DOCUMENT
65 -- V16 ANALYTICS - Attachment
- Notice Date
- 4/15/2011
- Notice Type
- Attachment
- NAICS
- 541512
— Computer Systems Design Services
- Contracting Office
- Department of Veterans Affairs;Chief, A&MM (90C/NLR);Central Arkansas Veterans HCS;2200 Fort Roots Drive, Bldg 41, Room 200;North Little Rock AR 72114 1706
- Solicitation Number
- VA25611RP0428
- Response Due
- 4/27/2011
- Archive Date
- 6/26/2011
- Point of Contact
- Sheila D Reed
- E-Mail Address
-
7-1053<br
- Small Business Set-Aside
- N/A
- Description
- The Department of Veterans Affairs, South Central VA Health Care Network (SCVAHCN), VISN 16 Network Contracting Activity, intends to negotiate a sole source procurement in accordance with FAR Part 12 and FAR Part 13.5 with RGI Informatics, LLC, under the authority of FAR 6.302-1. This procurement is a Non-Developmental Item (NDI) of healthcare analytics software and system with associated supplies and services for all facilities located within VISN 16. The resulting contract will be a firm fixed price contract for a VISN-wide Term License and shall include all labor, material, tools, equipment, training, software/software license, and all associated hardware required to furnish and install the healthcare analytics software. The contractor shall also provide five years of support for the system, which shall include periodic updates to the software, hosting / infrastructure, and professional services (data warehouse maintenance, server & database administration, analytics support, basic user support, and data standardization support). In conjunction with the healthcare analytics software provided under this contract, VISN 16 intends to install an Anesthesia Record Keeper (ARK) and / or Intensive Care Unit (ICU) Clinical Information System (CIS). Executive Summary. VISN 16 is implementing the Department of Veterans Affairs CIS (ICU/ARK) and Analytics program. This program establishes technology infrastructure for the capture, storage and analysis of clinical data during the most critical and data intensive portions of a patient's hospital stay with the goals of improving patient safety and clinical outcomes, conserving heath care resources, and supporting research. The upcoming solicitation will be for the requirements for the analytics component from the perspective of the intended clinical users. The data available from electronic medical records contain a wealth of detailed information that is useful for clinical care, traditional and clinical effectiveness research, and the administration of health care - medical analytics must provide the tools needed to access and examine the data. Medical analytics in the critical care areas (intensive care units, the operating and recovery rooms, as well as the emergency department) has great value. Patients in these areas have the most complex diseases and therapies, variable clinical courses, and morbidity and mortality of all hospital locations. Specialized CIS medical record systems capture and store the vast amount of data recorded on patients while undergoing anesthesia and surgery or while in the intensive care unit. Together these systems capture and store thousands of records of clinical data for every patient. The Challenge of Medical Analytics. Unprocessed healthcare data are difficult to use and resident in a diversity of database architectures. Analyzing that data has proven difficult in part because most medical analytics systems developed as an outgrowth of business analytics not biomedical research. Unfortunately business analytics information technology is not well suited for the analysis of healthcare data. The most basic business transaction is the buying and selling of goods and services. The semantics of business transactions are straightforward and generally accepted. The behavior of each type of business data, and its relationship to other data can readily be defined and incorporated in an analytic model as "business rules" or metadata. Before data can be used in business analytics or by business analytic systems, it must be well defined and its properties included in an analytic model. These requirements severely limit the application of business analytics systems to healthcare. Clinical transactions and its associated data are fundamentally different than business transactions. The semantics of healthcare data are not well defined or generally accepted for a broad range of healthcare data types and clinical business rules have, for the most part, yet to be developed. The types and sources of healthcare data are both diverse and dissimilar. The healthcare community has adopted only very limited standardized nomenclature to name data, or structure field entries. Even within a unified organization like the Department of Veterans Affairs, there are major differences from hospital to hospital in the name and use of many of the VA's electronic medical record fields. As a result, medical analytics requires a new generation of analytics technology that can accept and store healthcare data without first requiring semantic modeling or the pre-programming of clinical business rules. Medical analytics has additional requirements not addressed by most business analytics solutions. It must include the ability to analyze and find patterns across millions of rows of physiologic or genomic data and determine temporal relationships among all the diverse data sets. It must provide a true "ad hoc" and iterative query environment with rapid query response times despite billions of records. Furthermore, the architecture of many business intelligence, statistical or graphical visualization software tools requires that the data to be analyzed undergo 'pre-analyses' and