REQUEST FOR PROPOSAL INTEGRATED RADIOLOGY INFORMATION SYSTEM (RIS) AND PICTURE ARCHIVAL COMMUNICATIONS SYSTEM (PACS) FOR Your Hospital Name Here File No.: _____________________ Solicitation No: _______________ Proposal Opening Date:___________ Proposal Opening Time:___________ V7 Table of Contents REQUEST FOR PROPOSAL ................................................................................................................ 3 PART I. ADMINISTRATIVE AND GENERAL INFORMATION (REV. 8/07) ..................................... 3 1.1 Background .................................................................................................................................... 3 1.1.1 Purpose .................................................................................................................................... 5 1.1.1.1 Table of Radiology Exams....................................................................................................... 6 1.1.2 Goals and Objectives .............................................................................................................. 6 1.2 - Definitions .................................................................................................................................... 9 1.3 - Schedule of Events .................................................................................................................... 10 1.4 - Proposal Submittal .................................................................................................................... 10 1.5 - Proposal Response Format ...................................................................................................... 11 1.5.2 Legibility/Clarity .................................................................................................................... 12 1.6 - Confidential Information, Trade Secrets, and Proprietary Information .................................. 13 1.7 - Proposal Clarifications Prior to Submittal ...................................... Error! Bookmark not defined. 1.7.1 Pre-proposal Conference ............................................................. Error! Bookmark not defined. 1.7.2 Proposer Inquiry Periods ............................................................. Error! Bookmark not defined. 1.8 - Errors and Omissions in Proposal ........................................................................................... 13 1.9 - Proposal Guarantee (if required) .............................................................................................. 13 1.10 - Performance Bond (if required) .............................................................................................. 13 1.11 - Changes, Addenda, Withdrawals............................................................................................ 13 1.12 - Withdrawal of Proposal ........................................................................................................... 13 1.13 - Material in the RFP .................................................................................................................. 13 1.14 – Waiver of Administrative Informalities .................................................................................. 13 1.15 - Proposal Rejection ................................................................................................................. 14 1.16 - Ownership of Proposal ............................................................................................................ 14 1.17 - Cost of Offer Preparation ........................................................................................................ 14 1.18 - Non-negotiable Contract Terms.............................................................................................. 14 1.19 -Taxes ......................................................................................................................................... 14 1.20 - Proposal Validity...................................................................................................................... 14 1.21 - Prime Contractor Responsibilities ......................................................................................... 14 1.22 - Use of Subcontractors ............................................................................................................ 14 1.23 - Written or Oral Discussions/Presentations ........................................................................... 14 1.24 - Acceptance of Proposal Content ............................................................................................ 14 1.25 - Evaluation and Selection ........................................................................................................ 15 1.26 - Contract Negotiations ............................................................................................................. 15 1.27 - Contract Award and Execution ............................................................................................... 15 1.28 - Notice of Intent to Award ........................................................................................................ 15 1.29 - Debriefings ............................................................................................................................... 15 1.30 - Insurance Requirements ......................................................................................................... 15 1.31 - Subcontractor Insurance ........................................................................................................ 15 1.32- Indemnification and Limitation of Liability ............................................................................ 15 1.33 - Fidelity Bond Requirements ................................................................................................... 15 1.34 - Payment for Services .............................................................................................................. 