Memorandum for General RFP Configuration



Memorandum for General RFP Configuration

To: Vendors with a current valid proposal for General RFP # 3363 for Consulting ServicesVendors with a current valid proposal for General RFP # 3363 for Consulting Services

From: David L. Litchliter

CC: Project FileProject File

Date: August 4, 2004

Project Number: 3529135291

Contact Name: Teresa KarnesTeresa Karnes

Contact Phone Number: 601-359-2615601-359-2615

Contact E-mail Address: karnes@its.state.ms.uskarnes@its.state.ms.us

The Mississippi State Department of Health (MSDH) is seeking the services described below. Our records indicate that your company currently has a valid proposal on file at ITS in response to General RFP #3363 for Consulting Services. Our preliminary review of this proposal indicates that your company offers services that are appropriate to the requirements of this project.

MSDH is in the initial stages of planning a replacement for their Patient Information Management System (PIMS). This system contains patient information and is used by the clinics located throughout the state for clinic functions such as patient registration, billing, etc. As part of this replacement project, MSDH desires to acquire an integrated solution that includes other aspects of the agency that currently run their own systems. An overview of these functional areas is provided in the LOC.

The purpose of this LOC is to obtain services to identify and document the business, functional, and technical requirements for each of the programmatic areas described in Section 1. Background Information. In addition, there are some areas for which interface requirements will need to be defined. These areas are also included in Section 1. The vendor will be required to interview personnel from each of these areas and provide process narratives, process flows, data models, and entity relationship diagrams.

This work must be completed within 90 days of the start date or January 31, 2005 whichever is earlier. In order to complete the project in a timely manner, MSDH and ITS anticipate that the vendor will have a team of analysts to conduct interviews and perform the required analyses in a parallel fashion and then integrate the information, as appropriate. It will be necessary for the vendor to make onsite visits to each of the agency’s nine district offices. These offices are located in: Gulfport, Hattiesburg, Batesville, Tupelo, Greenwood, Starkville, Jackson, Meridian, and McComb.

Note: A mandatory vendor’s conference will be held on August 10, 2004 at 3:00 central time in the Cobb Auditorium which is located on the first floor of the Osborne Building, 570 East Woodrow Wilson, Jackson, MS.

1. BACKGROUND INFORMATION

a. WIC

The existing WIC clinical system was developed in COBOL by Electronic Data Systems (EDS) some 19 years ago as part of an envisioned single system encompassing both clinical and food distribution processes. The EDS system was the first attempt to automate statewide MSDH WIC Program information. Except for modifications required for Y2K compliance, the system has remained substantially unchanged since that time.

WIC certification data is written on paper forms in the clinics, batched with other certification forms, and sent to the state office for data entry. The system’s original purpose was to provide a participant master file for federal reporting purposes and to support the food distribution accounting process. The system did not successfully support food inventory functions and an essentially manual inventory management system continued to operate until MWITS was developed.

The EDS WIC clinical system consists of a combination of manual and automated processes. It is a paper-based, batch processing system still involving some ground shipment of data. Local data gathering consists of completion of several manual forms in addition to the WIC Certification data entry form (Turn Around Document – TAD). Only batch identification and certification form data is input.

All data entry and processing is centralized. Data entry and data correction tasks are performed by six in-house staff members. Following daily batch transmission from the WIC central office to the mainframe, the edit/update programs are run. Error routines analyze the certification information and produce records of two levels of error conditions: Major and Minor. Major errors in a participant record will prevent it from updating the master file. These must be corrected either by state staff intervention and/or physical return of the paper form to the local agency. Minor errors can be corrected on the next TAD. To support error correction at the state office level, a VB/ACCESS program was developed in-house. It allows for an online search of the EDS master file when a data entry document is kicked out for an error condition.

b. Breast and Cervical Cancer Early Detection Program

The Breast and Cervical Cancer Early Detection Program (BCCP) is designed to provide high quality, early screening, diagnosis, and follow-up to women in an effort to reduce morbidity and mortality due to breast and cervical cancer. The BCCP is dedicated to saving lives of women in Mississippi by detecting breast and cervical cancer early, when they are most successfully treated.

With funding from the CDC and matching non-federal funds, BCCP provides comprehensive services such as Clinic Breast Exam (CBE), Mammography, Pelvic Exam, Pap test, Follow-Up and Referral and Health Education. BCCP will target women who are low income, minority, underinsured and uninsured who have no other third party reimbursement source. The target age for breast screening is 50 - 64 years old. The target age for cervical cancer screening is the 18 - 64 year old woman who is not already in a program that provides cervical cancer screening.

The system currently used is called CaST, an acronym that stands for Cancer Screening and Tracking System. It has been provided by the CDC through contract with Information Management Service, Inc (IMS) for Programs in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). CaST allows the user to track women through the length of the study and collect information on screening and diagnostic procedures done for breast and cervical cancer. Data entry in CaST is comprised of baseline data (patient demographic and contact information), along with cycle and procedure information for both breast and screening and follow-up. Each patient in the baseline table has corresponding records in the cycle table, and each cycle has corresponding records in procedures tables. Cycle information includes location (providers), referral information, and final diagnosis and treatment results. Most cycles begin with a screening procedure, either a Mammogram, a CBE, a Pap test, or a pelvic exam. If further diagnostic tests are necessary, additional procedures will be entered for that cycle.

