r date september 12, 2016, 2 pm et - informing health care ... · these clinical data are then made...

VERMONT INFORMATION TECHNOLOGY LEADERS

REQUEST FOR INFORMATION

FOR

VERMONT HEALTH INFORMATION EXCHANGE (VHIE) &

VITL DATA MANAGEMENT

ISSUE DATE: AUGUST 3, 2016

RESPONSE DATE: SEPTEMBER 12, 2016, 2 PM ET

ONLINE INFORMATION: https://www.vitl.net/about/request-proposals

https://www.vitl.net/about/request-proposals

Request for Information

Revised: 8/3/2016 Copyright © 2016 VITL – All rights reserved i VITL-VHIE-RFI-08-03-16-fnl

Table of Contents

Section 1 – General Information ................................................................................................. 1

A. Purpose ................................................................................................................................. 1

B. VITL Point of Contact ......................................................................................................... 1

C. Pertinent Dates ..................................................................................................................... 2

D. Scope .................................................................................................................................... 2

E. Information Requested from Vendors ................................................................................. 2

F. Submission Instructions ....................................................................................................... 2

G. Response Format .................................................................................................................. 2

H. RFI Addenda or Updates ..................................................................................................... 2

I. Vendor Presentations ........................................................................................................... 3

J. Confidentiality and RFI Ownership ..................................................................................... 3

K. Disclosure of Proposal Contents .......................................................................................... 3

L. Summary .............................................................................................................................. 3

Section 2 – Description of the Organization ............................................................................... 4

A. VITL History and Background ............................................................................................ 4

B. VITL Strategic Direction ..................................................................................................... 5

C. Current Technology, User Environment, and Future Plans ................................................. 6

Section 3 – Requested Information ............................................................................................. 8

A. General Vendor Information ................................................................................................ 8

B. VITL RFI Questions ............................................................................................................ 8


Revised: 8/3/2016 Copyright © 2016 VITL – All rights reserved ii VITL-VHIE-RFI-08-03-16-fnl

List of Terms

ACO Accountable Care Organization

ADT Admission, Discharge and Transfer

API Application Program Interface

CCD Continuity of Care Document

CDMI Clinical Data Management Infrastructure

CFR Code of Federal Regulations

CHIP Children's Health Insurance Program

EHR Electronic Health Record

EMR Electronic Medical Record

HIT Health Information Technology

HIE Health Information Exchange

HIS Hospital Information System

LIS Laboratory Information System

MACRA Medicare Access and CHIP Reauthorization Act

MIPS Merit-Based Incentive Payment System

MPI Master Patient Index

NLP Natural Language Processing

RIS Radiology Information System

RFI Request for Information

RFP Request for Proposal

SQL Structured Query Language

USB Universal Serial Bus

VITL Vermont Information Technology Leaders, Inc.

VHIE Vermont Health Information Exchange

XCA Cross Community Access


Revised: 8/3/2016 Copyright © 2016 VITL – All rights reserved 1 VITL-VHIE-RFI-08-03-16-fnl

Section 1 – General Information

A. Purpose

The purpose of this Request for Information (RFI) is to evaluate the current product offerings for

Health Information Exchanges (HIEs) and clinical data management services that will allow Vermont

Information Technology Leaders (VITL) to successfully evolve and thrive in our advanced healthcare

market.

Since its incorporation in 2005, VITL has sought to achieve the vision of a transformed health care

system where health information is secure and readily available when people need it, positioning

Vermont as a national example of high quality, cost effective care. Designated by statute as the

exclusive operator of the HIE for Vermont, VITL is uniquely positioned to improve clinical decision-

making and population health management for patients.

The goal of this RFI is to discover and evaluate the products and services that may best help VITL

continue to achieve our vision over time as the healthcare market evolves and changes.

The issuance of this RFI does not constitute a commitment to issue a request for bids/proposals,

award a contract, or pay any costs incurred in preparation of a response to this RFI.

