SOLICITATION NOTICE
B -- Community of Practice for Local Health Information Infrastructures
- Notice Date
- 5/5/2004
- Notice Type
- Solicitation Notice
- NAICS
- 541690
— Other Scientific and Technical Consulting Services
- Contracting Office
- Department of Health and Human Services, Program Support Center, Division of Acquisition Management, Parklawn Building Room 5-101 5600 Fishers Lane, Rockville, MD, 20857
- ZIP Code
- 20857
- Solicitation Number
- 04EASPE000851
- Response Due
- 5/20/2004
- Point of Contact
- Kevin McGowan, Contract Specialist, Phone 301-443-0708, Fax 301-443-3238, - Joe Pirrone, Contracting Officer, Phone 301-443-4852, Fax 301-443-3238,
- E-Mail Address
-
kmcgowan@psc.gov, jpirrone@psc.gov
- Description
- Requirement 04A104031 SECTION C - DESCRIPTION/SPECIFICATION/WORKSTATEMENT C.1. TITLE Community of Practice for Local Health Information Infrastructures C.2. BACKGROUND The National Health Information Infrastructure (NHII) is envisioned as the technologies, standards, laws, policies, programs and practices that enable health information to be appropriately and safely shared among health decision-makers, including consumers and patients, to promote improvements in health and healthcare. The development of a vision for the NHII began more than a decade ago when an Institute of Medicine report, (The Computer-Based Patient Record), investigated computerized patient records and concluded ?a major coordinated national effort with federal funding and strong advisory support from private sector is needed to accelerate the pace of change in the United States.? A recent report from the National Committee on Vital and Health Statistics (NCVHS), entitled Information for Health: A Strategy for Building the National Health Information Infrastructure (http://ncvhs.hhs.gov/nhiilayo.pdf), reaffirmed the importance of the NHII. The path to a national network of healthcare information is through the development and networking of local initiatives linking health data sources with users. Such local systems are called Local Health Information Infrastructures (LHII). The widely acknowledged lack of coordination and communication among United States healthcare programs and health data systems result in services that are not well integrated or coordinated. Poorly integrated services result in: delays in delivery and inadequate care; an increase of morbidity, mortality, and disability; and attendant healthcare costs to the family and individual (The Institute of Medicine, To Err is Human, 1999 [http://www.iom.edu/includes/dbfile.asp?id=4117] and Crossing the Quality Chasm 2001 [http://www.iom.edu/includes/dbfile.asp?id=4124]). Past attempts to develop integrated health care data systems were limited by management and procedural issues. Lorenzi in Strategies for Creating Successful Local Health Information Infrastructure Initiatives December, 2003 (http://aspe.hhs.gov/sp/nhii/LHII-Lorenzi-12.16.03.pdf) identifies barriers that caused early LHIIs to stumble. She says, ?The earlier health information sharing experiment was called, Community Health Information Network (CHIN). Nearly all failed. CHINs were an intellectually supported ?concept?, but were not fully conceptualized at the implementation level. Most efforts were disbanded because of organizational barriers to their success, that is: 1. Buy-in because of conflicting missions and poorly conceived objectives 2. Perceived loss of control and lack of trust in the process. 3. Lack of clear ownership over data systems and information. 4. Lack of clarity about how a CHIN would be financed. 5. Less sophisticated technology along with the perceived need for a centralized community-based data repository.? Detmer also has considered healthcare data integration and notes several hurdles to the development of integrated health information systems (Detmer D. It is about health: securing a National Health Information Infrastructure in The National Quality Forum, Information Technology and Healthcare 2003 [http://www.qualityforum.org/txITSummitFINALPUBLICprint.pdf ]) Detmer?s bottlenecks are: 1. Technical ? need for standards and multiplicity of vendors; 2. Financial ? the costs of acquiring and operating IT systems; 3. Legal ? ownership of the data and fraud and abuse rules that hamper collaboration; 4. Cultural and organizational ? resistance to change; 5. Personnel ? trained manpower; 6. Leadership ? need for strong visionary leadership. Despite these difficulties healthcare data integration is a burgeoning issue. To envision an LHII or the NHII consider existing large scale information systems; for example the SABRE airline reservations system, commercial inventory management, and banking ATM machines. Such systems provide information where and when needed around the world with privacy and authority. These, however, are single focus networks with limited and specific types of data. Healthcare is multidimensional and exponentially more complex requiring demographic, economic, geographic, physical, laboratory, and image data for use by