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FBO DAILY - FEDBIZOPPS ISSUE OF APRIL 13, 2017 FBO #5620
DOCUMENT

D -- Supplemental Commercial Health Information Technology Platform - RFI - Attachment

Notice Date

4/11/2017
 

Notice Type

Attachment
 

NAICS

541519 — Other Computer Related Services
 

Contracting Office

Department of Veterans Affairs;Technology Acquisition Center;23 Christopher Way;Eatontown NJ 07724
 

ZIP Code

07724
 

Solicitation Number

VA11817N2021
 

Response Due

4/25/2017
 

Archive Date

6/24/2017
 

Point of Contact

Brandon Caltabilota
 

E-Mail Address

5-1114<br
 

Small Business Set-Aside

N/A
 

Description

1 RFI: Supplemental Commercial Health Information Technology (HIT) Platform Purpose This RFI seeks to inform VA's strategy to commercialize or acquire commercial capabilities similar to those developed and planned for VA s health information technology (HIT) platforms such as the Enterprise Health Management Platform (eHMP), to support continuous VA innovation addressing somewhat unique mission challenges, while minimizing acquisition risk and maximizing probability of robust markets for capabilities and content that VA needs. Mission Challenge VA is committed to providing improved experiences for Veterans and VA Administrative Offices. To meet this challenge of more holistic, improved care for more Veterans, VA needs to transform its healthcare delivery practices. One part of this transformation is deployment of evidence-based, standardized practices that allow faster achievement of Veteran-specified health-related experiences at lower cost. Deployment and management of improved clinical practices requires significant improvement over legacy HIT for process management and care coordination. In other words, VA needs a HIT that supports more models of care that are intensively Veteran centric, team based, and quality driven. Additional background is at the end of the RFI. That background also explains what is meant by "content," which includes decision support algorithms, data entry forms, order sets, and detailed, modeled system and business processes. Overview of VA s Developed HIT (known as eHMP) The concept behind VA s HIT is as an intelligence platform and user experience (UX) that could potentially "sit on top" of any number of electronic health record (EHR) systems and provide clinicians with decision and process support against the longitudinal electronic health record of the patient. It has three main tiers: longitudinal database, service-oriented-architecture-(SOA)-style intelligence applications, and user interface. VA s newly developed HIT is currently designed to interface with VistA, so responses to this RFI should include how the vendor would interface a commercialized version of eHMP or a commercial alternative with VistA and/or commercial EHRs. eHMP v.2.0 is currently installed to work with all 130 VA VistA instances and is in Initial Operating Capability (IOC) production testing. Although all VistA s are connected to VA s current HIT, not all data elements available to the legacy CPRS application are yet available to VA s current HIT s data exchange called the VistA Exchange. Also, VA has provided the eHMP code and all documentation at the Open Source repository managed by Open Source Electronic Health Record Association (OSEHRA). Moderately detailed information can be found at https://www.osehra.org/content/ehmp-architecture. Functionality Desired by VA to meet VA Priorities High performance networks and improved access to care Improve Veteran Access to coordinated care from VA to its high-performance network, ensuring Veterans receive the most appropriate care, at the most appropriate time, and through the most appropriate interaction. Manage care across organizational boundaries Standardized business processes Decision and workflow management that supports best VA delivery of health care using standards-based, highly automated, event-driven workflows. The HIT should provide the capability to incorporate standards-based content for data-entry, process, and decision support developed by both VA and industry partners. Specifically, VA wants to develop standards-based computable clinical content now, deploy that content nationally, and reuse the same or similar workflows with a new EHR system through the possible transition from VistA to the new EHR system. Capabilities for team management, modeled care plans, patient flow, clinical dashboards, and cohort management/population health. Improve the employee experience Alert management that appropriately adapts to user and contextual characteristics to better manage alerts for interrupting, focusing, guiding, or not bothering users. Allow team-based distribution care responsibilities across members and modalities so that every person is operating at the top of his or her license. Minimize user data entry for administrative purposes. Supports rewarding clinical staff for helping Veterans achieve their own desired health-related experiences with appropriate consideration of population health goals. Restore trust Provide a performance monitoring system that will support accurate reporting of clinical and technical quality and support quality feed-back loops for clinical and technical improvements. Technical capabilities that allow scalability, security, interoperability, etc. Assumptions VA is in the process of making a decision for its EHR strategy. The HIT under consideration here will help carry the VA until a new or enhanced EHR can be transitioned and possibly beyond that point. The costs and benefits related to organizational change management far outweigh those for technical acquisitions and integration. The largest benefit to VA from a commercialized HIT (e.g. eHMP concept or alternative) and functionality will be from access to a large and robust content market for clinical process, decision support, and analytical workflows. General Requirements VA is committed to open standards including those promoted by Healthcare Services Platform Consortium (HSPC), Health Level 7 (HL7), Fast Healthcare Interoperability Resources (FHIR) and Object Management Group (OMG). IT acquisition priority is commercial off the shelf (COTS) first. VA requires Section 508 compliant and user-friendly products (https://section508.gov). VA has a tremendous amount of legacy data that is important for ongoing benefits and health missions of VA. Electronic health data dating back to the year 2,000 is relevant, but VA will consider all options if Veteran data can be made retrievable. Provide a