Download Document

REQUEST FOR INFORMATION (RFI)
Issue date:
02/12/2015
Closing date: 03/06/2015
Subject:
The State of Idaho’s Statewide Healthcare Innovation Plan’s (SHIP) Request for
Information (RFI) on Health Information and Data Analytics.
The State of Idaho, Department of Health and Welfare (DHW) and the Idaho HealthCare Coalition (IHC),
has a requirement for information concerning the furnishing of services for acquiring health information
from various providers and stakeholders pursuant to this innovation plan, and provide an analytics design
and dashboard for evaluating outcomes specific to Idaho’s Performance Measure Catalog. Information
obtained from the responses to this RFI may be used to refine the requirements for a formal Request for
Proposal (RFP) which may be released at a later date, assist us in projecting a budget for acquiring the
services, and also to identify potential vendors who may be interested in providing a competitive
proposal. We highly encourage all respondents to read and review more detailed information regarding
the SHIP. Please visit the website at:
http://www.healthandwelfare.idaho.gov/Medical/StateHealthcareInnovationPlan/tabid/2282/Default.aspx
It is important to note that this is a request for information only, not a solicitation.
No award will be made based upon the information received.
I. Introduction and Background
Idaho envisions a statewide healthcare system transformation that changes the standard of practice for
health care for the state, delivering integrated, efficient and effective primary care services through the
patient-centered medical home (PCMH), which is integrated within the local medical community, and
supported and incentivized by multi-payer, value-based reimbursement methodologies. Through this
transformation, Idaho will improve the quality and experience of care for all Idahoans, improve health
outcomes and control costs.
Health information technology (HIT) will enhance patient care through shared patient information via the
Idaho Health Data Exchange (IHDE), through coordination of care across delivery settings, through
communication with patients across multiple formats, and by utilization of Electronic Health Records
(EHRs), patient portals, and other HIT tools to provide integrated, effective, and efficient patient care.
The model design will require incorporation of data sharing, interconnectivity, analytics and reporting for
the sharing of critical information at the patient and population levels.
1
II. Description of Items or Services Required
DHW and IHC are looking for information regarding vendors experience and expertise in architecting and
building a statewide health care analytics system to track, analyze and report feedback to individual
providers on selected performance and outcome measures to improve their practice. This includes the
integration of clinical data, Medicaid claims and/or payer data at the patient and aggregate levels for
reporting and analysis. This will not be an all-payer claims database, but rather a model that integrates
clinical data with related claims –based data from payers. The data analytics system will also report on
regional population management metrics which will be used to identify and address regional population
management issues. At the state level data analysis will inform policy development and program
monitoring for the entire healthcare system transformation.
The preference is for vendors and companies responding to this RFI to have significant knowledge of the
Healthcare industry and information technology, with the capability to extract data based on key
performance measures, and develop an analytics dashboard. These key performance measures are
identified along with their use in Idaho’s Initial Performance Measure Catalog (Attachment A). These
measures may change over time.
III. Requested information
It is requested that interested vendors provide the following information:
1.) Briefly describe your company, services, history, ownership, financial information, and other
information you deem relevant. Please provide a contact person’s name and telephone
number for any clarifications.
2.) Is your organization capable of or interested in furnishing the items or services described in
this RFI? Please describe both your history of furnishing the items or services and your
capabilities for furnishing them in the future.
Please provide the following information about your organization:



Profile of vendor’s existing client base (e.g. # health systems: hospitals, clinics, labs, payers,
providers, and their respective services / projects).
Tenure (dates) of existing client (above).
History of enrollments/terminations of client base.
3.) What issues do you feel need to be addressed in order to assure a successful project with
regard to these items or services or preparation of an RFP?
4.) From your experience in providing these items or services, what lessons learned can you
share with us?
5.) Cost estimate or range of cost (This is a cost estimate only. Any information provided will be
used to assist us in developing a budget for the acquisition. You will not be held to any
information or prices provided):
a. What items or services need to be provided on a one-time basis? What is the estimated
cost of each?
2
b. What items or services need to be provided on an on-going basis?
estimated cost of each?
What is the
c. Are there any other items or services which will affect pricing? What is the estimated
cost of each?
d. Are there any volume discounts or payment options which may affect pricing? What
are the estimated cost saving of each?
6.) How long do you estimate that it will take to provide each of the items or services describe in
this RFI. What issues may affect the delivery or needs to be addressed in the preparation of
an RFP?
Clinical and Claims based Analytics --- at a minimum include detailed information on:

The data management capabilities of your company’s system including support for SQL
Server, DB2, Oracle, and others

The provision and migration of clinical data, claims data, multi-dimensional clinical and
claims data marts, and the generation and support of OLAP data cubes

The ability to prevent the duplication of data resulting from extracting data from hospital and
practice based EHRs and receiving direct data feeds from hospital and free-standing labs and
imaging centers

The ability to produce retrospective and prospective analysis of resource utilization and
outcomes including predictive models of future resource utilization and projected outcomes

The ability for authorized users to access their data at the repository and warehouse levels,
create their own data marts and data cubes, and to produce their own canned or custom
reports

Identifying all nationally recognized quality measures that your offering supports “out of the
box” or with some level of customization, and the capabilities of reporting on those measures
for Patient Centered Medical Homes.