Any information received in response to this RFI will assist VITL’s project team in finalizing the

scope of work and requirements which may be used at a future date in the issuance of a Request for

Proposal (RFP). Submitting a response to this RFI is not a guarantee in any way that a vendor will be

selected to respond to any subsequent RFP, nor does it preclude any vendor from responding to future

procurement opportunities. Any confidential information provided must be clearly marked by the

respondent.

B. VITL Point of Contact

The sole point of contact for this RFI is listed below.

Regi Wahl

RE: VITL VHIE RFI Response

Vermont Information Technology Leaders, Inc. (VITL)

1 Mill Street, Suite 249

Burlington, Vermont 05401

[email protected]

802-318-5269

Please refer all RFI inquiries and questions to the VITL designated point of contact.

mailto:[email protected]



C. Pertinent Dates

VITL Hosted Question & Answer Conference Call: Monday, August 22, 2016, 12 – 1 PM ET.

(Conference call is optional for vendors. Answers will be posted. Refer to website for call details.)

Deadline for vendors to submit questions on the RFI: Thursday, August 25, 2016, 2:00 PM ET.

RFI Submission Deadline: Monday, September 12, 2016, 2:00 PM ET.

D. Scope

VITL is evaluating current product and service offerings in the HIE and clinical data management

market so that VITL may be instrumental in improving the quality of care delivery, enhancing patient

safety, and reducing the cost of care for Vermont.

Interested vendors are welcome to respond with focus on a limited aspect of the scope or to respond

to the scope in full. Vendors may also respond as a group with other partners to fulfill any part of the

request.

E. Information Requested from Vendors

Vendors are to respond to the questions listed in Section 3. Vendors are encouraged to recommend

changes to the request if it is determined, based on their experience, that there is a better approach.

VITL is seeking best practices in this area.

F. Submission Instructions

Responses to this RFI must be submitted by the deadline to the designated point of contact and must

include the following:

One (1) electronic copy (email or USB drive).

Two (2) hardcopies of your response. It is the vendor’s responsibility to insure delivery of

hardcopy materials by the deadline.

The designated point of contact will acknowledge receipt of the submission via email.

G. Response Format

Responses are to be straightforward, clear, concise, and specific to the information requested. In

order for submissions to be considered complete, vendors must provide the following information:

Transmittal Letter; include a statement of any proprietary information, if applicable.

Response to Section 3, General Vendor Information and Questions

H. RFI Addenda or Updates

VITL response to vendor questions and any RFI addenda/updates will be made available at VITL’s

web site:





I. Vendor Presentations

VITL may request vendors to provide a presentation of some of the functionality described in their

response. All costs associated by such presentations will be borne by the vendor. Promotional items

shall not be provided at these presentations.

J. Confidentiality and RFI Ownership

VITL reserves the right to recall this RFI in its entirety or in part. Vendors are granted permission to

reproduce portions of this RFI in their responses. Vendors agree that they will not duplicate, distribute

or otherwise disseminate or make available this document or the information contained in it without

the express written consent of VITL’s designated point of contact, identified above.

Vendors shall not include or reference this RFI in any publicity without prior written approval from

VITL, which, if granted, shall be granted by the designated point of contact. Vendors must accept all

of the foregoing terms and conditions without exception. All responses to the RFI will become the

property of VITL and will not be returned.

K. Disclosure of Proposal Contents

Cost and price information provided in proposals will be held in confidence and will not be revealed

or discussed with competitors, except to the extent required by law. All other material submitted

becomes the property of VITL and may be returned only at VITL’s option. Proposals submitted to

VITL may be reviewed and evaluated by any person other than competing bidders at the discretion of

VITL. VITL has the right to use any or all ideas presented in any response to the RFI. Where

confidential or proprietary information is required, or should the vendor deem it necessary to submit

such matter, mark each page/section in large bold type (PROPRIETARY INFORMATION).