15 1.35 - Termination .............................................................................................................................. 15 1.35.1 TERMINATION OF THIS AGREEMENT FOR CAUSE ................ Error! Bookmark not defined. 1.35.2 TERMINATION OF THIS AGREEMENT FOR CONVENIENCE ............ Error! Bookmark not defined. 1 V7 1.35.3 TERMINATION FOR NON-APPROPRIATION OF FUNDS ..... Error! Bookmark not defined. 1.36 - Assignment .............................................................................................................................. 15 1.37 - No Guarantee of Quantities..................................................................................................... 16 1.38 - Audit of Records ...................................................................................................................... 16 1.39 - Civil Rights Compliance .......................................................................................................... 16 1.40 - Record Retention ..................................................................................................................... 16 1.41 - Record Ownership ................................................................................................................... 16 1.42 - Content of Contract/ Order of Precedence............................................................................ 16 1.43 - Contract Changes ................................................................................................................... 16 1.44 - Substitution of Personnel ....................................................................................................... 16 1.45 - Governing Law ......................................................................................................................... 16 1.46 - Claims or Controversies ......................................................................................................... 16 1.47 - Proposer’s Certification of OMB A-133 Compliance .................... 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PART II SCOPE OF WORK/SERVICES .......................................................................................... 17 2.1 - Scope of Work/Services ............................................................................................................ 17 2.1.1 Radiology Information Management System (RIS) and Picture Archival Communications System (PACS) Description........................................................................................................... 17 2.1.2 Installation and Technical Support Services .................................................................... 18 2.2 - Period of Agreement ................................................................................................................. 18 2.3 - Price Schedule ........................................................................................................................... 18 2.4 - Deliverables ............................................................................................................................... 18 2.5 - Location ..................................................................................................................................... 19 2.6 - Proposal Elements .................................................................................................................... 19 2.6.1 Financial............................................................................................................................... 19 2.6.2 Technical.............................................................................................................................. 20 PART III EVALUATION ................................................................................................................. 20 3.1 - Financial Proposal ..................................................................................................................... 21 3.2 - Technical Proposal .................................................................................................................... 24 3.2.1 Vendor background/Financial stability ( 5 points) ............................................................ 24 3.2.2 Training/Continuing Education (5 points)........................................................................ 25 3.2.3 Implementation Plan (5 points)....................................................................................... 25 3.2.4 Technical Services and Support (10 Points) ................................................................... 26 3.2.5 Functional Systems Design - System Capabilities and Approach (25 points) .............. 27 PART IV. PERFORMANCE STANDARDS ..................................................................................... 47 4.1 - Performance Requirements ...................................................................................................... 47 4.2 - Performance Measurement/Evaluation .................................................................................... 47 Appendix A......................................................................................................................................... 48 Price Schedule ............................................................................................................................... 48 Appendix B ......................................................................................................................................... 50 Network Maps as of 10/15/2007 ..................................................................................................... 50 Appendix C ......................................................................................................................................... 51 Equipment Requirements .............................................................................................................. 51 Appendix D ......................................................................................................................................... 