The ability to utilize event triggers to connect to hospital and practice based systems to obtain
and exchange information

The ability for authorized users to copy and customize national quality measures and to be
able to track and report on these custom measures

The ability for authorized users to access and modify standard displays, dashboards and
reports

Support for the creation, interactive access, and distribution of diagnosis and treatment based
patient registries (e.g. patient diabetes registry, smoking cessation registry, colorectal cancer
screening registry, etc.)

Support for the creation, viewing, and distribution of patient and physician quality measures
and treatment protocol based score cards
3
Hosting Hardware and Software --- at a minimum include detailed information about:

High Availability capabilities for all hardware, data storage, and network components.

Hardware and operating systems architecture; include detail information related to the use of
physical and virtual server configurations; identify whether or not there is sharing resources
across customers.

Data storage technologies utilized and database architectures utilized; include detail
information related to data backup and recovery processes and practices; Idaho Health Data
Exchange (IHDE) requirements prohibit the sharing of databases with other vendor
customers.

Hosting services qualifications and experience; include detailed information related to the
hosting data center’s physical environment, and its SSAE 16 certification.
Project Management (PM) --- at a minimum include detailed information related to:

Project management processes, practices or methodologies used

Provide examples of a project plan related to this type of RFI including:
o
Project staff – organizational structure
o
Project scoping process
o
Success metrics / ratings: deliverables, timelines, cost containment
o
PM tools used
Support Services --- at a minimum include detailed information related to:

Account Management Processes

Help Desk Process and SLAs

Service Level Agreement; include performance measures, monitoring, reporting, and
penalties

Procurement of Additional and New Services

Product Maintenance and Support Process; include information related to frequency and
timing of the application of product fixes

Product Feature and Function Enhancement Process

Product Release Process; include frequency and schedule for releases

Involvement of DHW / IHDE / IHC and associated workgroups in the testing and verification
of usability and serviceability of product fixes, enhancements, and new features and releases

User Group Support; include the process description for users to submit requests and
suggestions for changes and improvements in products and services, and your process for the
review and response to these items

Recommended staffing to support your company’s system (e.g. position types and quantity).
4

For multi-vendor a solution, provide details of each vendor’s role and support responsibilities
related to the solution offered. Provide details if your solution includes first level support
prior to involving a third-party vendor’s product support.

Approach and goals towards knowledge transfer to customers in the areas of:
o
System Administration
o
Interface Development
o
Best Practices – Use of functionality
Solution Programming Language and Browser Support --- at a minimum include detailed information
on:

Programming language(s) are utilized for each solution(s) offered

Which browsers are supported for each solution(s) offered
Privacy, Security, and Audit --- Please provide information regarding the following:

Product features and functions

HIPAA, HITECH, NIST and other security and privacy standards and requirements with
which your offering is compliant

Support for 2-factor user authentication

Certification of the components of your offering including the identification of the certifying
organizations (e.g. HITSP, ONC HIT Certification, etc.)

