SPECIAL NOTICE
R -- Functional Assist-patient Monitoring Services
- Notice Date
- 9/22/2010
- Notice Type
- Special Notice
- NAICS
- 541611
— Administrative Management and General Management Consulting Services
- Contracting Office
- Southeast Regional Contracting Office, ATTN: MCAA SE, Building 39706, Fort Gordon, GA 30905-5650
- ZIP Code
- 30905-5650
- Solicitation Number
- W91YTV-10-T-0128
- Archive Date
- 12/21/2010
- Point of Contact
- Sebrena L. Hackley-Lane, (706)787-2377
- E-Mail Address
-
Southeast Regional Contracting Office
(sebrena.lafaye.hackleylane@us.army.mil)
- Small Business Set-Aside
- N/A
- Description
- Notice of Intent to Award a Sole Source Contract The U. S. Army Medical Command, Southern Regional Contracting Office on the behalf of Fox Army Health Clinic, Redstone Arsenal, AL has a requirement for Functional Assistance Patient Monitoring Services in accordance with the attached Performa Work Statement. The government intends to award a sole source contract IAW Subpart 5.202 (a) (10) exception; under conditions described in FAR 6.302-5 (b) (6), Full and open competition need not be provided for when sole source awards under the Veterans Benefits Act of 2003 (15 U.S.C. 657f). Award will be made to Small-disabled Veteran-owned Small Business Concern. The suggested contractor is Rite Solutions, Inc; 110 West Board St. Fl 1, Pawcatuck, CT 06379-1828. Period of Performance shall include based and one (1) option period. PERFORMANCE WORK STATEMENT 1. GENERAL. This Performance Work Statement details the requirements for providing health care solutions to Fox Army Health Center (FAHC) as a pilot site and expanded support to United States Army Medical Command (MEDCOM) in support of the Office of The Surgeon General (OTSG). Both FAHC and MEDCOM desire assistance in attaining innovative decision support solutions and business intelligence applications. The primary objective of this task involves providing health solutions, to include interactive business management and training tools, and to field innovative technology solutions that will: nRemediate the existing knowledge gap in the area of clinic management nImprove the Relative Value Unit (RVU) reimbursement rate for the medical facilities nSimplify many of the complexities associated with the electronic health record (currently AHLTA), and implement a program that will ensure that the improvement of knowledge and skills via this effort is maintained through any future global or economic upheaval nProvide a foundational knowledge base for the Composite Health Care System (CHCS) nFacilitate knowledge engineering and propagation of best practices to local military treatment facility (MTF) facilitators and develop training curriculums designed to sustain the growth achieved in fulfilling the strategic plan Develop actionable recommendations derived from data-driven tools that can be used for business forensics, business intelligence/analytics and predictive modeling and simulation. FAHC and MEDCOM request assistance in correcting inefficient creation and administration of patient encounters and records. Inefficient use of AHLTA in MTFs/RMCs results in the completion of patient encounter documentation in which information is not as complete as it could be and therefore RVU reimbursement is not optimized. As the Performance Based Adjustment Model (PBAM) expands as the reimbursement model for the Army and migrates to the Prospective Payment System (PPS), increased emphasis will be placed on financial efficiency, process improvement and opportunities for improvements in the health care arena. This project seeks to focus on health care solutions that contribute to fmancial improvements and the operational attributes that impact resourcing FAHC and MEDCOM require assistance in health solutions that are modular, multi-faceted, and will provide training to close the knowledge gap both in the near term and in the future. These solutions will provide tools and decision aids to support physicians/providers and clinic managers with the proper use and employment of AHLTA, CHCS, and medical staff scheduling in response to actual or forecasted patient demand. Improvement in these factors will enhance the RVU reimbursement rate and patient access. These solutions will also capture the knowledge and expertise of the key staff at the MTF and archive that knowledge in such a way so that the value of their experience is available to the next wave of assigned personnel and is coupled with an approach and doctrine to compel that knowledge transfer during the rotation process. The objective of this task is to provide assistance in the planning, re-engineering and implementation of new health care solutions to compliment AHLTA; CHCS, and medical capabilities and improve the all-inclusive method/manner in which healthcare is rendered to beneficiaries within the MTF. In conjunction with the contractor team, government partners will design and participate in Health Solutions to improve patient access to care, healthcare provider documentation, and healthcare data captured within AHLTA and CHCS, continuity of care, patient