57 HL7 Interfaces ................................................................................................................................ 57 Appendix E ......................................................................................................................................... 58 Implementation Schedule .............................................................................................................. 58 2 V7 REQUEST FOR PROPOSAL INTEGRATED RADIOLOGY INFORMATION MANAGEMENT SYSTEM (RIS) AND PICTURE ARCHIVAL COMMUNICATIONS SYSTEM (PACS) PART I. ADMINISTRATIVE AND GENERAL INFORMATION (REV. 8/07) ______________________________________________________________________ 1.1 Background Provide your general details regarding existing sites and capabilites. This is intended to give the vendor a general overview or where you are and where you are trying to go. 3 V7 Hospital Locations and Statistics: Your Hospital Name Address Licensed Beds: Staffed Beds: Employees: Inpatient Days: ER Visits: Outpatient Visits: Number of Transcriptionists: Number of Radiologists: Number of Radiology Residents: RIS: PACS: Continue for other sites if applicable 4 V7 436 386 > 5,000 19,649 54,195 425,125 6 17 12 Vendor X Vendor Y Data Center Locations: List your data center locations and whether you have remote disaster recovery and with whom. 1.1.1 Purpose The purpose of this Request for Proposal (RFP) is to obtain competitive proposals from bona fide, qualified proposers who are interested in providing an integrated Radiology Information System (RIS) and Picture Archival Communications System (PACS) with integrated Voice Recognition System (VR) and Digital Mammography System (DM). The RIS will accommodate all hospitals on one central server. The PACS will replace the current film-based system for performing radiology services AND/OR the current RIS and PACS. Any data will also need to be migrated to the selected vendor’s PACS. RIS: 1. Implement automated failover RIS servers at each of the two listed data centers. 2. The RIS servers will also be configured in a failover, load-balancing mode with a user configurable high water mark (typically 80%). The data would be kept in sync between the RIS servers and each server could support all hospitals in the event that either RIS was down. PACS: 1. Keep twelve (12) Months of Short-Term Storage at each hospital in a redundant automated failover configuration. 2. Keep sixty (60) Months of Long-Term Storage at each datacenter in an automated failover EMC Centera SAN configuration. 3. Provide access to patient images in worklists and via ad hoc searches from any of the participating hospital’s PACS from any hospital. Configurable worklists should allow any or all exams done by any of the hospitals to be accessible to any Radiologist via their normal workflow. 4. The PACS at each hospital should continue to operate in the event of a wide area network (WAN) outage that disables access to the RIS. 5 V7 1.1.1.1 Table of Radiology Exams List your exam counts here. (See Appendix C for Equipment Requirements) (See Appendix D for HL7 Interfaces) (See Appendix E for Implementation Schedule) (See Attachment X for Modality List) 1.1.2 Goals and Objectives The goal of this RFP is to obtain an integrated Radiology Information System (RIS) and Picture Archiving and Communications System (PACS) with integrated Voice Recognition (VR) and Digital Mammography (DM) that will enhance the efficiency of the radiology workflow for the radiologists and all users, and access to patient studies by authorized users from anywhere inside or outside of the network, and to provide a system that allows for total system redundancy in the event of a disaster. The objective is to: 1. Provide the radiologist with a system that is easy to use; 2. Ensure that selected radiology images can be accessed both directly through the PACS system ensuring that radiology images are accessible from any authorized PC internally or externally; 3. Provide access to radiology reports and images via one screen without having to change to a separate screen to access each item; 4. Support electronic downloads of patient demographic data to modalities, where possible; 5. Display RIS diagnostic reports with medical images on user-friendly, high performance, applications-oriented workstations, and automated image management and distribution; 6. Allow the PACS rules for image management to be determined by the customer; 7. Eliminate misplaced and lost films and reports; 8. Eliminate the time spent retrieving archived film, resulting in eventual reduction/redistribution of film file staff; 9. Improve exam reading and report turnaround; 10. Improve quality of imaging, particularly portable imaging, through the use of computed radiography (CR) and/or digital radiography (DR); 11. Consolidate the work of the radiologists, to enable each to optimize their work time; 12. Link the medical facilities together so that records and images can be reviewed at any location, thus providing better quality of patient care; 13. Provide access to all patient studies in the archive from any reading desktop at any hospital; 14. Ensure that data between the RIS and the PACS is automatically kept consistent and in sync; 15. Automatic updating of key patient demographic information, that changes in the HIS, via the ADT interface, without the need for physical intervention; 16. Ensure that the PACS can continue to operate at the hospitals if network connectivity to the data center is interrupted; 17. Provide an integrated system that supports an efficient workflow for all users; a. All access will be privilege based (detailed in other sections). b. The RIS system should integrate with the PACS system to provide a workflow that is consistent for Technologists, Radiologists and Clinicians alike. Data for worklists, 6 V7 schedules, patient flow and any other workflow should be easily accessed with a consistent view whether access is via the RIS or the PACS application. c. The