A.General Information - Veterans Affairs



Statement of WorkDepartment of Veterans AffairsVeterans Health AdministrationHIG SST Point of Care, Drug Database and Diagnostic Tool SubscriptionJanuary 2018A.General Information1.0Introduction:The Department of Veterans Affairs (DVA), Veterans Health Administration (VHA), requires online access to a commercial, off-the-shelf, point of care (POC) clinical information subscription, with an integrated, commercial, off-the-shelf, drug database subscription (DDB), with an integrated, commercial, off-the-shelf, clinical diagnostic tool (DT), that will be made available throughout the VHA healthcare system. Access shall include Continuing Medical Education (CME) credits for the POC and DT databases, remote access via OpenAthens accounts, and mobile platforms to include various popular hand held devices, for all physicians and all other health care providers across the Department of Veterans Affairs (DVA). These databases will serve to assist health care providers in their clinical decision making and drug information needs.2.0Background: The DVA, which includes 153 medical centers, affiliated Community Based Outpatient Clinics, and other physical work and off-site locations, requires online web access to searchable medical and drug references for retrieval of current, authoritative, and evidence-based medical and drug information for health care providers and patients. Electronic medical references reduce the need for multiple individual hard copies of expensive print resources and allow for cross searching multiple clinical information resources. This method provides a more efficient manner of retrieving medically necessary information to meet the clinical mission of providing quality care to Veterans within the DVA Network. Health care providers need these online tools to be available on VA networked and non-VA networked computers, both onsite and offsite, as well as on mobile devices, to have health information available to provide care for patients.All VA Medical Centers have access to nationally purchased databases and resources that are made available through the VA Library Network Office (LNO). These databases include already subscribed content from: Clinical Key, OVID MD, the Access Suite from McGraw Hill, and many others. The POC, DDB, and DT databases required in this statement of work are to complement these resources. These resources must provide patient health information that is printable and can be provided to Veteran patients, their family members and caregivers. 3.0Scope of Work:The contractor shall provide all resources necessary to meet the requirements described in this statement of work for an online, commercial, off-the-shelf, point of care (POC) clinical information subscription, with an integrated, commercial, off-the-shelf, drug database subscription (DDB), with an integrated, commercial, off-the-shelf, clinical diagnostic tool (DT). The contractor shall ensure that the POC and DT databases includes Continuing Medical Education (CME) credits. The contractor shall provide 24/7 online web access to the POC, DDB, and DT subscription as stated herein for staff at facilities in the DVA (via IP), to their mobile devices (via Apps or mobile websites), or to their remote work areas (via IP or OpenAthens).4.0Performance Period: One (1) year from date of award, plus four (4) one (1) year option periods to be exercised at the discretion of the Government. 5.0Required POC Clinical Information Subscription Requirements and Salient Characteristics: The contractor shall provide a POC clinical information subscription which addresses the following requirements and salient characteristics:Summaries and recommendations are provided, giving very specific and summarized statements that allow for ease of readability;User-friendly login and search engine; Efficiency, timeliness, and ease of navigation through search results;Comprehensive disease state information, management, diagnosis, and treatment; Summary of new or changing therapies; Links to full text articles; Tools to aid in information retrieval assessment (e.g. medical calculators, tables, graphics); Platform to easily record, track, and redeem CME/CE credits with each topic review; Vendor-provided original patient information at a basic level (two levels of reading level is preferred); Sources are from vendor produced and updated information;Different types of treatment are clearly labeled within the table of contents;Content covers pathophysiology, diagnosis, prognosis, etiology, laboratory tests, and recommended treatment of medical conditions with grading of evidence, if appropriate;Provides content that is synthesized into clear and concise answers;Provides information about laboratory tests including normative values, contraindications and risks.Fully integrated with link-out ability specifically from the POC clinical information resource to the relevant drug information in the DDB resource and to the content in the DT resource. Continuing