be removed from the analytics system computer to the user's computer. This distribution of patient specific data is a threat to patient confidentiality and privacy. VISN 16 REQUIREMENTS FOR MEDICAL ANALYTICS. Within any ICU/ARK Analytics system procured for VISN 16, the need for the medical Analytics component is to implement functionality for: a.integrated critical care data among the VistA systems of the VISN and the CIS (or ICU CIS and ARK), b.compliance with national standards for critical care date, c.clinical and managerial use of the data through specialized, critical-care-data-aware analytics, d.providing reports and export of critical care data that is compliant with national data standards. The needed functionality supports and extends the meaningful use of the Electronic Health Records (EHR). Meaningful Use refers to a requirement of the Office of the National Coordinator for Health Information Technology not just the use EHRs, but to use the records to meet health care goals. In the critical care setting, medical analytics must allow physicians and other clinicians to leverage the value of data generated by clinical information systems and medical devices to: a. Determine and implement best practice (comparative effectiveness), b. Reduce medical errors, c. Add value to traditional research initiatives, and d. Improve the quality the care. Medical Analytics can play a critical role in improving the quality and reducing the cost of health care. The desired outcome will enable healthcare professionals to directly access clinical data stores, which will improve patient care, reduce medical errors, and enable a broad range of research capabilities. The software and hardware shall be compatible with all existing computer programs/operating systems currently installed and shall allow for future upgrades to the existing systems in VISN 16. These shall include but not be limited to the Electronic Medical Records (EMR), VISTA/CPRS, Microsoft Windows Products (7, XP, and Vista), Microsoft Office Products, Internet Explorer, VA Windows Based programs, Citrix, and VA antivirus software. All software to be provided under any resulting contract shall be Section 508 compliant. Application will not interfere with VA approved programs including but not limited to VA Computerized Patient Record System (CPRS), VHA Barcode Medication Administration System (BCMA), Internet browser, and so forth. BUSINESS REQUIREMENT 1: An analytic solution must be capable of extracting value from clinical data stores, (including but not limited to CIS (ICU and ARK), VISTA, and National Surgical Quality Improvement Program (NSQIP), specifically addressing issues relating to clinical quality; medical errors; healthcare costs; and comparisons of costs, practice patterns, and outcomes in addition to clinical and comparative effectiveness research endeavors. The healthcare analytics shall accept extract data from VISTA to include (but not limited to) data regarding inpatient and outpatient medications, Patient Treatment File (PTF) data, orders, allergies, code status (including Crisis Notes, Warning Notes, Allergies and Directives (CWAD)), problem lists, vital signs, laboratory results, bed movement, the VISTA Surgery Package (including NSQIP elements), and from a CIS. Types of data include all clinical and administrative data-and specifically very granular data-recording physiologic and other clinical measurements as frequently as every 30 seconds. The granularity of the analytic tables shall reflect and directly relate to the clinical unit of inquiry and source system extract capabilities. The solution must accept data from any clinical system that is Open Database Connectivity (ODBC) compliant or able to export or "print" to flat files. The analytic solution shall be capable of including data from diverse sources, and specifically shall be able to integrate VISTA, ICU, and Operating Room (OR) clinical systems data, regardless of vendor or model. BUSINESS REQUIREMENT 1a: The analytic solution shall be capable, at a minimum, of processing updates on a daily basis from the CIS, ARK, VISTA, and NSQIP data sources. The supporting data stores shall store data at the most detailed level captured by the CIS and still support high performance query response times. BUSINESS REQUIREMENT 2: Analytics data shall span not only the entire critical care or surgical visit and include data from numerous sources as defined herein but also relevant historic healthcare data for each patient (prior hospitalizations, ICU encounters, operations, diagnoses, etc.). The analytic database must be capable of including data from diverse sources and must specifically be able to: a. Integrate CIS/ARK and VISTA data, b. Accept data from any system that can export data, regardless of underlying software or hardware platform, and c. Store and integrate data from all major ICU and OR clinical information system vendors. BUSINESS REQUIREMENT 3: The analysis of detailed physiologic and assessment data offers an unprecedented opportunity to advance the quality of patient care. Analytics design shall specifically allow for the storage and analysis of all very granular data captured by the CIS or ARK rather than a sample or summary of the data. Physiologic data, including but not limited to, heart rate, blood pressure, and respiratory rate, shall be captured by the CIS at least once a minute. The analytic database must provide access to (store and retrieve) physiologic data at the most detailed level available from the monitoring device or source clinical information system including digitized waveform. At a minimum, it must store thirty second data from the OR and sixty second data from