Technologist should have an application allowing ease of data entry and tracking that enhances their workflow. This access can be in the form of bar coding, easy to populate and select Graphical User Interfaces (GUI), and could include handheld functionality if deemed appropriate. It should provide lists and reports that enhance the patient flow through the department. There should be a performance monitor Dashboard to allow issues to be easily recognized, and to enhance patient flow through the department. d. The Radiologist should have a work environment that allows for any function to be performed that enhances reading efficiency and improves report turnaround time. The primary workstation should enable any applications needed to be run on the same machine. Easy to set up and access worklists will provide the primary driver, and all applications must pick up the context currently selected in any of the applications. The following applications should be provided: i. Reading/Image Display software (PACS) to navigate, manipulate and manage current and prior studies. ii. RIS software to enable reporting, information access, and other data obtained in performing the exams, including Mammography software to support ACQA compliance. iii. A common, consistent mechanism to create flexible worklists that allow the radiologist to view any set of exams, from any set of locations, together or separately. iv. The RIS software must allow for the full use of voice recognition with self correction by the radiologist from all reading stations at all facilities. v. The RIS software must allow full use of voice recognition software with correction by a transcriptionist from all reading stations at all facilities. vi. The RIS software must also allow for the use of voice dictation by the radiologist and a way for the transcriptionist to listen and type the dictation. vii. The RIS software should allow for the creation of report templates, either by the transcriptionists or the radiologists, on the fly and save them for later use. viii. 3D, Advanced Visualization, and Quantitative/Statistical Analysis software, preferably thin client/server based either using unlimited licensing or at a minimum, concurrent licensure. ix. Orthopedic templating. x. Integrated applications to enable efficient ED preliminary reporting and error notification, and Critical Test Results notification to ensure the appropriate clinician is aware of emergent issues. Both of these systems must allow data tracking and collection, auditing and reporting. xi. Seamless access to decision support and reference material on the workstation. Internet searches should utilize multiple search engines which can be triggered by manual input or from some indicator on the screen the radiologist is working on. xii. Integrated teaching file and clinical trial export (should utilize the IHE TCE profile). e. The Clinician should be able to have access to any data that enhances their workflow. This will not be their primary medical record, but if they access it directly they should be able to see any data their privileges allow. Images should be easily accessible, and allow all of the same functionality for image manipulation. f. Coders should have access to an efficient and easy to use billing module that can be used to correct billing/coding information before the exams are sent to final billing. 7 V7 18. Provide access to all appropriate functionality wherever needed; a. In the clinical setting, both Radiologists and Clinicians should be able to perform the same image manipulations wherever they are located, including 3D visualization. Privilege setting will allow certain users to perform functions such as Save, Dictate, Report etc. b. Access to the same functionality should be available remotely as well. Once a user is set up, they should be able to access all functionality from home or when traveling. c. Provide access to radiology reports and images within one system without having to change to a separate system screen to access each item. d. Display RIS diagnostic reports with medical images on user-friendly, highperformance, applications oriented workstations, with the ability to do automated image management and distribution. e. Consolidate the work of the radiologists to enable each to optimize their work time. 19. Provide access to all exams in the system at all sites; a. Allow any rules for image management to be determined by the customer. b. Enable access to reports and images from any location to enhance the quality of patient care. c. Provide access to all patient studies in the archive from any reading desktop. d. Ensure that data between the RIS and the PACS is automatically kept consistent and in sync. e. Automate updating key patient information that is changed without physical intervention. f. Ensure that the PACS can continue to operate at each local hospital in the event that network connectivity to the data center is interrupted. 20. Provide technology to support a film-less, paper-less environment that enables quality control and improvement; a. Eliminate misplaced and lost films and reports. b. Eliminate the time spent retrieving archived film, and moving film around. c. Support electronic downloads of patient demographic data to modalities, where possible. This should utilize DICOM Modality Worklists. d. Provide an efficient workflow in the file room for handling outside CDs and film imports, with the possible reduction/redistribution of film file staff. Any CDs created should conform to the DICOM Part 10 standard and the IHE Portable Data for Imaging profile. Importing CDs must allow for modification of DICOM header information manually, or via Modality Worklist or PACS Query. The import function must be able to display thumbnail images before the exam is sent to PACS. e. Improve the quality of films, particularly portable films, through the use of computed radiography (CR) and/or digital radiography (DR). f. Provide mechanisms to create documents in software that can accept electronic signatures via signing