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Services Description GPSoC Service Name GPSoC Service ID Service Overview HealthShare Personal Community ISC-HS-PC Successful health care organisations recognise the need to create and sustain engaged communities of clinicians, patients, families, and other healthcare participants. The principal objective of engaging the patient community is to harness the power of the most underutilised asset in healthcare, the patient. For this reason, InterSystems has developed the HealthShare Personal Community. HealthShare Personal Community has been designed to educate, empower, and engage individuals in the healthcare process. Personal Community makes patients’ entire Composite Health Records available to them and their designated representatives in a visually appealing and understandable fashion. It supports selfcare and dependent-care management, streamlines communication and care activities, and respects client privacy. Figure 1 - Timeline view of Patient History Key features of HealthShare Personal Community include: Personal health timeline: A visual representation of the patient’s or dependent’s medical history, show in figure 1. Consolidated personal record viewer: Presents a comprehensive view of the full healthcare record for the patient or the patient’s dependents. Consent management: Define the access privileges to a patient record. Personal record management: Allows patients or their proxies to add records and documents, respond to surveys, and request updates to records Patient-provider communications: Secure messaging functions to support ongoing communications between patients and providers. Patient education: Provides ready access to localised clinical reference and patient education materials, as well as relevant news and event notifications. Care activity management: Enable patients to request appointments, referrals and medication updates. Administrative functions: Manage enrolment, consent policies, educational content, and other configurable components of the portal. Care providers and patients both need access to complete and accurate health information, but the appropriate presentation of that information varies by audience. HealthShare Personal Community uses simple layouts, graphical data presentations, and links to relevant reference materials to provide health records to clients and their representatives in a meaningful way. Personal Community includes several different approaches to locating information, including a personal health timeline that displays past healthcare activities in a sequential format as shown in Figure 5, a timeline view of Patient History. Figure 2 - Information of Interest Alternatively, patients and their designated representatives can select the type of information of interest to them, for example, immunisations, and move directly to that portion of the record as shown in Figure 6. The entire clinical record is available for viewing and is segmented into sections, including: Demographics, Medications, Allergies, Laboratory results, Encounters, Vital signs and Observations, Clinical notes, Upcoming appointments, and Care plan documents. A critical component of the community portal is control over access to an individual’s records. Families and other caregivers may need access to information about their dependents. Patients need to know that information will only be shared in accordance with their wishes. Personal Community provides functionality for providers and clients to balance both needs Patients need to communicate with care providers with questions about a condition, diagnostic test results or other reasons. Personal Community guides clients through the communication process securely and intuitively. Personal Community also connects patients to reliable information about their conditions, treatments, and options. Educational content within Personal Community is completely configurable to address local needs, language requirements, and specific clinical populations, for example, paediatrics or oncology. Content can include reference materials, information about self-management, health-related news, upcoming healthcare classes or events, and links to other information and care sources. Personal Community can also be used to solicit information from clients including standardised record components such as medical, family and social history or specialised screening surveys such as depression screens or functional status evaluations. Similarly, information can be pushed back to clients in response to survey responses, for example messages or educational materials. The more the portal is used as a communication and interaction tool, the higher the level of client engagement in the care process. Ideally, clients should come to see the Personal Community as an essential component of their healthcare ecosystem. Importantly, the Personal Community user interface can be quickly rebranded allowing different organisations to present a clear identity to their patient communities. A complementary administrative tool, the Community Workbench, is used by administrators to manage enrolments, tasks, configuration and setup, as well as operational monitoring. It provides a central, workflow-based application for carrying out tasks requested by patients using the Personal Community that require human intervention and cannot otherwise be automated. Community Workbench gives healthcare administrators and information managers the ability to perform tasks on behalf of patients; report on community usage; manage the content displayed within the Personal Community portal; and perform general management tasks for the Personal Community. Case Studies Support For appropriate case studies please contact InterSystems, or alternatively, please see InterSystems Website for details of case studies in this service area. Support Arrangements Support for the HealthShare packaged services is provided directly by InterSystems. InterSystems approach to support is based on delivery of processes and procedures in accordance with Information Technology Infrastructure Library (ITIL) best practices, a philosophy of “Continuous Improvement”, and root-cause analysis aimed the aim of reducing the level of calls to the Service Desk whilst improving customer satisfaction. Services are provisioned by combining a proactive