Request for Proposal



Community and Hospital Assessments for HIE

Request for Proposals

Executive Summary

The Rural Health Information Technology Consortium (RHITC) was formed to enable all willing rural providers achieve HIE and meaningful use of health information technology.

The RHITC plan is to organize and deploy local experts to create an adaptive and comprehensive HIE plan for every rural community in the state.  Rural medical trading areas revolve around the rural anchor tenant: the community hospital. Without enabling rural hospitals to achieve meaningful use of EHRs and HIE, local rural healthcare providers are unlikely to achieve meaningful use, qualify for incentive payments, and fully utilize Federal investments in broadband and telehealth services.

An unintended consequence of ARRA could be the loss of significant outpatient laboratory revenue if rural hospitals don’t exchange lab data with their providers, who will be forced to use chain laboratories to achieve meaningful use. Outpatient revenue represents almost half of rural hospitals total revenue, a significant portion of it coming from the lab.

By leveraging local Health IT expertise to rapidly assemble a comprehensive inventory of Health IT assets at each rural and critical access hospital and determine its medical trading area, a comprehensive plan can be prepared to enable all willing healthcare providers, clinics, hospitals, public and mental health departments and other local caregivers to achieve HIE and meaningful use. These plans can be used to support the efforts of CalHIPSO, CTN, Cal eConnect, the Medi-Cal EHR Incentive Program, grant applications and loan fund development.

Purpose and Scope

The purpose of this effort is to assess the health IT readiness of California’s medical trading areas anchored by its 69 rural hospitals, and prepare hospital and community plans for health information technology and exchange that will support rural providers ability to achieve meaningful use, as defined by CMS.

Each community assessment is to include the following:

• A detailed HIT assessment of the designated critical access or rural hospital of the community, outlining timing and budget to achieve meaningful use and participate in community-wide HIE.

• A list of all providers and healthcare facilities in the medical trading area, to include primary contacts, email addresses and phone numbers:

o All rural and community clinics in the service area

o The public health department(s) serving the area

o Independent providers, including IPAs and medical groups

o Indian Health Service facilities

o Department of Defense facilities

o Veterans Administration facilities

o Long-term care and skilled nursing facilities

o Mental health services and facilities

o Telemedicine functioning in the service area

o Any local health coalition

o Independent pharmacies

o Independent laboratories

o Corrections facilities

• A list of all healthcare professional’s whose patients use the hospitals outpatient laboratory services

Tasks To Be Accomplished

The following activities are to be accomplished by the consortium.

Questionnaires

In each community, the local hospital will be a key participant in meaningful use and HIE. If the hospital cannot exchange information such as laboratory results, radiology reports and prescription information, the providers in the community cannot achieve meaningful use. Thus the hospital is central to the community of prioritized primary care providers being able to achieve meaningful use incentives.

The consortium is expected to perform the hospital assessment as follows:

1. Contact the CEO of the hospital to be surveyed. For a critical access hospital, Ray Hino, the director of the Critical Access Hospital Network, will have emailed each CEO notifying him/her of this study. For rural hospitals, Evan Rayner, Chair of the Rural Health Advisory Committee of the California Hospital Association, will have notified the CEO of each hospital of this study. Request the participation of the hospital.

2. Once the CEO has agreed, request that his/her Administrative Assistant coordinate the participation of the key hospital staff listed in the Questionnaires section above. Ask the AA to schedule SurveyMonkey questionnaire completion and a single day when the contractor can perform onsite interviews of all the executives to expand upon information provided in SurveyMonkey responses. See item 6 below.

3. Provide a request for documents to the AA for distribution to several executives, primarily the CEO and the IT Director. The later is asked to provide a number of documents. A list of documents to be requested appears in Attachment A.

4. Provide the hospital the questionnaires for determining the level of IT performance of the hospital and request its completion.

5. Determine the following:

a. HIE activity in the service area;

b. The hospital’s approach to privacy and security;

c. The tertiary hospitals used for referrals with referral statistics

d. Outpatient providers that use laboratory services

6. Write up findings and have it reviewed by CEO before submission for payment.

Deliverables

The contractor will provide to RHITC the following product :

A report on the community survey organized as follows:

1. Executive Summary

2. Background with Community Map (showing all facilities of all types and referral hospitals)

3. Hospital Findings (based on questionnaire responses and interviews)

a. CEO Perspective

b. CFO Perspective

c. CNO Perspective

d. IT Director Perspective

e. Laboratory Director Perspective

f. Medical Imaging Director Perspective

g. Pharmacy Director Perspective

h. Telemedicine Capabilities

i. Outpatient pharmacy HIE readiness

j. Outpatient laboratory HIE readiness

k. Existing or planned HIE operations

4. Table of IT Systems (see format provided in Attachment A, showing systems gap for achieving meaningful use and dollar cost of needed systems)

5. IT Staffing Matrix (showing after-hours coverage arrangements and positions needed to reach meaningful use as estimated by agreement between IT Director, CEO or CFO and contractor)

6. Table of outpatient providers by type and specialty, with full contact information, including phone and email address, where available.

