Statement of Work ePCR.pdf

Statement of Work

Cloud Based Electronic Patient Care Report for Pre-Hospital Emergency Medical Services

C.1. GENERAL. Fort Sill Pre-Hospital Emergency Medical Services (EMS) provides EMS coverage of 94,000 acres for Fort Sill, Oklahoma. Fort Sill is located adjacent to Lawton, OK and 90 miles from Oklahoma City, Oklahoma. The contingency response to all emergencies is support by 2 Advance Life Support Ambulances.

C.1.1 PURPOSE. Contractor shall provide Fort Sill PHEMS with a charting solution that offers dynamic electronic data collection and management solutions for emergency medical services. It provides mobile access to web-based applications at a low cost and no additional hardware or software expenses. The suite enables rapid data acquisition and dissemination to external organizations and third-party software through various interfaces. While pre-hospital information management focuses on medical records, emergency care providers have broader needs. The charting application should create an intranet dedicated to improving the organization's information management.

Medical Records should be designed from a clinical perspective. This module should provide complete electronic charting capabilities to eliminate Patient Care Record (PCR) errors and maintain pertinent information. The Medical Record module should include the following features:

• Streamlined data entry with dialog and drop-down menus

• Clinically driven system design to mirror patient care

• Flexible user-defined system configuration

• Instant access to information for improved patient healthcare

• Customized data elements to meet service's specific needs

• Electronic exports of PCR to the state level

• HIPAA compliance with quality assurance locks and security privileges

• Minimal redundant data entry for time savings and consistency

• Detailed activity logs documenting patient care

• Form letter templates for Medicare, reporting, and customer support purposes

• Supply tracking for improved inventory control

• Infinite reporting capabilities with text and graphic presentations

• Built-in PCR audit process for improved quality control

Quality Assurance should be designed to provide an audit trail for monitoring all aspects of critical care and emergency transport services.

• Custom QA process for controlling and monitoring PCR

• Real-time chart review for improved patient care

• Real-time procedure monitoring of employee performance

• Comprehensive reporting for QA program

• Real-time risk management reporting, tracking, and event trends

Chart Summaries should display information from patient demographics and chart data to assist in the reimbursement process.

• Export information to external billing package or third-party service to eliminate redundant data entry

• Provide Utilization Reviews to ensure sufficient documentation has been completed

• Collaborate with supply tracking for inventory demands and costs

It should improve communications between management, employees, peers, and volunteers.

• Message board provides a forum for message postings and replies

• Special Reports keep everyone informed of incidents and events

• Calendar provides space to schedule events and meetings

• Phone message area allows for electronic message taking

• Links area shares outside resources in one central location

The hosted faxing should provide the following features:

• Automatic fax of patient record upon chart closure

• Pre-configured destinations based on the call type

• Manual transmission of patient record to any fax number upon request

• Email notification for successful and/or unsuccessful fax attempts

• Access to a fax log showing successful and unsuccessful faxes

• Optional inclusion of chart attachments

• Self-hosted solution available for larger volume agencies

The charting PCR Archiving / Database Export should allow scheduled downloads of data in Microsoft Access and/or PDF format. It should store data on servers in an easily accessible format, while providing peace of mind that all data is duplicated and locally stored at your location. Agencies can use MS Access formatted data to run supplemental reports out of Access if desired.

The charting service online EKG interface should import vital sign data, wave forms, and events from the monitor directly into the patient record, reducing data entry time and streamlining the process.

EKG Import Features:

• Import trended vitals and event markers into the patient record

• Attach wave forms electronically to the ePCR

• Allow modification, update, or removal of imported data

• Import Zoll X series through a case review account with Zoll

Crew Scheduling, Credential Awareness, and Mass Notification Features Pre-Hospital Emergency Medical Services provides 24-hour emergency medical coverage every day of the year. Due to human employees' nature, there may be vacancies and last-minute shortages of personnel. It is also necessary to maintain certain certifications and training schedules. The scheduler should be reliable, industry-proven, and user-friendly, ensuring dependability for all staff needs.

• Improve efficiency

• Minimize overtime with Best Fit scheduling

• Robust certification management

• Communications tools provide informed staff with bulletin board messaging, text messaging, and email.

Health Level Seven (HL7) is a standard for the exchange, management, and integration of electronic healthcare information. The HL7 format can be used to develop custom interfaces with many hospitals electronic medical record (EMR) systems to exchange electronic data between the ePCR and the hospital record. Charting accepts an HL7 feed to import Admit, Discharge, and Transfer (ADT) data back into the patient’s medical record, thereby replacing the practice of crews waiting for a face sheet from the ER registrars. The feed automatically updates prehospital medical records with the receiving hospital's Medical Record Number and Account Number.

HL7 Interface Features

• Creates a secure connection to auto-populate hospital electronic medical record (EMR) software (unidirectional flow) and charting software (bi-directional flow).

• Accepts an HL7 feed to import Admit, Discharge, and Transfer (ADT) data back into the patient’s medical record, thus replacing the practice of crews waiting for a face sheet from the ER registrars.

• Outbound feed: Exports ePCR data to hospital EMR in real-time, securely, and encrypted.

