1 - Corporate Qualifications - San Joaquin County, California



1 - Corporate Qualifications1.1 - MAIN CONTACTNameTitleAddressTelephone NumberFax NumberEmail Address:1.2 - COMPANY PROFILENameAddress (Headquarters)Main Telephone NumberWebsiteProvide a description of your CompanyCompany Ownership- Private or PublicParent Company Name (If Applicable)AddressTelephone NumberProvide an organization chart of your company and the portion responsible for the solutionHow long has the company been in business providing the proposed products and services?How many total employees are dedicated to the proposed product or solution?List the number of employees by categoryExecutives and ManagersMarketing / SalesInstallationResearch and DevelopmentApplication SupportTechnical SupportCustomer ServiceOtherThose with clinical background-Physicians-RN’s- Other cliniciansHas your company been acquired or merged with any other organizations in the past three years? If so, please list each organization and the purpose behind such activity.List all previous, or pending or threatening litigation, arbitration, administrative or other proceedings involving the Company, any subsidiary or any joint venture involving the Company or any subsidiary, or any office or director (including parties, remedies sought and nature of action.List and description of all previous, pending or threatened government or other investigations involving the Company, and subsidiary or any officer or director.List any regulatory or compliance issues previously or currently being addressed by the company where there were any notices or other correspondence concerning any known or alleged violation of Federal, state, or local laws, regulations, agreements and / or commitments.Please describe your alliances and partnerships.Please provide your most recently completed fiscal year financial statements and annual report.Please provide a letter of credit equal to your proposed five-year cost that will remain in effect during the five-year contract period.1.3 - MARKET DATAAnnual RevenueYears in Ambulatory MarketCurrent health care clients using your proposed system total?List number of clients by categoryFederally Qualified Health Centers, Rural Health Centers, Free Clinics, and Community Health CentersHospitals (count safety net/public hospitals separately)Physician OfficesHome CareExtended Care FacilitiesNumber of total sites implemented by local implementation team.How many de-installs has your company had in the last 12 months and why?1.4 - PRODUCT INFORMATIONAll attestations are based on the currently RELEASED version of your company’s software NOT FUTURE releases.Product name and version Is this product Open Source?What year was your EHR system developed?Indicate whether the system was internally developed or acquired from an outside source.Is your proposed product web based or client/ server?Size of largest installation (Provider licenses)How often is the product upgraded?Do you have a Users Group?If ‘Yes’, how often does it meet?Is the product certified by an ONC Authorized Testing and Certification Body (ATCB)?Version and Year(s) of CertificationCertifying Body2 - Pricing and ContractsPlease provide a pricing proposal for software, implementation, interfaces and hardware as described in our profile. Separate EHR, Practice Management, Patient Portal, etc. How are your products priced (number of users, patient visits, providers, per PC, etc)? Please explain. Is training included in your quoted price?Please provide a copy of your standard contract and SLA.Please explain at what point the maintenance contract begins and any hardware/software warranty or install/acceptance period ends.Do the proposed acquisition and/or ongoing maintenance/support costs include:Future enhancements to acquired/licensed application modules?Operating system and related environmental software?Interface maintenance?Architectural changes such as migration to emerging technologies and new methods of systems deployment?Please describe the conditions and terms under which enhancements/new releases are made available to existing customers.3 – Service3.1 - PROJECT MANAGEMENTIndicate the specific senior executive responsible for the proposed solution.Provide a resume, years of experience supporting projects like ours, and years of experience with the company.Indicate the number of other accounts this person may be responsible for during our project.How many employees would comprise the project team responsible for the installation/implementation of this project? Describe the experience level, tenure, and certification of your project managers, implementation consultants, and project team members.Indicate the number of customer accounts the project team may be responsible for during our project.Describe the resources required from the client and also from your company during the implementation. Indicate roles and skills required. Are implementation staff persons used from any 3rd party organizations?List any approved or recommended consulting organizations that can assist with implementation services.In what timeframe after contract signing can your resources begin the project and the implementation start?Provide the normal length of an implementation of the proposed solution.Describe the implementation strategy and conversion approach you would use to carry out this project.With your proposed solution are you able to implement components or modules of the application over time? Conversely, can you implement the entire solution at once? What would your organization typically recommend?Identify project management best practices you previously employed in other projects involving the proposed solution which you would also use during our project.Include studies that support your recommended approach.Describe the change management procedures that will be used for this project.Describe the approval, prioritization, and governance procedures.Provide a description of the decision-making chain of command you would propose for this project implementation and for post-project ongoing support.What support do you provide for process redesign? Is this a separate engagement or is it available as part of the implementation?Describe procedures for acceptance testing.Include a proposed work plan, with an associated schedule to complete the work for this project successfully.Please detail any reliance on 3rd party products or services.3.2 - TRAINING/DOCUMENTATIONDescribe the training needed by the client to be successful during the implementation.Indicate the length and location of the training and whether it is targeted for implementation team or end users.Describe the documentation (both system and training) provided as part of the standard installation including:Manager and user interface manuals (applications)User operator/system administrator manualsHardware/OS manualsTraining manuals (initial and ongoing user self-training)What documentation is provided with the system? Is the documentation available in hardcopy and electronically?How often are documentation updates made available to the user and in what format (memo, revised manual, online, CD, etc)?Describe the types of training offered, e.g. end user, system administrator, installer, etc.How often is training offered?Please provide the duration of each class, the location of the training, associated costs, and recommended number of people that should attend. Who provides the proposed product training?Describe the post implementation education services available from your company. Include a discussion of the types of media offered (e.g. classroom, CBT, webinars)Describe the training database available in your system. Is it a mirror image of the production files and the system’s test database?Describe your approach for training of new releases and enhancements.Describe the testing database available for your systems? Can new software be loaded and tested in the test database before it is loaded into the live production system?3.3 - SUPPORT SERVICESDescribe the ongoing support services offered to your customers.What are your Customer Support hours? Please include the time zone.Where are your Customer Support Offices located?Is there a charge for after hour support?Describe the procedures customers follow to report problems. What are the methods of contacting the support center?What is the escalation process to address an outstanding issue?What is the location of your Field Support Office or Field Support Resources?Indicate the availability of support services after normal business hours.Describe how updates, enhancements, and new releases are delivered to customers.Indicate how software changes may be made in order to keep up with any novel federal and state regulatory and compliance issues.Describe the bug identification and response process.Describe the break fix process (Break fix: refers to the situation when an application function was working prior to a software upgrade but fails afterwards.)What is the frequency of software versions and releases?What is covered during the software warranty period? How long is the warranty period?Describe how you engage the community for input to product development. Indicate the types of groups and how they interact with your company.Do you have advisory groups? Describe their membership.Detail how the customer can submit product enhancement requests.Is an Internet-based support portal available to the customer?Is a knowledge base available for customers to self-service their support questions?Describe the process of adding and managing users who can make support calls or access the support portal.Detail any support or maintenance for the system that is provided by other companies.Please list the top 5 support questions you receive from clients.What is the range and average for system downtime (scheduled and unscheduled) for your clients’ systems?4 - HIPAAWill your company sign a Business Partner Agreement incorporating the Business Partner and Chain of Trust components as defined in the HIPAA regulations?How is your organization preparing for software changes required by the meaningful use initiative and other legislation?Indicate if your product is compliant with the following HIPAA application security requirements:Access ControlsAudit ControlsData AuthenticationEntity Authentication (including unique user IDs, Automatic Logoff)Transmission SecurityIntegrity5 - Vendor Instructions For Completing The Specifications ChecklistAll vendors are required to complete all information requested in the “Vendor Profile” section.Fill out all answers in BlueWhen responding to the functional specification section, note that each functional statement’s priority is indicated in the “PRI” column which contains one of the following values:H = Highly Desirable D = DesirableAn “X” under the MU (Meaningful Use) column indicates that the function is required under the Meaningful Use Final Rule.Where the function is (or is not) provided by the system, place an “X” under one of the following columns:“Yes, Included” = the function is available in the system and it is part of the basic system“Yes, Additional Cost” = the function is available but it requires system customization at an additional cost“No” = the function is not availableIn addition, enter your response in the RESP (Response) column in accordance to one of the following: 5 = Completely meets requirements today. The function will be available on day 1 of ‘go live’. 