7. Conclusions and recommendations for community engagement in HIE.

Proposal Instructions

The proposal should not exceed 3 pages (excluding attachments and optional addendum) and include the following:

1. Page 1: Background -- demonstrate understanding of the project

2. Page 2: Qualifications and Experience

1. Relevant Background, particularly to communities chosen (max 1 page)

3. Page 3: List of Rural Hospitals Proposed To Survey, costs (including expenses) and proposed schedule (see Attachment B, hospital list)

NOTE: CAHs are a priority. All CAHs must be completed by June 30, 2010.

EXAMPLE

|Rural Hospital |Assessment Bid |Completion Date |

|Biggs Gridley |$3500 |May 20, 2010 |

|Ridgecrest |$4000 |July 5, 2010 |

4. OPTIONAL Addendum: Please indicate if you are also willing to perform HIT readiness assessments for rural outpatient physicians and clinics. If so, please attach a copy of your readiness assessment tool and quote a price for performing outpatient provider assessments for small (0-2), medium (3-7) and large practices (8+ providers).

5. Attachments: Resume(s) and optional letters of support

Criteria for award:

A total of 100 points will be awarded: 25 points for experience, 25 points for community relationships, 25 points for schedule and 25 points for reasonableness of budget. A minimum of 50 points is required. If multiple vendors are above 50 points and are equally available, the hospital CEO will choose the vendor. Initial awards will be made on to applicants with acceptable scores and no geographic competition. Subsequent awards will be made on a rolling basis until all 69 assessments are complete.

Terms

Terms will be net 30 upon approval of the report. Reports will be reviewed for approval within ten working days of receipt and may be returned for further work before approval. Expenses will not be reimbursed separately.

Timing

|RFP Release |Technical Assistance Call |Initial |Initial Awards. |

| | |Response Due Date | |

|April 29, 2010 |April 30, 2010 |May 5, 2010 |May 10, 2010 |

| |2:00 PM |Midnight | |

| |877-533-6338 Conference ID: | | |

| |24534 | | |

Submission Instructions:

Email PDF version of submission to rhitcrfp@. Subject line must say “RHITC RFP”

Attachment A: Hospital Questionnaires (see survey monkey)















Attachment B: Hospital List

|Banner Lassen Medical Center |Susanville |25 |25 |CAH |

|Biggs-Gridley Memorial Hospital |Gridley |45 |24 |CAH |

|Catalina Island Medical Center |Avalon |12 |8 |CAH |

|Colorado River Medical Center |Needles |25 |25 |CAH |

|Eastern Plumas Health Care |Portola |76 |10 |CAH |

|Fairchild Medical Center |Yreka |25 |25 |CAH |

|Frank R. Howard Memorial Hospital/Adventist Health |Willits |25 |25 |CAH |

|Glenn Medical Center |Willows |47 |47 |CAH |

|Healdsburg District Hospital |Healdsburg |43 |26 |CAH |

|Jerold Phelps Community Hospital |Garberville |17 |9 |CAH |

|John C. Fremont Healthcare District |Mariposa |34 |18 |CAH |

|Kern Valley Healthcare District |Lake Isabella |101 |27 |CAH |

|Mammoth Hospital |Mammoth Lakes |17 |17 |CAH |

|Mayers Memorial Hospital District |Fall River Mills |121 |22 |CAH |

|Mendocino Coast District Hospital |Fort Bragg |49 |49 |CAH |

|Mercy Medical Center Mount Shasta |Mount Shasta |80 |33 |CAH |

|Modoc Medical Center |Alturas |87 |16 |CAH |

|Northern Inyo Hospital |Bishop |25 |25 |CAH |

|Plumas District Hospital |Quincy |25 |25 |CAH |

|Redwood Memorial Hospital |Fortuna |25 |25 |CAH |

|San Bernardino Mountains Community Hospital District |Lake Arrowhead |37 |17 |CAH |