and reactive approach. Events are continuously monitored and alerts are automatically generated in order to avoid potential future problems. Helpdesk Arrangements InterSystems Help Desk is staffed by UK based personnel and forms part of the InterSystems Worldwide Response Centre (WRC), a global network of regional centres with extensive expertise across the product portfolio. The organisation is comprised of teams of individuals working together to provide support services that InterSystems customers require. The Help Desk is located in Eton at the InterSystems UK headquarters and will serve as the main point of communication for NHS organisations. The Service Centre maintains a structured approach to application support services based upon an ITIL V3 compliant methodology and provides a single point of contact for the control and management of all issues relating to the collaborative working applications being supported. The Service Centre is managed and supported by the appropriate mix of specialists required to support a managed service operation for customers. The Worldwide Response Centre (WRC) is available by phone, e-mail, and online 24x365 to provide product support to HealthShare clients who subscribe to support services. Guaranteed response is 30 minutes and at least 75% of all contacts are immediate. Clients determine the priority (Crisis, High or Medium) and requests are not closed without client permission. Clients rate the WRC staff 9.8 out of 10 for courtesy and professionalism. The WRC meets ITIL best practices and provides Incident Management, Problem Management, Change and Release Management. Specific Service Level Agreements are determined for clients based on their requirements contracts. All incidents, service requests, problems, and change requests, regardless of which component they affect, are managed using the Service desk application. When an incident (an event that negatively impacts the service to the user) is reported to the Service Desk, a new incident ticket is opened and an investigation triggered. The initial focus of the investigation is always to resolve the incident and return the portion of the affected system to normal operation. In the event an incident requires a deeper level of investigation, a problem incident may be triggered and a Root Cause Analysis performed. In cases where a Problem investigation is warranted, the Service Desk application will again be used to record investigation activity. This allows the customer visibility into every step of the resolution process. Only when the customer has confirmed that the problem has been resolved to their satisfaction, will the Service Desk ticket will be closed. Once closed, the problem record forms part of a searchable database, to aide in future problem investigations/resolution. Help Desk Response Time / Incident Fix Times Standard: Incident Category Response Time 1 2 3 4 15 mins 30 mins 2 hours 1 day Resolution or Provision of a workaround 2 hours 4 hours 2 days Next New Version Table 1 - Help Desk Response Time / Incident Fix Times Standard Service Availability Clients that manage their own systems can achieve at least 99% uptime, excluding planned outages, if they implement our recommended configurations and follow systems management best practices. Where selected, InterSystems’ hosted service offering provides a minimum of 99% uptime excluding planned outages that are agreed with the client 30 days in advance. Contractual Remedies Specific Service Level Agreements and related remedies, such as credits for service failures and termination options, will be included in Call Off contracts with each client. Customer Satisfaction The InterSystems Worldwide Response centre boasts an unrivalled track record of customer satisfaction, having achieved an average of 98% overall satisfaction rating since 2001. This has been derived from customer satisfaction feedback, provided by thousands of InterSystems customers and responded to by tens of thousands of end users. A formal governance mechanism for escalation of satisfaction issues will be agreed and regular management reviews may take place, over and above the monthly service review meetings. CLIENT PRIORITY Escalation CRISIS HIGH MEDIUM Immediate verbal notification to all appropriate senior managers by the director of client support. Immediate automated notification to senior management. Immediate automated notification to WRC management. Table 2 - Escalation Governance Simple satisfaction surveys are automatically generated for the designated customer contact upon closure of every incident within the Service Desk application. The “simple” survey inquires as to whether or not the incident was resolved to the customer’s satisfaction (Yes/No) and whether or not they have any additional feedback to share. Comprehensive satisfaction surveys are also automatically generated on a random selection of incidents. The InterSystems executive team meets formally on a weekly basis to review customer satisfaction and address issues of service delivery and/or service support. Low or “unsatisfied” results automatically trigger instant management alerts that will result in a detailed internal review and subsequently; a follow up process with the customer is initiated. More comprehensive satisfaction surveys will be conducted throughout the service management lifecycle, for the duration of the contract, as agreed with the customer. Dependencies Service Dependencies Prerequisite for the HealthShare Personal Community is to have the HealthShare Information Exchange (HIE) installed and configured. Refer to HIE for associated dependencies. To ensure successful delivery to a schedule to be agreed with InterSystems, the customer must ensure that all source system providers to connect to the HealthShare Personal Community have empowered and knowledgeable staff, complete end-point interface documentation and technical staff able to verify message delivery available as agreed (If applicable). The customer must make sure that they are staffed fully in accordance with levels defined by InterSystems and agreed prior to commencement of the project in order to fulfil the agreed project plan. The customer must ensure that all end-point production and test systems are actively available at all times as required by InterSystems and mutually agreed. Third Party Dependencies