REQUEST FOR PROPOSALS
RFP NUMBER:0A1220
DATE ISSUED:May 29, 2018
The State of Ohio, through the Department of Administrative Services, for the Ohio Department of Rehabilitation and Correction (ODRC) is requesting proposals for:
ODRC Electronic Health Record(EHR) System
INQUIRY PERIOD BEGINS:May 29, 2018
PRE-PROPOSAL CONFERENCE:June 7, 2018 at 11:00 a.m.
INQUIRY PERIOD ENDS:June 19, 2018 at 8:00 AM (Columbus, Ohio local time)
OPENING DATE:June 25, 2018
OPENING TIME: 1:00 PM (Columbus, Ohio local time)
OPENING LOCATION:Department of Administrative Services
Bid Desk
4200 Surface Road
Columbus, Ohio 43228-1313
This RFP consists of five (5) parts andten(10) attachments totaling 77consecutively numbered pages. Supplements are also attached to this RFP with a beginning header page. Please verify that you have a complete copy.
In lieu of taking exceptions to RFP requirements, including but not limited to terms and conditions, scope of work statements, service levels requirements, etc., or providing assumptions that may be unacceptable to the State, Offerors are strongly encouraged to use the inquiry process in Part Three of the RFP.
PART ONE: EXECUTIVE SUMMARY
Purpose. This is a Request for Competitive Sealed Proposals (“RFP”) under Sections 125.071 and 125.18 of the Ohio Revised Code (the “Revised Code”) and Section 123:5-1-8 of the Ohio Administrative Code (the “Administrative Code”). The Ohio Department of Rehabilitation and Correction(ODRC)has asked the Office of Information Technology to solicit competitive sealed proposals (“Proposals”) for itsODRC Electronic Health Record(EHR) System (the “Project”), and this RFP is the result of that request.
If a suitable single Offeror solution is made in response to this RFP, the State, through the Department of Administrative Services (DAS), may enter into a contract (the “Contract”) to have the selected Offeror (the “Contractor”) perform all or part of the Project.
This RFP provides details on what is required to submit a Proposal for the Project, how the State will evaluate the Proposals, and what will be required of each Contractor in performing the Project.
This RFP also gives the estimated dates for the various events in the submission process, selection process, and performance of the Project. While these dates are subject to change, prospective Offerors must be prepared to meet them as they currently stand.
Once awarded, the term of the Contract will be from the award date until the Project is completed to the satisfaction of the State and the Contractor is paidor June 30, 2019 whichever is sooner. The State may renew this Contract for up to four(4)additional two (2) year term(s), subject to and contingent on the discretionary decision of the Ohio General Assembly to appropriate funds for this Contract in each new biennium. Anysuch renewalof all or part of the Contract also is subject to the satisfactory performance of the Contractor and the needs of the Ohio Department of Rehabilitation and Correction.
The State may reject any Proposal if the Offeror fails to meet a deadline in the submission or evaluation phases of the selection process or objects to the dates for performance of the Projector the terms and conditions in this RFP.
Background. The Ohio Department of Rehabilitation and Correction (ODRC) is seeking a qualified Contractor to provide an ODRC Electronic Health Record (EHR) system. The ODRC mission is “To Reduce Recidivism Among Those We Touch.” A comprehensive health record in electronic format that may be shared on patient release using inter-operability features contributes to continuity of care and the ODRC mission. The ODRC’s vision for our current and future EHR is to improve the quality, timeliness and effectiveness of patient care by providing real time access to comprehensive clinical information wherever and whenever needed. The ODRC EHR selected is expected to:
- Improve quality of care
- Increase patient safety
- Increase health care staff productivity
- Decrease administrative expenses
- Decrease litigation costs
The Ohio Department of Rehabilitation and Correction is one of the largest agencies in the state of Ohio and is the fifth largest prison system in the nation, with operations throughout the state. The Ohio Department of Rehabilitation and Correction’s twenty-five (25) state-administered and three (3) privately administered adult correctional institutions currently provide comprehensive medical, dental, mental health, substance abuse recovery, and sex offender treatment services to all inmates under the umbrella of the Office of Correctional Healthcare (OCHC). The current inmate population is approximately 49,500 and has a turnover rate of around 45% per year. The OCHC operates to provide health care within the ODRCutilizing approximately 1500 civil servant employees and 350advanced health care providers, in addition to the employees contracted through temporary services and other agencies.
OCHC medical services provided include primary medical care, ambulatory,pharmacy, laboratory, x-ray and diagnostic, podiatry, optometry, nutrition consultation, and dental services within each institution.More extensive medical services are provided through the Franklin Medical Center prison which operates as a step-down, sub-acute, skilled nursing facility, and the Pickaway Correctional Institution prison which offers long-term care and dialysis services.Specialty and inpatient hospital care is provided through contracts with The Ohio State University Medical Center and, in some institutions, through a comprehensive medical contract.Emergency services are provided at local hospital emergency departments throughout the state in addition to the Ohio State University Medical Center.Each ODRC prison operates a medical infirmary with beds allocated for short-term in-patient acute care. These beds may include negative pressure rooms, or suicide watch cells. Managing women’s health issues, including pregnancy management and post-partum care, is also part of the overall healthcare provided. The ODRC operates a nursery program for qualified inmates who are permitted to keep their new-born children on-site at the Ohio Reformatory for Women prison. At any given time, there are approximately 5-10 children below five (5) years of age participating in this program.