|Santa Ynez Valley Cottage Hospital |Solvang |10 |10 |CAH |

|Seneca Healthcare District |Chester |26 |10 |CAH |

|Southern Inyo Hospital |Lone Pine |37 |4 |CAH |

|St. Helena Hospital/Clearlake |Clearlake |25 |25 |CAH |

|Surprise Valley Health Care District |Cedarville |26 |4 |CAH |

|Sutter Lakeside Hospital |Lakeport |49 |49 |CAH |

|Tahoe Forest Hospital District |Truckee |62 |25 |CAH |

|Tehachapi Valley Healthcare District |Tehachapi |24 |24 |CAH |

|Trinity Hospital |Weaverville |51 |25 |CAH |

|Palo Verde Hospital |Blythe |25 |25 |Pending CAH |

|Adventist Health/Central Valley General Hospital |Hanford |49 |49 |  |

|Adventist Health/Hanford Community Medical Center |Hanford |121 |121 |  |

|Adventist Health/Selma Community Hospital |Selma |47 |47 |  |

|Barstow Community Hospital |Barstow |105 |56 |  |

|Barton Memorial Hospital |South Lake Tahoe |119 |71 |  |

|Bear Valley Community Hospital |Big Bear Lake |30 |9 |  |

|Coalinga Regional Medical Center |Coalinga |138 |24 |  |

|Colusa Regional Medical Center |Colusa |48 |42 |  |

|Corcoran District Hospital |Corcoran |32 |1 |  |

|Dos Palos Memorial Hospital |Dos Palos |27 |27 |  |

|El Centro Regional Medical Center |El Centro |165 |165 |  |

|Fallbrook Hospital |Fallbrook |140 |47 |  |

|George L. Mee Memorial Hospital |King City |119 |103 |  |

|Hazel Hawkins Memorial Hospital |Hollister |171 |49 |  |

|Hi-Desert Medical Center |Joshua Tree |59 |59 |  |

|Kingsburg District Hospital |Kingsburg |20 |20 |  |

|Lompoc Valley Medical Center |Lompoc |170 |60 |  |

|Mad River Community Hospital |Arcata |78 |78 |  |

|Mark Twain St. Joseph's Hospital |San Andreas |48 |48 |  |

|Marshall Medical Center |Placerville |105 |91 |  |

|Memorial Hospital Los Banos |Los Banos |46 |46 |  |

|Oak Valley Hospital District |Oakdale |150 |35 |  |

|Ojai Valley Community Hospital |Ojai |103 |37 |  |

|Palm Drive Hospital |Sebastopol |37 |37 |  |

|Pioneers Memorial Healthcare District |Brawley |107 |107 |  |

|Ridgecrest Regional Hospital |Ridgecrest |98 |98 |  |

|San Gorgonio Memorial Hospital |Banning |77 |61 |  |

|Seton Coastside |Moss Beach |121 |5 |  |

|Sierra Kings District Hospital |Reedley |44 |44 |  |

|Sierra Nevada Memorial Hospital |Grass Valley |104 |87 |  |

|Sonora Regional Medical Center/Adventist Health |Sonora |140 |72 |  |

|St. Elizabeth Community Hospital |Red Bluff |76 |76 |  |

|St. Mary Medical Center |Apple Valley |186 |186 |  |

|Sutter Amador Hospital |Jackson |42 |42 |  |

|Sutter Coast Hospital |Crescent City |59 |59 |  |

|Twin Cities Community Hospital |Templeton |114 |114 |  |

|Ukiah Valley Medical Center/Adventist Health |Ukiah |78 |78 |  |

|Victor Valley Community Hospital |Victorville |115 |99 |  |

Attachment C: Definitions

Selected Definitions Relevant to the Medicare EHR Incentives

1886 (d) Hospitals: Section 1886(d) of the Social Security Act (the Act) sets forth a system of payment for the operating costs of acute care hospital inpatient stays under Medicare Part A (Hospital Insurance) based on prospectively set rates. This payment system is referred to as the inpatient prospective payment system (IPPS). Acute-care hospitals subject to IPPS 1886(d) are often referred to as 1886(d) hospitals.

Eligible Hospital: Per Title 18 of the Social Security Act as amended by Title IV in Division B of ARRA, an 1886(d) inpatient acute care hospital paid under the Medicare inpatient prospective payment system (IPPS) or an 1814(l) Critical Access Hospital (CAHs).