To assist in the tracking of women, CaST has the ability to generate reports, queries, and client/patient reminders that allow the user to generate a list and corresponding mailing labels for all women due in for next annul services or follow-up). It also provides a means to report the Minimum Data Elements (MDEs) to the CDC.

CaST data, by default, are stored in Microsoft Access tables. It uses a relational database model, using patient_id, cycle number, and procedures number to link the table.

c. Perinatal High Risk Management (PHRM)

The Perinatal High Risk Management (PHRM) Infant Services System focuses on lowering the infant and maternal mortality and morbidity rates in Mississippi. PHRM provides comprehensive, individualized, enhanced services, including medical, nursing, nutrition and social services, to high-risk pregnant women and infants as early as possible. This program served 22,408 high-risk mothers and infants in FY 2002.

d. Pregnancy Risk Assessment Monitoring System (PRAMS)

The MSDH has received funding to implement a statewide PRAMS project. PRAMS is part of a Centers for Disease Control and Prevention (CDC) initiative to reduce infant mortality and low birthweight. PRAMS is an ongoing, state-specific, population-based surveillance system designed to identify and monitor selected behavior and experiences before, during, and after pregnancy. The overall goal of PRAMS is to reduce infant morbidity and mortality by influencing maternal behavior during and immediately after pregnancy. Four specific objectives to achieve PRAMS' goals are to:

• Collect maternity-related population-based data;

• Conduct comprehensive data analysis to better understand the relationship between behavior, attitudes, and experiences during and immediately after pregnancy;

• Translate results from analyses into information for planning and evaluating public health programs and policy; and,

• Build the capacity of states to collect, analyze, and translate data to address relevant public health services.

e. Patient Information Management System

The Patient Information Management System (PIMS) is an integrated, clinic-based information system designed to provide automated support for clinic-based activities throughout the state. The goal is to provide timely access to accurate patient information as a by-product of providing patient service in the clinic. The PIMS system provides the districts and clinics with the information needed to manage resources and patient information while providing program management information to the central office program areas.

Through PIMS, programmatic data is collected and reported for all programs for which patients receive service in the clinics. An estimated 1200 users and 800 providers of care use PIMS in approximately 140 sites throughout the state. These providers are from many disciplines including physicians, nurse practitioners, nurses, nutritionists, and social workers. Services are provided to over 350,000 patients with over 1.2 million visits each year through these clinic sites.

The system provides automated support for patient registration and common demographics, encounter processing, appointments, patient and insurance billing, online Medicaid eligibility, and reporting. While common information is collected for all program areas, program specific information is collected and reported for the family planning and immunization programs. PIMS also serves as the statewide immunization registry and provides immunization information to private physicians through web access. PIMS also interfaces to lab, immunization, and sanitation applications.

PIMS application software and end-user processing is supported by five systems analysts and two application help desk staff. The hardware and network support is provided by the agency’s technology infrastructure staff.

Note: A group of approximately 12 people who are representative samples of provider disciplines and end users would be needed in further defining the functional requirements of a patient information management system.

f. Current Disease or Condition Surveillance Systems in Mississippi

1. Infectious Disease

Epidemiology maintains the general infectious disease database. Initially written in 1985 as a Dbase III platform, it has undergone several conversions to its current operating system of Foxpro26 (Windows version). The system is maintained by the Office of Epidemiology. All data are entered into the system by Epidemiology staff. Data are transmitted electronically to CDC weekly and monthly.

2. Influenza and Encephalitis

Epidemiology in conjunction with the CDC has sentinel systems. The influenza surveillance system consists of a state implemented sentinel physician system and a sentinel hospital system for surveillance of viral encephalitis.

Note: The two above mentioned systems contain patient information on positive cases meeting the Rules and Regulations for Reportable Disease and Conditions. Persons in the Epidemiology databases are not generally seen in the Public Health Clinics, however they could be incorporated into the PIMS system using the demographics and provide a module for data entry.

3. Bioterrorism

BT Syndromic surveillance was written using the general infectious disease database architecture and modified to contain data submitted manually to the District offices from sentinel hospitals throughout the state for patients presenting with respiratory and rash symptoms. This system collects aggregate data only at this time.

4. West Nile Virus System

The West Nile virus surveillance system was written using the general infectious disease database architecture and modified to contain arboviral test results that can be electronically imported from the LIMS system using HL-7 file format.

The West Nile virus system is two systems in one. All arbovirus (human) cases are maintained in this system (positive and negative). It contains the complete picture to include lab results. All positive arbovirus cases are merged into the Morbid database. Animals are also contained in the West Nile Virus System. Reports by individuals on birds and horses are stored in this module of the system. This could be a module because individuals bring their dead birds to the county clinics. There the county office can enter the information instead of waiting for a form to be sent to the central office to be entered.

5. Neurological Injury

The Injury Surveillance program and registry is a comprehensive system that identifies and tracks spinal cord and traumatic brain injuries. The application was initially written in 1992, using the general infectious disease database architecture and modified to contain the National Center for Injury Prevention and Controls surveillance of central nervous system injury variables. The system was rewritten with an Oracle database and a Visual Foxpro front-end.