L. Summary

THIS IS A REQUEST FOR INFORMATION (RFI) ONLY to identify sources that can provide HIE

and clinical data management services. The information provided in the RFI is subject to change and

is not binding on VITL. VITL has not made a commitment to procure any of the items discussed, and

release of this RFI should not be construed as such a commitment or as authorization to incur cost for

which reimbursement would be required or sought. All materials submitted become the property of

VITL and may be returned only at VITL’s option.



Section 2 – Description of the Organization

A. VITL History and Background

VITL is a 501(c)(3) nonprofit organization that assists Vermont health care providers with adopting

and using health information technology to improve the quality of care delivery, to enhance patient

safety, and to reduce the cost of care. VITL is designated by statute as the exclusive operator of the

HIE for Vermont, and is governed by a collaborative group of stakeholders including health plans,

hospitals, physicians, other health care providers, state government, employers, and consumers.

Since its incorporation in 2005, VITL has sought to achieve the vision of a transformed health care

system where health information is secure and readily available when people need it, positioning

Vermont as a national example of high quality, cost effective care.

The Vermont Health Information Exchange (VHIE) securely collects and indexes clinical information

from all 14 Vermont hospitals, Dartmouth-Hitchcock Medical Center, all of Vermont’s 11 Federally

Qualified Health Centers, 148 primary and specialty care locations, five member agencies of the

VNAs of Vermont, and three commercial laboratories. Employing a specialized integration engine,

clinical information contributed to the VHIE is also stored in an enterprise clinical data warehouse for

analytics purposes.

These clinical data are then made available to health care providers, health care organizations, and

population health initiatives in several ways.

The VHIE informs clinical decisions at the point of care:

• 114 health care locations receive timely and accurate laboratory results directly into their

electronic health record system from the hospitals and commercial labs that generate them,

ensuring primary care providers have the latest patient information.

• Over 2100 providers at 134 locations around the state use VITLAccess, the secure provider

portal to the VHIE that allows clinicians, with a patient’s consent, to view their patients’

medical histories from other providers across the state. This longitudinal view of clinical data

helps providers better understand their patient’s medical history and may prevent an

unnecessary or repeated test. Mental health providers, physical therapists, and chiropractors

now have access to timely and accurate medical data that may help them provide better care.

VITL provides data for population health initiatives:

• Two of Vermont’s accountable care organizations (networks of providers who join together

to reduce the per-patient cost of health care) rely on VITL to provide clinical data marts for

their attributed beneficiaries.

• In support of the Vermont Blueprint for Health, the VHIE collects information for the

Blueprint clinical data registry, which in turn is used to manage chronic diseases in Vermont.

• Immunization reports are collected from 159 locations and forwarded to the VDH

Immunization Registry.



For improved data quality, VITL produces data quality reports and tools for contributing

organizations that can be used to increase the completeness, accuracy, and consistency of the data

they provide.

The VHIE provides data to third party applications, such as PatientPing, an event notification system

that improves care coordination between providers.

VITL has created a secure and reliable network that exceeds HIPAA security standards that is also

resilient, adaptive, and flexible to ever evolving health care system demands.

For more information, please visit https://www.vitl.net.

B. VITL Strategic Direction

VITL has the vision of:

A transformed health care system where health information is secure and readily available when

people need it, positioning Vermont as a national example of high quality, cost effective care.

To transform the health care system, VITL recognizes that data must be available at the point of care

for all treating providers and be aggregated in a central repository or warehouse to allow for care

management, population health management, creation of registries, accountable care organizations

and other activities in support of health reform that require clinical data analysis.

To support the growing needs of our clients, approximately two and a half years ago, VITL began to

develop a clinical data management infrastructure (CDMI) to augment the capabilities provided by

our HIE vendor. This new CDMI has allowed us to perform several new services which were not

possible before, such as a custom immunization interface to the Vermont Department of Health,

Cross Community Access (XCA) queries of the Epic Electronic Health Record (EHR) at the

University of Vermont Medical Center, development of data marts for Vermont’s Accountable Care

Organizations (ACOs) and data quality reports for individual contributing organizations. The CDMI

is a core element of our strategy going forward.