Identifying the available reports, displays, and dashboards
IV. Terms and Conditions
A. All material submitted in response to this RFI becomes the property of the State of Idaho,
Department of Health and Welfare, and shall not be returned to the responding vendor.
B. At the sole discretion of the Department the information provided may be used for the
following purposes:
1. Identify issues and refining the requirements for an RFP which may be released at a
later date.
2. Assist in projecting a budget for acquiring the services.
3. Identifying potential vendors who may be interested in providing a future competitive
proposal.
5
C. The Idaho Public Records Law, Idaho Code Sections 9-337 through 9-348, allows the open
inspection and copying of public records. Public records include any writing containing
information relating to the conduct or administration of the public's business prepared,
owned, used, or retained by a state or local agency regardless of the physical form or
character. All, or most, of the information contained in your response will be a public record
and as such will be subject to disclosure under the public records law. Certain exemptions
from disclosure can apply, one of which may be for “trade secrets” as defined in the Idaho
Public Records Act, Idaho Code Section 9-340D(1), a copy of which is available for viewing
on-line at: http://legislature.idaho.gov/idstat/Title9/T9CH3SECT9-340D.htm
1. Trade secrets include a formula, pattern, compilation, program, computer program,
device, method, technique or process that derives economic value, actual or potential,
from not being generally known to, and not being readily ascertainable by proper
means by, other persons and is subject to the efforts that are reasonable under the
circumstances to maintain its secrecy.
2. If you consider any element of your response to be a trade secret, or otherwise
protected from disclosure, you must so indicate by marking each page of the pertinent
document. Include the specific basis for your position that it be treated as exempt from
disclosure.
3. Marking your entire response as exempt is not acceptable or in accordance with the
Public Records Act and will not be honored. In addition, a legend or statement on one
(1) page that all or substantially all of the response is exempt from disclosure is not
acceptable or in accordance with the Public Records Act and will not be honored.
Prices quoted in your response are not a trade secret.
The Department, to the extent allowed by law and in accordance with these terms and
conditions will honor a designation of nondisclosure. You will be required to defend
any claim of trade secret or other basis for nondisclosure in the event of an
administrative or judicial challenge to the Department’s nondisclosure. Any questions
regarding the applicability of the Public Records Law should be addressed to the
Department or should be presented to your own legal counsel - prior to submission.
D. THIS IS NOT A BID, NO AWARD WILL BE MADE.
6
Response Information
Your written response shall not exceed thirty (30) total pages and shall include a detailed architectural
diagram delineating the components and their interactions and dependencies. However, you may attach
other information and materials that you believe relevant to your RFI response and the thirty (30) page
limit does not apply to such attachments.
V. Address for Responses
If you are interested in providing any of the information requested in this RFI, please submit your written
response via E-mail or USPS, UPS, Fed Ex or hand deliver by close of business Friday, March 6, 2015 to:
Idaho Department of Health & Welfare
Attention: RFI1500409
Contracting & Procurement Services
450 W. State Street (9th Floor)
Boise, ID, 83720-0036
Contact person: Mike Gwinn
Title: Purchasing Agent
e-mail: [email protected]
Telephone: 208-334-5734
7
ATTACHMENT A - Idaho’s Initial Performance Measure Catalog
Idaho’s Initial Performance Measure Catalog
Measure Name (and
Source)
Screening for clinical
depression.
Measure pair: (a.) Tobacco
use assessment.
(b.) Tobacco cessation
intervention (SIM)
Measure Description
Rationale for the Measure
In Idaho, 22.5% of persons aged 18 or older
had a mental illness and 5.8% had SMI in
2008–2009 while 7.5% of persons aged 18 or
older had a major depressive episode
(MDE). During the period 2005–2009, 9% of
persons aged 12-17 had a past MDE.
Suicide is the second leading cause of death
for Idahoans aged 15–34 and for males aged
10–14.
This measure aligns with Healthy People
2020.
Percentage of patients who In Idaho, 16.9% of the adult population were
were queried about tobacco smokers in 2010 (>187,000 individuals).
Idaho ranks fifteenth in the country in
use one or more times
prevalence of adult smokers and its smokingduring the two-year
attributable mortality rate is ranked eighth in
measurement period.
the country.
Percentage of patients
identified as tobacco users
who received cessation
intervention during the
two-year measurement
period.
Percentage of patients aged
12 years and older screened
for clinical depression
using a standardized tool
and follow up plan
documented.
Asthma ED visits.
Percentage of patients with
asthma who have greater
than or equal to one visit to
the ED for asthma during
the measurement period.
While asthma prevalence (those with current
asthma) in Idaho was 8.8% in 2010,
reduction of emergency treatment for
uncontrolled asthma is a reflection of high
quality patient care and patient engagement.
Acute care hospitalization
(risk-adjusted).
Percentage of patients who
had to be admitted to the
hospital.
While Idaho has one of the country’s lowest
hospital admission rates (81/1000 in 2011),
this measure is held as one of the standards
for evaluation of utilization and appropriate
use of hospital services as part of an
integrated network.
Data currently unavailable. Metric will be
used to establish baseline.
Readmission rate within 30 Percentage of patients who
days.
were readmitted to the
hospital within 30 days of
discharge from the hospital.
8
Measure Name (and
Source)
Measure Description
Rationale for the Measure
Avoidable emergency care
without hospitalization