clinics, pharmacies, hospitals, payers, public health, and consumers. Even now, local networks of health care providers (physicians, hospitals, and ancillary health care workers), public health organizations, payers, employers, insurers, and citizens groups are germinating with the purpose of sharing health care information for effective diagnosis and treatment, improving community health, and mitigating the effects of bioterror and newly emerging infectious disease. These local health information infrastructures are the foundation stones from which the NHII shall rise as a national structure. These nascent LHIIs may be as small as a county immunization registry and as large as a metropolitan area such as Indianapolis enjoys. LHIIs are composed of at least two geographically close institutions with the goal of sharing data; a group practice, even a large PPO or HMO would not be considered an LHII unless it participates in a collaborative data sharing with another local organization. Aware of failures of previous community health networks, those striving to solve this problem have expressed interest in coming together to share knowledge, experiences, and strategies for the creation and sustainability of Local Health Information Infrastructures (LHIIs). A course of action with a track record of success in organizing and managing complex knowledge challenges is to form an interest group in order to collaborate, to share ideas, to discuss best practices, and to synthesize experiences. A generic name for such an organization of similar organizations is a ?community of practice? (CoP). A Community of practice (CoP) is network of people and organizations that share a concern, a set of problems, or a passion about a topic; who work together, usually in a facilitated manner, to improve one another?s knowledge and expertise and to share this knowledge with the broader field of endeavor. Wenger suggests that a Community of Practice will: 1. Provide resolutions to institutionally generated conflicts; 2. Support a community memory that allows individuals to do their work without having to remember everything; 3. Helps newcomers; 4. Generates specific perspectives and terms to enable accomplishing what needs too be done; 5. Makes the job easier. (Wenger EC, Snyder WM. Communities of Practice: the organization frontier. Harvard Business Review 2000). Por suggests that Communities of Practice can: 1. Solve problems; 2. Develop and verify best practices; 3. Upgrade and distribute knowledge in daily use; 4. Foster unexpected ideas and innovations (www.co-i-l.com/coil/knowledge-garden/CoP/thought.shtml). C.3. PURPOSE The purpose of this project is to develop a CoP for LHIIs, and to use the CoP to energize the development of LHIIs nationally. The contractor will over the course of three years undertake a two stage process. They will define and develop a CoP for LHIIs and will then use this CoP for LHIIs to facilitate the development of LHIIs. The contractor will define in specific terms how community of practice concepts translate into specific activities or a ?model of practice? for local health information infrastructure projects. The contractor will develop a framework (i.e., set of steps and activities) necessary for establishing a ?Community of practice? for LHIIs. This framework may use and build on existing CoP and LHII knowledge. The contractor will formulate a framework for action that will guide the formation, growth and continued operation of a LHII community of practice. The contractor will identify and prioritize problems to be addressed and assess the most effective means for involving health care stakeholders relevant to LHII. The contractor will identify a process that leads to formation, operation and maintenance of a community of practice that produces tangible knowledge products (e.g., lessons learned, best practices, templates supporting key practices, etc.) and makes them available to others. LHIIs will benefit from participating the CoP. They will have the opportunity at first hand to understand and participate in the nine key elements critical to success for an IT integration project. These elements are: leadership, project governance, project management, stakeholder involvement, organizational and technical strategy, technical support and coordination, financial support and management, policy support, and evaluation (Public Health Informatics Institute. Integration of Newborn Screening and Genetic Service Systems with Other Maternal & Child Health Systems: A Sourcebook for Planning and Development 2003). These elements directly address many of the root causes of failure noted above. The CoP knowledge exchanges are a tremendous incentive for those involved in LHIIs, with their eye on success, to participate in the CoP. C.4. Work Description: The work will begin by providing a review of community of practice concepts and of local and regional healthcare information systems and their efforts to integrate. The contractor will take note of, build on, and refine work already done in this area including: * Lorenzi N. Strategies for Creating Successful Local Health Information Infrastructure Initiatives December, 2003 * Public Health Informatics Institute. Connections: Creating a Roadmap. 