pads, and the scanning of paper documents into the system for later retrieval. g. The RIS must provide a user friendly mechanism, within each facility, that will create, track and bill orders by department. Orders created outside of the radiology department, but maintained within the RIS/PACS, can be tracked and billed to the initiating department and not grouped together and billed under the radiology department, when sent from the RIS to the billing systems. h. The system must be able to allow outside exams to flow through the system and be billed properly. Once imported from the remote site, the exam should be treated as any other exam in our workflow. There must be an option to not archive these exams in the event XXX will not be permanently storing them. 8 V7 i. Enable DICOM Modality Performed Procedure Step functions to save manual steps in tracking and changing exams. Also provide DICOM Storage Commitment where possible to ensure exams are on PACS before they can be deleted from the modality. 21. Provide the ability to support the system; a. Provide a test bed system so that changes can be tested before they go live. This must at a minimum include the RIS/PACS and Speech Recognition systems, along with any interfaces between them. This should include test interfaces for all interfaces detailed in Appendix D. b. The system administrators and super users must have access to all system data in an easy to use fashion such as a customizable Dashboard. This should enable these support personnel to be notified of issues (by email, pager, cell etc.), problem areas, and data errors (e.g. exams not matched to patient information). c. Provide for error reporting via a centralized web based interface accessible to all users, with tracking, auditing and reporting. d. Provide for centralized functions such as password resets if handled through the RIS/PACS system. This should include error and downtime notifications that require immediate attention. The notification list should be customizable to accommodate different users and times. e. All systems must be able to provide audit information for HIPAA compliance. The audit logs should be exportable to a central repository. All data events must be recorded, including viewing, creating or modifying. This must include any exporting of data (via USB key, CD, or any other removable media) from any workstation. All workstations that can export data must have an option to create anonymous information, and the setting must be logged. f. Data stored in any database must be accessible to appropriate personnel. Data access via software such as MS Access, Crystal Reports etc. must be available. 22. Provide a system that shall include all equipment cabinetry, racks, console surfaces for input devices, and other items necessary to provide a suitable safe working surface and environment for the equipment; 23. XXX strongly supports utilization of Integrating the Healthcare Enterprise (IHE) profiles (see Section 3.2.5.1.17). These profiles use the more flexible DICOM and HL7 standards to create a structured method for supporting common integration scenarios. Standard, consistent mechanisms for performing these scenarios will ease the administration and support of this complex set of systems. Vendors should be able to supply tested profiles, and should be committed to further development and enhancement of profiles. All vendors must supply complete DICOM Conformance Statements and IHE Integration Profiles for all appropriate systems. Manufacturers Discloser Statements for Medical Device Security (MDS2) forms must be supplied for all computers proposed. 1.2 - Definitions Note: The following section should include “A”, “B”, and “C”. - The other definitions added (if any) should be appropriate to the proposal. A. Shall – The term “shall” denotes mandatory requirements. B. Must - The terms “must” denotes mandatory requirements. C. May - The term “may” denotes an advisory or permissible action. 9 V7 D. Should – the term “should” denotes desirable E. Contractor – Any person having a contract with a governmental body. F. Agency- Any department, commission, council, board, office, bureau, committee, institution, agency, government, corporation, or other establishment of the executive branch of XXX authorized to participate in any contract resulting from this solicitation. G. State - The State of YYY. H. Discussions - for the purposes of this RFP, a formal, structured means of conducting written or oral communications/presentations with responsible Proposers who submit proposals in response to this RFP. 1.3 - Schedule of Events Purchasing Officer Note: This section shall not be deleted. Provide dates and times for each event. Mailing the RFP 30 days prior to the opening is statutorily required. Other time frames are a guideline and may be altered. Make certain each event is scheduled to allow enough time for receipt and responses. Indicate physical address of pre-proposal conference. Date Time (CT) 1. RFP mailed to prospective proposers and posted At least 30 days prior to the last day that proposals will be accepted 2. Pre-Proposal Conference (mandatory): 10-14 days after RFP mailed 3. Deadline to receive written inquiries 7-10 days after Preproposal Conference 4. Deadline to answer written inquiries 14 days after inquiry deadline 5. Proposal Opening Date (deadline for submitting 8 weeks after mailing proposals) responses to inquiries 6. Oral discussions with proposers, if applicable To be scheduled 7. Notice of Intent to Award to be mailed To be scheduled (approx. 3-4 weeks after #6.) Wait for protest time to lapse (14 days after #7.) 8. Contract Initiation NOTE: XXX reserves the right to revise this schedule. Any such revision will be formalized by the issuance of an addendum to the RFP. 1.4 - Proposal Submittal This RFP is available in electronic form at the YYY website. It is available in PDF format or in printed form by submitting a written request to the RFP Contracting Officer. 