4 = Partially meets requirements today 3 = Will completely meet requirements in future (specify date) 2 = Will partially meet requirements in future (specify required change and date) 1 = Can meet requirement through customization (specify price) 0 = Not planning to offerUse the column labeled “Comments / Clarifications” to include additional information you wish to include as part of your response. This column can also be used to indicate if a function is not currently available but will be available in a future release by indicating the version number and approximate month/year when the function will be available (e.g. V6.1/May 2013).6 - Specifications ChecklistSpecificationsPRIMURESPYes, IncludedYes, Additional CostNoComments / ClarificationsELECTRONIC HEALTH RECORDSMeaningful Use (as defined in CMS’ Final Rule for the Medicare & Medicaid EHR Incentive Program)The system supports the entire Meaningful Use Final Rule. Each of the specification target dates is met with ample time to allow for template modifications, data entry and report productionHXGeneral ?The system supports both a total paperless function and a hybrid function (part paper, part electronic) where the contents of the electronic record can be printed for inclusion in the paper chart.HThe system interfaces with a variety of digital and analog dictation systems (state devices).HThe system date and time stamps all entries.HThe system includes automatic translation of codes to data. For example:ICD-9-CMHDSM-IVDCDTDCPT (4 and 5)HICD-10 hSNOMED CThLOINCHAPChNDChAutomatic E&M coding, verification and charge pass-through to practice management are available.The system includes support and updates for the above vocabularies.hThe system supports user defined vocabularies, and allows for updates and enhancements of such vocabularies.dThe system supports the HIPAA Standards for Electronic Transactions.HThe system supports the integration of third party coding programs.HThe system includes extensive error checking of all user input data, including, but not limited to: ICD-9 (Check diagnosis against gender, age, other as necessary)dICD-9 procedure checking against diagnosis dExtensive date checking for validity as well as ensuring a valid chronological order of events (dx before treatment, scheduling after birth, etc.).dThe system includes SNOMED CT as the integrated standard nomenclature of clinical terms.hDemographics / Care Management?The system supports the Continuity of Care Document (CCD) as the harmonized format for the exchange of clinical information including patient demographics, medications, problems and allergies. H The system identifies and maintains a single patient record for each patient.hThe system is able to accept an HL7 ADT message from another hospital information system as the source of new patient record identifiers.HThe system supports a user verifiable record merge function.DThe system supports purging of incomplete or partial records (i.e. those created by auto population from the practice management system but for which no clinical data exists).DThe system captures and maintains demographic information. Where appropriate, the data should be clinically relevant, reportable, and traceable over time.hThe system creates and maintains patient-specific summary lists that are structured and coded where appropriate.dThe system has the capability of importing patient demographic data via HL7 interface from an existing Practice Management System, Patient Registration System, or any such system used for patient registration and/or scheduling. In addition to gender and date of birth, of specific interest, are the following data: hXCollect Race data with categories as specified by OMBhXRef: Ethnic Group as defined by IOM hXRef: Status including effective dateshMigrant Farm Worker Status including effective dateshThe system has the capability to import/create, review, update, and hide patient demographic information as well as other non-clinical information from the patient record in both PMS and EMR.HXThe system captures permanent patient address.HThe system captures temporary patient addresses.HPreferred spoken languageHXPreferred written languageHXTranslator neededDPatient History?The system allows the capture, review, and management of medical procedural/OB/surgical, oral health, social, and family history, including the capture of pertinent positive and negative histories, and patient-reported or externally available patient clinical history (includes birth history, dietary/nutrition history, immunization history, allergy and developmental history for children and behavioral health history).hFor each new patient, the system captures and stores risk factors. For example:History of STDs or STIsHSickle cell statusHTB StatusH Tobacco use and history including number of years and packs per day (PPD)HX Alcohol use, historyHDrug use, historyHOccupational EnvironmenthLiving/Residential EnvironmenthFor each new patient, the system captures and stores the following social history elements:? The system allows the tracking of domestic partners as well as married couples.HOccupationHReligious preferenceHSocioeconomic statusHEducation/LiteracyHHousing StatusdDisabilitiesdThe system has the capability to import patient health history data, including obstetrical history data, from an existing system.dThe system documents hospitalization and emergency department data including:?Admission and Discharge dates for all type of hospitalizations (i.e. behavioral health, substance abuse, physical rehabilitation, ER, etc.)HChief complaintDAdmitting diagnosis / Other diagnosesHProcedures performedHDischarge summary HDischarge dispositionHEmergency room visit and discharge date(s)hThe system documents all existing allergies, interactions, and adverse reactions such as:DrugHXFoodHDrug-food plus other (e.g. bee sting, environmental allergies)hThe system captures history of received immunizations.HThe system captures alternative and herbal medications, OTC medications, and supplements.HXThe system has the capability of linking or grouping records of other family members on file.HThe system has the capability to capture and store genograms.dThe system collects and stores family history, including, but not limited to:?History of chronic diseases, including date of diagnosisHDisease statusDFamily member functional statusDIf deceased: date and cause of deathDThe system presents a chronological, filterable, and comprehensive review of patient’s EHR, which may be summarized, subject to privacy and confidentiality requirements.hThe system captures and explicitly labels patient-provided and patient-entered (and/or parent-, family member-, or guardian-provided or -entered) clinical data and supports provider authentication for inclusion in patient history.dCurrent Health Data, Encounters, Health Risk Appraisal ?The system includes a combination of system default, provider customizable, and provider-defined and reusable templates for data capture.HThe system obtains test results from laboratory, radiology / imaging, or other equipment or technology related procedures and other clinical documents and notes via standard HL7 interface. HXThe system has the capability to incorporate clinical documentation from external sources.hThe system has the capability to capture and monitor patient health risk factors in a standard format.HThe system can display encounter data using a problem-oriented format.DThe system supports online completion of health surveys or other forms (portal functions).DThe system supports the capture, graphic display, and plotting of forms requiring graphic representation.dThe system has the capability of reproducing and displaying a variety of end user patient and treatment forms.DThe system has the capability to update other portions of the record with captured vital signs data. At minimum, the system collects: ?HeightHXWeightHXPulseHRespiratory rateHBlood pressure (including multiples)HXDifferent position blood pressuresHOximetry (with FiO2 identifier)hPainhBMI (calculated)hXVisual Acuity (corrected / uncorrected)hAudiology screeninghLast menstrual periodhThe system incorporates one or more accepted measure of functional level, e.g. the GAF.HThe system has the capability to import/create, review, update, and amend health data (objective and subjective) regarding the patient’s current health status, including (as applicable):Chief complaintHOnset of symptomsHInjury mechanismHPhysical examination findingsHPsychological and social assessment findingsHThe system provides a flexible mechanism for retrieval of encounter information that can be organized in variety of ‘views’. For example:?By name (last, first; first, last; etc.)HBy date of birthHChronological by encounter dateHBy diagnosisHBy diagnosis typehBy chart numberHBy family group / linkageDThe system provides a flexible, user modifiable, search mechanism for retrieval of information captured during encounter documentation.HThe system provides a mechanism to capture, review, or amend history of current illness.HThe system ensures dynamic documentation during the encounter complying with all standard coding rules.DThe system enables the origination, documentation, and tracking of referrals between care providers or healthcare organizations, including clinical and administrative details of the referral.hThe system has the capability to evaluate referrals within the context of the patient’s clinical data.dThe system is capable of providing a summary of care record for each referral, when a patient is referred to another provider of careDXThe system captures the following referral information:?Referral type (Reason for referral)HDateHReasonHReferring ProviderHReferred to ProviderHPayerdThe system tracks consultations and referrals.HThe system has the capability of printing consultations / referrals forms.HThe system provides a mechanism to capture, review, track (assign a number), and print a specific consultation or specialist reporthDescribe how templates can be created for different types of specialty practices. Are they user defined? Can multiple templates be combined and used by the physician?HChildren’s HealthThe system displays the age of a child in appropriate units as specified by CCHIT Child Health Criteria.HSee 2011 Comprehensive Child EHR Certification Criteria CHO1.01Height (children) English/metric – Calculated percentileHWeight (children) English/metric – Calculated percentileHXHead circumference (children) English/metric – Calculated percentileHBody mass index (children) English/metric – Calculated percentileHXThe system displays growth charts showing plotted values of height, weight, head circumference and BMI against age and sex normed dataHXThe system suggests appropriate drug dose in volume/dose when given a drug formulation specifying concentration and mg/mL, a patient’s weight (in lb. or kg), a dose in mg/kg and a frequency (e.g. given a 250mg/ml formulation, a 12 lb child, and planned dose of 80 mg/kg/day divided twice daily, suggests mL/dose).HNewborn screening results (including sickle cell status)hStage of sexual maturity (e.g., Tanner stages)hDevelopmental Status (based on standardized screening tool)hPregnancy CareThe system accepts coded input for historical items that are asked at each pregnancy visit (could include, but not limited to key symptoms e.g. loss of fluid, fetal movement, etc.)HThe system makes pregnancy past history available to the provider for future pregnancies and displayed separate from past medical history.HThe system records fetal heart rate, fundal height, weight, urine analysis and blood pressure at each visitHThe system provides for a flexible configuration for dates or time since a specified event to be used for notification and alertsHThe system displays the estimated date of delivery (EDD) given the patient’s last menstrual