6. STD (Sexually Transmitted Disease) /HIV

The Division of STD/HIV currently has three databases which maintain data on all reportable STDs, including HIV and AIDS. These databases are each written on different platforms and have different architectures. The Division has blended various categorical funds to facilitate data sharing between these systems within the Division’s secure LAN and to establish the backbone of the LIMS. These efforts have been supplemented by technical assistance from various CDC information technology staff elements.

7. HIV LOG

This FoxPro database was developed in the late 1980's to capture all public health HIV antibody test results (positives and negatives) and served until 2000 as the Division’s Counseling and Testing (CT) Database. All historical CT data are archived in this system. The newly implemented LIMS now performs this function with the capacity to report to a segregated receiving point in the Division which evaluates the data and subsequently transmits it to the secure LAN, a Novell system.

8. HARS - CDCs HIV and AIDS Reporting System

This system was implemented beginning in1987 and resides on the Division’s secure LAN. The system captures, encrypts, and transmits blinded HIV/AIDS electronic reports to CDC. It has a PRODAS report package included, but this software is incapable of generating epidemiologically correct reports for the diseases over time. The Deputy State Epidemiologist must download the database into SAS and process it that way. CDC staff are reportedly developing a newer iteration of HARS which will be on a Windows NT platform and could possibly have SAS or Access included for report generation.

9. STD*MIS - CDCs STD Management Information System

This system was implemented in 1995 and resides on the Division’s secure LAN and supports reporting, tracking, and quality assurance of STD, HIV, and AIDS data. It is written in Clipper and is a referential system which allows a great deal of information to be collected on individual clients. STD*MIS is used by Division staff to monitor all STD/HIV/AIDS field epidemiology efforts, as well as to compile and generate statistical information for all STDs (except HIV and AIDS which are derived from HARS and processed as indicated in that section). The Division will receive technical assistance from CDC staff to implement the external laboratory reporting module of STD*MIS. When this is in place, outside laboratories desiring to report electronically may do so in much the same fashion as the public health laboratory.

10. COMPIS

COMPIS is a commercial database used by the Division’s Care and Services staff to capture various information related to the provision of services (AIDS Drug Assistance Program, Home-based Services, etc.) but does not have the capacity to interface with other Division databases. This is a distinct disadvantage since clinical data are available on the other systems to facilitate outcome evaluation.

11. Immunization

The Division of Immunizations system has been in operation since 1994. The immunization registry is linked to PIMS for billing and tracking purposes. It is a statewide system that is operational in 106 county health departments. Most private providers have expanded access to the registry via the statewide immunization registry network, paper forms process of reporting or the Barcode-System process reporting. Private providers report to and access immunization status from the registry through a number of options:

• Non-computer private providers may inquire the immunization status by calling a 1-800 phone number

• Computer capable private providers may inquire the immunization status via an Internet browser

• Private providers may report immunizations to the registry by using a paper-based reporting system or the Barcode-System

• Private providers, schools, childcare facilities, and the Mississippi Department of Education may access the registry via an Internet browser.

Specific report information can be generated using registry data. This information includes compliance forms for school entry, and reminder/recall lists by provider. The Registry has the ability to generate specific immunization reports by provider and population sub-groups.

The immunization registry was developed for all children 0-18 years of age. Currently, access to the system for providers and others whose interests include the appropriate immunization of children is limited. Mississippi Immunization Program management desires a wider more technologically appropriate access for authorized parties on a need-to-know basis. This user-friendly access will enhance the overall level of immunization coverage and assist in ensuring proper immunization of the states children.

g. Child Health

The MSDH Bureau of Child Health provides a variety of services to children and their families and is responsible for reporting on the overall status and statistics regarding children's health to appropriate agencies. To accomplish these tasks, MSDH has six applications that serve the various working groups within the Bureau of Child Services. Each of these systems maintains datasets that are customized to meet specific needs. However, children are frequently enrolled in a variety of different programs and, therefore, may be found in several datasets.

Five of the Bureau's existing systems that include data on individual children and their families are written in Microsoft Access, using the native JET database engine, and reside on three different servers. The only exception is the Lead Program which utilizes Microsoft Access in addition to other products. A brief description of the existing systems is included below to give the Vendor an overview of the different programs affected by this project.

1. Lead Program

The Lead Program tracks children who are shown to have high levels of lead through the Stellar system (Systematic Tracking of Elevated Lead Levels and Remediation). It is written in Clarion and contains approximately 90,000 records. An MS Access program takes the flat files from two different laboratories and creates a dBase III file which is imported into the Solar product that converts the flat files into a format suited for import into the Stellar system. Solar and Stellar are both furnished and supported by the Centers for Disease Control. The data for the repository can be pulled from the Stellar system.

2. Children's Medical Program (CMP)

This program provides medical and surgical services for children up to 20 years of age who have certain conditions. This system contains approximately 6,000 records and is used to capture all data elements on the CMP application form. The system is used for reporting and statistical analyses. It is also used by district personnel to determine if children are covered by CMP and under what diagnoses. The data is stored on a server that is accessed by individual workstations running Access 2002 runtime with MDB. Online help for the system is done in FrontPage 2002. This is a statewide system offering a variety of reports.