NEMSIS Features

• NEMSIS Gold Compliant.

• Allows agencies to customize their data set while maintaining NEMSIS Compliance.

• Ability to show or hide certain fields to comply with local and/or regional requirements.

• Automatically generates NEMSIS data at the completion of every chart.

Validates records during export and tests against the NEMSIS XSD templates

Charting should deploy the NEMSIS data set with agency customization while maintaining a single source database. It should offer levels of access for local customization, such as quality assurance and incident reporting. For instance, seaside New Jersey counties may have distinct injury patterns compared to inland areas. Regions can create their own values and report them back to NEMSIS, combining control with user satisfaction and maintaining a clean data dictionary. This creates an efficient platform for reporting to state departments like information technology and licensure.

State data exporting ability is included at no extra cost. Exports are available as ASCII files, XML documents, and Comma Delimited Files, with some configurations allowing automatic exports to state regulatory agencies.

State Export Features:

• Included at no additional cost.

• Export file generated with a button click.

• Automatic data transfer where available.

45 CFR Part 142: Security and Electronic Signature Standards The Charting application should function as a central repository for Protected Health Information (PHI) and facilitate access through a web-based interface. Customers often express concerns regarding HIPAA compliance, particularly in relation to the Internet and remotely located databases. Part 142 specifies security measures that must be implemented, including Administrative Processes, Physical Safeguards, Technical Security

Services, and Technical Mechanisms. The charting application should have instituted sufficient safeguards to ensure compliance with all provisions of 45 CFR Part 142.

45 CFR Parts 160 and 164: Standards for Privacy of Individually Identifiable Health Information Parts 160 and 164 primarily address the creation of administrative policies and procedures for the Covered Entity. To support this process, the charting application's suite of products should include features such as:

• Access Audit Trail

• Tracking of Notice of Privacy Practices (including updates)

• Role-based security access

• Data maintenance and disaster recovery

• Policy and Procedures online

• Online seminars - services can provide HIPAA training seminars for both initial and ongoing education.

The FY23 National Defense Authorization Act (NDAA) mandates that all cloud services comply with the Federal Risk and Authorization Management Program (FedRAMP).

Established in 2011, FedRAMP offers a cost-effective, risk-based framework for federal cloud service adoption. The Act designates FedRAMP as the standard method for security assessment and authorization of cloud computing products handling unclassified federal information.

FedRAMP aims to:

• Reduce duplicative efforts, inconsistencies, and costs.

• Foster public-private partnerships for secure technology innovation.

• Accelerate federal cloud computing adoption with transparent security standards.

• Increase secure cloud technology usage among government agencies.

• Enhance the cloud security authorization framework.

• Strengthen partnerships with FedRAMP stakeholders.

C.1.2. POINT OF CONTACT. The Contractor shall provide the Contracting Officer the name and telephone number of an individual responsible for oversight of the contract. The individual shall have full authority to act for the Contractor. The name and telephone number shall be provided to the Contracting Officer within 10 days after contract award.

C.1.2.1. HOURS OF COVERAGE. The Contractor's point of contact shall provide technical telephone support and remote diagnostics (if remote diagnostics is available for the equipment) 24 hours a day, 7 days a week. The Contractor shall furnish fully qualified back-up personnel to provide coverage during scheduled and unscheduled absences of their primary personnel.

Contractor will provide a reasonable amount of clinical applications support Monday – Friday, 8:00AM to 5:00PM central standard time, excluding Contractor holidays, by telephone in response to inquiries by Customer personnel that have been trained by Contractor to properly use the software and/or hardware (if clinical applications support is available for such software and/or hardware).

Contractor will provide on-site service if the service issue cannot be resolved remotely, as determined by Contractor Technical Support.

C.1.2.2. RESPONSE. The Contractor's point of contact shall/will provide technical telephone support and remote diagnostics (if remote diagnostics is available for the equipment) 24 hours a day, 7 days a week. The Contractor shall furnish fully qualified back-up personnel to provide coverage during scheduled and unscheduled absences of their primary personnel.

Contractor will provide a reasonable amount of clinical applications support Monday – Friday, 8:00AM to 5:00PM central standard time, excluding Contractor holidays, by telephone in response to inquiries by Customer personnel that have been trained by Contractor to properly use the software and/or hardware (if clinical applications support is available for such software and/or hardware).

Contractor will provide on-site service if the service issue cannot be resolved remotely, as determined by Contractor Technical Support.

C.1.3. SUPERVISION. The Contractor shall provide services in accordance with US Army Medical Activity Fort Sill and PHEMS directives and policies. This is a non-personnel contract; however, contract personnel are subject to direction from the Chief, Pre- Hospital Emergency Medical Services or his/her representative.

C.1.4. QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT. Contractor shall be responsible for compliance with all procedures in accordance with applicable US Army Medical Activity Fort Sill and PHEMS written policies, procedures and regulations. Contract personnel shall not introduce new services without prior approval from the Contracting Officer and US Army Medical Activity Fort Sill Commander. All standards shall be practiced and met or exceeded during the performance of this contract.