administration, appointment scheduling, laboratory/radiology/pharmacy (tests, procedures & orders), and general hospital administration. The success of the Health Solutions effort will be measured by improvement in MTF metrics for: "Productivity- Relative Value Units (RVUs) and Relative Weighted Products (RWPs) "Access to Care "Inpatient bed days for deferred care to the network and for MEDCOM efforts focused on RWP generation for inpatient facilities "Patient Cycle Time "Data Quality Improvements "Purchased Care Trends (Outside MTF referrals and expenses) "Population - HEDIS standards "Data quality improvements to include RVU optimization efforts and other tools for applicability for MEDCOM-wide, demand forecasting tools/models to enhance strategic decision making, and staff analysis capability. 1.Background FAHC is a health clinic within the U.S. Army Medical Commands Southern Region that serves approximately 11,000 active duty, active duty family members and retirees. In 2004, SERMC began implementing the Armed Forces Health Longitudinal Technology Application (AHLTA), the militarys electronic health record (EHR). FAHC will be the pilot site for supporting the entire Army, through MEDCOM. The Department of Defense is leading the nation in this effort by completing the implementation of AHLTA, the interoperable, globally-accessible, protected and always available EHR for Uniformed Services members, retirees and their families, by 2011. AHLTA marks the beginning of a significant new era in healthcare for the Military Health System (MHS) beneficiaries. AHLTA allows military healthcare providers to access data about beneficiaries, conditions, prescriptions, diagnostic tests and additional information essential to providing quality care. AHLTAs new capabilities are transforming MTF work processes and MTFs have made internal transformational strides to optimize AHLTA and associated processes. However, greater analytical capability of process flow, organizational effectiveness, new solutions, stakeholder understanding and acceptance of process improvements and documentation of new processes is required. Other processes in addition to AHLTA require special attention to improve productivity, efficiency and patient care. 2.Objective The objective of this task is to provide assistance to the FAHC MTF Commander, MEDCOM Chief of Staff, Chief of RM, Decision Support Center and the Office of the Surgeon General (OTSG) in the planning, re-engineering and implementation of new health solutions to compliment AHLTAs capabilities and improve the all- inclusive method/manner in which healthcare is rendered to beneficiaries within the MTF. In conjunction with the contractor consultant team, SRMC and its MTF Command teams will design and participate in processes to improve patient access to care, healthcare provider documentation, healthcare recorded within AHLTA, continuity of care, patient administration, scheduling of appointments, laboratory and radiological tests/procedures, and general hospital administration. The success of this effort will be measured by improvement in MTF metrics for: "Productivity- Relative Value Units (RVUs) and Relative Weighted Products (RWPs) "Access to Care "Inpatient bed days "Patient Cycle Time "Data Quality Improvements "Purchased Care Trends (Outside MTFs referrals and expenses) "Population- HEDIS standards 3. Health Care Solutions Concept During the Base Year of the contract, the contractor will prepare a draft a Memorandum of Agreement (MOA) in collaboration with FAHC and MEDCOM Staff. The MOA will establish overall governance of the effort; identify the key MTF areas for health care solutions, sources and methods for collecting and evaluating critical MTF healthcare information, and key MTF participants and expected/anticipated roles. It will establish priorities, timelines for achieving success and application opportunities gained (lessons learned) from previous efforts. The contractor and government representatives will meet at a government office to develop the basic framework, milestones and critical elements of the MOA. The contractor will prepare and participate in briefing the Command for approval of the MOA and permission to enter the 1st Year Option Period of the contract. During the 1st Year Option Period the contractor will conduct on-site work at each MTF to evaluate current processes, design process and work flow improvements, evaluate AHLTA training levels and initiate AHLTA refresher training, review current AHLTA provider templates, tailor the templates to meet MTF/clinic healthcare mission requirements, and construct MTF specific management tools for evaluating healthcare accomplishments. The contractor will assist in setting up and participating in a quarterly meeting to review the activities of the prior period and discuss planned activities for following quarter. Additionally, the contractor will provide progress reports as requested. The contractor will complete efforts initiated in the lst Year Option Period, help establish mechanisms for continual renewal of improvement efforts, establish refresher training programs and write supplemental training material and document the Health Care Solution efforts. Contractor will propose requisite team to support level of effort as tasks are prescribed to this effort. 