the ICU and provide for the future addition and analysis of genomic data. BUSINESS REQUIREMENT 4: Permit clinical users who understand the data but do not have programming skills to directly analyze clinical data from ICU/ARK systems and VISTA. New queries or algorithms can be deployed without first requiring support from information technology experts. To use the analytics, a clinical user need understand only the meaning of the data (e.g. what is a heart rate); it does not require specialized data analysis or programming skills. The analytic application or environment shall be both open and enabling. It shall allow the user (e.g., clinician with no special technical system training) to: a. Investigate the contents of fields through simple statistics, sorting, bounding, and filtering; b. Create new tables and new queries; and c. Access analytic tables; including the ability to modify and add data elements, create new analytic tables, and author / program new queries. The analytic solution, including the capability of writing new questions, shall ensure high performance query response times (typically seconds up to few minutes), even in the face of large databases and long tables. The analytic solution shall allow the user to create new analytic events and stratifications of populations from all suitable elements in the analytic solution and to join any number of elements or events using the full range of Boolean operators. BUSINESS REQUIREMENT 5: Accept user-generated concepts on the fly. The analytics system must enable users to ask clinical questions of data without knowing the question in advance (true "ad hoc" queries). The analytic solution must allow the clinical user to create new analytic events (business rules) and stratifications of populations from all suitable elements in the analytic database but also to define data properties, define the relationship between data elements, and join any number of elements or events using the full range of Boolean operators. The response time for these questions shall be rapid (within seconds up to few minutes). BUSINESS REQUIREMENT 6: The analytics system must include the ability to analyze and find patterns across billions of rows of physiologic or genomic data and determine temporal relationships. The solution must be able to work across rows and to provide for sequential analysis of data (time series) for all time-stamped elements or events. BUSINESS REQUIREMENT 7: The analytics system must support an iterative query environment, allowing the clinical user to iteratively formulate, test, and refine questions and accelerate the knowledge discovery process. The response time for the majority of these queries must on the average be rapid (within seconds up to few minutes). BUSINESS REQUIREMENT 8: The analytics system must be a ready to use and a fully functioning commercially available system with demonstrated use in a complex clinical setting including EMR, ICU, and ARK data operations. BUSINESS REQUIREMENT 9: The analytics system shall easily support "standard" queries or reports as well as easily and rapidly develop new queries. BUSINESS REQUIREMENT 10: The analytics system shall have the capacity of developing/combing queries from individual VA facilities or from other VISNs, as well as a rollup of national data. BUSINESS REQUIREMENT 11: The analytics system shall eliminate the costly and time consuming steps that most analytic systems and business intelligence software require before data can be used. a. Data shall be easily and readily available for analysis. b. Data shall not require standardized nomenclature or field use. c. The analytics does not require semantic modeling, the modeling of relationships or the pre-programming of clinical business rules. BUSINESS REQUIREMENT 12: VA Policies on Confidentiality shall be strictly adhered. The analytics must provide for the security of the data and protect the privacy of the patients with no data residing on the workstation. The application shall meet standards set forth by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), The Privacy Act of 1974, Enterprise Architecture standards, and VA Cyber-Security requirements. BUSINESS REQUIREMENT 13: The application shall be accessed through a web interface or equivalent technology with an extensive graphical user interface for sophisticated query generation including time series analyses and table joins. Graphic User Interface (GUI) application must support remote view capabilities within hospital and from outside utilizing Virtual Private Network (VPN) and Citrix. BUSINESS REQUIREMENT 14: The system shall be sized such that typical individual queries and analyses do not incur additional incremental costs. BUSINESS REQUIREMENT 15: The system must be capable of adapting new analysis technologies while maintaining functionality. BUSINESS REQUIREMENT 16: Libraries of queries shall be included to facilitate groups of analyses and analysts. BUSINESS REQUIREMENT 17: Administrative management tools must be capable of limiting data/query access by user, patient, time ranges, facility, and individual data elements. These tools must be intuitive, able to manage multiple individuals, and web-based. BUSINESS REQUIREMENT 18: The system must be capable of efficient data loads on a recurring 2 to 24 hour frequency. BUSINESS REQUIREMENT 19: The system must be capable of administering activities of groups of users by easy sharing of queries, integrated help systems, and version control of reports and queries. BUSINESS REQUIREMENT 20: The system must provide full statistical packages (e.g., SAS, STATA), extensive graphing capabilities, export of summary data results with tight controls for exporting