3. Newborn Screening

This area is responsible for testing infants to determine if they have any of 40 possible genetic disorders. The system for this area contains over 100,000 records. Data for 15 fields is transmitted electronically from the laboratory in Pennsylvania that performs the testing to the Division of Genetic Services at MSDH. This data is encrypted and transmitted in a DBF file format. Data for five other fields are entered by the Genetics and laboratory staff. The system resides on a server in the Division of Genetic Services at the Central Office and is utilized by each Genetics/CMP Coordinator through their PCs at the district offices for viewing purposes only. Editing is permitted only by Central Office staff.

4. Birth Defects Registry System

This system contains 10,000 records related to birth defects in individuals born on or after January 1, 2000 and resides on the same server as the Newborn Screening System. It can be accessed and edited by each District Genetics/CMP Coordinator, as well as Division of Genetic Services' Central Office staff. Data for this system is obtained from hospital discharge summaries via diskettes mailed in by the hospitals. The diskettes are forwarded to the GCR Company in New Orleans, LA where the data is downloaded and edited. The edited data is sent to the Division of Genetic Services on a monthly basis, with some exceptions, for reporting by type of disorder, grant information, statistical information, and surveillance functions.

5. First Steps Information System (FSIS)

First Steps is a program that matches the needs of infants and toddlers who have developmental delays with professional resources available within the community. The First Steps Information System contains 9,000 records and was developed for the capture and dissemination of data on a statewide basis. The system captures demographic information and other First Steps-specific information needed to report activities as required by grant obligations. The data entry is done by field staff throughout the state on local computers. This information is then transmitted from the local computers to each District office and then to the Central Office. At the Central Office, the information is combined into one data set for reporting and searches. This statewide data set is created once a month and then archived.

6. Early Hearing Detection and Intervention System

The Early Hearing Detection and Intervention System was developed for the capture and dissemination of data for children with possible hearing loss. Information is either faxed or mailed to MSDH where it is keyed. The system captures demographic information and other specific information needed to report activities as required by grant obligations, such as types and severity of hearing losses in the state.

h. MSDH Division of Oral Health

The Division of Oral Health does not currently have any applications. However, the following is a description of potential systems this division would like to have.

1. Oral Health Assessments

This division conducts clinical oral health assessments. These assessments are required by the MCHB Title V Block Grant and reported to the CDC National Oral Health Surveillance System (NOHSS). The data collected includes: % of children with dental caries experience, % of children with untreated dental caries, % of children needing dental treatment according to urgency of need, and % of children with sealant on 1+ permanent molar. The goal is to collect data that will interface with existing PIMS data for demographic data and secondary data analysis to provide perspective about the underlying population.

2. Risk Reduction Surveillance

This Division must be able to report the percentage of people served by community water systems with optimally fluoridated water. Surveillance is reported using CDC Water Fluoridation Reporting System (WFRS). Data sharing is required between Division of Water Supply’s databases and Division of Oral Health’s databases. WFRS reporting will go online in July 2004.

3. Systems Development / Access / Assurance

It will be necessary to track oral health screenings performed at the Children’s Medical Program Blake Clinic. Currently, CMP staff uses one CPT code to record all dental procedures performed at the Blake Clinic. Staff should use PIMS to record and refer children with cleft lip/cleft palate, or other congenital / developmental anomalies. Appropriate dental procedures codes should be selected using CDT-5 (Current Dental Terminology).

EPSDT screening is performed at health department clinics, and this screening should include a dental screening. With dental screening, children can be identified that have urgent dental problems and referred to a dental home. MSDH staff should use PIMS to record and refer children who need dental care. It is also necessary to monitor referrals made to dental providers and provide follow-up to assure that the children were seen.

The percent of individuals served by preventive dental care at MSDH sites should be tracked. These services include: fluoride mouth rinses, chewable fluoride tablet prescriptions, dental sealants, fluoride varnish application, tobacco cessation instruction, and oral hygiene instruction). The MSDH must be able to track preventive dental services that are rendered at all MSDH clinic sites.

4. MSDH Cross Roads Dental Clinic

This facility is administered by the Division of HIV/STD and will provide dental care to individuals enrolled in the AIDS Drug Assistance Program. The clinic is located in the Jackson Medical Mall. This facility must be able to record and monitor dental procedures using PIMS. Additionally, it is anticipated that Cross Roads will have electronic health records. If so, program-specific information such as a dental charting and recording component will need to be included.

5. School-based Dental Services

The Children’s Oral Health Protection Program (COHP) will provide school-based fluorides and sealants. The MSDH will employ regional certified dental hygienists to implement this program through regional public school systems. It will be necessary to record and track children who participate in this program.

i. Asthma

The overall purpose of the Mississippi Asthma Surveillance System is to describe the epidemiology of asthma among Mississippi residents and reduce its morbidity and mortality. This system shall be created to better organize asthma data using geographical, demographic, and environmental information to track asthma cases in Mississippi.

The Centers for Disease Control and Prevention (CDC) recommends utilizing the Public Health Information Network (PHIN) Functions and Specifications to establish industry standards. The web-based asthma surveillance system should have the ability to securely and automatically send and receive information, as appropriate, between computer systems, to achieve a "live" network for data exchange between our partners in public health. The system's implementation should focus on sending and receiving information between the MSDH and health partners that run information systems.

