SOURCES SOUGHT
Q -- Evaluating Access to Medline via Handhled Computers in the Clinical Setting
- Notice Date
- 7/7/2005
- Notice Type
- Sources Sought
- NAICS
- 541990
— All Other Professional, Scientific, and Technical Services
- Contracting Office
- Department of Health and Human Services, National Institutes of Health, National Library of Medicine, 8600 Rockville Pike, Bethesda, MD, 20894
- ZIP Code
- 20894
- Solicitation Number
- 05-140-CYC
- Response Due
- 7/22/2005
- Archive Date
- 8/6/2005
- Description
- Task Title: Evaluating Access to MEDLINE? via Handheld Computers in the Clinical Setting. Background: Medline Database on Tap (MD on Tap) is a research project of the Lister Hill National Center for Biomedical Communications, National Library of Medicine. The first test bed and freely available public client software were released in May 2003. The MD on Tap project seeks to discover design principles for the delivery of on-line information to mobile healthcare providers at the point-of-care via wireless handheld computers. Healthcare providers, especially younger clinicians, residents and medical students, are increasingly adopting the use of handheld computers for access to a variety of information sources. The handheld computer hardware, operating systems, peripherals, communications and input modalities are all in flux, with each new generation of device boasting improved performance and usability. Providers of online information resources, such as NLM with its MEDLINE database, need to employ well-founded design principles to effectively serve mobile healthcare providers over the wide and changing handheld computer platforms available. The MD on Tap system consists of client applications for Palm and Pocket PC wireless (802.11b/g compatible) handheld computers. These applications support real-time search of and retrieval from MEDLINE. The clients communicate over the Internet with an intermediate http server that communicates with the National Library of Medicine?s PubMed via the entrez e-utilities to execute MEDLINE searches and retrieve citation data. The intermediate server records de-identified transactions received from clients. Through analysis of these stored transactions we have learned several aspects of aggregate user behavior regarding searching MEDLINE with a small device. However, the analysis does not fully relate the query terms and retrieved citations to the clinical scenario being addressed. Careful manual examination can occasionally infer the clinical question being asked, but with insufficient confidence to determine if the question was answered by the citations retrieved. Purpose of this contract task: The National Library of Medicine (NLM) intends to extend the research work of the MD on Tap project by conducting a structured evaluation of the MD on Tap system through real-time use of the system in a clinical environment in which many questions are raised at the point-of-care. NLM is interested in knowing the clinical scenario in which questions arise, the nature of the clinical questions that arise, the occurrence of MEDLINE citations that address those questions and the ability of the MD on Tap system to assist the clinician to quickly find relevant, high quality MEDLINE citations at the point-of-care. Description of Services: NLM expects to secure the services of a trained medical doctor (hereafter referred to as a medical practitioner or practitioner) with access to a variety of clinical care environments in a teaching hospital that has wireless Internet access via an 802.11b/g compatible networked infrastructure on most of the wards, for a ten week process evaluation and technology assessment of the use of handheld computers (or ?PDA?s) by clinicians in their ability to provide real-time information at the point-of-care. The practitioner is also expected to have access to and some familiarity with wireless PDAs using either the Palm Operating System or the Pocket PC operating System. These elements are necessary for the desired explicit evaluation of the use of a handheld computer application, MD on Tap (for Medline Database on Tap), for real-time access to MEDLINE to answer clinical questions raised at the bedside, evaluation of the ability of the MD on Tap application to be an effective interface to MEDLINE in clinical settings, and evaluation of the role of MEDLINE in answering such questions. The successful contractor will provide the combination of all of the stated elements. The combination of all the elements is necessary. A clinical care environment in a teaching hospital is necessary to insure an environment in which a variety of clinical questions are likely to arise at the point-of-care. A trained medical practitioner with broad medical expertise is required to describe the clinical scenario, recognize the clinical question and be able to categorize it by Evidence Based Medicine category, generate a suitable MEDLINE query using the MD on Tap PDA client application, and identify MEDLINE citations that address the clinical question within the bounds of the clinical scenario. Wireless Internet access in most of the hospital wards at the bedside is necessary to support real-time use of the MD on Tap application, which requires wireless access to the Internet. The 802.11b/g LAN is required to insure sufficient communication bandwidth for fast interaction between the wireless PDA and the NLM servers. Wireless PDAs with either the Palm OS Operating System or the Pocket PC Operating System are required to support the MD on Tap client application. In addition, the successful contractor will be responsible for providing the medical practitioner and the teaching hospital with an IT support person(s) dedicated at least part time solely to support wireless PDA operation and network connectivity related issues. Review and Award Process: The review and award process will follow a two-step process: 1. A Request for Information (RFI) - Search for Sources will be conducted: Any offeror or group wishing to participate in the competition process MUST reply to this search for sources. Potential sources for this work must describe the teaching hospital environment in which the task will be conducted: the composition of Medical teams making rounds in the hospital, the frequency of such rounds, the wards in which rounds are made. Potential sources for this work must also describe the nature and extent of the wireless infrastructure in the hospital and the IT support available for the infrastructure. Potential sources for this work must also describe the qualifications of the medical practitioner who will be using the wireless PDA and the MD on Tap application. A Technical Evaluation Group (TEG) will evaluate the potential sources on their existing facilities, IT support, and expertise of the proposed medical practitioner. NIH personnel reserve the right to visit potential sites as part of the search for sources; however, a site visit is not required for a future award. 