4.Applicable Documents: None. 5.Task ManagerINTENTIONAL LEFT BLANK 7. Specific Tasks a. Redstone Army Health Center Tasks (1) General. The contractor will provide monthly reports on performance and progress, addressing delivery order activities and accomplishments to the MTF command team and MEDCOM task leader. Monthly reports will provide an overview of contract activities and will highlight accomplishments, significant problems, personnel labor hours, and expenditures. (a)The contractor will also provide reports and briefings as necessary, and make recommendations for Health Solutions and report results. (b)The contractor will provide management and expertise needed to provide the required services, quality control and administration in each task area. (c)The objective of this task is to augment the efforts of the contract team, by providing documentation as noted by deliverables of the original contract, and any other documents that support the contract. Technical writer support will allow the consultants to focus on data mining, analysis, and working with MEDCOM decision makers to implement required recommendations as well as knowledge transfer maintenance. The metrics of this modification are in line with the original contract. (2) Health Care Solution Activities. The contractor shall provide consultant(s) to work with Command Teams on BPR. Government will provide the overall priority of effort. At a minimum, Health Care consultant(s) shall evaluate and perform the following: (a)Assessment of patient flow and continuity of care (b)Identification of aspects of care that could be re-engineered to optimize AHLTA s use and satisfaction, including the usage of standardized templates with Clinical Practice Guidelines (CPG) and Order Sets (c)Assessment and re-design of the patient healthcare encounter to include: scheduling, appointments, record keeping, check-in process; support staff assistance on Review of Systems (ROS), Past Medical History (PMH), History of Present Illness (HPI), prescription refills, CPG compliance, etc... (d)Re-engineering use of the Primary Care Manager panel (e)Improvement of coding on outpatient as well as inpatient settings, including appropriate Current Procedural Terminology (CPT), physicians coding knowledge and charting review strategy (f)Assessment and improvement of the inpatient process starting from Emergency Department and moving through admissions, bed days, disposition, transfers, social work, support staff, documentation, consults, radiology department etc... (g)Analysis and improvement on outside MTF referrals, purchase care trends, expenses and recapturing patients (h)Patient flow mapping (i)Referring and scheduling of laboratory, radiological tests and procedures (j)In addition, the contract team shall design forensic tools to track and define real-time data required to determine performance throughout the MTF. The programmer developer will develop tables, file validation, error logging and Extract, Transfer and Load (ETL) packages as well as the development of stored procedures. The programmer developer will also provide knowledge transfer documentation. The Programmer/Developer will provide successful knowledge transfer to document process for government knowledge. The database and tools will be installed at MEDCOM in similar structure to support the MEDCOM level tools identified from SERMC initiatives. 3. Health Care Solution Measures. Activities shall be conducted as described above with the goal of improving one or more of the below listed measures in each MTF reengineered. The contractor shall work with the MTF staff to measure selected metrics in each facility before, during, and after reengineering. Business process analytical tools and process solutions created by the consultants shall be provided for propagation for continued use during and after re-engineering effort. (a)Productivity Statistical analysis of: patient load, no shows, cancellations, walk-ins, visits to the ERlUrgent Care Facilities, RVUs, RWPs, CPTs, etc. (b)Panel Management Number of open slots per day; slots filled per day; appropriate time slots (new vs. established patient). (c)Access Number of patients on waiting list; appointment waiting time; peak appointment times; waiting time for PCM; waiting time for referral. (d)Patient Encounter Total duration of patient visit (patient cycle time), reporting time for laboratory and radiology studies; time to schedule procedure/surgery, number of times patient was able to see own Primary Care Manger (PCM) (PCM by-name continuity), number of patients requesting change of PCM. (e)Patient Flow Patient care algorithms, integration of practice guidelines, pre-printed patient instructions. (t) Improved Medical Documentation Chart delinquencies; improved data quality using medical record as a tool. (g)Improved Staff Analysis Capability Tools and techniques to pull and manipulate data for real