Our data collection capabilities must also be augmented and broadened. We will need to collect

many other types of clinical data and quality measures, such as medical images. No longer will it be

enough to collect clinical data from providers and claims from payers, but we must embrace the

collection of data from home health, patient monitoring devices, smart phones, and organizations who

can report on social determinants of health. We will also need to connect to other HIEs, networks and

providers to query and retrieve data from any system where one of our patients has valuable data.

Our strategic direction is to continue to support the data needs of our stakeholders while creating new

capabilities for initiatives like Medicare Access and CHIP Reauthorization Act (MACRA), Merit-

Based Incentive Payment System (MIPS) and next generation ACOs. To do this, we will need to

evolve our data management capabilities with terminology services and a more robust Master Patient

Index (MPI). We will also need to improve our internal data analytics capabilities. We envision a

convergence of claims and clinical data in a combined warehouse where the impacts of state policies,

care management initiatives, and changes in reimbursement models can be analyzed.

https://www.vitl.net/



C. Current Technology, User Environment, and Future Plans

Our current technology stack is becoming quite robust, as shown in Figure 1; The VHIE consists of

HIE technology to exchange patient data electronically, match patients across the community, and

ensure secure access to view that data. We are currently sending all the messages that are received

into the VHIE into our CDMI. The CDMI started humbly with the Rhapsody integration engine,

Microsoft SQL Enterprise, and hardware hosted by Rackspace.

We spent nine months learning Rhapsody and building the clinical message store. Then, in March of

2015, we incorporated the data feed from the VHIE, which included admission, discharges, and

transfers (ADTs), labs, transcribed reports, continuity of care documents (CCDs) and immunizations.

By June of 2015, ADTs and labs were being stored in our SQL Enterprise, and we had the beginning

of a clinical data warehouse. Over the last year we have:

• Fully parsed CCDs,

• Implemented and learned Tableau,

• Developed version 2 of the parsing algorithms,

• Built gateways for all three Vermont ACOs,

• Redesigned and coded new interfaces to the Vermont Blueprint Clinical Registry,

• Developed a data mart for OneCare Vermont ACO,

• Developed data quality reports, and

• Implemented the Health Language terminology services engine.

Our next phase includes implementing OpenEMPI within the CDMI to improve patient match rates

using probabilistic algorithms, add more sites to the data quality reporting, and make these reports

interactive. We must rapidly implement terminology services mapping capabilities for several

medical code sets such as labs, medications, problem lists, and others. We need to evolve the early

work of our message-based warehouse and start to develop data models for more robust data

analytics. To do this, we will need additional statistical analysis tools and reporting tools. We plan to

add Natural Language Processing (NLP) capabilities to our tool kit within the next year.

Currently, we only have internal VITL users but that will change over the next year as we rollout

terminology services and develop interactive data quality reports using Tableau Server.

It isn’t clear that the current technology stack can evolve to support our vision going forward. Our

needs are growing rapidly and our analytics capabilities need improvement. We are looking for a

vendor to augment or replace these capabilities within a solid architectural framework, which still

allows us to extend and customize our capabilities, and perhaps grow our CDMI capabilities to other

states or large health systems.

Req

uest

for

Info

rmati

on

Rev

ised

: 8

/3/2

016

Co

py

rig

ht

© 2

01

6 V

ITL

– A

ll r

igh

ts r

eser

ved

7

VIT

L-V

HIE

-RF

I-0

8-0

3-1

6-f

nl

Fig

ure

1 V

ITL

Cu

rre

nt a

nd

Fu

ture

Arc

hite

ctu

re



Section 3 – Requested Information

A. General Vendor Information

VITL is asking interested vendors to submit a response containing, at a minimum, the following

information:

1. Description of the reason for your interest in providing the HIE with data management

services and/or products.