(risk-adjusted).
Percentage of patients who
had avoidable use of a
hospital ED.
Elective delivery.
Rate of babies electively
delivered before full-term.
While Idaho has one of the country’s lowest
hospital ED utilization rates (327/1000,
2011), this measure is still held as one of the
standards for evaluation of utilization and
appropriate use of emergency services, as
well as a reflection of quality and patient
engagement in primary care related to
avoidable treatment.
Data currently unavailable. Metric will be
used to establish baseline.
While Idaho’s percentage of low birth
weight babies is low compared to the
national average, the opportunity to improve
prenatal care across settings is an indicator
of system quality.
1,355 babies in Idaho had low birth weights
in 2011, compared to 1,160 in 1997.
Idaho has a 100% shortage of mental health
The percentage of
individuals 18–64 years of providers statewide. Without these critical
providers, there is little or no support for
age during the
patient engagement and medication
measurement year with
adherence.
schizophrenia who were
Improved adherence may be a reflection of
dispensed and remained on improved access to care and patient
an antipsychotic medication engagement.
for at least 80% of their
treatment period.
Low birth weight rate (PQI This measure is used to
9).
assess the number of low
birth weight infants per 100
births.
Adherence to
antipsychotics for
individuals with
schizophrenia (HEDIS).
Weight assessment and
Percentage of children, two
counseling for children and through 17 years of age,
adolescents (SIM).
whose weight is classified
based on Body Mass Index
(BMI), who receive
counseling for nutrition and
physical activity.
9
In 2011, 13.4% of children were overweight
as defined by being above the 85th percentile,
but below the 95th percentile for BMI by age
and sex, while 9.2% were obese, i.e., at or
above the 95th percentile for BMI by age and
sex.
Measure Name (and
Source)
Measure Description
Rationale for the Measure
Comprehensive diabetes
care (SIM).
The percentage of patients
18-75 with a diagnosis of
diabetes, who have
optimally managed
modifiable risk factors
(A1c<8.0%, LDL<100
mg/dL, blood
pressure<140/90 mm Hg,
tobacco non-use, and daily
aspirin usage for patients
with diagnosis of IVD)
with the intent of
preventing or reducing
future complications
associated with poorly
managed diabetes.
Adult diabetes prevalence in 2010 was 8.0%.
Overall, this represented one in 12 people in
Idaho had diabetes.
Access to care.
Members report adequate
and timely access to PCPs,
BEHAVIORAL HEALTH,
and dentistry (measure
adjusted to reflect shortages
in Idaho).
Idaho has a critical access shortage of
primary care providers, behavioral health
providers, and dentists across the State
which impedes access to the appropriate
level of care.
Childhood immunization
status.
Percentage of children two
years of age who had four
DtaP/DT, three IPV, one
MMR, three H influenza
type B, three hepatitis B,
one chicken pox vaccine,
and four pneumococcal
conjugate vaccines by their
second birthday. The
measure calculates a rate
for each vaccine and two
separate combination rates.
While there have been significant
improvements in immunization rates, Idaho
ranks 43rd in the nation with an
immunization rate of 87.33% in 2012.
This measure aligns with Healthy People
2020.
10
Measure Name (and
Source)
Measure Description
Rationale for the Measure
Adult BMI Assessment.
The percentage of members In 2010, 62.9% of adults in Idaho were
overweight, and 26.9% of adults in Idaho
18 to 74 years of age who
were obese.
had an outpatient visit and
who’s BMI was
documented during the
measurement year or the
year prior to the
measurement year.
Non-malignant opioid use.
Percent of patients
chronically prescribed an
opioid medication for noncancer pain (defined as
three consecutive months of
prescriptions) that have a
controlled substance
agreement in force (updated
annually).
From 2010–2011, Idaho had the fourth
highest non-medical use of prescription pain
relievers in the country among persons aged
12 or older at 5.73%.
The timeline for developing a baseline and establishing performance reporting to achieve population
health management is outlined below.
The IHC will establish a baseline for each of these measures in Year 1 of model testing.
Due to the lack of uniform reporting that exists today, the IHC will develop a baseline from the
pockets of information that are currently available across payers and populations. An external
organization with expertise in performance data collection, analysis, and reporting will assist the IHC
in gathering and analyzing the data to establish a baseline by the end of Year 1.
In Year 2, the IHC will select four core performance measures from the initial Performance Measure
Catalog to be reported by all PCMHs in Year 2.
The statewide performance measures for Year 2 will include the three SIM measures: tobacco
cessation intervention, weight assessment and counseling for children and adolescents, and
comprehensive diabetes care.
In consultation with the IHC, Regional Collaborative (RCs) will identify additional performance
measures from the Performance Measure Catalog to be collected from PCMHs in their respective
regions in Year 3.
The additional measures collected in Year 3 may vary from region to region depending on
performance and regional health needs and will be informed by community health assessments and
regional specific clinical data.
During the first year of implementation and model testing, the IHC will analyze the current system
capabilities and constraints regarding statewide data collection and reporting. By the end of Year 1,
decisions regarding construction of the statewide database and protocols for PCMHs to report on
11
performance measures will have been developed. The IHC will engage stakeholders in this discussion to
ensure that a statewide solution is viable and acceptable to the different communities in Idaho.
The development of a Performance Measure Catalog and reporting of statewide performance measures
across multiple payers and populations is a major first step for Idaho as we move toward population
health management.
12