period (LMP). The system will calculate an EDD given an ultrasound date and the estimated gestational date (EGA) given by the ultrasound. The provider may specify which of the above methods will be used to calculate the patient’s final due date. The EGA (based on the method specified by the provider) is clearly visible at each visitHThe system will prompt the provider about care that is due at each visit based on the EGA (calculated using the specified method above.)HThe system creates a printable view of all visits, labs, due date, ultrasound, problem list and plans which can be given to a patient for purposes of communicating with providers on a Labor and Delivery floor.HThe system can exchange data about the current pregnancy with other hospital and/or health information exchange systems.HBehavioral HealthThe system shares the medication list across the entire system.HXThe system includes a single medication module shared by both the primary care and the behavioral health moduleHXThe system includes an integrated diagnostic module shared with the behavioral health module.HXThe system can limit the sharing of behavioral health diagnoses and medications if configured this way by the organizationHFor FQHCs doing Behavioral Health in addition to primary care, the system requires/allows for a treatment plan.HEncounter – Progress NotesThe system records progress notes utilizing a combination of system default, provider customizable, and provider-defined templates.HThe system has the capability to automatically update other sections of the record with data entered in the progress note.HThe encounter - progress note template includes space for entering performed and planned procedures. It also includes:HPerformed/planned laboratory procedures HDiagnosisHGoals (provider’s and patient’s) and follow-up plans including next visitHMedications prescribedHNon-drug prescriptions (e.g. exercise, dietary recommendations, complementary and alternative therapies including massage)HPatient education materials are culturally and linguistically appropriate and are written at an appropriate health literacy levelHConsultation/referralsHPatient condition or statusHThe system includes a progress note template that is problem oriented and can be linked to either a diagnosis or problem number.DThe system has the capability of retrieving encounters by a variety of user-defined parameters.DThe system enables standard phrases to be defined/contained in tables and used as pull down menus to reduce the key entry effort.DThe system allows for a number of different types of input methods (e.g. OCR, image capture, voice recognition, dictation/transcription services, keyboard entry.)HThe system enables progress notes to be sorted for viewing in chronological or reverse chronological order by encounter date in relation to the active care plan.DThe system applies security controls to progress notes to ensure that data cannot be deleted or altered except within the current session and by an authorized user.HThe system includes a medical terminology dictionary and a spell checker within the progress notes data entry module.DThe system supports the capability to automatically collect the data elements defined by the associated clinical practice guideline or order.HProblem Lists?The system creates and maintains patient-specific problem lists. Separation of chronic and acute problems is readily evident.hXThe system provides a problem status (active, inactive) for each shown problem.HXThe system organizes applicable patient data into comprehensive problem summary lists.hThe system provides problem descriptions based on the SNOMED CT standard controlled vocabularyhThe system allows clinicians to identify and record new patient problems as well as the current status of existing problems.HThe system expands the problem summary list on demand.DThe system updates the active problem list from relevant data in the progress note with appropriate end-user confirmation.DWhen capturing problem information, the system captures: ?Diagnosis / problem date(s)HSeverity of illness, as appropriate.HFor each problem, the system has the capability to create, review, or amend information regarding a change on the status of a problem (e.g. the date of diagnosis).DThe system has the capability of allowing the display of past interventions, hospitalizations, diagnostic procedures, and therapies for review at the option of the providerHClinical Practice Guidelines (CPG)?The system includes and maintains evidence-based Clinical Practice Guidelines (CPGs) published and maintained by nationally recognized authoritative sources (e.g. U.S. Preventive Services Task Force (USPSTF) or others). The guidelines incorporate patient education and actionable alerts and reminders.HAt minimum the system includes CPGs for the following: AsthmaHCongestive Heart FailureHDepressionHDiabetesHCoronary Artery DiseaseHHyperlipidemiaHCOPDHHIV/AIDSHCervical CancerHBreast CancerHHypertensionHThe system has the capability of allowing initial authoring and revising of clinical practice guidelines.hThe system allows for import of CPG and other CDS from outside content providers (e.g. Zynx).HThe CPG module imports/creates the facility for rapid documentation of the patient’s progress along the CPG phases.HThe format utilized by the guideline for documenting is intuitive, easy to use, and user customizable. hThe CPG module utilizes pull down menus and check boxes to speed up data entry. hThe system allows reporting and analysis of any / all components included in the CPG.HIncluded in each CPG, the system has the capability to create, review, and update information about:The performance measures that will be used to monitor the attainment of objectiveshThe quantitative and qualitative data to be collectedhPerformance metrics: CPG shall allow for decision support based on standardized discrete data to be used to calculate clinical performance measures (e.g. HEDIS).hCollection means and origin of data to be evaluatedhThe system allows the provider or other authorized user to override any or all parts of the guideline. The system is able to collect exceptions for NOT following the CPG.hCare PlansThe system provides administrative tools for organizations to build care plans and guidelines, for use during patient care planning and care.hThe system is capable of providing a summary of care record for each transition of care or referral, when a patient is transitioned to another setting of care or provider of care or is referred to another provider of care.HXThe system identifies and presents the appropriate care plans, guidelines, and/or protocols for the management of specific conditions that are patient-specific. At minimum, the system shall provide care plans for chronic diseases referenced in 7.2 above. hThe system has the capability to import/create, review, and amend information about the desired single or multi-disciplinary long / short term goals and objectives that will be accompanied by the care plan.hThe system has the capability to import/create, review, and amend information about the proposed set of single or multi-disciplinary care plan options that are based upon expected outcomes.hThe system generates and automatically records in the final document, patient-specific instructions related to pre- and post-procedural and post-discharge requirements. The instructions must be simple to access.dThe system can generate and automatically record in the final document "Time Out" was done prior to the procedure - to includeCorrect patient identifiedHCorrect procedure confirmedHProcedure and risk were explainedHCorrect side and site confirmedHQuestions were answered and patient agrees to procedureHAccurate consent obtainedHThe system can generate and automatically record patient - specific multilingual educational instruction related to their medical condition.HThe system has the capability to import/create, review, and amend information about:The provider’s explanation and the patient or patient representative’s understanding of the recommended and/or alternative care plan optionsdThe medical orders, which authorize the execution of the selected, care pland The collection of specimens (body fluids, tissue, etc.) from the patient to be used for diagnostic or treatment purposesdThe actions taken to safeguard the patient to avert the occurrence of morbidity, trauma, infection, or condition deteriorationhThe provider's explanation and the patient or patient representative's understanding of health proxy and DNR consentHPreventionThe system has the capability to display prevention prompts on the summary display. The prompts must be dynamic and take into account sex, age, and chronic conditions.hThe system allows interactive prevention status documentation. At minimum: Date addressedh Resulth Reason not performedhWhere performedhThe system allows the preventive measures done on the visit to automatically populate the health maintenance summary templateHThe system includes user-modifiable health maintenance templates.hThe system includes a patient tracking and reminder capability (patient follow-up) updatable by the user at the time an event is set or complied with.hThe system allows the graphing of pertinent data into flow sheets for presentation/display.hThe system includes the incorporation of immunization protocols:Universal childhUniversal adulthSpecific foreign travelDThe system includes immunization forecasting and notifies the user of vaccines that are past due and of due dates for upcoming due vaccines, and is capable of documenting vaccine refusalHThe system allows providers to order appropriate vaccines, with staff having access to those ordered on a separate computer (tablet), on which they can record specific manufacturers/lots used (drop-down lists), site of administration, and VIS publication dates/dates provided; (drop-down lists will display only vaccine lots – private vs. state – appropriate to patient’s status as private insured, Medicaid, uninsured, underinsured, etc)HThe system displays a “Vaccine Administration Record” (informed consent) type form, which displays the above information and is electronically signed by the party responsible for granting consent and the person administering the vaccinesHThe system allows for printing an updated “shot record” (perhaps also height, weight, etc. information) at the end of each visitHThe system updates the practice inventory of available vaccines each time one is recorded as having been administered; a report on private and public funded vaccine inventories can be displayed or printed at any timeHThe system will send and receive information from the state’s Department of Health Immunization Information System website, if one exists, including vaccine inventories, individual patient vaccine administration histories and updated demographicsHThe system is capable of reporting to VAERS to report reactions to vaccinationsDSupport the ability to view all of the patient’s physicians (e.g. consulting, attending, admitting, and referring) and their role in a single “population” view. DSupport the ability to add or remove patients from the “population” individually or by group. HDisplay measurement indicators with patient name on the “population”.HPatients can be added automatically to a “population” based on problems, diagnoses, allergies, medications, age, and/or gender.HProvide a long-term repository for all clinical patient data with a longitudinal view of the patient’s clinical data.DProvide the ability to “drill down” from summary to detail without paging through multiple screens.HSupport trending and graphing of result information.HSupport