time reporting and decision making. (h)Adequate Staff/Support staff ratio b. MEDCOM Tasks 1. General. (a)As requested, the Contractor shall provide analyst capabilities to identify data source, research potential opportunities for improving MEDCOM workload, and develop actionable recommendations that can be incorporated into the MEDCOM business processes. (b)As requested, the Contractor shall provide staff analysis capability, such as: -Tools and techniques to extract and manipulate data for real time workload reporting, decision-making, and prospective assessment by MEDCOM. -Improve analytical capabilities for strategic decision making tools to support the Prospective Workload/Revenue Planning Models, assess PPS changes based on MRS Data Repository (MDR) data, and Prospective Payment System (PPS) tools to project revenue. - Staff analysis support will include data source identification, researching potential opportunities for improving MEDCOM workload, and developing actionable recommendations that can be incorporated into the MEDCOM business processes. (c) The Contractor shall provide monthly reports on performance and progress, addressing delivery order activities and accomplishments to the MEDCOM task leader. Monthly reports will provide an overview of contract activities and will highlight accomplishments, significant problems, personnel labor hours, and expenditures. The Contractor shall also provide reports and briefings as necessary, and make recommendations for data quality and/or other areas related to existing business processes. 2. Systemic Correction of MTF Taxonomy Errors. The Contract shall perform MEDCOM-wide data quality improvement to correct MTF taxonomy errors. As part of this data quality improvement task, the contractor shall identify MTF-specific provider file and taxonomy errors, provide the business process and programming logic to systemically correct the provider taxonomy errors, load ad hoc reports, perform the clean-up process, install and execute conversion software to reprocess SADR encounters. 3. Systemic Correction of MTF ADM Write-back Errors. The Contract shall perform MEDCOMwide data quality improvement to correct ADM write-back errors. As part of this data quality improvement task, the contractor shall identify the MTF ADM write-back errors and strategy for correction; utilize established business processes, methodologies, and programming logic (conversion tools) to automatically reprocess ADM transmissions for all Army MTFs having previously-identified ADM write back errors. The Contractor shall introduce reconciliation and monitoring to prevent increased workload losses by reevaluating system upgrades and providing overall system integration architecture oversight. The re-transmissions shall be performed systemically in an automated mode without Army MTF intervention or effort. The Contractor shall escalate system level issues for error code generation at IT level. 4. Knowledge transfer documentation. The Contractor shall export Government-owned tools, to include the SADR RT, Cross Walk Tool, Hot Zone Report, and Demand Management model. (a)The Contractor shall provide knowledge transfer documentation to enable and facilitate seamless incorporation by the MEDCOM systems analyst and database managers at USAMITC. (b)The Contractor shall configure an SQL database to facilitate migration of current outpatient and inpatient MS Access database tables to SQL. Develop inpatient tables in SQL, file validation, error logging and Extract, Transfer and Load (ETL) packages as well as the development of stored procedures. Provide knowledge transfer documentation to facilitate web front-end reports. (c)The Contractor shall provide management and expertise needed to provide the required services, quality control and administration in each task area. (d)Development server and database installation and configuration (e)Create tables, relationships, indices, etc. (f)Configure SQL Server Integration Services (g)Develop file validation and error logging (f)Develop ETL packages (g)Develop stored procedures (h)Ensure stored procedures work reporting components (i)Development testing (j)Deployment to production server (k)Testing (I) Go Live (m) Data Base Administration (DBA) Briefmg/Knowledge Transfer 8.Security Requirements. The contractor does not require access to classified data. 9.Period of Performance. The contract will be awarded with a Base Year (12-month) and One (1) One-year Option Period. The Government reserves the right to exercise option period. 