method where VA can develop innovative functionality to the vendor provided HIT for possible inclusion in the commercial HIT. Such functionality would become part of the vendor s product commercial baseline. Goals Relieve VA from maintaining software, thus lowering costs and strain on human resources. VHA to benefit earlier and at lower cost from functionality that the development partner will add to its product based on acceleration of its own backlog. Promote interoperability standards such as those championed by the DOD/VA Interagency Program Office, Office of the National Coordinator (ONC) and Healthcare Services Platform Consortium (HSPC). Questions General approach What can VA expect relative to cost and risk for the alternatives: continued government custom development vs. commercialization of eHMP vs. commercial alternative(s)? How can VA organize this effort to best promote the advancement of the market for standards-based, machine-consumable content for data-entry forms, order sets, clinical pathways, etc.? On the way to acquiring a commercialized system Discuss a recommended legal/acquisition framework with the vendor for commercialization of eHMP or acquiring a COTS alternative so VA can meet its goals and requirements? If Commercialization of eHMP: Please address the intellectual property model, contractual relationships between vendor(s) and VA, and a pricing model that works for both parties. What functional or technical change management does VA need to undertake in preparation for acquisition of commercialized system or alternative? After acquisition of a commercialized system Given that VA is investigating an EHR solution, what is the best approach for minimizing cost and risk of change management in both functional and technical domains and what specific change-management hazards should VA be aware of and how should it mitigate them. How can VA minimize cost and risks of testing and deployment of a commercialized product? Given that VA and any vendor have different priorities for their development backlogs, what measures can VA put in place to avoid forking of code while allowing VA to satisfy its key priorities? Identify risks and their mitigation if the new system is owned by an entity other than the new EHR vendor. For example, a major risk is that VA selects a commercialization partner that is not its EHR vendor; VA s EHR vendor releases part of the functionality that the HIT has; VA faces user experience (UX) and workflow complications of multiple products. If you are recommending to commercialize eHMP or to provide an alternative COTS solution and you did not address the following in your responses above, or if you wish to give the government guidance in these areas for a potential vendor: Describe how your company would fulfil VA s desired state of functionality whether that the solution be a commercialized version of eHMP or COTS alternative. Please address market share, sales, customers, ability to provide support to VA s user base, etc. If you are recommending commercializing eHMP, what is your past experience/performance regarding commercialization of products made by others and that have similar complexity? If you are recommending a commercial alternative to eHMP, how does your product address VA needs or address needs that VA may not recognize? Please address ability to consume standards based content referenced above. What are your pricing/licensing models that address scalability? What specific integration is required for product? How does your company address intellectual property rights, licensing, etc.? What are your company s processes to satisfy the requirements for adherence to schedule, agility, flexibility, responsiveness, scalable and reliability, service quality and consistency, and continuous improvement? Additional Background Technical history: For decades, VA has been using a custom EHR called VistA with a Delphi-based front-end called Computerized Patient Record System (CPRS). The technical foundations of VistA are solid, and CPRS has won many accolades. VA has 130 instances of this EHR, each of which is somewhat but significantly different. The differences in data and business logic result in significant heterogeneity of clinical practices and make it difficult to standardize them. VistA improvements include standardization of code and providing APIs. However, Data and business logic has not been standardized across the VistAs. Custom-technology challenges: Since VA decided on open-source VistA modernization and platform development seven years ago, HIT markets for technology and labor have significantly changed. Subsequent to the American Recovery and Reinvestment Act of 2009, investment in commercial EHR systems has soared, while investment in VistA has remained relatively flat. Any HIT provided as COTS or commercialized eHMP will need to be hosted and maintained remotely. Content challenges: To support the business transformation that VHA requires, information technologies will require a large volume of continuously improved, evidence-based content. This content includes decision support algorithms, data entry forms, order sets, and detailed modeled business processes. VHA and federal partners will not be able to generate and maintain the required content on their own. Similar to markets for technology, VHA will need to draw on robust markets for content. VHA and other leading healthcare systems believe that robust markets for content require that it be platform independent and computable. The HIT should provide tooling that allows provider organizations to participate in continuous evolution, quality-control, and risk-management of the content. Organizations such as HSPC are working with standards development organizations on semantic and notation standards that allow a standardized representation of the content and reliable execution of the content using data native to provider organizations. However, such standards-based, computable content is not currently available at volume. VHA does not want to develop content multiple times to fit capabilities of various HIT systems. Changing the content to fit certain HIT solutions often results in workflow changes that, over hundreds of thousands of employees, result in significant-change management costs. Commercial technology gaps: VA is currently considering courses of action for improving its core EHR capabilities and intends to announce this strategy by July 1st 2017. However, VA is not sure the current commercial EHR suites have the necessary functionality to support VHA in the