the ability to launch images from result view (including PACS viewer).DSupport multiple normal reference range values for individual observations.HHighlight abnormal and critical values as defined by the customer.HAbnormal or critical values are indicated along with reference ranges for each test. HAbility for the physician to add comments to lab results. DSupport access to results using flexible search criteria and non-unique service names. HSupport configurable flow sheets for specialized results presentation. HPatient EducationThe system has the capability to create, review, update, or delete patient education materials. The materials must originate from a credible source and be maintained by the vendor as frequently as necessary.HThe system has the capability of providing printed or electronic patient-specific education materials or resources to the patient on demand or automatically at the end of the encounter. HXThe system is capable of providing the materials or resources indicated in 14.2, in the patient’s preferred language. At minimum, the materials must be provided in English and Spanish as applicable.HThe system includes or the capability to develop patient instructions in English and in the patient’s preferred language for a broad range of treatments and services delivered by providers. Examples: Care of woundh Exercise regimenh Diet guidelineshOral HealthHBehavioral HealthHAdministration and care of medications:HThe system allows patient instructions to be selected from a pull down listdThe system allows user modifications to instructions to suit individual patient needs without altering the original contentdThe system enables the linkage of patient instructions to care plans/care maps/ practice guidelines/orders, enabling automatic printingdThe system allows patient instructions to be printed on demand independent of care plans/care maps/guidelines/orders.dThe system includes the facility to create a directory of information for patient support groups and to include any applicable support group information in the instructions.DThe system is capable of listing the educational materials printed for the patient on the final documentHAlerts / RemindersThe system includes user customizable alert screens / messages, enabling capture of alert details, including, but not being limited to:Text describing the alertHDate and time of the alertHThe system prints the alert on demandHThe system has the capability of forwarding the alert to a specific provider(s) or other authorized users via secure electronic mail or by other means of secure electronic communications.DThe system tracks the user’s response to an alert. Alert frequency and override reasons are reportable by user or group.HThe system allows the user to document rationale for following/not following an alert.HRelevant Reminders/Alerts are displayed when a patient chart is opened.DThe system is capable of utilizing alerts to facilitate sending of reminders to patients per patient preference for preventive or follow up care; and to track that status of such remindersHXThe system includes an internal “notes” function that clinicians can use to remind themselves of non-alert/reminder issues. These items should be easily removed when complete.DOrders?The system includes an electronic Order Entry module that has the capability to be interfaced with a number of key systems (lab, pharmacy, radiology) through standard, real time, HL7 bidirectional interfaces.hXThe system captures and tracks orders based on input from specific care providers.hThe system has the capability to submit diagnostic test orders based on input from specific care providers.hThe system has the capability to print orders for manual transmission.hThe system has the capability to fax orders. When faxing orders, the system shall determine and report whether the transmission was successful (i.e. received at destination).hThe system has the capability to require that all orders be digitally signed at the completion of each order.hThe system accepts orders from multiple locations.hThe system has the capability to assign and display an order number for active, hold, and pending orders.dDuring the order entry process, the system has the capability to require the user to acknowledge an error message prior to being allowed to continue with the data entry function.hThe system allows the user to accept, override, or cancel an order.hThe system requires the user to enter a justification for overriding, changing, or canceling an order prior to being allowed to continue.hThe system includes the visual indication of orders in need of review.hThe system detects and displays duplicate orders issuing visual and auditory warnings, and allows the user to override the warning after entering a justification for the override.hThe system includes the capability to: Define order sets, based on provider input or system prompt, for each provider or service department.HAccept order sets from a third-party content provider (e.g. Zynx Ambulatory).H Contain all information specific to one order in one display screenh Include a pull-down list of all order departments to enable multiple ordersh Include a user-configurable / customizable pull-down list of tests and services from which to place one or more ordersdThe system allows the provider to create/modify the most commonly used orders to assist in order placementdThe system can display all order sets including components, by any of the following:By proceduredBy providerdBy diagnosisdBy datedThe system has the capability to specify/display exploding orders.hThe system has the capability to enable selected orders to be recurring orders.hThe system includes an order inquiry mechanism to allow providers to inquire on the details of an order.hThe order inquiry function is accessible within the order entry flow before the session is terminated.hAn order, at the user’s option, displays all the detail data associated with the order, including demographics, order parameters, electronic signatures, and order statusdThe system displays order summaries on demand to allow the clinician to review/correct all orders prior to transmitting/printing the orders for processing by the receiving entity.hThe system is capable of reporting/listing all orders which have not been completed or receivedHSupport all areas of the General Laboratory (i.e. Chemistry, Hematology), Microbiology, Blood Bank and Anatomic Pathology. HAutomatically assign ICD-9CM or ICD-10 codes given the diagnosis is provided by the physicians during the ordering protocol. HSupport for Point-of-Care testing devices. HProvide a detailed explanation of eSignature architecture and related operational flow. What controls are in place? Does the application support a secondary password/pin entry at time of signature? Does the application support co-signatures and other types of supervisory review/approval? How does the application support and track multiple provider entries for various components of documentation? Be specific as to how eSignature supports the workflow in an academic facility with significant resident and student activity.ResultsThe system has the capability to route, manage, and present current and historical test results to appropriate clinical personnel for review, with the ability to filter and compare resultsdThe system accepts results via standard bidirectional HL7 interfaces from all standard interface compliant / capable entities or through direct data entry. Specifically – Laboratory (clinical and anatomic pathology), Radiology, and Pharmacy information systems; clinical laboratory test results are incorporated into the EHR as structured datahXThe system includes an intuitive interface for graphing and trending lab resultsHThe system allows authorized users to copy selected results into a notehWhen displaying results, the system, at a minimum, displays the patient name, date and time of order, date and time results were last updated, as well as any alerts identifying changes/amendments to the test or procedure, and test name to include source of results (i.e. PHR, hospital, etc.)hThe system is capable of providing on-demand to the patient an electronic copy of their health information (including diagnostic test results, problem list, mediation lists, medication allergies)HXThe system is capable of providing clinical summaries for patients for each office visitHXThe system has the capability to evaluate results against normal values and notify the provider. HThe system uses visual cues to highlight abnormal results.hThe system allows reporting of relevant electronic laboratory results for reportable conditions to appropriate public health authoritiesDThe system is capable of exchanging key clinical information (e.g., problem list, medication list, medication allergies, diagnostic test results), among providers of care and patient authorized entities electronicallyHXThe system allows the provider to signoff and comment on received lab results.HPACS/imaging integration HHow does the system screen lab results and send parameter-based panic alerts based on user-defined criteria in the system? (e.g.: Different panic level parameters for dialysis patients vs. non-dialysis patients)How are incorrectly posted lab results removed or revised?Medication and Immunization ManagementThe system creates e-prescriptions or other medication/immunization orders, including herbal medications and orders for durable goods, with detail adequate for correct filling and administration. It provides information regarding compliance of medication orders with formularies.HXThe system presents to appropriate clinicians the list of medications/immunizations that are to be administered to a patient, under what circumstances, and captures administration details.DThe system identifies patient drug allergy, drug - drug interaction and drug – disease severity of interaction warnings (prescription, over the counter) at the point of medication ordering. Clinical Decision Support (CDS) include drug-drug, drug-allergy and drug-formulary as stated in MU Reg.hXThe system alerts providers to potential administration errors for both adults and children, such as incorrect patient, incorrect drug, incorrect dose, incorrect route, and incorrect time in support of medication administration or pharmacy dispense/supply management and workflow.DThe medication module includes access to the National Drug Classification (NDC) database.hThe system stores common prescriptions/immunizations for quick entry and allows users to define favorites.hThe system supports multiple drug formularies and prescribing guidelines.hXThe system provides the capability to select both the patient and the drug in an intuitive, easy to manage user interfaceh The system has the capability of displaying medications/immunizations prescribed both before and after the visit, of creating and maintaining a current medication list for each patient and updating the progress note with prescription information as necessary, and verification of medications hX The has capability to perform medication/immunization reconciliation HXAt the provider’s option the system has the capability of selecting drugs to be prescribed from the patient’s medication list.hThe system allows the provider the ability to document the effectiveness or ineffectiveness of a medication.hThe system stores refill and repeat prescription information.hThe system allows storage of prescription/immunization data for retrieval by any of the following:Drug nameh Drug code number (NDC)hDosage prescribedhSchedule, including formulary managementhOther user defined selection criteria (e.g. route of