sensitive data, and a full audit trail of all user and administrative activities. The healthcare analytics solution shall display results as tables or graphs at the discretion of the user. The user shall be able to save and/or display query parameters with the results. BUSINESS REQUIREMENT 21: Individual provider reports created upon sign-in with access/verify codes. Access limited to the provider's specific patients. The system shall allow: a. The creation of custom reports, modification of existing reports, and custom enhancements to the user interface, b. Development of VISN and other sites specific reports, and c. Flexibility of developing reports as the needs of the facility change. BUSINESS REQUIREMENT 22: Sophisticated analysts must have programming access to the full system analytic and data management capabilities. BUSINESS REQUIREMENT 23: The contractor shall provide the analytic solution as a fully hosted service offering including support and management of the server, physical database, and analytic functions for the duration of the contract. The contractor shall install the software required on one contractor furnished server at the VA OI&T datacenter designated by the VISN 16. BUSINESS REQUIREMENT 24: The contractor shall provide the make, model, and manufacturer specifications for the required Database Server and Database Storage Requirements needed for the analytic solution. The minimum requirements are as follows: a. Pentium 4 3GHz or higher 8-Way Processer Server b. Internal CD Rom c. Back-up Unit capable of backing up the database and system files d. 8 GB RAM e. 1.5 TB (useable disk space) BUSINESS REQUIREMENT 25: The system shall provide at initial implementation a "public library" of standard reports, events, stratifications, and queries available to all users. Users must be able to store their own events, stratification, and query parameters for future use in an organized and searchable user-defined library. The VISN shall be able to expand the public library with appropriate user defined contributions. BUSINESS REQUIREMENT 26: The system shall allow for collaboration among self-selected groups of individuals sharing selected tables, queries, and results. Libraries can be shared across other VISNs with no additional expense. BUSINESS REQUIREMENT 27: The system shall currently be fully operational and in use at another VA medical facility. BUSINESS REQUIREMENT 28: The system shall be in compliance with VA Directive 6500-Information Security Program, VA Handbook 6500-Information Security Program, and the Federal Information Security Management Act of 2002 (FISMA), 44 U.S.C. § § 3541-3549. BUSINESS REQUIREMENT 29: Data format may be ASCII flat files, XML, or possibly HL7. BUSINESS REQUIREMENT 30: The user must be able to "copy" displayed results and graphics to a "clipboard" and then "paste" to a document in another application, and if permitted, export to ASCII delimited/fixed files. BUSINESS REQUIREMENT 31: From a browser based GUI, the solution will provide assisted access to basic statistical analysis (means, one-way and two-way tables, t-test, 95% confidence limits) and means to visualize the data (e.g. line plots with 95% confidence limits, box and whiskers plots, histograms). BUSINESS REQUIREMENT 32: The system shall be capable of restricting individual-user access to the areas of the database to which they have been granted privileges including specific tables, fields, and reports. BUSINESS REQUIREMENT 33: The system must include the ability to download query results as a delimited text file, but the system must provide for the selective granting of this privilege to users with the appropriate authority. BUSINESS REQUIREMENT 34: Complete system package must include the necessary skills and experience to perform an analysis of the most cost efficient approach to disaster recovery of the data on the CIS servers at VISN 16 medical facilities. Based on that analysis to develop and deliver a detailed disaster recovery approach and implementation plan for those servers, and then assist VISN 16 with implementation of that plan. This is a sources sought to determine the availability of potential sources having the skills and capabilities necessary to perform/provide the functionality of the RGI Healthcare Analytics Solution. All interested vendors are invited to provide information to contribute to this market survey/sources sought including commercial market information. The purpose of this synopsis is to gain knowledge of potential qualified sources and their size classification (Service Disabled/Veteran Owned Small Business (SDVOSB/VOSB), Hub-zone, 8(a), small, small disadvantage, woman-owned small business, or large business) relative to NAICS 541512, Computer Systems Design Services (size standard $25 Million). Responses to this synopsis will be used by the Government to make appropriate acquisition decisions. This SOURCES SOUGHT NOTICE IS NOT a request for competitive proposals. Interested parties must identify their interest and capability to respond to the requirements by submitting literature and documentation detailing their experience in providing these products to the Contracting Officer via email at Sheila.reed@va.gov ONLY. The format for submission of literature/documentation is to numerate and address each BUSINESS REQUIREMENT specifically and in detail. A determination by the Government not to compete this proposed contract based on responses to this notice is solely within the discretion of the Government. The SCVAHCN will consider all responses that are submitted in the format stated above and received by 3:00PM, CT April 25, 2011.
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