business transformation necessary to meet its extreme challenges. Whereas EHR or other companies are likely to develop viable products and make them available three to six years from now, VHA needs something like eHMP today. VA would like an option to license a commercial, standards-based intelligence platform, as an existing COTS or as a new Software, similar to eHMP that provides robust team and process management. VHA is not aware of current products with a viable market share that could replace eHMP and vended by companies capable of acquiring a significant market share to ensure continued development of HIT and supporting content. The commercial HIT will need target a number of business problems. This was looked in the initial development of eHMP, which need to be continued in a commercialized eHMP or COTS alternative. The primary target is development and enterprise deployment of evidence-based, standardized clinical processes that allow all members of a team to operate at the top of their licenses. This is essentially applying manufacturing principles to healthcare for shortened cycles at reduced costs for productivity, aka realization of Veteran's health ­ related goals. A future, desired, related component is activity-based costing and productivity assessments. The commercial HIT must include a better UX and cohort management than VA s current VistA UX, called CPRS. The commercialized eHMP or COTS alternative should provide a UX that is both more enjoyable and provides better support for a variety of clinical workflows than CPRS. Cohort management is about dynamically defining a cohort of patients, determining how to better address their needs through a defined or dynamic investigative workflow, and intervening in groups of patients or individual patients. The HIT should provide or have on it near term roadmap to provide Cohort management should also include all registry functions. VA also wants the commercial HIT to be a bridge between existing and future EHR systems. This allows VA to more easily deploy new clinical practices now through any future new EHR deployment. There are technical, semantic, and process interoperability requirements that EHRs must meet for the HIT to be as effective as with VistA. eHMP Current and In Process Highlights eHMP 1.2 Functionality (Read Only) (1.2.7 c National Released across VA) (eHMP is built in an Agile fashion, so many feature are listed with initial capability. Future development is planned for full elaborated use.) Milestones Introduce new platform UX design with revolutionary gist/trend/summary views User-configured and condition-based workspaces with persistent filters VX Sync 2.0 major redesign MVI integration for global patient search VLER integration for community data Global patient search CCOW vault integration Patient selection enhancements Global date filter w/ timeline Comprehensive applet redesign Medication review enhancements Tile sorting InfoButton access Health summaries Sync/Display C-32 community health summaries from VLER Text search enhancements Condition-based workspaces TIU access controls On-line help Enhanced auditing VX sync redesign Operational data sync ADK/RDK enhancements Standard UI component library eHMP 2.0 Functionality (Initial write-back version) (At 5 IOC sites currently. IOC is scheduled to run through 6/30/2017 before national release would begin.) (eHMP is built in an Agile fashion, so many feature are listed with initial capability. Future development is planned for full elaborated use.) Milestones UX support for parallel workflow Enterprise clinical data repository Integrated production services Activity/order management Activity/order selection Clinical decision support Notification/alert management Concept relationship management Access control/user permissions Data entry tray/parallel workflow UX Task request creation/management Enterprise order selection service Enterprise order management service (Additional orders are planned.) Consult orders/fulfillment activity (Basic order. Additional ones are planned.) Team/roles management (Initial version with some roles. Other roles are planned) Notifications/alerts service Note addenda Basic note objects Problem List write-back Immunizations (VIMM) write-back Highlight concept relationships Context persistence User analytics Performance/scalability enhancements SSOi integration with PIV Disaster recovery/fail-over VX cache update on initial write-back Note: If a COTS alternative HIT is proposed it should include a way to integrate (as a tab, button, etc.) the DOD/VA Joint Legacy Viewer (JLV) until its functionality is fully subsumed by the HIT and/or VA s future EHR. Instructions for Submitting Questions and the RFI Response: The VA Technology Acquisition Center points of contact for this RFI are Contract Specialist, Brandon Caltabilota and Contracting Officer, Mark Junda. Submit any questions to this RFI directly to Brandon Caltabilota at Brandon.Caltabilota@va.gov and Mark Junda at Mark.Junda@va.gov. RFI responses are to be submitted directly to Brandon Caltabilota and Mark Junda by 12:00 PM Eastern Standard Time, April 25, 2017. If possible, please limit responses to 15 pages or less. Vendors may also submit additional information not specifically requested above, which would provide value and insight to the Government. Please do not submit general capability statements, marketing materials, or other nonspecific information. Please provide the following information specific to your company: Company Name POC Information CAGE/DUNS Socioeconomic Type *Please Note: VA may elect to contact individual companies based upon the content of their RFI submission. VA may engage these companies to gather further information through email correspondence, telephone calls, virtual or physically located meetings, or other means. All proprietary/company confidential material shall be clearly marked on every page that contains such.
 

Web Link

FBO.gov Permalink
(https://www.fbo.gov/notices/4a3a01b82b7492bc9ece13f208b8a7f6)
 

Document(s)

Attachment
 

File Name: VA118-17-N-2021 VA118-17-N-2021.docx (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=3409456&FileName=VA118-17-N-2021-000.docx)

Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=3409456&FileName=VA118-17-N-2021-000.docx

 

Note: If links are broken, refer to Point of Contact above or contact the FBO Help Desk at 877-472-3779.
 

Record

SN04467562-W 20170413/170411234325-4a3a01b82b7492bc9ece13f208b8a7f6 (fbodaily.com)
 

Source

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