10 V7 All proposals shall be received by the XXX no later than the date and time shown in the Schedule of Events. Important - - Clearly mark outside of envelope, box or package with the following information and format: Proposal Name: Identify File Number: Identify , Solicitation No. Proposal Opening Date: Identify Identify Proposers are hereby advised that the U. S. Postal Service does not make deliveries to our physical location. Proposals may be mailed through the U. S. Postal Service to our box at: Your Address Proposals may be delivered by hand or courier service to our physical location at: Your Location Proposer is solely responsible for ensuring that its courier service provider makes inside deliveries to our physical location. XXX is not responsible for any delays caused by the proposer’s chosen means of proposal delivery. Proposers should be aware of security requirements for XXX. Proposer is solely responsible for the timely delivery of its proposal. Failure to meet the proposal opening date and time shall result in rejection of the proposal. PROPOSALS SHALL BE OPENED PUBLICLY AND ONLY PROPOSERS SUBMITTING PROPOSALS SHALL BE IDENTIFIED ALOUD. PRICES SHALL NOT BE READ. 1.5 - Proposal Response Format Proposals submitted for consideration should follow the format and order of presentation described below. Items A through F should be packaged together and labeled “Technical Submission.” The Financial Proposal, should be labeled Item G A. Cover Letter: The cover letter should exhibit The Proposer’s understanding and approach to the project. It should contain a summary of Proposer’s ability to perform the services described in the RFP and confirm that Proposer is willing to perform those services and enter into a contract. By signing the letter and/or the proposal, the proposer certifies compliance with the signature authority required by XXX. The person signing the proposal must be: 11 V7 1. A current corporate officer, partnership member, or other individual specifically authorized to submit a proposal as reflected in the appropriate records on file; or 2. An individual authorized to bind the company as reflected by a corporate resolution, certificate or affidavit; or 3. Provide other documents indicating authority which are acceptable to the public entity. The cover letter should also: 1. Identify the submitting Proposer; 2. Identify the name, title, address, telephone number, fax number, and email address of each person authorized by the Proposer to contractually obligate the Proposer; 3. Identify the name, address, telephone number, fax number, and email address of the contact person for technical and contractual clarifications throughout the evaluation period. B. Table of Contents: Organized in the order cited in the format contained herein. C. Proposer Qualifications and Experience: History and background of Proposer, financial strength and stability, related services provided to government entities, existing customer satisfaction, demonstrated volume of merchants, etc. D. Proposed Solution/Technical Response: Illustrating and describing proposed technical solution and compliance with the RFP requirements. E. Innovative Concepts: Presentation of innovative concepts, if any, for consideration. F. Project Schedule: Detailed schedule of implementation plan for pilot (if applicable) and full implementation. This schedule is to include implementation actions, timelines, responsible parties, etc. G. Financial Proposal: Proposer’s fees and other costs, if any, shall be submitted (usually in accordance with an attached price schedule) Prices proposed shall be firm for the duration of the contract (unless there is some provision in the RFP for price escalation). This financial proposal shall include any and all costs the Contractor wishes to have considered in the contractual arrangement. 1.5.1 Number of Response Copies Each Proposer shall submit one (1) signed original response. 9 additional copies of the proposal should be provided, as well as one (1) redacted copy, if applicable (See Section 1.6). 1.5.2 Legibility/Clarity Responses to the requirements of this RFP in the formats requested are desirable with all questions answered in as much detail as practicable. The Proposer’s response is to demonstrate an understanding of the requirements. Proposals prepared simply and economically, providing a straightforward, concise description of the Proposer’s ability to meet the requirements of the RFP are also desired. Each Proposer is solely responsible for the accuracy and completeness of its proposal. 12 V7 1.6 - Confidential Information, Trade Secrets, and Proprietary Information Apply your legal boilerplate here. Inquiries concerning this solicitation may be delivered by mail, express courier, e-mail, hand, or fax to: Your contact information here. 1.8 - Errors and Omissions in Proposal Apply your legal boilerplate. 1.9 - Proposal Guarantee (if required) Apply your legal boilerplate. 1.10 - Performance Bond (if required) Apply your legal boilerplate. 1.11 - Changes, Addenda, Withdrawals Apply your legal boilerplate. If the proposer needs to submit changes or addenda, such shall be submitted in writing, signed by an authorized representative of the proposer, cross-referenced clearly to the relevant proposal section, prior to the proposal opening, and should be submitted in a sealed envelope. Such shall meet all requirements for the proposal. 1.12 - Withdrawal of Proposal A proposer may withdraw a proposal that has been submitted at any time up to the proposal closing date and time. To accomplish this, a written request signed by the authorized representative of the proposer must be submitted to the agency soliciting proposals. 1.13 - Material in the RFP Proposals shall be based only on the material contained in this RFP. The RFP includes official responses to questions, addenda, and other material, which may be provided by XXX pursuant to the RFP. 1.14 – Waiver of Administrative Informalities 13 V7 Apply your legal boilerplate. 1.15 - Proposal Rejection Apply your legal boilerplate. 1.16 - Ownership of Proposal Apply your legal boilerplate. 