2003 http://www.allkidscount.org/pdfs/CreatingRoadMap.pdf * Public Health Informatics Institute. Integration of Newborn Screening and Genetic Service Systems with Other Maternal & Child Health Systems: A Tool for Assessment and Planning 2003. http://www.allkidscount.org/pdfs/HRSAsourcebook.pdf * Wenger EC, Snyder WM. Communities of Practice: the organization frontier. Harvard Business Review 2000 The outlined tasks and deliverables propose to translate such ongoing work and concepts into a model of practice for local healthcare information integration with agreed upon core elements, functions and performance measures. Year 1 defines the long-range vision for the community of practice. The formulation of the ?model of practice? is a collaborative process with key stakeholders. It includes prioritizing integration steps, establishing preliminary core functions for the integrated system, and drafting potential indicators to measure the performance across systems. The key deliverables for year one are the formation of the CoP with a plan for sustainability and a white paper describing the model of practice for integration. Year 2 (OPTIONAL) expands the conceptual vision from Year 1 to recommendations for transitioning from current practices to the model of practice and the identification and testing of performance indicators for the new model of practice for LHIIs. Deliverables will include stakeholder-supported identified policy and practical issues, core functions, standards, and performance measures summarized in reports. Year 3 (OPTIONAL) will build upon work in the first two years by refining and retesting the performance measures and build a policy case for the adoption of the model of practice for integration. The final deliverable for Year 3 is the required information to assist the policy case for integrating healthcare data and information systems programs with other public health programs and their systems. The information will be presented to NHII/ASPE and other federal, state, and community stakeholders. C.5. TASKS The Contractor shall perform the tasks indicated below. And all deliverables are subject to the review and approval of the NHII GPO. YEAR 1 Year 1 has three significant steps to conceptualize and define a CoP for LHIIs and to begin to use the CoP to define a model of practice for LHIIs. Task 1: Meeting with NHII GPO Task 1.1: Discuss the scope of the task ahead, including but not limited to: goals and objectives, processes, time frames, priorities, budgetary issues, deliverables related to the work to be performed and other related activities of the contractor for the purpose of reviewing, clarifying and confirming the process and outcome expectations of NHII/ASPE. Task 2: Select seven (7) members from Private, Public, and Community Sectors to participate in workgroup to develop the community of practice Task 2.1: In collaboration with NHII GPO, establish criteria to select workgroup members; Task 2.2: Assess progress and status of current LHIIs to identify which ones will participate in the workgroup; Task 2.3: Select expert and key stakeholder partners such as organizational behavior and informatics policy experts, provider and family organizations and public agencies to join workgroup; Task 2.4: Conduct conference call with NHII and workgroup to discuss project and identify workgroup roles and responsibilities; Task 2.5: Identify no more than nine (9) LHII ?partners? who will participate as ?founding members? in the CoP Task 3: Using the CoP begin to define the ?Model of Practice? for integrating local healthcare data and information systems Task 3.1: Bring together workgroup and LHII partners to discuss and define the model of practice for integration of healthcare data and information systems and prioritize integration steps. This shall be a one and one half day meeting in Washington DC as close as possible to the NHII04 meeting, with one hotel night, expenses, and airfare for the 16 workgroup and LHII partners paid by the contract; Task 3.2: Engage in an on-going dialogue with workgroup regarding definition, core functions, and standards of practice for the model. The dialogue shall include site visits to LHIIs as necessary; Task 3.3: Synthesize and Analyze Existing Policies and Recommendations for Integrating Healthcare data and information systems; Task 3.4: Conduct a comparative analysis of selected policies and standards of practice and identify how they support or conflict with each other Task 3.5: In collaboration with the workgroup, draft and disseminate a white paper of no more than 70 pages that describes the problem and issues confronting newborn LHIIs, defines a model of practice for integration, identifies key elements, definitions, core functions for the model, and raises issues that need further attention. YEAR 2 - OPTION The purpose of Year 