10.Place of Performance. Services shall be performed on site as necessary at Fox Army Health Clinic (FAHC) and MEDCOM to facilitate necessary health care solutions. Travel will be required as mandated to support MEDCOM and OTSG. The consultant shall provide briefings and conduct discussions as required. Primary work site is off-site, via telecommuting, although there is an expectation for one consultant to be on site at MEDCOM in San Antonio, Texas. When not on-site (MTF or HQ MEDCOM), the consultant shall be available via telephone (including teleconference), email, and web-based document conferencing (e.g. Adobe Connect) 11.Deliverables DescriptionElectronic CopiesDue Date 11.1Memorandum of Agreement1TBD 11.2MTF Baseline Statistical Analysis1 per MTFTBD 11.3Monthly Performance and Progress Report1Monthly: 15th 11.4Research Reports1As required 11.5Information Papers1As required 11.6Draft and Final Reports1 1 1As required 2 days after meeting As required 11.7Meeting Minutes for Specified Meetings 11.8Reports and presentations documenting recommendations and/or results 11.9MTF Workflow Analysis1 per MTFAs required 11.10 Trip Reports1As Occurs 11.11Conference Reports1As required 11.12Training Materials1As required 11.13Health Care Solution Summarization130 days prior to contract end date 11.14 Metric Improvement Analysis130 days prior to contract end date a.Deliverable 11.1 The contractor shall author a Memorandum of Agreement in collaboration with government representatives b.Deliverable 11.2 The contractor shall perform a baseline statistical analysis of the measures of effectiveness outlined in section 6.3 to determine the status of the MTF prior to the start of work. c.Deliverable 11.3 Prepare a Monthly Performance and Progress Report (MPR) to be presented documenting the performance on this delivery order to date. Task Manager (or Management) and the contractor shall meet regularly with the customer to review the MPR, identify any issues, and ensure that any resulting action items are addressed. The MPR shall summarize the progress and status of all contract activities and highlight: measurement of increase/decrease from baseline (determined by 11.2), milestones and achievements and problems encountered with the resultant impact. The MPR will measure contractors cost schedule and performance. d.Deliverable 11.4. The contractor shall document any research that is conducted and report findings as required, to include the methodology, logic, and approach utilized. e.Deliverable 11.5 The contractor shall provide Information papers as necessary to support SRMC in the BPR effort. f.Deliverable 11.6. The contractor shall provide Drafts and Final Reports as required to support the BPR tasking. The contractor shall provide documentation in a standardized template, employ version control, and provide documentation and reports as necessary. The contractor shall provide Meeting Minutes to specify or milestone meetings as designated by the Task Manager (not all discussions and/or meetings) within two days after the meeting and shall summarize the attendees, purpose of the meeting, and detail any findings/conclusions that result from the meeting. h.Deliverable 11.8 The contractor shall also provide Reports and Presentations/Briefings as necessary to make recommendations and report results. i.Deliverable 11.9 The contractor shall provide an analysis of the current workflow from patient initiation of a care request through completion of care to resolve the medical condition. The work flow analysis will identify log jams and other impediments to rendering world class healthcare. j.Deliverable 11.10 The contractor shall provide any site visits in a Trip Report that includes any meetings or key personnel encountered during the visit, key drivers for the visit, validation of assumptions, process observations, and any briefings related to the trip as each visit occurs. k.Deliverable 11.11 The contractor shall document any conference attendances and provide a Conference Report that includes information such as attendees, purpose, and general discussion points as required. Details related to the task shall be addressed comprehensively in the Conference Report. I. Deliverable 11.12 The contractor shall develop and provide training material to enable the MTF to present training on hospital processes to newly assigned personnel and periodic refresher training of all assigned personnel. In. Deliverable 11.13 The contractor shall provide a concluding report that includes information regarding the status of the MIT prior to this effort, changes that were recommended and incorporated during the engagement process and an assessment of MTF improved functionality using baseline statistical metrics developed in Del 11.2. n. Deliverable 11.14 The contractor shall perform a final analysis of baseline statistical metrics developed in Del 11.2 with current MTF performance six (6) months after the conclusion of the effort to determine improvement of MTF functions as a result of implementation of contractor recommendations. 