administration)dThe system provides the following drug/prescription order information:Drug contraindicationhActive problem interactionshCheck that appropriate laboratory monitoring has been obtainedh The system provides extensive drug interaction informationhThe system creates and maintains an active patient-specific drug allergy and adverse reaction lists and allows on demand or scheduled reporting from such lists.hXThe system includes clinician-modifiable therapeutic guidelines.hThe system maintains a history of all prescribed medications including those prescribed elsewhere and/or by outside physicians; and OTC medications, supplements, alternative or herbal remedies as reported by the patient. The history segment contains space for appropriate comments.hThe system fully complies with existing regulations and restrictions applicable to the prescription of dangerous or regulated drugs.hThe system alerts providers to potential misuse of controlled substances by reference to a public health controlled substance databaseDThe system provides the capability for e-prescribing to a pharmacy or organization selected pharmacy for dispensing.hXThe system allows faxing when e-prescribing is not availableHThe system includes other methods of prescribing when those above are not availableHThe system has the capability to capture sample medications including lot number and expiration date.HAllows user to specify the ordering physician during order entry HSupport entry of non-formulary drug orders. HIdentifies automatically that medication is FDA approved per diagnosis. DHandle non-standard dosing frequencies (for example, every other day, M-W-F, daily for 21 days - skip 7 days - repeat, every Monday, etc.) HPerform price calculation during drug inquiry. HManage “stop orders” and easily identify “stop orders” on screen and on Medication Summary Report. Provide a report for “stop orders”. DAbility to redirect orders to provider other than ordering provider and can be changed by a system administrator.HAbility to calculate dosages based upon different weights (ideal body weight, absolute body weight, admission weight, birth weight, etc).DAbility to print MAR on demand.HEnable user to document medication errors and adverse drug events. HSupport management of floor stock inventory. DAbility to print floor stock item list for each unit. DProvide an inventory control module that supports the process of conducting a complete physical inventory. DInterface with the wholesaler’s electronic order entry system. DAbility to automatically generate restock orders to the wholesaler. DAbility to automatically update pricing and packaging information based upon data received from wholesaler. DProvide standard drug utilization reports with various sort options. HSupport reporting and documentation required for participation in 340B Federal Drug Discount program. HSupports multiple sample medication inventory areas.DPrint the sample medication inventory by area. DSupports reporting of sample medication issue by provider and can stratify by patient type.DAbility to sort orders for verification according to defined categories of order prioritization, e.g. STAT orders that need verification before regular orders. HThe system is capable of submitting electronic data to immunization registries or Immunization Information Systems in accordance with applicable law and practiceHXDiscuss security and auditing within the Pharmacy system.Describe the capabilities of system’s report writer and provide sample reports.Describe the integration with pharmacy clearinghouses such as SureScripts or RxHub?Describe the capability to configure the system’s drug interaction/clinical decision support alerts.Describe how the prescription is automatically checked for prior adverse reactions and potential drug interactions.Describe how the prescription is automatically checked for insurance formulary compliance?Document ImagingSupports XML, PDF, BMP and JPEG formats.HVersioning of documents. HRotate images (e.g. 45, 90, 180 degrees).HStore any/all documents that would normally be part of the paper-based patient record. HAccept encapsulated PDF via HL7 transmission from other hospital information systems (e.g. inpatient EHR).Includes a section for documents not produced internally by our health organization.DSecure to the folder level medical records that are considered sensitive (e.g. behavioral health, diagnosed conditions such as HIV, or in the case of staff). HHow do you define/support the legal EHR?Confidentiality and Security?The system protects electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities (based on a risk analysis per 45 CFR 164.308 (a)(1))HXThe system supports single-sign on technology. It also supports biometric technology for logon as well as 2-factor authentication.HSupports industry standard electronic signatures.hThe system controls access to and within the system at multiple levels (e.g. per user, per user role, per area, per section of the chart) through a consistent mechanism of identification and authentication of all users in accordance with the ‘Role Based Access Control’ (RBAC) standard.hThe system verifies and enforces control to all EHR components, information and functions for end users, applications, sites, etc., to prevent unauthorized use of a resource, including the prevention or use of a resource in an unauthorized manner.HNon Repudiation – The system limits a user’s ability to deny (repudiate) an electronic data exchange originated, received, or authorized by that user.DThe system secures all modes of EHR data exchange through the use of data obfuscation and destination and source authentication and other standard security methods used to ensure appropriate security and privacy considerations.DThe system manages attestation of information including the retention of the signature of attestation (or certificate of authenticity) associated with incoming or outgoing information.DThe system enforces the applicable jurisdiction’s patient privacy rules as they apply to various parts of the EHR through the implementation of standard security mechanisms.DThe system establishes patient/physician data element confidentiality.dThe system incorporates audit trails of each access to specific data.hThe system incorporates an audit trail for all system transactions including look-ups of patient data. A configurable report of all accesses to a patient’s record is available on patient demand.hProvides automatic analysis of audit trails and unauthorized access attempts.hThe operating systems required for the product, server and related systems operated hardware are B-2 or above ratedhfor more information see: Discuss your approach to data/ information security, especially with regards to Internet technologies.Is your security consistent with the latest industry approach for encryption and authentication?Clinical Decision Support?CDS should be built using national clinical data standards (LOINC, SNOMED, CPT, ICD9, ICD10, etc).HThe system offers prompts to support the adherence to care plans, guidelines, and protocols at the point of information capture and is capable of tracking compliance to such care plans, guidelines, and protocols (rules).HXThe system identifies trends that may lead to significant problems and provide prompts for consideration.dThe system supports the integration of patient and family preferences into clinical decision support at all appropriate opportunities.dThe system includes access to medical research and literature databases such as MEDLINE, JAMA, and others without logging out of the system. The system also allows for import of evidence-based CDS content from a third-party supplier (e.g. Zynx).hThe system utilizes health data from all sections of the chart to provide decision support to providers.hThe system triggers alerts to providers when individual documented data indicates that critical interventions may be required.hThe system automatically triggers an alert upon documentation of a diagnoses or event that requires reporting to outside agencies or public health authority, including the local public health department, Centers for Disease Control and Prevention (CDC), state health and mental hygiene departments, and state cancer registries.hRestrict the ability for a clinician to subscribe/unsubscribe from a rule, unless given proper authorization per security rights.HThe system automatically triggers an alert upon documentation of patient health data for a member of an existing medical registry or disease management program.hThe system’s alert/reminder functions are driven by appropriate multi-disciplinary clinical guidelines.hThe system incorporates preventive medicine questionnaires to be completed by clinicians and if applicable, patients, during the encounter.dCost Measuring / Quality Improvement / Reporting?The system has built-in mechanism/access to other systems to capture cost information.dThe system generates an evaluation survey (scheduled, on-demand or randomly selected) that will record patient satisfaction.HThe system supports real-time or retrospective trending, analysis, and reporting of clinical, operational, demographic, or other user-specified data including current and future UDS reports, HEDIS reports, custom reports.hSee When producing aggregate level reports, the system has the capability to drill down to the patient level.HThe system is capable of generating lists of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreachHXThe system produces clinician productivity/workload measures including RVUHThe system has the capability to perform automatic cost analysis for courses of drug/medication treatments.dThe system provides the capability for authorized users to develop volume statistics reports on user determined data fields.HThe system has the capability to produce population-based reports or studies based on flexible, end-user modifiable criteria.hThe system has the capability of producing scheduled and on demand case mix reports.dThe system allows customized reports or studies to be performed utilizing individual and group health data from the electronic record.HThe system is capable of generating clinical reports or letters for schools, camps, sports physicals, other providers, or other entities requiring such reports/letters; and is capable of maintaining such a report/letter in the patient records. The system is capable of generating ancillary billing documents for submission to outside regulatory and compliance agencies (e.g. PM160).HThe system will provide support for third-party report writing products.HThe system supports real-time or retrospective trending, analysis, and reporting of aggregate numerator and denominator of clinical quality measures, including the CQMs of meaningful use (MU) to CMS, the States, or other regulatory entities, through means that they require (e.g., attestation, electronic submission).HXRef: Disease Management / Population HealthThe system provides support for the management of populations of patients that share diagnoses, problems, demographic characteristics, etc.hThe system supports disease management registries by:Allowing patient tracking and follow-up based on user-defined diagnoseshIntegrating all patient information within the systemhProviding a longitudinal view of the patient medical historyhProviding a longitudinal view of the patient’s demographic and social history, including occupation, industry worked in, and residential addressDProviding intuitive access to patient treatments and outcomeshThe system is capable of submitting electronically syndromic surveillance data to public health agencies in accordance with