C.1.5. SOFTWARE/APPLICATION UPDATES AN UPGRADES. Contractor will provide software/application updates and consist of any error correction or modification that maintains existing software features and functionality and are made generally available to Contractor’s customer installed base.

Software/Application upgrades are included and consist of any revisions or enhancements of the software by Contractor that improves or expands existing software features or functionality that are made generally available to Contractor’s customer installed base.

Software/Application updates and upgrades will be installed between Monday - Friday, 8:00AM-5:00PM local site time.

Software/Application updates and upgrades do not include any separately licensed software modules, which provide additional functionality relating to an application or feature for the hardware or software.

Additional hardware and/or software (including upgrades to 3rd party software, such as operating system software) required for the software updates are excluded. Customer is responsible for the cost of such additional hardware and/or software updates, upgrades and such other changes (including training, project management and integration services) as may be necessary to support the software updates and/or upgrades.

C.1.6. DATABASE MAINTENANCE. Contractor will not be responsible for providing system database maintenance for Customer. All activities related to system database maintenance, including backup, database administration activities such as, adding new users and privileges, updating list, and data integrity, are the responsibility of Customer.

C.1.7. CUSTOMER REQUIREMENTS. Customer is required to always remain within at least two (2) versions or releases of the most current version or release of the software/application during the term of this SSA.

Customer will designate a Customer employee (and an alternate employee in case the first is unavailable) to act as Customer’s equipment administrator. Such employees will have the necessary technical knowledge and expertise to reasonably assist Contractor technical personnel in performing service.

Customer will provide Contractor with access via a connection validated by Contractor for the product such as an internet connection, VPN persistent access, or other secure remote access reasonably requested by Contractor to permit Contractor to perform support services and meet service levels, including remote diagnostic, monitoring and repair services.

If Customer does not permit Contractor to connect via a connection validated by Contractor for the product, and the Contractor field engineer must therefore be dispatched to the Customer site, then the Customer will pay Contractor at Contractor’s then current hourly service rates in accordance with Contractor’s policies, at the reduced contract rate.

Unless Customer specifically requests in writing that Contractor disable the remote connection, the remote connection will continue to connect to Customer products following expiration of any applicable product warranty or service contract. For products not covered by a current warranty or service contract, Contractor disclaims any obligation to monitor such products via a remote connection or advise Customer of any possible product error or malfunction.

C.1.8. BILLING. Contractor will bill quarterly or annually in equal installments for the use and maintenance of the electronic patient care report (ePCR) software/application.

C.1.9. TRAINING AND CERTIFICATION. Contractor or contractor representative shall be fully trained and certified on all equipment provided by the company.

All contractor employees, to include subcontractor employees, requiring access Army installations, facilities and controlled access areas shall complete AT Level I awareness training within 30 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. The contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee, to the COR or to the contracting officer, if a COR is not assigned, within 30 calendar days after completion of training by all employees and subcontractor personnel. AT level I awareness training is available at the following website: http://jko.jten.mil

The contractor and all associated sub-contractors shall brief all employees on the local iWATCH program (training standards provided by the requiring activity ATO).

This local developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR. This training shall be completed within 30 calendar days of contract award and within 45 calendar days of new employees commencing performance with the results reported to the COR NLT 45 calendar days after contract award.

All Contractor employees with access to a Government info system must be http://jko.jten.mil/ registered in the ATCTS (Army Training Certification Tracking System) at commencement of services and must successfully complete the DOD Information Assurance Awareness for information assurance (IA)/information technology (IT) certification. Per DoD 8570.01-M, DFARS 252.239.7001 and AR 25-2, the Contractor employees supporting IA/IT functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DoD 8570.01-M must be completed upon contract award prior to access to the information systems and then annually thereafter.

C.1.10. WARRANTY. If the Contractors software/application fails to perform substantially in accordance with the applicable licensed software documentation (as defined herein) (“errors”), then the Contractor will use commercially reasonable efforts to fix such errors within a reasonable period of time after notification by Customer or detection by Contractor, provided such errors are verifiable and reproducible. “Licensed software documentation” means the Contractor user manuals, on-line help functions, technical specifications and user instructions regarding the operation, installation and use of the software as made available by Contractor to Customer. Contractor may provide correction of an error by means of a “temporary fix” consisting of sufficient programming and operating instructions to implement such error correction that causes the software to perform substantially in accordance with the applicable licensed software documentation, and Contractor may include such error correction or an equivalent in updates or upgrades of the software.

C.1.11. ACCESS, GENERAL PROTECTION, AND SECURITY POLICY AND PROCEDURES.

This standard language text is for contractor employees with an area of performance within an Army controlled installation, facility, or area. Contractor and all associated sub-contractors’ employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. Contractor workforce must comply with all personal identity verification requirements (FAR clause 52.204-9, Personal Identity Verification of Contractor Personnel) as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

Contractor and all associated sub-contractors employees shall comply with adjudication standards and procedures using the National Crime Information Center Interstate Identification Index (NCIC-III) and Terrorist Screening Database (TSDB) (Army Directive 2014-05/AR 190-13), applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government representative), or, at OCONUS locations, in accordance with status of forces agreements and other theater regulations.