US Department of State, Office of Acquisition, P.O. Box 9115, Rosslyn Station, Arlington, VA 22219-0244

70 -- ELECTRONIC MEDICAL RECORD SOFTWARE POC Contact Bob Wissman on 703/875-6059 or Julie Odend'hal on 703; /875-6054. This is amendment no. 2 to solicitation notice no. S-OPRAQ-96-R-0623 for Electronic Medical Record Software advertised in the CBD on 9/30/96. Amendment no. 2 amends the solicitation as follows: Under Section A.3, Security, the words ''care giver or device'' are revised to read ''care giver''. Under Section E.10, Technical and Development Support, the words ''systems analyst'' are revised to read ''systems administrator''. Amendment no. 2 answers vendors questions as follows: Q1. Section A.2, Operating Environment, states ''...operate on a non-proprietary, SQL-Compliant RDBMS...'' Is the offeror required to provide the SQL compliant RDBMS documentation and training? A1. Yes, you are required to provide the subject documentation and training for this mandatory software requirement. Q2. Section A.2, Operating Environment, states ''...is a turn-key application that includes all required communications software.'' Does a turn-key application assume that the network operating system, RDBMS, and the communications software are installed by DoS prior to the offeror loading the EMR software on the network? A2. DoS will provide the user workstations, application servers, and basic network connectivity to include the network operating system. The vendor is required to provide all software necessary for proper operation of the EMR to include, but not limited to, installation of the RDBMS, the EMR product, the Keyfile Interface and any software necessary for interoperability of these components. Q3. Section A.3, Security, states ''Shall allow originator (care giver or device)...'' Please explain what you mean by device in this context. A3. The DoS has deleted the term ''device'' from Section A.3 of the solicitation notice. Q4. Section A.4, Patient Encounter, states ''...and follow-ups shall be tied to standardized data dictionaries...'' Are you referring to ''data dictionaries'' in a generic way or are you referring to a particular product? A4. The term ''data dictionary'' is used in a generic sense. Q5. Section A.7, Documentation, states ''...provide one copy each of the source and executable codes...'' Please confirm that the only source and executable code to be provided is for customized extensions to the COTS product. A5. The only source and executable code that is currently required to be provided is for customized extensions; however, DoS does have the option to obtain the source and executable code for the COTS product itself under FAR Clause 52.227-16, ''Additional Data Requirements''. The DoS may want to obtain the COTS product code in the event that the product is discontinued or that the company undergoes a catastrophic event such as bankruptcy. Q6. Section A.10, Miscellaneous, states ''...the warranty shall extend for at least one year, beginning the first day of acceptance.'' What are the acceptance criteria and how long is the acceptance test period? A6. The EMR will be accepted when the vendor has installed the EMR in the operational environment in the Exam Clinic in Washington D.C. and has demonstrated to the satisfaction of DoS that the EMR works as advertised by the vendor. The acceptance criteria shall include installation of the server and, at a minimum, two clients, and demonstration that all server capabilities can be run from the server and that all client capabilities can be run from either client. If, during the warranty period, MED finds that the EMR does not meet either the mandatory or the desired requirements as advertised by the vendor, then the vendor must either repair or replace the software at its cost. Q7. Section A, General. Please describe the operational medical environment in which the application will be used. For example, will it be used in an ambulatory clinical environment? Will there be multiple clinics? Will these clinics be geographically dispersed? Will all of the clinics need to share patient information on a real-time basis? What is the enterprise level plan for deployment of this system? A7. The DoS Office of Medical Services has primary responsibility for providing medical care to Foreign Service Officers worldwide. The Exam Clinic, located in Washington D.C., operates similar to an outpatient clinic. Foreign Service Officers visit the US Exam Clinic for a physical exam before being assigned overseas. Foreign Service Officers who cannot visit the Exam Clinic may visit their own providers, but the physical exam results are forwarded and centrally stored in the Exam Clinic in Washington, D.C. Health units, located all over the world, care for the Foreign Service population while they are overseas. There is a need for the overseas health units to exchange patient information with the Exam Clinic in Washington D.C. This information exchange will occur in batch mode, not in real-time. The EMR may be deployed in phases by geographic regions. The EMR will first be installed and used in the