applicable law and practice.HXThe system automatically identifies all high-risk patients and notifies clinical staff for preventive care.hThe system utilizes user-authored and/or third-party developed clinical guidelines for disease and registry management.hThe system tracks / provides reminders and validates care process against clinical practice guidelines.h The system generates follow-up letters to physicians, consultants, external sources, and patients based on a variety of parameters such as date, time since last event, etc. for the purpose of collecting health data and functional status for updating the patient’s record.hPrint patient reminder letters or recall notices with pertinent information. HUser-configurable, automated printing of health maintenance reminder letters. HAt a minimum, the system is able to generate a variety of reports based on performance measures identified by the Physician Consortium for Performance Improvement (AMA/Consortium), the Centers for Medicare & Medicaid Services (CMS), and the National Committee for Quality Assurance (NCQA) for chronic diseases including diabetes, coronary artery disease, heart failure, behavioral health, hypertension, osteoarthritis, and asthma, as well as for prenatal care and several preventive services including immunizations, lead testing, tobacco use cessation, and problem drinking. Information on these measures can be found at: . The system follows measures approved by NQF (national quality form) and prompted by the AQA (ambulatory quality alliance) as well as those identified by the HRSA’s Health Disparities Collaborative, see .HThe system links Disease Management functions to all other sections of the EHR.dConsents, Authorizations, and DirectivesThe system allows for or provides a mechanism for patients to electronically access their health information (including lab results, problem list, medication lists, and medication allergies) within four business days of the information being available to the EP, subject to the EP’s discretion to withhold certain information.HXThe system has the capability for a patient or responsible party (e.g., parent, guardian) to sign consent electronically.HThe system has the capability to restrict access or sharing data electronically with other systems based on consents/authorizations provided by patient or guardian subject to national or jurisdictional requirements.HThe system has the capability for the user to create and maintain consents and authorizations when required in the patient’s preferred languageH The systems captures, maintains, and provides access to and print a copy of patient advance directives.dTechnical UnderpinningsSupport flexible search criteria during the patient identification process: for example, partial name, Soundex, medical record number, account number, age, date of birth, sex, combinations of data. Please comment on other types of search options. HSupport an enterprise number as well as separate, multiple medical record numbers HSupport different numbering schemes to accommodate each facility’s requirements. HFunctionality disallows occurrence of duplication medical record numbers and duplicate encounter numbers.HProvide embedded weighted algorithm to assist with the identification of potential duplicate accounts. Please describe. HProvide merge capability for 2 records for same person (e.g. duplicates, erroneous registration) HProvide capability to un-merge records incorrectly linked.HSupport collection of user defined data. Please indicate limitations. HGenerate a report indicating patients with multiple medical record numbers. HSupport for receiving HL7 merge transactions (ex. A18, A30,A34, etc.). HThe system auto-populates user defined data fields with patient demographics at the time of order or request.hThe system is scalable (i.e. has the capability to support additional storage requirements without major investments in hardware other than disk space)hThe system incorporates a consistent user interface for data entry independent of the platform.hThe system will be accessible and available to all authorized users 99.5% of the time.hThe system supports indexed document scanning.HThe system supports an immediate response time (0.5 – 1.0) seconds 90% of the time.hThe system supports an instantaneous response time (0.1 – 0.2 seconds 80% of the time.hThe system incorporates extensive, secure telecommunications capabilities that link staff and clinicians from remote locations to the central site.hThe system supports an industry standard locking mechanism to prevent unauthorized updates.hThe system supports and implements system redundancy / fault tolerance for 100% availability.hThe system logs all transactions processing and archiving.hThe system alerts simultaneous users of each other’s presence in the same record.hHow does the EMR/EHR prevent duplicate encounters and duplicate medical records from occurring? Please describe in detail.Provide a detailed explanation of eSignature architecture and related operational flow. What controls are in place? Does the application support a secondary password/pin entry at time of signature? Does the application support co-signatures and other types of supervisory review/approval? How does the application support and track multiple provider entries for various components of documentation? Be specific as to how eSignature supports the workflow in an academic facility with significant resident and student activity.Clinical IT Data DictionaryThe system is structured to an expandable EHR through the use of user defined fields.hProvides attributes for each data element; supports all data types.hSupports static/dynamic data element relationship.hThe system documentation includes a list of all data elements contained within the system along with their characteristics and pertinent information (metadata) needed for use by ad-hoc report writing and/or for mapping to third party report-writing software or interfaces.H Input MechanismsThe system supports a full range of input technologies.hInput protocol is easy/fast, intuitive input interface.hSupport a variety of point of care and input devices, specifically: Signature Capture HHand held/portable - Radio Frequency HLaptopHTouch ScreenHPenHVoice RecognitionHKeyboard/MouseHMobile DevicesHiPadHiPad AppHThe system allows easy access to existing, previously captured data for information purposes or for copying data.hThe system has the ability to allow inclusion of free text as well as the capture of discrete data in accordance with site preferences and site-specific system configuration.HFor a patient participating in a group visit, the system has the ability to create a note that is shared by all patients in the group.DErgonomic PresentationThe system places emphasis on user friendliness.hThe system incorporates a consistent presentation of information across the entire system.hThe system incorporates visual cues.hThe system provides consistent formatting to aid users in finding information.hBillingThe system meets RBRVS/E&M documentation and coding guidelines.hThe system provides a bidirectional interface a variety of information systems such as practice management, laboratory, state immunization registry, etc.hThe system provides support to the provider on E & M coding based on documentation from the current visit.HSystem Infrastructure & ScalabilityHardware configuration operates on industry standard Intel servers such as IBM or HP. HOperating system environment supports, the following minimum system requirements, Microsoft Windows XP Professional and Windows 7 and Microsoft Windows 2008 Server. HSystem can be configured in a high availability mode that continues operation in the event of specific component failures. Describe system capabilities in this context.HUse clustering software to load balance and demonstrate quick, automatic failover across all servers, if multiple servers are required or recommended. HSupport a web-based interface. DSupport Citrix XenApp and XenDesktop.DRecommended hardware platform provides capability for hot swappable, mirrored/raided disk drives. HSupport the ability to conduct routine backup procedures without the users having to be off the system. HSystem is based on a relational database management system.HData elements can be viewed, printed, interfaced, updated, reported on and/or listed as needed. HHProvide Common Reporting Tools and Analytics that are compatible with recognized, industry standard reporting tools such as Microsoft SQL Server Reporting Services, Crystal Reporting. HVendor provides load testing tools and load testing as part of their implementation. DSystem is scalable to accommodate additional utilization, users, transactions and/or additional local/remote sites. HSupport multiple environments including test, production, distributed, reporting, mirror and training. DProvide a data dictionary. HDatabase tools are provided to allow end-user access for queries and extraction or output of data into other file formats.HApplication and interface servers can be implemented as virtual machines under VMWare.HManagement of client/PC software is centrally managed. DApplication can be monitored via common enterprise monitoring systems. HApplication provides an alerting and monitoring utility. DApplication exposes data via Web Services. DSupport the use of industry standard interface engines. HInterface engine runs as a system service.HSupport standard HL7 interfaces. HSupport industry standards such as DICOM and XML. HInterface with legacy systems, departmental systems, repository systems, foreign systems, modalities and devices. DUsers can view a display of archived transactions and audit file as well as the transactions as they are being processed. DIncludes flexible table features that enable a user to build tables for the translation of data. DSupport the ability to conditionally map data and the ability to compare and group condition tests. HProvide a custom adapter development kit such as COM or API, making it possible for a user to create utilities and applications that can communicate directly. DThe generation of alert messages can be configured by the time of day and day of week, for each interface via user-defined peak, off-peak and scheduled downtimes. DAlert messages can be sent to any device including, pagers and printers as well as to other interfaces. Alerts can also be configured based on change of interface status, idle time and excessive transaction backlog. HSupport data mapping and conditional routing.DThe following data types are supported: ASCII, BLOB, EBCDIC, hex16, hex32, printable, raw, signed binary and unsigned binary. HError Monitoring provides an alert subsystem which generates alert messages that are stored and viewable online and can be routed via various mechanisms such as e-mail and pagers. HInclude a variety of monitoring and troubleshooting tools that allow for the immediate identification and correction of any problem you may encounter. These intuitive tools are easy to access via “point and click” or “drag and drop” features. HA field can easily be setup such that some values are translated and others are passed through without translation. HTemplates exist for various protocol, connections types and interface ports. DHolds message waiting to be processed in memory and writes them to disk. Each message is flagged with a status that indicates whether it has been processed and received by the destination system. HProvide templates that allow users to assign attributes to a particular definition then copy these attributes for other similar builds are provided. DPlease explain how your proposed system(s) would