The scope of work for this project is to develop and implement a web-based asthma surveillance system. The system should capture asthma data on all hospital asthma visits and admissions in Mississippi.

The Office of Epidemiology (OE) has conducted numerous pilot studies on asthma over the past five years. In 2003, an asthma surveillance system was established. Data were collected on all Emergency Department, Inpatient, and Outpatient visits from acute care hospitals in the tri county area (Hinds, Madison, and Rankin).

In 2004, the current asthma surveillance system was expanded to include all hospitals in the state. Data from acute care hospitals in three public health districts (5, 9, 3) are submitted via diskette in Excel, ASCII, Comma or text delimited files by Health Information Directors

Note: The following areas require interface requirements only. Vendor is expected to provide a definition of integration points.

j. Mississippi Public Health Laboratory

The purpose of the Mississippi Department of Health Laboratory Information Management System (LIMS) is to electronically collect, manage and report patient information, submitter information, specimen information and test information for the Public Health Laboratory (PHL). The Mississippi Public Health Laboratory receives specimens for testing from health department county clinics, hospitals, private clinics, private physicians, jails, and penitentiaries across the state. The PHL contains both environmental and clinical laboratories and currently the PHL has a LIMS for the clinical testing. The vendor is M/MGMT Systems; the application is called Mlab. There is no LIMS in place for the environmental testing.

The LIMS has a real-time connection with the agency’s Patient Information Management System (PIMS) via a software product called Openlink. The Openlink software allows for PIMS to send patient demographics electronically to the LIMS. The LIMS generates electronic reports that are sent to the STD/HIV program office, the Epidemiology program office, and the Tuberculosis program office within the agency. It also generates and sends electronic reports to the Centers for Disease Control.

The clinical data collected by the LIMS resides on a Cache database at the PHL on the central campus in Jackson, Mississippi. The LIMS currently handles approximately 340,000 specimens per year.

k. Public Health Statistics

The Bureau of Public Health Statistics is required to provide a system of records management for various life events. Among these events are registrations of births, adoptions, deaths, fetal deaths, induced terminations, marriages and divorces, as well as amendments to these records. Other responsibilities of the Bureau include the certifications of births, deaths, and marriages; record searches for divorces; audit reporting of request fees received; and tracking of all certification requests. The Bureau is further charged with the preservation of these records. An auxiliary requirement involves the maintenance of the privacy or confidentiality of these records within the confines of the laws that established the requirements.

Vital records information is gathered from various sources across the State. County circuit and chancery clerks, hospitals, physicians, coroners, midwives, funeral directors, and all other persons or facilities having knowledge of reportable vital events file records and reports. All information is currently provided on paper forms designed and provided by the Bureau. Additionally, approximately 85 percent of the birth records are provided by diskette in electronic format using an electronic birth certificate (EBC) system by Genesis Systems, Inc.

The current vital records system was customized for Mississippi by KE Software, Inc. of Vancouver, BC in Canada and went into production in June 2003. The basis for the customization was an existing product called LifeData that was subsequently renamed to KE VitalWare. This system manages:

• the data entry, editing, querying of hospitals, funeral homes and mothers for missing information;

• searching of records for issuance of certified copies, amendments and corrections to records;

• the point of sale system for mail, telephone and front counter sales; and

• and interfaces with two third-party vendors for web-based certificate ordering.

The system also allows for the production of reports and file extracts that support the above activities.

KE VitalWare utilizes the KE Texpress database engine. KE Texpress is a multi-user, object-oriented database management system. KE Texpress incorporates an ODBC interface for compatibility with third-party client tools.

Interacting with the current software is the Genesis EBC system. This software allows hospitals to key birth information into a local PC. When the birth record is complete, a copy is printed at the hospital for the signatures, then the diskette and the paper copy are mailed to the MSDH Registration unit. The diskette is then edited at the state level and certificate numbers added. These records are then uploaded into the registration birth file in KE VitalWare.

The calendar year 2002 annual registration levels of records are as follows:

40,535 Birth Records 18,447 Marriages

28,161 Death Records 14,196 Divorces

396 Fetal Deaths 1,024 Adoptions

3,605 Induced Terminations 5,407 Record amendments

Approximately 4,800,000 birth records 1,176,000 death records and 1,100,000 records for the remaining record types are searchable online. Approximately 408,000 point of sale transactions (~1,600 per day) were completed during FY 2004.

l. Tuberculosis

This area recently purchased a customized secure web-based data entry and data management system. All patient medical, medications, contacts, and information are stored in an Episode-based system. The TB Bureau began using the electronic record system as its sole system in January 2004. Individual counties and districts are being brought online as agency personnel install equipment in the clinics/offices and field and central office staff complete training.