Medical Education (CME) included: Users shall be able to track CME activity after establishing an account as provided by the contractor. All username/password and account maintenance shall be the responsibility of the contractor. Accreditation providers shall include a majority of the following:Accreditation Council for Continuing Medical Education (ACCME).American Medical Association (AMA).American Academy of Family Physicians (AAFP). American Academy of Pediatrics (AAP). American Academy of Physician Assistants (AAPA). American Association of Nurse Practitioners (AANP).American College of Emergency Physicians (ACEP). American College of Obstetricians and Gynecologists (ACOG). American Osteopathic Association (AOA).American Midwifery Certification Board (AMCB).National Board of Certification and Recertification of Nurse Anesthetists (NBCRNA).Maintenance of Certification (MOC) included:? Users shall be able to track MOC activity after establishing an account as provided by the contractor.? All username/password and account maintenance shall be the responsibility of the contractor.? Accreditation providers shall include a majority of the following:American Board of Internal Medicine.American Board of Medical Specialties MOC Directory.MOC Part II CME Activity included:? Users shall be able to track MOC Part II CME activity after establishing an account as provided by the contractor.? All username/password and account maintenance shall be the responsibility of the contractor.? Accreditation providers shall include a majority of the following:American Board of Allergy and Immunology.American Board of Anesthesiology.American Board of Colon and Rectal Surgery.American Board of Family Medicine.American Board of Physical Medicine and Rehabilitation.American Board of Preventive Medicine.American Board of Psychiatry and Neurology.American Board of Thoracic Surgery.American Board of Surgery. The contractor shall provide 24/7 license rights for immediate access to multiple simultaneous users from any web-enabled computer and mobile device. The database shall provide multiple simultaneous users, via one interface and one search platform, extensive evidence-based and peer-reviewed information on the following specialty areas including, but not limited to: Adult Emergency Medicine. Adult Primary Care and Internal Medicine. Allergy and Immunology. Anesthesiology. Cardiovascular Medicine. Dermatology. Endocrinology and Diabetes. Family Medicine and General Practice. Gastroenterology and Hepatology. General Surgery. Geriatrics. Hematology.Hospice and Palliative Care.Hospital Medicine. Infectious Diseases. Nephrology and Hypertension.Neurology. Obstetrics, Gynecology and Women’s Health. Oncology. Pulmonary, Critical Care and Sleep Medicine. Content presentation and provision shall be appropriate for a large-scale teaching hospital’s usage and relevant to its medical education curriculum.? Content shall be appropriate to use in the development of an educational curriculum, not solely developed for the practicing physicians’ use. ??Content shall be presented with/in a scholarly based approach. It shall be developed and presented with concise and expansive evidence-based information and not in a “recipe book” or “short answer” format. Content shall provide insight to an understanding of the clinical application of the diagnosis and treatment of specialty areas in medicine.Content must be in a narrative format suitable for health sciences students, residents, and fellows to educate themselves on point of care/clinical topics.An overall academic basis approach is required in the presentation and content of the clinical information.Theory/Clinical Insights/Understanding methods are presented and included in the content provided.The POC information shall be written for a wide range of health professionals, but is targeted to internal medicine and related specialists. Designed to provide concise, practical answers (with recommendations with lists of evidence grades), the topics are written exclusively for clinicians in a minimum of 17 different medical specialties. Content is comprised of topic reviews written by recognized physician experts who address specific topics, synthesize research and make recommendations for treatment in their area of expertise. For content written by participating physicians, a wide range of medical journals are searched regularly along with the biomedical databases and hand-searching of the literature. Content shall be written and reviewed by expert physicians in their specialty and peer-reviewed by other experts in the specialty. ?Credentials and affiliations of the authors and reviews shall be included in the content, and potential conflicts of interest clearly delineated. Authors or content experts for each section shall be recognizable as experts in that field. Components of the clinical topic review (diseases, conditions, symptoms, and other presentations) shall include the following information fields:Date of record/review update