Prerequisite for the HealthShare Personal Community is to have the HealthShare Information Exchange (HIE) installed and configured. Refer to HIE for associated dependencies. Access to N3 and/or other network/internet provision as per the individual end user policy. Dependence on third party systems connecting to HIE if the Personal Community will be used to support interactions with those source systems. See HIE dependencies. Infrastructure Dependencies The InterSystems HealthShare Personal Community solution will require the defined system-software, servers, and storage requirements to be provided for each individual contract. Two options are available for deployment, either a client self-hosted solution or an InterSystems hosted solution within appropriate secure data-centre capacity within the UK. In all cases it is anticipated the customer will provide user access devices (for example desktop/ tablet/ smartphone) with appropriate network access for all users. Client Self-Hosted Option In a client self-hosted environment a detailed document will be provided detailing all of the server, storage, and system-software such but not limited to virtualisation, operating systems, and backup management. The hardware resource requirements will be determined based on the expected workload in terms of both processing and storage requirements. The HealthShare solution is supported on a wide variety of platforms and operating systems. These operating systems include Microsoft Windows Server, Linux (Red Hat and SUSE), and IBM AIX UNIX. Network topology is to be provided by the client to convey network connectivity options (copper, SFP, SFP+, etc…), network (VLAN) assignments, DMZ and firewall requirements, and any other established pertinent network security practices. This information is necessary to understand the deployment model and determine if there are any security risks or vulnerabilities. InterSystems Hosted Option In an InterSystems hosted environment, HealthShare will be deployed onto InterSystems owned and operated equipment as a fully managed service and will be provisioned to support the contract terms. InterSystems leverage a completely virtualised architecture providing elastic resources to be agile and rapidly respond to changing requirements. Network connectivity methods (N3, MPLS, IPSEC, VPN etc.) and bandwidth requirements will need to be determined along with the respective demarcation points/addresses to establish WAN connectivity between the client and InterSystems data centres. Local Personnel Dependencies This will be discussed as part of the call off, for customer-led initiatives the local resource requirements will vary according to the scope of use of the solution. The customer will provide project sponsorship, project management, as well as functional and technical resources required by the project. Personal Community is a capability that may be used by end users’ in house resources where local customisation/branding is desired. For customer-led initiatives the local resource requirements will vary according to the scope of use of the solution. Where InterSystems has responsibility for delivery of Personal Community project, the customer must make sure that they are staffed fully in accordance with levels defined by InterSystems and agreed prior to commencement of the project in order to fulfil its part of the agreed project plan. Sub-Contractor(s) InterSystems do not expect to sub-contract the delivery of any Catalogue item or Service. Contract staff may be sourced and used to support and extend the InterSystems delivery capacity, however contractual responsibility for any delivery will remain entirely with InterSystems Pricing Information Implementation Charges Below implementation sections are standard for setting up the HealthShare Personal Community package. Depending on the specific customer requirements, the implementation steps can vary slightly in terms of man-days as well as in the number of steps. Therefore, the implementation man-days and number of steps presented below, is indicative. Standard Setup of HealthShare Personal Community Infrastructure (17 man-days): Install HealthShare Personal Community and its components with dummy interfaces to make sure the solution is properly installed, configured, tested and ready to be connected Infrastructure (17 man-days): Install HealthShare Personal Community and its components in accordance with the customer requirements at the disaster recovery centre (if applicable) Documentation (17 man-days): Provide documentation in accordance with the agreed project plan and deliverables Participate to the creation of Interface Technical Design and Mapping documents. One document per interface is required Update the Systems document to reflect components and processes used for interface(s) Configuration (39 man-days): Configure/tuning of Hardware, Infrastructure & Environments Configure the HealthShare Personal Community platform according to customer requirements: Development environment Integration/Operability tools dB Management system (Repositories/Registries) Education Services Messaging Services Community Portal Health Record Services Auditing and Reporting Services Community Benchmark Personal Health Services Configure a data transformation layer and routing rules for message transformation as defined in the agreed Systems document Customisation/Development (average 17 man-days per development area): Provide and participate with customization as required and agreed in project plan before project commences. Testing (17 man-days): Testing in accordance with the agreed project plan Address issues logged in InterSystems’ web-based Trak Resolution Centre (TRC) Perform Unit Test Unit Test Plan Unit Test Execution Support the Pre-Production Test with the customer end users – Using data supplied by the connecting source systems, the customer reviews the representation of the data in HealthShare Personal Community (UAT environment) Pre-Production Test Plan Pre-Production Test Execution – Performed by staff from customer end users Documented Pre-Production Test Results – Created by the customer end users Integrated Test (Live feed from source systems to HealthShare Personal Community – real time) Cutover to Production (17 man-days): Create the technical cutover checklist Enable data feed flow into the LIVE