m. Home Health

The Bureau of Home Health has been providing services since 1965. Home Health services are available on a part time basis to homebound patients, those under the care of a physician, and those who require intermittent nursing or various types of therapeutic care. The Bureau is licensed to provide skilled nursing , home health aide, social service, physical therapy, speech/audio therapy, and occupational therapy services, as well as patient equipment and medical supplies. Referrals are accepted for services in compliance with Medicare, Medicaid, and as one of the low cost providers in the state. Services are also provided to the Veteran’s Administration, private insurers, and self-pay patients. When services are not available directly through the state’s public health agency, the agency social worker explores other resources in an effort to meet each patient’s health and social needs. Home Health is divided into 13 regions.

n. EMS - Trauma

The purpose of the Mississippi Trauma Data Collection System is to enable Mississippi State Department of Health personnel to electronically collect, manage, and report Trauma System data. Data is to be used to identify, design and implement mechanisms to reduce trauma, ultimately improving health care for the citizens of Mississippi. The software will assist trauma center staff with performance improvement activities within the hospital. The data collected will allow the trauma center to monitor and improve its trauma program. The trauma region will use the data to develop and monitor pre-hospital triage protocols, transfer agreements, and policies. The data is used for injury prevention activities, legislative initiatives, and monitoring of the Trauma Care Trust Fund. Finally, the State will submit its data to the National Trauma Data Bank (NTDB).

Passage of legislation during the 1991 Mississippi legislative session designated the Division of Emergency Medical Services (DEMS), Mississippi State Department of Health (MSDH), as the lead agency to develop a trauma care plan for the state. The law provides that the State Department of Health, Division of Emergency Medical Services, acting as lead agency, in consultation with and having solicited advice from the Emergency Medical Services Advisory Council, shall develop a plan and submit to the Legislature a plan for the triage, transport, and treatment of major trauma victims that at a minimum addresses the following:

• The magnitude of the trauma problem in Mississippi and the need for a statewide system of trauma care;

• The structure and organization of a trauma care system for Mississippi;

• Pre-hospital care management guidelines for triage and transportation of major trauma victims;

• Trauma system design and resources, including air transportation services, and provision for inter-facility transfer;

• Guidelines for resources, equipment, and personnel within facilities treating major trauma victims;

• Data collection and evaluation regarding system operation, patient outcome, and quality improvement;

• Public information and education about the trauma system;

• Medical control and accountability;

• Confidentiality of patient care information;

• Cost of major trauma in Mississippi; and

• Research alternatives and provide recommendations for financial assistance of the trauma system in Mississippi, including, but not limited to, trauma system management and uncompensated trauma care.

2. GENERAL PROJECT REQUIREMENTS

a. The vendor is requested to provide details on the features, functions, or other considerations exclusive of the specified requirements that the company affords the customer that may provide a distinct value to MSDH. In the event it is determined that such features, functions, or other considerations provide a distinct benefit, the State reserves the right to give the vendor additional consideration. ITS and MSDH will make the sole assessment of the relative merits of each added value proposal to the agency.

b. The vendor must agree to act as prime contractor on this project and must guarantee the performance and delivery of all tasks, goods and services under this contract regardless of the number of subcontractors employed by the proposing vendor.

c. The vendor must propose an adequate level of staffing to ensure the successful completion of the project in the required time frame. The proposed individuals should possess the necessary skills and certifications for the roles they are filling. All individuals proposed for this project must have a minimum of two years experience performing the role they are proposed to fill. Vendor must provide a project organization chart and clearly describe the roles of each proposed individual.

d. The vendor must include resumes for all individuals proposed for this project. These resumes should include project references that may be called by MSDH and ITS to verify experience. MSDH and ITS reserve the right to approve all individuals assigned to this project. Proposals submitted without the required resumes will be eliminated from consideration. All individuals proposed must be proficient in written and spoken English.

e. Vendor must provide references for a minimum of three similar projects successfully implemented by the vendor. Information must be provided regarding the scope of the project and the project time frame. In addition, the following contact information must be included: project contact name, contact title, contact phone number, contact fax number and contact-e-mail.

f. Vendor must provide a narrative that fully discusses the approach they plan to take on this project. All issues pertinent to this undertaking must be outlined and a methodology must be defined for producing the desired results. For each issue identified, the vendor must detail key elements of the problem and the manner in which they will approach resolution.

g. Vendor must provide a detailed project work plan. Since the vendor team must work closely with the State’s staff in all aspects of this project, the work plan must specify what responsibilities will be mandatory for the customer staff to fulfill relative to assisting in this project. The vendor must allow MSDH staff a minimum of five (5) working days to review and approve each deliverable.

h. The vendor must detail in the work plan the personnel resources assigned to each task, as well as the number of hours for each person. The evaluation team will review this information. If it is determined by the evaluation team that the vendor has underestimated the work effort, the State reserves the right to eliminate the proposal from further consideration.

i. For each functional area requiring an analysis for interface purposes, vendor must provide, at a minimum, the following deliverables.

• Definitions of data integration points

• Detailed list of technical requirements, including any applicable federal standards or guidelines

j. For each functional area requiring a complete analysis, vendor must provide, at a minimum, the following deliverables. These deliverables must be provided in hard copy and in an electronic format using either Microsoft Word, Microsoft Project, Visio, and/or ERwin.