for each entry.Author(s)/editor(s) of record/review update for each entry. Author(s)/editor(s) credentials for each entry. Author(s)/editor(s) affiliation of record/review update for each entry. Specialty peer reviewer(s), credentials & affiliation of record/review update for each entry.General Information/Overview. Epidemiology/Incidence/Prevalence/Causes/Risk Factors.Pathophysiology.Diagnosis/Prognosis/Treatment/Laboratory Tests/Complications/Prevention/rmation for patients written at different levels to meet the varying needs of patients.Hyperlinks to MEDLINE abstracts within the body of the record and in record/review references section. Graphics (figures, pictures, graphs, tables, etc.) integrated into record/review that can be printed or exported.References/Guidelines section with hyperlinks to MEDLINE abstracts.Hyperlinks to related record/review topics.Summary/Recommendations with grading.Ability and ease of remote connection.Updates of content at no additional cost. Static URL for access within DVA IP firewall and account login and password for access outside DVA IP firewall. Outside of IP firewall access, the contractor shall adhere to the OpenAthens time period for verification of (1) authorized user access; and, for (2) CME tracking. Currently, the OpenAthens accounts are established for a 2-year renewal cycle for permanent employees and a self-reported service expiration date for non-permanent employees, not to exceed 2 years. Justification for alternative time periods must be provided and acceptable to the LNO.The electronic reference must be easily accessible remotely by mobile devices and non-VA equipment for employees of the DVA. The contractor shall provide usage statistics on a monthly basis. The format of the usage statistics is provided either via email or contractor provided login username/password and shall include session count, search count, total document retrievals per title, top topics searched, method of access (onsite, remote, mobile), and a breakdown by IP/medical center is required.The contractor shall conduct online national webinars and provide online tutorials. Contractor shall also provide on-site training, briefings, and updates to facilities within the DVA Network as requested.If a plug-in, additional software or recommended software is required for optimal use, specific requirements must be included. Contractor shall address any questions or problems encountered when using this product with supported software or hardware.Contractor shall provide technical support telephone numbers and email addresses. Customer service shall be available to troubleshoot website/connectivity issues via telephone and email. Issues unresolved in excess of two (2) business days shall be reported via email to the LNO at vhalno@6.0Required DDB Subscription Requirements and Salient Characteristics: The contractor shall provide a DDB Subscription which addresses the following requirements and salient characteristics:Provides up-to-date drug information [prescription, OTC, alternative medicine]; Determines dosing, side effects, and interactions;Identifies drugs and provide comparisons;Provides full-text databases on chemical, pharmaceutical, and related biological substances used in clinical patient care;Covers teratogenicity, toxicology, alternative medicine, and pharmaceutical information;Includes drug reviews, guidelines, clinical reviews, and information from package inserts and drug texts;Contains calculators (dosing, clinical, measurement, laboratory values, etc.);Provides access to Black-Box warnings;Contains access/link to I.V. compatibility resource(s);Provides access/link to infectious disease resource(s);Provides patient education material;Provides drug formulary information; Provides up-to-date FDA approved drug information;Contains a clinical teaching section to assist in communicating information to patients [this is a patient education requirement];Provides comparison tables to compare drugs within a class for features like half-life or other important information; Components of the clinical topic review for drug information shall include the following fields:Medical Safety Issues/Alerts.Brand Names.Pharmacologic Category.Dosing (Adults, Elderly, Pediatric, etc.) and Forms (capsule, tablet, liquid, etc.).Generic Alternative availability.Administration, Use, Contraindications, Warnings/Precautions.Specific Populations (Pregnancy Risk Factor/Lactation/Breast Feeding, Pediatric, Geriatric, etc.).Dietary Considerations.Mechanism of Action.Metabolism/Interactions.Pharmacodynamics/Kinetics. References section.Graphics (figures, pictures, graphics, tables, etc.) integrated into record/review that can be printed or exported. Hyperlinks to related record/review topics.The contractor shall provide users an intuitive navigation interface for searching, navigating, and reading through database content and the results of a database search. Users shall be able to: Enter a search phrase consisting of one or more terms or select a