system Assist the customer end users with validation in the LIVE system Observe and communicate any issues related to data processing for two weeks following go live in the production environment Transition to InterSystems Support (if applicable) Training (17 man-days): Train the various users in accordance with the agreed project plan Train the customer super users on usage of the TRC response centre application Service Charges The total average implementation of the HealthShare Personal Community is 141 man-days + 17 man-days per development area. Charge Description Unit Price (exc VAT); Service Subscription Fees The pricing for HealthShare Personal Community is based on two factors: a base subscription that provides the underlying software needed to operate the solution, and a service subscription that reflects the number of patients/citizens enrolled to use the service. For the initial production instance that operates Personal Community we charge a primary server subscription fee. For subsequent production instances and additional systems used for training, testing, development, or failover, we offer a secondary server subscription fee. Subscriptions include Software License, Software Update and Technical Assistance services. A subscription can be upgraded to larger capacity at any time. Subscriptions are available on a month-to-month basis, with no fixed term, or on a fixed term basis for up to ten years. Service subscription fees for HealthShare Personal Community are based on the number of patients/citizens enrolled to use the service. Illustrative Licensing Example: A HealthShare Personal Community service is deployed to serve 10,000 enrolled patients. The deployment architecture includes 1 primary production instance and 3 secondary instances of the Personal Community software. Monthly Subscription Pricing: 1 x Primary @ £2,587 3 x Secondary @ £647 10 x 1000 patients @ £143 Total Monthly Fee = £5,958 Personal Community can be deployed at an end user location or remote hosting facility. Primary Server Monthly Subscription = £2,587 Secondary Server Monthly Subscription = £647 Monthly Service Subscription £143 per 1,000 enrolled patients These prices do not include hosting or managed service these are available from InterSystems and will be negotiated at call off. Software Licenses As an alternative to using HealthShare on a subscription basis, HealthShare Personal Community server capacity is available on a traditional one-timecharge license basis. Primary Server License = £81,671 Secondary Server License = £20,418 In this case, Software Update and Technical Assistance services must be purchased separately (see below) Prices for up-front payment of monthly service subscriptions are available on request. Monthly Service Subscription = £143 per 1,000 enrolled patients Personal Community can be deployed at an end user location or remote hosting facility. These prices do not include hosting or managed service these are available from InterSystems and will be negotiated at call off. Software Update Programme The Software Update programme provides free updates to new software versions. In addition, when switching computers, the Software Updates programme provides free transfers in some cases and trade-in credits in other cases. Annual Software Update fees are calculated as a percentage of the License Fees stated above. Annual Software Update Fees = 15% license list price Technical Assistance Program The Technical Assistance Programme provides assistance via telephone, fax, or email for problem resolution during normal business hours; emergency assistance 24 hours/day, 7 days/week; and problem updates via email. Participation in the Software Update Programme is a prerequisite for Technical Assistance. On-site Annual Technical Assistance Fees = 7% license list price software installation is not included in Technical Assistance or License Fees. Annual Technical Assistance fees are calculated as a percentage of the License Fees stated above. Personal Community can be deployed at an end user location or remote hosting facility. These prices do not include hosting or managed service these are available from InterSystems and will be negotiated at call off. Exit Charges On termination of contract, users will no longer have access to the HealthShare Personal Community solution. The necessary steps at termination of contract include removing hardware, infrastructure, and software and transfer the data stored in the HealthShare Personal Community (if applicable). This is a 17 mandays project. A specific Exit Plan would be agreed at call off as appropriate. The standard rate card would apply. Invoicing Terms HealthShare Service Subscription fees (which include License, Software Update and Technical Assistance) are invoiced monthly in arrears and are chargeable from the beginning through to the end of the contract. HealthShare One-Time-Charge license fees are invoiced upon electronic delivery of the license key. For HealthShare One-Time-Charge License fees, associated Software Update and Technical Assistance fees are invoiced monthly in arrears and the fees are chargeable from delivery of the license key through to the end of the contract. Implementation and other agreed professional service fees are invoiced on delivery of the service or provision of resource (rate card) to the client which could include milestone payments for implementation services. Additional Charges Any travel expenses, wire fees, sales taxes, value added taxes, import duties, or other government-imposed charges applicable to License and services fees shall be paid by the Customer. Shipping terms are FOB Destination, unless otherwise noted on the invoice. The Customer shall pay shipping and handling charges as detailed on each invoice. Payment Terms Discounts Resource Based Pricing All fees are due 30 days from the date of invoice, unless otherwise agreed in the Call Off. None proposed in this submission InterSystems can offer a range of Implementation and Consulting services, pricing for these resource based offerings can be found in Schedule 7.1 Annex C for details of InterSystems Rate Card. Other Pricing Information Any change request must be consistent with the scope of the project and not a substantial change to InterSystems standard products or services, other than the required configuration for the project.