• Process Narrative

• List of functional requirements

• Detailed list of technical requirements, including any applicable federal standards or guidelines

• Process Flows

• Data Elements

• High Level Data Model

• Entity Relationship Diagram

• High Level Data Dictionary

• Interfaces to lab equipment, PDAs, field devices, etc

k. Vendor must provide examples of the following work products in order for the State to assess the quality and detail of work from previous projects. These examples should include:

• Process Flows

• Process Narrative

• Data Elements

• High Level Data Model

• Entity Relationship Diagram

• High Level Data Dictionary

l. It is anticipated that the winning vendor will begin work by mid-October. Vendor must assign adequate resources to complete this project no later than January 31, 2005. The evaluation team may, at its discretion, provide additional consideration to vendors who can provide resources and propose a project work plan to complete the project within a shorter time frame.

m. All findings, documentation, and other deliverables under this contract will become exclusive property of MSDH. Any termination of consulting services will result in the project team using all deliverables to secure proposals from alternate consultants.

n. The winning vendor must be prepared to sign a HIPAA Business Associate Agreement.

o. As stated earlier, the purpose of this LOC is to develop business requirements that will be included in the future release of an RFP to replace the existing PIMS system. The winning vendor will be heavily involved in developing the RFP requirements for the new system and is, therefore, prohibited from competing on the future procurement for the replacement of the PIMS system.

p. Vendors may request additional information or clarifications to this LOC using the following procedure. Vendors must clearly identify the specified paragraph(s) in the LOC that is/are in question. Vendor must deliver a written document to Teresa Karnes at ITS by Thursday, August 12, 2004, at 3:00 P.M. This document may be delivered by hand, via mail, or e-mail.

ITS WILL NOT BE RESPONSIBLE FOR DELAYS IN THE DELIVERY OF QUESTION DOCUMENTS. It is solely the responsibility of the vendor that the clarification document reach ITS on time. ITS is under no obligation to respond to questions received after the deadline date above. All questions will be compiled and answered. A written document containing all questions submitted and corresponding answers will be distributed to each vendor by close of business on Friday, August 20, 2004.

Contact information is as follows:

Teresa Karnes, Technology Consultant

Mississippi Department of Information Technology Services

301 North Lamar Street, Suite 508

Jackson, MS 39201

601-359-2615

FAX 601-354-6016

3. COST INFORMATION

a. Vendor must provide a fixed price for the services requested by deliverable. Any travel, lodging and per diem or related expenses must be included in the proposed pricing. Vendor must submit, as part of the proposal, a schedule of deliverables with associated payments and due dates. This payment schedule will be finalized during contract negotiations.

b. Vendor should be aware that the deliverable-based payments for this project will be made only upon State acceptance of the prescribed deliverables.

c. Vendor must also include a rate schedule listing the hourly rate for all roles that are proposed for the project. These rates will be used as the definitive rates for change orders and should be the very best bottom line rate available. All expenses associated with change orders are subject to MSDH pre-approval and will be negotiated at the time of the change order.

d. At the conclusion of this project, the MSDH may, at its discretion, choose to continue a working relationship to assist with further development of the RFP for the new patient information system and in the subsequent proposal evaluation process.

4. EVALUATION CRITERIA

The proposal evaluation will occur progressively over the following steps. Vendors satisfying the evaluation criteria in a given step will qualify for the subsequent step. Vendors failing to meet the criteria in a step or failing to score a minimum of 80% will be immediately disqualified.

Step 1 – Proposal Validation

Vendors’ proposals will be reviewed to insure all specifications have been properly addressed, furnishing the information needed to facilitate a proper technical, financial and background evaluation. Vendors will be contacted on those proposals found to require minor clarification. Vendors whose proposals do not adhere to the specifications, contain consistently vague responses, or omit information will be disqualified from further evaluation.

Step II – Vendor Company and Staff Experience Qualification

Vendors will be evaluated upon the experience of their organization and proposed staff relative to analysis projects and definition of business/functional requirements. Vendors possessing bad references or who are deemed lacking experience in the estimation of the State will be disqualified.

Step III – Technical Proposal

Vendors will be evaluated on the “technical” aspects of their proposals. This category includes their methodology and approach to the project, the reasonableness of the project work plan, etc.

Step IV - Quantitative Evaluation

Scores will be assigned for the following categories. Each of these categories is assigned of between 5 and 50 points with the sum of all categories equaling 100 points, plus up to five additional points for added value. All information provided by the vendor and other information available to the State will be used to evaluate the proposals.

• Project cost

• Vendor organization and proposed staff – must score a minimum of 80% of total possible points for further consideration.

• Technical Proposal – must score a minimum of 80% of total possible points for further consideration.

• Vendor References - must score a minimum of 80% of total possible points for further consideration. Reference calls will be made only for those vendors who are in the competitive range.

• Added Value

Step V – Vendor Interview

At its option, the State may request an interview from vendors in a competitive range in the evaluation. Vendors must be prepared to meet with MSDH staff within five (5) days of notification. All costs associated with the interview will be the responsibility of the vendor.