term from drop down menu of possible matches after typing the first few characters of the term.Enter names of diseases, symptoms, laboratory abnormalities, procedures, drugs, classes of drugs, etc. to retrieve topical reviews.Enter common synonyms, abbreviations, and acronyms that will be mapped to the appropriate topical review(s) in display results.Search for drug information and retrieve topic reviews containing information about the drug. Search for drug information by retrieving the drug record.Search for drug interactions by entering drug name to display a complete list of interactions for the drug. Choose and use medical specialty calculators interactively by entering required values/units of information to determine mathematical calculation.Sort search results for display through the use of categorization options such as adult, pediatric, etc. Browse search results by positioning mouse pointer over search results to display topical review outline. Find specific text within a topic review using the product’s find tool.Select among various output options, including printing all or selected portions of the topical review7.0Required DT Subscription Requirements and Salient Characteristics: The contractor shall provide a DT Subscription which addresses the following requirements and salient characteristics:Images and knowledge-based information to assist the primary care provider in the identification, diagnosis and management of common skin disorders. Vivid displays of dermatology images showing the variation of disease presentation through various ethnic groups and skin types in relation to age and stage.A decision support system to allow the clinicians to enter patient findings in order to dynamically build a differential diagnosis displayed by medical images.A substantial, considerable and exhaustive number of images from sources with a long standing, authoritative history of producing the photographic visual representations of required subjects in clinical medicine. A diagnostic clinical decision support system to enhance diagnostic accuracy, aid therapeutic decisions, and improve patient safety. Includes searching by diagnosis, building a patient-specific differential, and reviewing travel or medication-related events at the point of care, including but not limited to the areas of diagnosing skin conditions, general and emergency medicine conditions, and medication reactions.Provides access to the full spectrum of human diseases across skin types, body location, morphologic variation, and other diagnostic features. To adequately capture the immense variation inherent in disease requires access to hundreds of specialized image collections that span dermatology, ophthalmology, oral medicine, infectious disease, emergency medicine, radiology, and pathology.An established and efficient means for uploading and centralizing images developed by medical experts from around the world; cases that include tropical and rare diseases, as well as common conditions represented within various ethnic groups and skin types.Continuing Medical Education (CME) included: Users shall be able to track CME activity after establishing an account as provided by the contractor. All username/password and account maintenance shall be the responsibility of the contractor. CME credits shall include: AMA PRA Category 1. Credits would primarily be appropriate for physicians in the Family Medicine, Internal Medicine, Emergency Medicine, Hospital Medicine, Dermatology, and other medical specialties.8.0Additional Customer Support Requirements: A single point of contact for customer service issues is named, available by both phone and email, and assigned to LNO Program Manager or its representative. At least one alternative contact is provided for absences of the provided single point of contact. A single point of contact shall be supplied for each the three (3) databases, and shall follow all of the following terms:The single point of contact should be available via telephone and email during normal business hours and should not have excessive business travel or all day training commitments. Any scheduled out of office time must be notified to the LNO Program Manager with a minimum of two (2) week notice. These contact requirements apply to each database (POC, DDB, and DT), and all products provided within these commercial databases. The contractor’s POCs shall provide monthly reports to the LNO Program Manager of technical service requests provided to VA customers from each of the three (3) databases. The contractor’s POCs shall meet with the LNO Program Manager via conference call to review reports (date/time/frequency TBD).Each report shall provide at a minimum the following columns in Excel format with: Reference #.Date Created.First Assigned Technical Service Representative.Customer Full Name.Email Address of customer.Issue/Request Statement.Status.Result.Other information per Contractor choice. ................
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