interface/ integrate with existing clinical applications from NTT DATA, i2i Systems, Bottomline Technologies, ExitCare.Please describe the process in which disputes over the interface between your solution and the Practice Management System application are resolved.Describe your overall approach to developing, testing, implementing, and upgrading system interfaces to other third party systems.Discuss any limitations/ issues regarding your willingness or ability to interface / integrate your product with foreign automated systems.Describe the operating system, hardware/server platform, and database, programming language that supports your proposed product.Has any client implemented the System in a virtualized environment?Does your solution employ a true Service Oriented Architecture (SOA)? Explain.In the context of a true SOA, explain how your data and service modeling is done and what advantages it provides to the customer.Describe the vendor’s approach to data integrity and redundancy.Describe the vendor’s approach and tools for backup, recovery and SAN/NAS recommendations.Detail the number of environments that are recommended for implementation and their purposes, ex. Test, Development, QA, Production?Describe the process of environment management and migrating from one environment to another.What is the source code for the application written in?What database architecture does your solution use? Please include version.How many application releases per year does the vendor provide?How are minor and major releases communicated and provided to the client?Detail the printing process for the application.Provide your definition and vision of interoperability and how you are incorporating interoperability within your solutions.Describe your method for establishing HL7 connectivity as well as the version you support.Describe your overall design approach to developing, testing, implementing and upgrading system interfaces.Describe how you support systems without standard interfaces.What tools does your system provide to allow monitoring and guaranteed delivery of your interfaces?What interface engines have your existing clients used?Describe the auditing capabilities to verify the counts of records sent or received by your system.How many levels of software releases are supported for the proposed product?What backup schedule do you recommend?Discuss the data archiving and restoring from archive within all applications of the software.What are the capabilities in restoring from archive?Please provide a Systems Environment Specification that outlines the server, networking and communication requirement for your product.Please provide a copy of your Quality Assurance Guidelines for new software work CapabilitiesSupports Wireless protocols such as 802.11a-b-g-n.HCritical data (security and authentication data) is passed between various layers using at least 128 bit encryption. The browser/server communication can also be set using standard SSL based authentication. HCapable of using IP and the standard network protocol. HSupport secure TCP/IP remote access for users (e.g., PPTP, SSL, Kerberos, etc.). HRequired network devices can be managed from a central location. DSupport Network Load Balancing to offer higher throughput for increased user load. HSupport Layer 3 switching HHas the solution been implemented within an MPLS Network?HIf “Yes” describe any challenges or workarounds implemented.Please describe your LAN/WAN network requirements.On the Wide Area Network, what is the minimum bandwidth requirement?Describe in detail the remote access methods you currently support for your application and how you would support devices at remote locations.What cellular protocols does the system support?What are the throughput response time requirements?What encryption standard does your solution utilize?SecuritySupport Role Based Access. HSupport task-based and object-based user authorization profiles. HProvide an audit trail that can be used to identify transactions or data accesses that have been performed by: FunctionHPatientHUserHTerminalDProvide field level audit log reporting features. HLog all unsuccessful logons and lock out users after a certain number of unsuccessful attempts as defined by the customer. HProvide a “time out” feature that automatically signs off a user if a workstation has been left unattended for a user-defined time period. Application recognizes key press as evidence of application activity.HSupports authentication via LDAP. DReport on access levels by patient, user, and location. HProvide functions to restrict access to specific patient records for individual users. H Permit creation of temporary user accounts with specific expiration timeframes. D Permit the security administrator to specify that User IDs and passwords must contain a combination of alphabetic, numeric, and special characters. HPermit the security administrator to specify that passwords must adhere to strong password guidelines. HPermit the security administrator to specify a minimum password length that will be enforced by the system. HForce a user to select a password at initial sign-on and when the password has been reset. HProhibit the reuse of User IDs and passwords per user based upon security administrator controllable setting. HSupport the encryption of the password file and password information. HPermit the security administrator to set events that are considered security violations as well as provide real-time notification of any violations. HProposed solution provides at least 128-bit encryption over the Internet and intranet as a standard feature (https)HProposed solution provides full user activity audit trail HDiscuss the system’s ability to define and control user and role profiles within and across facilities.Describe the system user name and password structure and the ability to enforce it.Discuss the authentication process including encryption and wireless devices.How does your system support single sign-on?Does the system provide audit logs/error logs to detect unauthorized access or activity?Describe the system components in place that support a user/ client’s adherence to the HIPAA security regulations.PRACTICE MANAGEMENTGeneralSupport an Enterprise Master Patient Index (EMPI) across the continuum of care: acute care, ambulatory, physician office, SNF, home health, and ancillary services. HIdentify potential duplicates and alerts the user of a potential duplicate during assignment of a new medical record number. HFlag deceased patients and integrates information with registration and clinical modules.HAble to add new patients via registration/ admission or scheduling process. HAble to add new patients or revise demographic data for existing patients outside of registration/admission process. HSupport alternative name/alias processing.DProvide on-line inquiry and retrieval capabilities to the EMPI history for an unlimited number of years. DAbility to write ad-hoc reports on all EMPI data fields with a standard report writer application. HAbility to provide real-time access to the EMPI from other, interfaced systems. Please indicate interface standards supported. HSupport for sending HL7 merge transactions (ex. A18, A30,A34, etc.). HAbility to audit EMPI activity. HAbility to notify all systems when new patients are added or when demographics are updated by another system. HOn demand patient statements at time of service. DElectronic insurance eligibility checking. HAbility to calculate anticipated patient responsibility at scheduling. HAutomated tasks to remind physicians of missing charges and complete reconciliation features to the Practice Management SystemDSchedulingIncorporate user-defined, knowledge-based scheduling capabilities to ensure the medically appropriate sequence and timeframes to schedule selected medical services (e.g., pre-defined duration between treatment appointments, time allotted by treatment defined in physician order). HIdentifies available appointment sequence options, e.g., treatment followed by physician visit then lab, and allows scheduler to select preferred option HUser-defined number of appointment types/treatments provided during selected period with override capability. HDefault template with rules that prompts for appropriate data (for example, appointment duration, pre and post procedure time, set-up requirements, prerequisites). HUser-defined rule sets for prompts based on diagnosis/testing (for example, mammogram under 25). HSchedule patient appointments/treatments online by department, by provider, by procedure/treatment, by resource and room. DAutomatically identify next available time slot by individual provider and specialty. HSchedule multiple patients with a single provider or multiple providers. DRecurring clinic/therapy schedules, for example, every other week, every other weekday, and specific dates within a month. HSchedule meeting rooms, specify room set- up, specify equipment /flip charts, etc. DOn-line warning when a patient has been scheduled for multiple appointments/procedures on the same or overlapping date and time with capability to override warning message. DCreates alert if there is a required pre-payment for a pending appointment HCreates alert if insurance verification required HCreates reminders regarding unresolved prior balance, required pre-payment HMove patients between providers, time slots, days, therapists, etc. H“Ticker” file for follow-up requirements e.g., reminders. DTrack “no shows,” no show status and cancelled reason. HFlag patients with a history of no-shows. Print reports of no show patients. DTracks cancelled appointments with a “reason for cancellation,” and print a Cancelled Appointments Report. HTrack on-call schedules with rules (for example, days off, consecutive weeks) DOverlapping of resources for group visit and group assignments to therapist. DAccommodate changes in appointment dates both for individual patients and for identified groups of patients (for example, reschedule an entire day's patient load) without user re-entering all patient information. HCopy/paste into template when moving entire schedule. DBlock the same slot over many days or weeks without requiring user to block the slot for each individual day, including non-consecutive days. HOffsite physician offices access the scheduling system for displaying schedules. DDownload schedules to e-mail. DGenerate list of all patients scheduled from current date through user-defined date (for example, next two weeks) and have report emailed directly to staff workstations. DPrint appointment/facility documents, confirmation and re-schedule letters. DIncludes interface with Interactive Voice Response (IVR) software for callback to remind patients of upcoming appointments. i.e. Phone TreeHA unique Provider ID can have multiple site templates on same day.HDescribe how your system manages “person” data collection. Describe person management as it relates to patient, guarantor, or relative roles. Address how these roles are linked to encounters.Provide an overview of the enterprise scheduling features, including appointment scheduling, conflict checking, rules, patient preferences, auditing, and report features. Describe the ability of the system to produce common metrics (productivity, access, continuity). Describe patient empanelment functions.Describe any medical necessity checking features.Describe how to define appointments or activities and associated resources. Describe how to define for each resource, where the activity can be performed and other rules regarding when the activity can be scheduled based on the specific resources’ availability.Describe