1.17 - Cost of Offer Preparation XXX is not liable for any costs incurred by prospective Proposers or Contractors prior to issuance of or entering into a Contract. Costs associated with developing the proposal, preparing for oral presentations, and any other expenses incurred by the Proposer in responding to the RFP are entirely the responsibility of the Proposer, and shall not be reimbursed in any manner by XXX. 1.18 - Non-negotiable Contract Terms Apply your legal boilerplate. 1.19 -Taxes Apply your legal boilerplate. 1.20 - Proposal Validity Apply your legal boilerplate. 1.21 - Prime Contractor Responsibilities The selected Proposer shall be required to assume responsibility for all items and services offered in the proposal whether or not he produces or provides them. XXX shall consider the selected Proposer to be the sole point of contact with regard to contractual matters, including payment of any and all charges resulting from the contract. 1.22 - Use of Subcontractors Apply your legal boilerplate. 1.23 - Written or Oral Discussions/Presentations Apply your legal boilerplate. 1.24 - Acceptance of Proposal Content Apply your legal boilerplate. 14 V7 1.25 - Evaluation and Selection Apply your legal boilerplate. 1.26 - Contract Negotiations Apply your legal boilerplate. 1.27 - Contract Award and Execution Apply your legal boilerplate. 1.28 - Notice of Intent to Award Apply your legal boilerplate. 1.29 - Debriefings Apply your legal boilerplate. 1.30 - Insurance Requirements Apply your legal boilerplate. . 1.31 - Subcontractor Insurance Apply your legal boilerplate. 1.32- Indemnification and Limitation of Liability Apply your legal boilerplate. 1.33 - Fidelity Bond Requirements Apply your legal boilerplate. 1.34 - Payment for Services Apply your legal boilerplate. 1.35 - Termination Apply your legal boilerplate. 1.36 - Assignment Apply your legal boilerplate. 15 V7 1.37 - No Guarantee of Quantities Apply your legal boilerplate. 1.38 - Audit of Records Apply your legal boilerplate. 1.39 - Civil Rights Compliance Apply your legal boilerplate. 1.40 - Record Retention Apply your legal boilerplate. 1.41 - Record Ownership Apply your legal boilerplate. 1.42 - Content of Contract/ Order of Precedence Apply your legal boilerplate. 1.43 - Contract Changes Apply your legal boilerplate. 1.44 - Substitution of Personnel Apply your legal boilerplate. 1.45 - Governing Law Apply your legal boilerplate. 1.46 - Claims or Controversies Apply your legal boilerplate. 16 V7 PART II SCOPE OF WORK/SERVICES 2.1 - Scope of Work/Services 2.1.1 Radiology Information Management System (RIS) and Picture Archival Communications System (PACS) Description (System Requirements are in Section 3.1) User Base and Activity The user base consists of radiologists, radiology technicians, radiology managers, and clinicians across XXX as well as contract radiologists and contract transcriptionists. The user base uses the system to remove any and all dependency on film and manual transcription. The system must allow for simplified Radiology Resident Reading with Attending Radiologist review and sign off. 1. The radiologist logs onto the RIS/PACS/VR once and establishes a session in all three applications automatically, selects a patient from the “unread” worklist causing the current images to open, a worklist of prior images to open, for the radiologist to choose from, and the voice dictation to be initiated. The radiologist interprets the case and signs off the case with one mouse click and moves to the next patient. The radiologist will have seamless access to decision support data, 3D/Advanced Visualization, Quantitative and Statistical Analysis and templating, and ED and CTR notification systems. If the exam needs to go to a teaching file or clinical trial system, the radiologist can easily select where to send it while they are in the exam. 2. The clinician and the radiologist have access to images within their department, at outpatient center locations, across multiple facilities within the system, or from home. 3. The ED physician performs “wet reads” and fills out an interactive on-line form that will be read by the radiologist when the diagnostic read is performed. 4. Critical Results Notification can be performed by the radiologist at the workstation while reading and this will be sent to the referring clinician (multiple ways) with record of receipt. This can be vendor software or third party ancillary application. 5. The radiologist will have the ability to perform the same functions at local or remote (home) workstations. 6. The contract radiologists must have the ability to perform the same functions, from their remote location, as the local radiologists can onsite. 7. The RIS must allow for multiple dictation and speech recognition options, as listed here. Some radiologists will want to use speech recognition and utilize self correction. Others will want to use speech recognition but allow for transcriptionists to do the correction. There may also be instances where XXX needs to utilize dictation only and allow for a transcriptionist to type from the voice. 8. The RIS must allow for outside transcription services to type directly into the RIS or send the voice files to the transcription service via an outbound HL7 interface and receive the completed reports into the RIS via an inbound HL7 interface. XXX desires that implementation of the RIS/PACS project begin immediately upon RFP award and be completed system-wide within a period of 12 months. A detailed, specific implementation timeline must be provided by the accepted vendor with potential penalties for delays caused by the vendor specified. Capital appropriations for the project have been identified and are currently in place awaiting RFP award. 