Exam Clinic, then in La Paz, Bolivia and then in the remainder of the Latin American health units. During the option years that follow, the EMR may be rolled out to health units in other regions - Asia, Africa, Europe, etc. Q8. Section A, General. Our product automatically extracts documents from your transcriptionists and incorporates them in the EMR. Who do you use for your transcription work, and what word processor/document manager do they use? A8. DoS/MED does not use dictation as a normal course of business during the patient encounter and therefore does not use a transcriptionist. Some documents are received in electronic form. They are either in ASCII text or in Microsoft Word. Q9. Section B.8. To what extent does the COTS product have to interface with Keyfile? Please provide detailed information on Keyfile, such as file format, platform and conversion. A9. It is desirable for the EMR to interface with Keyfile, to the extent that the Keyfile properties (indices) can be viewed from the EMR. Upon selecting the properties, the EMR may launch the Keyfile application and display the associated image of the medical document. Keyfile stores its objects in a proprietary object database; therefore, Keyfile file formats are unknown. Q10. Section B.12. Please provide an example of a medical knowledge base. Is this a generic reference to knowledge bases or is there a specific product? A10. Medical knowledge bases are referred to generically - DoS has no product in mind. A sample medical knowledge base would be a drug interaction base, with information similar to what is found in the Physician's Desk Reference (PDR). The drug interaction knowledge base should provide the physician with recommended doses when prescribing medications, alert the physician of harmful side effect, alert the physician of adverse interactions with other medications. In addition, the drug interaction knowledge base could suggest alternative medications in lieu of what was prescribed and allow the physician to either change or keep the prescribed medication. Q11. Section B.17 states ''Ability to generate and read barcode labels.'' Please define the barcoding application and usage. A11. Labels containing patient identifiers such as patient number, name, date of birth and social security number are used to label specimens collected for laboratory testing. The barcode labels are used to track specimens and accurately match and record the laboratory results for a given patient. Q12. Section C.2, Training. Please provide us with background information on the DoS Administrators the offeror will be training. For example, are the Administrators fully conversant in Windows NT or will the offeror be providing Windows NT training? A12. It should be assumed that the DoS Administrators have working knowledge of the network operational environment. (i.e. They can perform duties normally considered within the scope of network administration, such as adding users, updating user accounts, configuring print queues, etc.) Q13. Section E.1, Client and Server EMR Software. This section requests pricing based on units from 1-10 to 101+ units. Please define what constitutes a ''unit''. A13. One unit equals one single machine perpetual license. The unit price may include the cost of other items such as documentation and other mandatory or desirable software requirements which are not separately priced. The Government has tried to structure the pricing requirements to allow flexibility in the way prices are proposed. Q14. Section H.3.b., Technical Evaluation, states that the ''Offerors shall be required to conduct an 1-day comprehensive technical product demonstration...and DoS supplied test data.'' How many days in advance will the DoS notify the offeror of the demo date? What will the DoS supplied test data consist of? When will the offeror be given the test data to prepare for the comprehensive demo? A14. DoS will notify the Offeror approximately 10 business days in advance of the demo date. Test data will consist of 5000 records provided in an Access 7 table consisting of demographic data. The data elements that will be include but may not be limited to are: Last Name, First Name, Social Security Number, Address, Post, Date of Birth, Blood Type and ID Number. The test data will also be provided approximately 10 business days prior to the demo date. Q15. Section H.6. There are several references throughout the solicitation to information the offerors are suppose to look up on the DoS Internet address of http://www.statebuy.inter.net/home.htm. We are unable to find any of the vendor certifications, DoS clauses or FAR clauses at this address or any reference to this solicitation. Please provide further direction. A15. There was a delay in posting the subject information on the Internet. The information was subsequently posted on 10/10/96 and can be downloaded for your review. The receipt time and date of proposals remains 3:00 PM Eastern Time on 11/4/96. All other information publicized in the original solicitation notice is unchanged. (0297)

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