Currently, the OCHC provides medical care for approximately 30,000 inmates with chronic medical conditions. Examples of chronic medical conditions treated include but are not limited to hypertension and cardiac disease, diabetes, pulmonary disease and asthma, liver disease and hepatitis, seizure and neurological disorders, gastrointestinal and genitourinary disorders, HIV, and cancer. The ODRC operates facilities that are compliant with the Americans with Disabilities Act(ADA) and thus manages patients with special medical needs such as hearing impaired, vision impaired, speech impaired, mobility impaired, wheelchair, cane, and prosthetic use, and any other functional limitation.
The ODRC was an early adopter of videoconferencing technology prior to 2000, and utilizes an extensive telemedicine network in all prisons to provide both medical specialty care in conjunction with the Ohio State University Medical Center, and contract psychiatry services.The ODRC operates on-site computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), diagnostic imaging at the Franklin Medical Center prison. The ODRC owns and operates an x-ray picture archiving and communication systems (PACS) for all medical diagnostic imaging. Additionally, the ODRC utilizes a web-based PACS system for dental images.
Dental care provided to the ODRC inmate population occurs at all 28 prisons and includes treatment of routine and emergent dental conditions. Services provided include but are not limited to the following for patients meeting established criteria: reception screening and evaluation, oral hygiene, oral disease education, self-care instruction, dental radiography, routine dental examination and treatment, cleaning, periodontal screening, oral cancer screening, denture fabrication, and referral to specialty care / oral surgeryat the Ohio State University Medical Center.
The inmate population ranges across the human lifespan starting at approximately fifteen (15) years of age. Like the country at large, the ODRC has an aging inmate population. Inmates are medically classified upon reception, and reviewed as indicated, into one of four (4) levels based on the type and extent of their medical needs. These levels are tracked and institutions in the ODRC are classified for healthcare purposes as to which levels of care they can provide.
Mental health services provided include the planning, implementation, monitoring, and evaluation of comprehensive mental health needs for inmates. Mental health services are provided on an outpatient or inpatient basis. Services include screening and classification of inmates entering the ODRC, individual and group psychotherapy, psycho-educational programs, activity therapy, trauma treatment and interventions, psychotropic medications and crisis services tailored to the patient’s treatment plan. Also provided are treatment services to special populations such as patients with intellectual and developmental disabilities and sex offenses. Currently, approximately 11,000 inmates require some type of mental health treatment. In addition to providing general mental health services, mental health staff provide risk assessments for the Parole Board.They also monitor physician ordered restraints, conduct restrictive housing assessments and rounds, and are proactive in suicide prevention screening and monitoring. The OCHC operates six (6)Residential Treatment Units (RTU) at prisons around the state which serve as in-patient centers for intensive mental health care.If patients are on the mental health caseload, they are classified into levels based on the type and extent of services provided.
Sex Offender Services provided include planning, implementation, monitoring and evaluation of evidence-based assessment procedures and programs for sex offenders. Sex offender-specific assessments are conducted at the Sex Offender Risk Reduction Center (SORRC) at the Correctional Reception Center. Sex offenders who are assessed at the higher levels of risk to sexually reoffend undergo forensic evaluations. High-risk sex offenders are mandated to complete the Comprehensive Sex Offender Program, which is a 12-month evidence-based program. These offenders are identified for the program when they are within three (3) years of release.
Recovery, addiction, and community linkage services are provided by clinicians from the Ohio Department of Mental Health and Addiction Services (ODMHAS) under the auspices of an inter-agency memorandum of understanding (MOU). Recovery services staff is responsible for providing a comprehensive continuum of alcohol and other drug (AOD) treatment services. The average active caseload is approximately 10,000 offenders. This continuum begins at ODRC reception centers and continues through release. At reception, all inmates receive an alcohol and other drug screening and alcohol and other drug education. Parent institutions provide a variety of treatment services based on the institutional mission, physical capacity and staffing. These services include therapeutic communities, residential treatment programs, alcohol and other drug/literacy programs, day treatment programs, individual and group counseling, alcohol and other drug education groups and 12-Step/ Peer (self-help) groups.
The ODRC has partnered with the Ohio Department of Medicaid to screen inmate patients being released from the ODRC and enroll those eligible into a Medicaid managed care program. Approximately 98% of inmates being released are eligible. Inmate patients provide consent to release of necessary information from their health record to accomplish enrollment. While this process is currently performed outside of the ODRC EHR it may be desirable at some future point to have the ODRC EHR directly interface with Ohio Medicaid.