overbooking capabilities.Describe any alerts or warnings.Describe report writing capabilities and standard reports.BillingProvide a flexible schedule for the generation of patient bills based on patient type and payer/payer health plan or medical service.HProvide for several customer-defined bill hold criteria by patient type and insurance type including, missing data, diagnosis.HContinually validate that all necessary information has been entered based on payer/ payer health plan billing requirements. Provide worklists to alerts for missing information.HProvide for the display of detail on the account and the patient statement including: a. Source of payment (i.e.: Insurance payment, or Blue Cross payment) b. Date of service to which the payment was applied c. Contractual allowances or not-allowed amount d. Co-payment amount e. Co-insurance amount HProvide for UB-04 and 1500 CMS billing forms.HSupport electronic billing of third-party payers with automatic verification of transmittals, retransmission of corrected transmittals, and cancellation of prior transmittals.HSupport the transmission of HL7 messages to hospital’s existing RCM product for inclusion in the GL.What types of claims scrubbing and transport tools are available with your system?Describe the process for handling Primary, Straddle, Interim, Zero Balance, Rebills, Serial Bills or Demand Bills?Describe how the user maintains claim edits.How does the system produce a point of service bill?Charging Provide an enterprise charge definition and pricing master file for use by all facilities and locations with on-line access for query and updating. HAllow the entry of multiple prices for individual Charge Master File entries with an effective date for the specific price, maintaining an accessible history of price changes and dates.HAbility to “explode” bundled charges into individual components for revenue and statistical reporting while maintaining a single line item for billing or detailed line items.HWhat type of online editing is available when charges are entered?Describe options for time-based charging.Describe how the system supports online and batch charge entry.Reimbursement A contract engine embedded in the system that calculates reimbursement, adjustments, and identified underpayments in real-time without need for an interface to another system. HContracting FunctionsProvide a contract file, which includes payer information including addresses, contacts, expiration dates etc.HSophisticated criteria for grouping together like services for a reimbursement calculationHContract terms are grouped into contract packages that apply to specific encounters e.g. maternity, outpatient surgery, etc.HProvide comprehensive reimbursement calculationsHDescribe your contract management capabilities.What types of reimbursement calculations does your system provide?How does your system support denial management and the appeal process?Account Management Describe the system’s ability to transparently accept an account number and a medical record number generated by another hospital information system as the main source of ADT.HAllow the identification of receivables based on various criteria including: patient or guarantor name or number, phonetic name search, address, phone number, driver’s license, medical record number, social security number, date of birth, etc HAllow the definition of institutional accounts against which charges for multiple patients can be posted.HCollections Support the operation of a Central Billing Office serving multiple facilities and office locations with the ability to consolidate functions while maintaining separate accounting buckets. HSupport the operation of internal and external secondary business offices for collection of receivables. This could include external collection agencies. HAbility to define and monitor special payment arrangements by individual account. DProduce consolidated patient statements by guarantor showing all related patient or family accounts. HSupport automatic and on-demand generation of customer-defined collection letters based on account type and aging criteria to pull in patient and account information such as: a. Patient name (separate the name into first, last, middle initial, title) b. Encounter number c. Date of Service d. Insurance payer e. Total billed HElectronically accept claim denials and perform tracking and appeal processing. HPayments Support electronic remittance for Medicare, Medi-cal and selected insurance carrier. HEnable both online and batch posting of payment and adjustment transactions with adequate audit trail to ensure cash controls. HSupport multiple point-of-service cashiering sites with separate cash draws, receipts, and balancing functions. HApply payments to an account or line item level. HReporting Generate enterprise reports for the health system while maintaining ability to drill down to facility, departmental information, and provider. HProvide the ability to store all reports, bills and statements in an integrated document imaging repository. DProvide AR reports by a. Service/Location b. Providers c. Patient Type d. Insurance Payer/Health plan e. Insurance Type f. Type of Account g. Date of Service h. Age of Account i. Balance Range HProvide for generation of an A/R aging report sorted by delinquency period by specific information. HProvide friendly report writer tool and embedded analytics. HTransaction Handling Compliant with HIPAA 1510 requirements for transactional security HCompliant with HIPAA 5010 requirementsHHandle HL7 batch, real time communication HHandle EDI transaction via modem, ftp transfer HMaintains audit logs of user access, data transferredHPATIENT CENTERED – Patient PortalPatient SchedulingSupports self-scheduling and registration via the Web? HSupports appointment “hold” requests until the physician office review and subsequent approval/denial. HIntegrates fully the rules and clinical content between portal and central scheduling system.HOffers self scheduling 24/7. DElectronic Payment Posting Supports an on-line payment process, i.e. patients can pay on their accounts electronically. HSupports electronic patient bill payment by portal and reflects patient’s bill in main HIS or PPM patient accounting files. HPermits scheduling of single or recurring payments. HSupports patient posting of electronic payments:From any Internet locationdAt a Kiosk deskdEnables patient review of payment status and history. hSends due date reminders and e-mail notifications to patient. hSupports Interactive Voice Response (IVR) payment for those without Web access. Supports voice response payments accepted from patients using a telephone, not a PC. DGenerates standard reports for auditing and settlement. hElectronic Statements Provides online presentation of patient/guarantor statements, letters, via the health provider’s website. HSupports flexible statement/collection letter design in an easy-to-read format. HNotifies and directs patient to the Web site to view their statements and make payments using their credit card or bank account. DSupports customizable electronic statements with health system’s web content standards, logo; large, user-defined text areas; multi-color. Please address other options in Comments. DProvides identical image of printed paper statement. HIntegrates with electronic payment solution. HDemographicsSupports care providers viewing and printing patient face sheets. Supports patients remote update and verification of demographics and payor information. Describe how your system supports self-scheduling by the patient via web portal.Describe the options for custom statements and collection letter.How do electronic statements work in conjunction with electronic payments?What is the process for patients to pay bills online?Describe how the electronic patient payment solution reduces production and postage costs of bills, invoices, notices, and account statements.What payment types are supported e.g. credit card, cash, bank account, paypal?Patient Health PortalWeb based application providing secure anywhere/anytime remote access to care providers and their patients. HGUI front-end application that is user friendly and is easy to navigate. HSecure communication between patients and care givers. HProvide secure messaging capabilities including text, email, pager, etc. HAbility to integrate with external healthcare providers for participating in a health information exchange environment. HAbility to electronically view and send data to immunization and health registries. HAbility to display data from multiple disparate systems regardless of vendor. HAbility to display patient data as discreet data (ex. laboratory results) and images (ex. XRAY, EKG). HCompatible with portable devices such as tablets and smart phones. HProvider/Caregiver Ability to replace multiple disparate systems view of patient clinical data for the care provider. HMultiple options for displaying a list of patients (i.e. single physician, group practice, covering physician). Ability to limit exposed census by individual panel, group, department/facility, enterprise.HAbility to electronically receive, view, and process patient requests for prescription requests and refills. HSingle sign on capabilities. DProvide an electronic graphical view of patient clinical data. HElectronically capture and manage the patient problem list. HAbility to electronically notify the care provider of abnormal and/or critical values when logged in viewing results or via text, email, pager, etc. DLink to external websites through the portal for viewing educational or research materials. HAbility to electronically edit and/or sign transcribed documents. DProvides care providers with a directory of all healthcare provider information that can be used for electronic communications.HSecure messaging and “inbox” functionality that can be used for task assignment and communication.HExpert rules and alerts are built into the application. DThe system can create and display a CCD/CCR. HPatient visit checklists customizable by physician. HPatient/Family Member Educational materials and office visit notes can be sent electronically to the patient and/or a designated family member. HAbility for the patient or designated family member to query for lab, radiology and other diagnostic testing results. HAbility to receive reminders from the doctor’s office about the next immunization or lab due date. HProvide a secure portal with encryption for patients to provide SF-36 (Functional Status Survey), health risk or H&P information to providers. HProvides patients with a directory of healthcare providers contact information.DPatients are able to manage their personal health record by updating information such as allergies, medication list, flu shots, etc. HDo you have integration to an eHealth or patient on-line solution allowing patient populations to verify their medical record, access billing status, review tests results and communicate to the physician?DDescribe how information from a Personal Health Record (PHR) is automatically sent to a provider’s EHR.Describe how a provider can communicate with a patient through the use of a portal, e.g. can patient education material be distributed through the portal?Describe how security access is granted for individual physicians covering patients for situations such as within their physician group or consults.Describe where the database will reside, the work effort involved to build it, and ongoing support of the application. Describe hosting models that are available with this solution. ................
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