5. DELIVERY INSTRUCTIONS

a. Respond to each point in all sections and exhibits with the information requested. Label and respond to each outline point in each section and exhibit as it is labeled in the letter of configuration (LOC).

b. The vendor must respond with “ACKNOWLEDGED”, “WILL COMPLY”, or “AGREED” to each point in each section within this LOC with which the vendor can comply.

c. If vendor cannot respond with “ACKNOWLEDGED”, “WILL COMPLY”, or “AGREED”, then vendor must respond with “EXCEPTION”. If vendor responds with “EXCEPTION”, vendor must provide detailed information related to that response.

d. Where an outline point asks a question or requests information, vendor must respond with the specific answer or information requested.

e. Vendor should respond to each point in the Professional Services Contract (Attachment B). Vendor must respond with “ACKNOWLEDGED”, “WILL COMPLY” or “AGREED”. If Vendor cannot respond with either of these responses then Vendor must respond with “EXCEPTION”. Vendors who acknowledge any point in the standard contract may not later take exception to any of these points during contract negotiations. The Vendor may take exception to any point. If the Vendor takes exception, the exception must be clearly explained, along with any alternative or substitution the Vendor proposes to address the intent of the specification. The Vendor has no liability to provide items to which an exception has been taken. ITS has no obligation to accept any exception. During the contract negotiation process, the Vendor and ITS will discuss each exception.

f. Vendor must delivery four (4) copies of the response to Teresa Karnes at ITS by August 27, 2004 at 3:00 PM (Central Time). Responses may be delivered by hand or via mail. ITS WILL NOT BE RESPONSIBLE FOR DELAYS IN THE DELIVERY OF PROPOSALS. It is solely the responsibility of the vendor that proposals reach ITS on time. Vendors should contact Teresa Karnes to verify the receipt of their proposals. Proposals received after the deadline will be rejected.

EXHIBIT A

COST INFORMATION SUMMARY

Vendors must propose all applicable project costs in the matrix, which follows. Any cost not listed in this section may result in the Vendor providing those products or services at no charge to the State or face disqualification. The size of the following tables may be increased if necessary to accommodate proposed cost information:

|Major Phase and/or Deliverable |

|Program Areas Requiring Complete Analysis |

|WIC |Fixed Cost |

|Process Narrative | |

|Detailed Functional Specs | |

|Detailed Technical Specs | |

|Process Flow | |

|Data Elements | |

|Data Model | |

|Entity Relationship Diagram | |

|Data Dictionary | |

|Interface Requirements | |

|Subtotal | |

|Breast and Cervical Cancer Early Detection Program |

|Process Narrative | |

|Detailed Functional Specs | |

|Detailed Technical Specs | |

|Process Flow | |

|Data Elements | |

|Data Model | |

|Entity Relationship Diagram | |

|Data Dictionary | |

|Interface Requirements | |

|Subtotal | |

|Perinatal High Risk Management (PHRM) |

|Process Narrative | |

|Detailed Functional Specs | |

|Detailed Technical Specs | |

|Process Flow | |

|Data Elements | |

|Data Model | |

|Entity Relationship Diagram | |

|Data Dictionary | |

|Interface Requirements | |

|Subtotal | |

|Pregnancy Risk Assessment Monitoring System (PRAMS) |

|Process Narrative | |

|Detailed Functional Specs | |

|Detailed Technical Specs | |

|Process Flow | |

|Data Elements | |

|Data Model | |

|Entity Relationship Diagram | |

|Data Dictionary | |

|Interface Requirements | |

|Subtotal | |

|PIMS |

|Process Narrative | |

|Detailed Functional Specs | |

|Detailed Technical Specs | |

|Process Flow | |

|Data Elements | |

|Data Model | |

|Entity Relationship Diagram | |

|Data Dictionary | |

|Interface Requirements | |

|Data Dictionary | |

|Interface Requirements | |

|Subtotal | |

|Child Health Systems |

|Process Narrative | |

|Detailed Functional Specs | |

|Detailed Technical Specs | |

|Process Flow | |

|Data Elements | |

|Data Model | |

|Entity Relationship Diagram | |

|Data Dictionary | |

|Interface Requirements | |

|Subtotal | |

|Division of Oral Health |

|Process Narrative | |

|Detailed Functional Specs | |

|Detailed Technical Specs | |

|Process Flow | |

|Data Elements | |

|Data Model | |

|Entity Relationship Diagram | |

|Data Dictionary | |

|Interface Requirements | |

|Subtotal | |

|Asthma |

|Process Narrative | |

|Detailed Functional Specs | |

|Detailed Technical Specs | |

|Process Flow | |

|Data Elements | |

|Data Model | |

|Entity Relationship Diagram | |

|Data Dictionary | |

|Interface Requirements | |

|Subtotal | |

|Program Areas Requiring Only Interface Requirements |

|Mississippi Public Health Laboratory | |

|Definition of Data Integration Points | |

|Subtotal | |

|Public Health Statistics | |

|Definition of Data Integration Points | |

|Subtotal | |

|Tuberculosis | |

|Definition of Data Integration Points | |

|Subtotal | |

|Home Health | |

|Definition of Data Integration Points | |

|Subtotal | |

|EMS Trauma | |

|Definition of Data Integration Points | |

|Subtotal | |

|PROJECT TOTAL | |

|PROJECT HOURLY RATES |

|Type of Position (e.g., Business Systems Analyst, Senior Analyst, Project Manger, etc.) |Hourly Rate |

| | |

| | |

| | |

| | |

| | |

| | |

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David L. Litchliter, Executive Director

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