2 is to further define and operationalize the model and define and pilot test performance measures. Task 2-1: Refinement of core functions and definitions for the model and development of recommendations for transitioning from current practices to the new proposed model of practice. Task 2-1.1: Engage in on-going debate and discussion with workgroup and partners to refine core functions, processes, and information needs for the model of practice; Task 2-1.2: Describe how current LHII model functions and processes support or conflict with proposed model; Task 2-1.3: By means of telephone conference calls and site visits discuss with stakeholder/partners how to transition to the model of practice and how current practices support the model or need to be modified. Task 2-2: Develop performance indicators/measures for model of practice and methodology Task 2-2.1: Conduct a literature review of the existing health performance measures relevant to the proposed model. The review shall be no longer than 50 pages and shall provide a summary section of no more than 20 measures that are necessary to measure the proposed model. Task 2-2.2: Work with selected partners to develop a list of practical and relevant performance measures for the proposed model of practice; Task 2-2.3: Develop validity and reliability measures and tools; Task 2-2.4: Reach consensus on selected set of indicators to pilot test. Task 2-3: Pilot test performance measures/indicators with selected LHIIs. Task 2-3.1: Select LHIIs to participate in pilot test; Task 2-3.2: Develop database; Task 2-3.3: Conduct review; Task 2-3.4: Analyze results; Task 2-3.5: Convene pilot tests sites to discuss measures and methodology. This shall be a one and one half day meeting in Washington DC as close as possible to the NHII05 meeting, with one hotel night, expenses, and airfare for the no more than 16 workgroup and LHII partners paid by the contract; Task 2-3.6: Refine performance measures and methodology accordingly. YEAR 3 (OPTION) The purpose of Year 3 is to finalize the performance measures, identify next steps for broader adoption of measures by other LHIIs, develop a policy case for the proposed model of practice and build national consensus around model of practice. Task 3-1: Conduct review of refined performance measures and identify steps to promote adoption of performance measures by other LHIIs. Task 3-1.1: Conduct review of refined performance measures among selected sites; Task 3-1.2: Analyze results; Task 3-1.3: Summarize results and identify next steps for adoption of performance measures; Task 3-1.4: Disseminate findings in a paper. OMB & Publications Clearance Required prior to performing this Task. Task 3-2: Develop a policy case for model of practice for integration of primary data collectors with other essential health programs and services. Task 3-2.1: Engage workgroup and stakeholders in on-going discussions regarding implementation of proposed model of practice and best practices among LHIIs. This shall be a one and one half day meeting in Washington DC as close as possible to the NHII06 meeting, with one hotel night, expenses, and airfare for the no more than 16 workgroup and LHII partners paid by the contract; Task 3-2.2: Summarize lessons learned and identify issues in need of further research to facilitate implementation of model of practice; Task 3-2.3: Draft a policy case to support the adoption of the model of practice among stakeholder groups and community, state and federal partners. Task 3-3: Obtain Consensus and Endorsement of the Model of Practice by Partners and Stakeholders Task 3-3.1: Disseminate white paper to broad audience of stakeholders from private, public, and community sectors, assuring parental and pediatric participation; Task 3-3.2: Engage stakeholders and partners in discussions to identify the policy and practical issues associated with the proposed model, including funding issues and assessment of model; Task 3-3.3: Engage in discussions with workgroup and stakeholders to resolve identified issues and make recommendations next steps for implementation of the model; Task 3-3.4: Obtain endorsements and support for model of practice by key stakeholder groups. Sole Source Solicitation This proposed negotiated acquisition is for services for which the Government intends to solicit and negotiate with only one source (F.A.R. 6.302-1). A determination by the Government not to compete this proposed negotiated acquisition based upon responses to this notice is solely within the discretion of the Government. Contractors may forward capability statements demonstrating their ability to the referenced address. Electronic submissions are acceptable, but must be received prior to the close of business (5:00pm) on the response date. Information received will normally be considered solely for the purposes of determining wether or not to conduct a competitive procurement. See Numbered Note 22.
- Record
- SN00580310-W 20040507/040505211843 (fbodaily.com)
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