland Area IHS VistA/DICOM Imaging Network. The Contractor must specify acceptable compression ratio for a given study, before the contract is awarded.

Computer monitors utilized by the Contractor for purposes of radiology study interpretation must be calibrated at least quarterly, or in a fashion consistent with proper quality control procedures at the reading site.

The Contractor must also:

· Provide equipment quality control policies and certifications to the contact person, Mr. Steven Poitra, identified by the Portland Area !HS, upon request.

· Utilize acquisition equipment that is DICOM 3.0 part 10 compliant, and is current with ACR/NEMA Image data format.

· Establish local network firewalls and procedures to ensure patient confidentiality and security consistent with HIPAA (Health Insurance Portability and Accountability Act of 1996) regulations, and ACR (American College of Radiology) Guidelines.

C-7 PERFORMANCE PERIOD

Contract shall begin on or about July 1, 2020 through December 31, 2020.

C-8 VOLUME OF MEDICAL IMAGING EXAMINATIONS PER YEAR BY

CATEGORY AND REPORTING TIMEFRAMES

The following totals are estimated for radiographic exams (Studies). Multiple films for standard radiographic exam procedures will be forwarded to the Contractor for interpretation. Workload may vary depending upon the number of IHS facilities utilization if the service.

A. Routine Radiographic Exams(Studies) 9,460/year

1. Includes chest, abdominal, extremity, etc.

2. Exams to be sent to Contractor 24 hours per day, seven days a week.

B. Emergent Official Interpretation 5/week Monday through Friday, 8:00 AM to 5:00 PM

1. Includes chest, extremity etc. but also will include C-Spines series and others, as indicated.

Reporting Time - Preliminary Interpretations. Estimated Reporting Time for Preliminary Interpretations during the Coverage Periods ordinarily will not exceed 30 minutes, and usually will be less than 30 minutes. If no fax or p1inted report has arrived within forty five minutes, Portland Area facilities shall access Contractor's RIS for results or call Contractor to inquire about the status for the requested Interpretation.

Reporting Time Defined. Reporting Time means the interval between the later of:

A. The time facility correctly validates an order delivered to Contractor or B. The time all images (inclnding prior radiologic examinations as appropriate) and clinical histories associated with the order have been delivered to Contractor's PACS server, and

C. The time Contractor makes its report accessible to the facility by posting it on Contractor's RIS.

Contractor will concurrently fax the Report to the facility. Reporting Time specifically excludes:

A. Time necessary for Service to correctly validate orders and B. Time required to transmit images to Contractor.

Reporting Time shall be conclusively determined from the automated time entries in Contractor's RIS tele-radiology information systems.

The following information is supplemental estimated workload information provided by each participating IHS Service unit. Single sending facilities exist in most Service Units. It is not expected that all the workload below would be transmitted to the Contractor and should not be interpreted by the Contractor as definitive numbers to use for initial price quotes. Additional Indian Health Service facilities not listed below may request participation in this contract during the course of the contract. However, subject of prior approval by a Contractor Officer is required, so that systems and staffing are adjusted appropriately prior to desired start date of any new facilities.

"Study" means an Interpretation of a set of images for the smallest body segment that has a designated AMA Current Procedural Terminology (CPT) Code.

Examples of Studies

ABDOMEN 1 VIEW

ABDOMEN FLAT AND UPRIGHT ABDOMEN MIN 3 VIEWS+CHEST ACROMIOCLAVICULAR J BILAT ANKLE 2 VIEWS

ANKLE 3 OR MORE VIEWS

CALCANEOUS 2VIEWS

CHEST 2 VIEWS PA&LAT

CHEST SINGLE VIEW CLAVICLE

ELBOW 2 VIEWS

ELBOW 3 OR MORE VIEWS

FACIAL BONES COMPLETE, MINIMUM 3 VIEWS FEMUR 2 VIEWS

FINGER(S) 2 OR MORE VIEWS FOOT 3 OR MORE VIEWS FOREARM 2 VIEWS

HAND 3 OR MORE VIEWS

HANDS & WRISTS PA FOR ARTHRITIS HIP WITH PELVIS

HIPS BILATERAL 4 OR MORE VIEWS

HUMERUS 2 OR MORE VIEWS KNEE 4 OR MORE VIEWS NASAL BONES MIN 3 VIEWS NECK SOFT TISSUE

PELVIS 1 VIEW

RIBS UNILAT+CHEST 3 OR MORE VIEWS SCAPULA

SHOULDER 2 OR MORE VIEWS

SINUSES 3 OR MORE VIEWS SKULL 4 OR MORE VIEWS SPINE CERVICAL MIN 4 VIEWS

SPINE LUMBOSACRAL MIN 4 VIEWS SPINE SACRUM & COCCYX MIN 2 VIEWS SPINE THORACIC AP&LAT&SWIM VIEWS STERNUM 2 OR MORE VIEWS

TIBIA & FIBULA 2 VIEWS TOE(S) 2 OR MORE VIEWS WRIST 2 VIEWS

WRIST 3 OR MORE VIEWS

Portland Area Office Emergency Contact List for Virtual Radiology

Yakama contacts:

TBD

Colville contacts:

TBD

Wellpinit contacts:

TBD