12. Le vel of Effort a. Labor Support. (1)The Contractor shall propose the team make up. The Contractor shall provide analyst support to provide enhanced data quality, workload data reporting and electronic data transmissions from Army MTFs to MHS Data Repositories. The Contractor shall develop prospective workload reporting capabilities for MEDCOM and provide MEDCOM and other Army MTFs existing tools and techniques that extract and manipulate data for real-time reporting and decision making. (2)The Contractor shall require a thorough understanding of CHCS, the systems architecture for the encounter process, and will have the ability to navigate through technical, operational, and clinical components to develop actionable recommendations in support of PBAM. The Contractor shall have the ability to access all CHCS platforms. (3)Resumes are required for key personnel. (4)The Contractor shall propose key personnel with a comprehensive knowledge of the Military Health System and the Army Medical Command to include: at least 10 years of CHCS experience with the ability to extract raw data and distribute to a data center; ability to identify fields from M2, CCE, MDR, etc. and match to CHCS data to support PBAM. Contractor staff must have 5 years specific MRS Business Process Reengineering experience with the ability to improve Access to Care. (5)Key personnel must be able to demonstrate the following: (a)Understanding of technical complexities and interconnectivity between the Composite Health Care System (CHCS), AHLTA, and the underlying sub-systems such as MHS Mart (M2). (b)Ability to conduct root cause analysis for data flow between the originating visit to the generation of revenue to include understanding the process flow from a technical level from the time of patient check-in or appointment, the generation of the encounter documentation, creation of the SADR record, processing to the MDR, the transformation and tables that apply within this process, and the ultimate end state within the MIS Mart. (c)Understanding of processes that contribute to this technical data flow and the ability to develop, plan, and manage change to improve metrics in accordance with the project goals. (d)In-depth knowledge of cause and effect for various clinical processes, as well as the implications of business and clinical process changes to the data. (e)Ability to provide educational insight to clinical staff on proper use of the overall system, and explain the data flow between systems. (f)Both technical and functional knowledge of the systems in which the MIT operates, as well as the business rules that govern each system. b. ODC(s). The consultants primary duty location may be at a contractors office. The consultant will travel to MTFs, OTSG, MEDCOM, or other locations, as necessary, to support this task. Travel costs will be determined within the guidelines of the Governments Joint Travel Regulations and will be pre-approved by the Task Manager. 13. Government Furnished Equipment (GFE) and Information (GFI) The contractor will require the following support from the Government to successfully perform this task: a.MEDCOM email account for task related communications b.Network access when on-site at MTFs. c.Access to data required for the project contained within government computer systems. Access to data may be provided by giving the contractor access to computer systems containing the data (such as CHCS) or by having government personnel pull data (such as M2, MEPRS). This data may contain Protected Health Information (PHI) and well safeguarded JAW HIPAA regulations. d.Access.to Government facilities and personnel e.Class B VMS Access to CHCS Hosts. f.SQL Server 2005 software (USAMITC ELA). g. License key for SQL Server (USAMITC ELA) h. Government Furnished Equipment (GFE) to access the VPN network, CAC Cards, etc. as mandated under DoD Security Requirements. i. Access to MHS Mart (M2) Accounts for data extraction j. Network access to CHCS Hosts for data extraction from remote contract location in order to facilitate VPN access and file transfer to MEDCOM data repository. 14.Proprietary Information Statement Information identified by the Government staff as Sensitive Information (Exemption 2 through 9 DOD Privacy Act Program: DOD 5400.7-R) shall be handled and processed as For Official Use Only. Information identified as medical quality assurance information (DoD 6040.37) shall be processed as For Official Use Only. Contractor shall comply with RMO memorandum, Acquisition Documentation Security Markings, February 15, 1994. The Government will retain rights to all intellectual property produced. 15.Special Cons iderations. None. Parties interested in future announcements shall provide detailed information of their capabilities and certifications to clearly meet the requirements stated above. Responses(s) may be via email or on company letterhead: include companys name, point of contact, address, phone number, DUNS number, Tax ID, business size, and solicitation number. Responses may be faxed 706-787-6573. This requirement will result in the award of a Firm Fixed Price (FFP) contract for delivery dates to be determined in accordance with the deliverable schedule listed in the PWS. The NAICS code for this action is 541611 with a size standard of $7.0M. This Notice of Intent to award a sole source contract is not a request for competitive quotes. There will be no solicitation document. No RFQ will be available for competitive quotes. Phone calls will not be accepted. The point of contact for this posting is Ms. Sebrena L. Hackley-Lane, Contract Specialist at sebrena.lafaye.hacklevlane@us.anny.mil. This posting will close on 30 September 2010 at 4:00 P.M. EST.
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