2. Description of your vision, overall strategy, and product roadmap.

3. Brief history of your firm.

4. Publically available financial information for the past eight quarters including Profit and Loss

Statement, Balance Sheet, and Cash flow Statement.

5. Brief description of past experience providing similar services and/or products.

6. Company brochure/literature, if available.

7. Vendor contact information:

Website:

Vendor Location:

Office Hours:

Contact’s Name:

Contact’s Phone:

Contact’s email:

B. VITL RFI Questions

VITL requests that vendors answer the following questions in their response to this RFI:

1. Describe your interoperability strategy and how it aligns with the current and future

HIT/HIE/Meaningful Use/MACRA/MIPS landscape.

2. Describe your involvement and strategy in national interoperability efforts

(CommonWell Health Alliance, Carequality, etc.,).

3. Describe your interoperability capability including:

a. Meeting aggressive deadlines to client and stakeholder satisfaction,

b. Self-service capabilities (implementation, monitoring, configuration, testing,

development, APIs, etc.,), and

c. Data contributor/receiver onboarding tools and materials.

4. Describe your data integration capability currently offered and in development as it

pertains to data source contributors/receivers:

a. Traditional Data Integration: HIS, LIS, RIS, EHR/EMR, Imaging, Registries/Public

Health Records, Clearinghouses/Claims, Direct, and ACOs;

b. Non-Traditional Data Integration: Patient medical/monitoring devices, wearable

technology, databases, and consumer generated data;

c. Behavioral/Mental Health Data Integration: 42 CFR Part 2;

d. Device Integration: mobile health devices, medical devices, home medical devices,

smart phones, and wearable technology;



e. Other Data Integration: Emergency transport; Telemedicine/Virtual technology;

f. Master Patient Index (MPI); and

g. Patient consent.

5. Describe your current data management capability and strategy related to:

a. Data transport, ingest, storage, indexing, parsing, normalization, translation,

segregation, and delivery;

b. Analysis and data quality improvement;

c. Use of data for patient care and clinical improvement;

d. Standard and custom reporting, metrics, analytics, and business intelligence; and

e. Data presentation to different stakeholders, clients, and audiences (i.e., providers,

patients, researchers, state health department, payers, ACOs, etc.,).

6. Describe your operational capability as it pertains to:

a. Reliability and scalability,

b. User tools and documentation,

c. Client access for development, configuration, testing, and demonstration,

d. Disaster recovery strategy,

e. Monitoring and issue resolution, and

f. Project scheduling and delivery.

7. Describe your data monetization experience and strategy.

8. Describe your security and privacy strategy and capability as it pertains to:

a. Ensuring security and privacy of VITL’s data;

b. Auditing capabilities available to VITL (reports, dashboards, etc.,); and

c. Obtaining and maintaining security and privacy certifications (Please provide list of

current certifications.).

9. Describe your client relationship strategy, and what benefits VITL would enjoy as your

client?

a. Strategic partnership;

b. Financial (cost savings, paid services, free training, consultative services, etc.,);

c. Client conferences/engagements and user groups;

d. Client communication strategy; and

e. Accelerated or on-site services.

10. Describe core applications included in the platform (EHR, Provider Portal, Patient

Portal, Reporting, Results Delivery, etc.,);

11. Provide a high-level, conceptual architecture diagram(s) and an overview.

12. Describe the pricing model options for your products and/or services.

11. Vendor Table: List other vendors you integrate with and your current exchange capabilities

with those vendors. Include types of data and methods for integration/exchange, where

appropriate.

12. Client Table: List of current clients and the services you provide to them.

13. Other: Are there other features, functions, and technologies that you provide that we did not

request or are there products, services, organization or strategies that differentiate your

company from the competition?

r date september 12, 2016, 2 pm et - informing health care ... · these clinical data are then made...

Documents