The ODRC is committed to providing constitutional and effective health care to its patient population. Thus, the OCHC service areas operate robust continuous quality improvement (CQI) programs with a variety of components to improve quality of care, patient safety, and administrative utilization of resources, while also minimizing risk, cost, and litigation. Components of these programs include but are not limited to: concurrent and retrospective care reviews, quality indicator monitoring, morbidity and mortality reviews, clinician peer reviews, health care occurrence and medication error monitoring, utilization review, medication formulary control and approval process, and collegial review and approval process for specialty care and diagnostic care. Additionally, through CQI the ODRC monitors and tracks high-risk / low-volume events such as hunger strikes, forced medication, and restraint application.
By legal mandate, the Office of Correctional Healthcare must follow all applicable administrative regulations and laws regulating the provision of health care to the Ohio inmate population as well as the public at large. Accreditation standards that are applicable for care provided to the ODRC inmate population include American Correctional Association standards, National Commission on Correctional Healthcare standards, the agency’s internal policies and protocols, and the policies and protocols of the Ohio Department of Mental Health and Addiction Services as pertains to recovery and addiction services. The ODRC maintains accreditation in all facilities and service areas through the American Correctional Institution.All healthcare services are initiated upon reception of the inmate into the prison system and follow the inmate through discharge from prison. The Ohio Department of Rehabilitation and Correction also shares healthcare information when the inmate is transferred to other correctional systems or when discharged to a community based correctional facility. With the inmate’s approval, a copy of the medical records may be sent to his personal physician or attorney.
The ODRC is currently using an EHR for documentation of care provided to the inmate patient population in the service areas under the umbrella of the OCHC. The ODRC has been utilizing the EHR eClinicalWorks since 2012. Implementation was completed at all prisons in 2016. Currently the ODRC is not using the computerized physician order entry (CPOE) or electronic medication administration record (EMAR) components of our EHR as pertains to medications. It is planned to adopt these two (2) modules for use after upgrade to the most recent version of our current EHR in the first part of calendar year 2018. Thus, medication orders and administration records remain in the paper record. Medication orders are faxed to our pharmacy provider, the Ohio Department of Mental Health and Addiction Services (ODMAS), and administration records are printed from their Kalos software which is available on computers in our medication rooms at each prison. Nurses document in writing on the printed medication administration records. The ODRC has an interface to our pharmacy provider that was developed in partnership with the vendor eClinicalWorks and ODMHAS that will be activated upon implementation of these modules.
The ODRC EHR is interfaced to applications and health care entities to include the Department Offender Tracking System (DOTS), Labcorp, MobileX and Mid-Ohio x-ray companies, our own PACS system, CIPS -Kalos software at ODMHAS, and the Ohio State University document sharing system. The ODRC currently utilizes the Iguana HL7Integration Engine by iNTERFACEWARE to manage the interfaces.
The ODRC currently maintains the following functional environments for the EHR: 1. The production or live environment which is fully operational for all users and has connected interfaces, 2. The test environment which is available to administrative users only and has limited interface connectivity, and 3. The training environment which is available for EHR utilization practice to all users and has no interface connectivity. Additionally, the ODRC utilizes Dragon voice recognition software by Nuance for patient encounter dictation by selected advanced level providers. Dragon is integrated into our current EHR. On an average business day during peak time the ODRC will have approximately 1,200 concurrent users active in the EHR.
The ODRC network consists of over 9,500 networked computers, 400 servers, and LAN/WAN connectivity for over 31 sites/remote facilities. There are currently approximately 1,000 computers dedicated to the Office of Correctional Healthcare. Topaz signature pads are strategically deployed to capture staff and offender signatures in the EHR when necessary. The ODRC has RFID readers and bar code scanners on hand for when CPOE / EMAR are deployed in our current EHR this year.
Connectivity to remote sites includes 10/100mb Ethernet at the LAN level. Gigabit connections are present within the sites and datacenter operations. Gigabit connectivity is used for the core backbone. Cisco enterprise level hardware solutions provide the infrastructure for network connectivity for sites and datacenter operations.
The Ohio Department of Administrative Services (DAS) Office of Information Technology (OIT) currently manages all ODRC servers and storage, to include current ODRC EHR hosting. VMWare is the current standard for servers, running on any type of hardware. IBM SAN solutions are standard for enterprise level data storage. Microsoft operating system solutions are used for desktop, server, and networking. Microsoft SQL Server is the required database platform. Direct ODBC connectivity is not permitted between DRC systems and 3rd party systems, but access to copies of the data can be provided (ODBC connectivity to a copy of the data is a possibility). The Ohio Department of Rehabilitation and Correction is also standardizing on Microsoft as the primary solution for application development (Visual Studio), web services IIS, middle layer application services, and database management platforms. Standard peripheral devices used within the department includes HP, Lexmark, Toshiba, Konica/Minolta printers/scanners and Symbol Technology data collection devices.