2. A Request for Quotes (RFQ) will be issued for the data generation and reporting task. Only sources identified as competitive through the search for sources will be solicited for quotes for the data generation and reporting task. The TEG will be convened to make the award for the data generation and reporting task. This award will be executed quickly through a Simplified Acquisitions Mechanism under FAR Part 13. 3. The work will be coordinated with research personnel at NLM who will monitor data generation and assure the task is progressing smoothly. Task Description: NLM proposes to contract for data generation and reporting specifically to address three questions: 1) What questions do clinicians raise at the point of care? 2) For what scenarios is MEDLINE useful for answering those questions? 3) How well does the MD on Tap application facilitate finding relevant, high-quality evidence from MEDLINE? Toward that end, this task will consist of providing one medical practitioner and appropriate IT support, to accompany a general/internal medicine Medical team on all teaching hospital and clinic rounds for eight weeks. This practitioner will have a strong background in clinical medicine with sufficient experience to understand the clinical scenarios presented, the questions raised and the quality of potential answers to the questions. This practitioner will not be the attending physician or an essential member of the Medical team. During rounds whenever the Medical team fragments the practitioner will stay with the attending. On these rounds, the practitioner will be equipped with a wireless PDA set up to access the wireless network at the hospital and with the MD on Tap application installed. The practitioner will note (on the PDA) all questions raised, including those for which the practitioner knows the answer, but not including questions concerning data in the patients? records. The practitioner will also note the scenario for those questions, and, using the MD on Tap application, search for MEDLINE citations that address the question. Citations judged to be useful will be saved on the PDA. The MD on Tap intermediate server will recognize and store transactions from the practitioner?s PDA. Using a special desktop computer web-based program already developed at NLM, the practitioner can review the stored transactions at a later time to be reminded of the scenarios, questions and relevant citations. An example of the transaction review display is available at http://archive.nlm.nih.gov/proj/mdot/EvalDocs/Attachment1-xactTrackExp1.doc. In combination with the notes taken during rounds, the practitioner may use the transaction review to assist in writing and submitting electronically a daily summary of the clinical activity, including a brief clinical scenario for each MEDLINE search session. As part of the summary, the practitioner will indicate one or more EBM clinical tasks (Diagnosis, Treatment, Etiology, Prognosis) for each question posed at the scenario and citations judged to be useful in answering the question. NLM software will associate the summary information with the MEDLINE search sessions. NLM staff will check the summaries for consistency, corroborate the practitioner?s opinion regarding relevancy and quality of the selected citations and contact the practitioner by telephone or email to correct discrepancies or missing information. An in-house program will analyze the MEDLINE search queries to group the search terms into one or more Semantic Groups (Disorders, Anatomy, Intervention, Drugs, Groups, Other). Thus for each scenario NLM will have on record one or more clinical question. For each question NLM will have on record the EBM task category and one or more MEDLINE searches. Associated with each search will be one or more semantic groups and one or more citations (if they exist) that the practitioner judged to be useful. The practitioner will use the daily summaries for a final qualitative and quantitative assessment of the ability to find relevant evidence in MEDLINE. Over the course of the eight weeks, the practitioner will identify the features of MEDLINE searching (for example: limits, clinical queries), and the current features of MD on Tap (for example: history, EBM clusters) that are most useful for quickly finding useful citations, and any additional features that could facilitate that process. The practitioner?s opinions can be substantiated by the stored records of the features that were actually used. Additional in-house developed software will analyze the transactions and sessions for several measures including time and number of transactions needed to find relevant citations, semantic types of query terms most useful in finding relevant citations, and semantic types that appear frequently over the course of the study. NLM is specifically seeking a contractor that can provide the experienced medical practitioner, the teaching hospital environment and the wireless 802.11b/g compatible infrastructure. Deliverables:  The successful contractor is expected to generate many real-time MD on Tap search sessions per day at the point-of-care and manually record the associated clinical scenarios and clinical questions. The search transactions will be recorded automatically by the MD on Tap system intermediate server. Summaries of the clinical scenarios and clinical questions will be submitted electronically by email each day using the format and extent of content shown as an example at http://archive.nlm.nih.gov/proj/mdot/EvalDocs/Attachment2-DailySumExp.xls.  The proposed timeline for this data generation and reporting task are summarized in this table: Subtask Description : (1)Training - 5 training days: NLM trains the practitioner in the use of the wireless PDA and the MD on Tap application in a series of one-on-one sessions. 