Non-eligible Hospital: Per Title 18 of the Social Security Act as amended by Title IV in Division B of ARRA, any hospital other than an acute-care hospital under 1886(d) or Critical Access Hospital under 1814(l). (Per SSA 1886(d), examples include Long-term Care Hospitals, Inpatient Rehabilitation Hospitals, Inpatient Psychiatric Hospitals, non-IPPS Cancer Centers and Children’s Hospitals.)

Eligible Professional: For purposes of the Medicare incentive, an eligible professional is defined in Social Security Act Section 1848(o), as added by ARRA, as a physician as defined in Social Security Act 1861(r). The definition at1861(r) includes doctors of medicine, doctors of osteopathy, doctors of dental surgery or of dental medicine, doctors of podiatric medicine, doctors of optometry, and chiropractors.

Hospital-Based Professional: Social Security Act 1848(o)(1)(C)(ii), as added by ARRA, defines a ‘hospital-based professional’ for purposes of clause (i) of Social Security Act 1848(o)(1)(C). A hospital-based professional is an otherwise eligible professional, such as a pathologist, anesthesiologist, or emergency physician, who furnishes substantially all of his or her covered professional services in a hospital setting (whether inpatient or outpatient) and through the use of the facilities and equipment, including qualified electronic health records, of the hospital. The determination of whether an eligible professional is a hospital-based eligible physician shall be made on the basis of the site of service (as defined by the Secretary) and without regard to any employment or billing arrangement between the priority primary-care provider and any other provider. Social Security Act 1848(o)(1)(C)(i) that no Medicare incentive payments for meaningful use of certified EHR technology may be made to hospital-based eligible professionals.

Selected Definitions Relevant to Medicaid EHR Incentives

Eligible professional: Social Security Act 1903(t)(3)(B), as added by ARRA, defines an eligible professional for Medicaid health IT incentives as a physician, dentist, certified nurse mid-wife, nurse practitioner, or a physician assistant practicing in a rural health clinic or FQHC that is led by a physician assistant, if he/she meets the criteria set forth in Social Security Act 1903(t)(2)(A) as added by ARRA.

Rural Health Clinic: For purposes of this Funding Opportunity Announcement, “rural health clinic” is defined as clinic providing primarily outpatient care certified to receive special Medicare and Medicaid reimbursement. RHCs provide increased access to primary care in underserved rural areas using both physicians and other clinical professionals such as nurse practitioners, physician assistants, and certified nurse midwives to provide services. For the statutory definition of a Rural Health Clinic for purposes of provider reimbursement, please see Section 1861(aa) of the Social Security Act.

Federally Qualified Health Center (FQHC): FQHCs are safety net providers such as community health centers, public housing centers, outpatient health programs funded by the Indian Health Service, and programs serving migrants and the homeless. For the statutory definition of an FQHC, please see Section 1861(aa) of the Social Security Act. For further information about FQHCs, please see either or both of the following resources:

(1) the CMS Federally Qualified Health Center Fact Sheet, available online at ; and/or

(2) HRSA Policy Information Notice 2003-21: Federally Qualified Health Center Look-Alike Guidelines and Application, available online at

Eligible Hospital: The definition of Medicaid providers for purposes of eligibility for Medicaid HIT incentive payments, provided at Social Security Act 1903(t)(2)(B), as added by ARRA, is a Children's Hospital or an Acute Care Hospital with at least 10 percent patient volume attributable to Medicaid.

Health IT: certified EHRs and other technology and connectivity required to meaningfully use and exchange electronic health information

Priority primary care providers:  Primary-care providers in individual and small group practices (fewer than 10 physicians and/or other health care professionals with prescriptive privileges) primarily focused on primary care; and physicians, physician assistants, or nurse practitioners who provide primary care services in public and critical access hospitals, community health centers, rural health clinics, and in other settings that predominantly serve uninsured, underinsured, and medically underserved populations. 

Provider: All providers included in the definition of “Health Care Provider” in Section 3000(3) of the Public Health Service Act (PHSA) as added by ARRA. This includes, though it is not limited to, hospitals, physicians, priority primary- care providers, Federally Qualified Health Centers (and “Look-Alikes”) and Rural Health Centers . 

Primary-care physician: A licensed doctor of medicine (MD) or osteopathy (DO) who practices family, general internal or pediatric medicine or obstetrics and gynecology.

Primary-Care Provider: A primary-care physician or a nurse practitioner, nurse midwife, or physician assistant with prescriptive privileges in the locality where s/he practices and practicing in one of the specialty areas included in the definition of a primary-care physician for purposes of this announcement.

Meaningful use:

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download