2 weeks 40 hours (2) Field Work - The practitioner accompanies a Medical team on all rounds, using MD on Tap in real time to search for MEDLINE citations that are relevant to questions raise at the point-of-care. The practitioner prepares daily summaries of these activities. NLM staff monitor stored transactions, and review and confirm the summaries. 8 weeks 320 (40 hours /week) (3)Final Report - The practitioner prepares a final written report for submission to NLM and an oral presentation for presentation at NLM or via video teleconference. 1 week 40 hours The total work period for the project is expected to be three months. The target starting date is August 15, 2005.  The contractor shall provide a specified experienced clinical medicine practitioner for the field work. Using different or multiple practitioners for the field work will be at the sole discretion of the government.  The contractor shall arrange for access to the necessary clinical care teaching environment.  The practitioner shall provide daily summaries by email in an Excel spreadsheet, and a final written and oral report. An example of the desired format and extent of content of the daily summary is shown at http://archive.nlm.nih.gov/proj/mdot/EvalDocs/Attachment2-DailySumExp.xls.  The contractor shall assure on-site Information Technology support including but not limited to Internet access and wireless (802.11b/g compatible) infrastructure support, as well as PDAs (a minimum of two: one to use and one for backup) and PDA support (except for the MD on Tap application) at the clinical care teaching environment during the study period.  The contractor shall supply, at the option of the government, information, raw data and results, from all tasks.  Note 1: Unless otherwise noted or mutually agreed upon, all reports shall be in electronic format (Microsoft Word and/or PowerPoint, and/or Excel). The contractor shall unless otherwise specified report using the following narrative format: Purchase order number, reporting period, for each task, work accomplished, issues/comments areas, and plans for next reporting period.  Note 2: Training and analysis will be conducted by NLM.  Note 3: Training will be on site at the NIH, at a nearby at a suitably equipped facility with wireless network (802.11b/g) access to the Internet, or via video teleconferencing. A final narrative report and presentation summarizing the practitioner?s activity and opinions shall be provided to the government in Bethesda, MD. The final data, summaries and assessment will be owned by the National Institutes of Health. RFI Evaluation Criteria: Responses to the Request for Information (RFI) that constitutes the search for sources will evaluate: 1. The stated qualifications of the proposed medical practitioner that will conduct the field work including the practitioner?s experience in the practice of Evidence based Medicine, and the ability of the proposed practitioner to devote the required amount of time to the data generation and reporting task independent of other duties while in the teaching hospital environment. 2. The described clinical care teaching environment; the size of the teaching hospital; the likely composition of the Medical teams with whom the practitioner will be making rounds. Are there a sufficient number and variety of patients to assure that a large number of clinical questions will arise at the point-of-care over the proposed 8 weeks of fieldwork? Are the medical students and/or Residents encouraged to pose questions? How many patients is the proposed practitioner likely to see per day while on rounds? On average, how many clinical questions are expected to arise per day at the point-of-care while the teams are making rounds? 3. The described existing 802.11b/g wireless infrastructure in the clinical care teaching environment, and the ownership of wireless PDAs with the Palm Operating System or the Pocket PC Operating System. In how many wards is wireless access to the Internet available at the point-of-care? How many wireless PDAs are currently being used in the proposed clinical care environment? How many technicians are available to support the 802.11b/g wireless infrastructure and the wireless PDAs? Because this contract is not intended to provide funds for new equipment acquisition, the responders should describe their current capabilities for wireless Internet access and support for both the infrastructure and the wireless PDAs. NLM reserves the right to include a site visit as part of the RFI evaluation. NLM anticipates that the data generation and reporting task will be completed by the end of November 2005 and costs will not exceed $50,000. Page Limit: Responses to the RFI search for sources should be limited to 8 pages of textual information (with figures and tables). Additional illustrations, photographs and evidence of results (presented in photographs or digital information) may accompany the response. The total response should not exceed 16 pages (text plus pictures). If paper copies are supplied, five copies of each response are required. Due Date: Responses to the search for sources RFI are due on July 22, 2005. They may be submitted in writing to the National Library of Medicine, Office of Acquisitions Management, 8600 Rockville Pike, Building 38A, Room B1N20, Bethesda, Maryland 20894; Attention: Karen D. Riggs, Contracting Officer or by email to kr33v@nih.gov. NLM anticipates that the requirement for the task will be procured in accordance with FAR Part 12. A single award is expected for the task. Request for Quotations (RFQ) Number NLM 05-140 covering the feasibility study will be available on or about July 28, 2005. Request for RFQ NLM 05-140 may be obtained by writing to the National Library of Medicine, Office of Acquisitions Management, 8600 Rockville Pike, Building 38A, Room B1N20, Bethesda, Maryland 20894; Attention: Karen D. Riggs, Contracting Officer or by email request to kr33v@nih.gov. Facsimiles WILL NOT BE ACCEPTABLE. Awards for the task are anticipated on or about August 12, 2005. All sources that responded to the Search for Sources/Request for Information that were found competitive by the Technical Evaluation Group to review sources may submit a proposal which will be considered by the NLM.
- Place of Performance
- Address: 8600 Rockville Pike, Bethesda, Maryland
- Zip Code: 20894
- Country: USA
- Zip Code: 20894
- Record
- SN00842795-W 20050709/050707211828 (fbodaily.com)
- Source
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