17 V7 2.1.2 Installation and Technical Support Services Services to be provided to XXX by the bidder shall include: 1. Project Management with detailed project implementation plan. A minimum of one project manager per site having over 150 beds is required, along with a Global Project Manager as well. 2. Installation of all software required for a full implementation of a RIS/PACS/VR. 3. Implementation/configuration consulting with knowledge transfer of a. All parts of the RIS/PACS/VR to operate in XXX’s network and application environment as a failover system. b. Interfaces into and out of the RIS/PACS/VR including HL7 interfaces (detailed in Appendix D) and modality connections (detailed in Attachment YYY) including all licenses and fees. c. Requirements and planning of workflow. d. Design and build of software and reports. e. Connection and testing of all existing modalities. f. System testing. 4. Coordinate deployment and configuration of SANs. 5. Migration of existing PACS images from existing stores. A per study migration cost for each of the remaining facilities, for any DICOM studies captured before go-live of the RIS/PACS/VR. 6. Comprehensive training at each participating hospital for the radiology department and advanced training for the RIS and PACS administrators. 7. General training for clinicians and other PACS users utilize a ‘train the trainers’ methodology. Super users in each department will be designed for training, and they will then provide training to their departments. 8. Any existing RIS reports that are not included in the RIS and a default report must be written in the report writer of the new RIS. 9. RIS/PACS/VR maintenance services including version upgrades, bug fixes and appropriate training for the life of the contract. Version upgrades and bug fixes should be at no additional charge. 10. Help desk support - 24 hours a day 7 days a week, with 15 minute response time. 2.2 - Period of Agreement Apply your legal boilerplate. 2.3 - Price Schedule Prices proposed by the proposers should be submitted on the price schedule furnished herein on Appendix A. Prices submitted shall be firm for the term of the contract. Prices should include delivery of all items F.O.B. destination. 2.4 - Deliverables The deliverables listed in this section are the minimum desired from the successful proposer. Every proposer should describe what deliverables will be provided per their proposal and how the proposed deliverables will be provided. 18 V7 1. All Software, Hardware, System Integration, System Implementation, and Support Services required to meet the following RIS/PACS/VR integrated, failover/load balancing/replicated configuration or equivalent: a. A RIS at each primary data center with replication/automated failover capabilities and a preferred configuration that would allow load balancing. Data would be replicated and kept in sync on each RIS. b. A PACS at each hospital with automated failover capabilities and 12 months of image storage c. A real-time, replicated PACS archive SAN at each data center holding 5 years of patient data storage, 23 years for minors, and lifetime for mammography. The preferred configuration would allow for load balancing. Some method of Information Lifecycle Management would be preferred. While ata compression will need to be used, only industry standard lossless compression (JPEG 2000, et. al.) should be considered. 2. Statement of work to be accomplished. 3. Project plan for implementation. 4. Licensed Software – provided to XXX delivered on CDROM or other electronic media mutually agreed to by XXX and Proposer. 5. Configured Software – licensed software configured to accommodate the XXX network and applications environment and business rules. The software shall reside on the production servers configured with a failover/redundant/replicated strategy in place. 6. Training – training of XXX designated RIS/PACS personnel in use of and administration of the system. 7. Interfaces – All system interfaces as described in the system requirements must be made operational prior to going into production on the RIS/PACS. 8. Data migration - PACS images and RIS ADT and other pertinent documents such as scanned forms. A per study cost of study migration, for the remaining facilities, of any DICOM studies that are captures before go-live on the RIS/PACS/VR. This should include a rules based ability to skip old exams that are no longer needed. 9. Report Migration – All existing reports currently in use from one of the RIS systems in place at an XXX facility will need to be written in the new RIS report writer. 2.5 - Location All software licensed by XXX from the Proposer shall be delivered to and installed at the location specified by XXX when the order is placed. 2.6 - Proposal Elements Note: This section may be altered to meet actual RFP requirements. 2.6.1 Financial Proposal shall include prices per the schedule furnished in Appendix A, as well as other potential charges (if any) for proposed services associated with the RFP program implementation and 19 V7 administration that you wish XXX to consider. Please include pricing for Interfaces into and out of the RIS/PACS/VR including HL7 interfaces (detailed in Appendix D) and modality connections (detailed in Attachment YYY, including all licenses and fees. XXX would prefer to have per interface costs listed in the vendor’s proposal, because there could be other interfaces needed once implementation starts. It is a requirement that no gateway interfaces such as a PACS Broker be used in which to facilitate the connection between the RIS and the PACS. Please include integration and certification costs for any existing hardware that can be used with the new system. 2.6.2 Technical Each Proposer should address how the firm will meet all the requirements of this RFP, with particular attention to: 1. Plans and/or schedule for implementation, or orientation, or installation, etc. (whichever is relevant to the RFP requirements). 2. Plans for training. 3. Provision for customer service, including personnel assigned, toll-free number, and account inquiry, etc. 4. Resumes for account manager, designated customer service representative(s) and any other key personnel to be assigned to this project, including those of subcontractors, if any. 5. References for at least three states, government agencies, or private firms for whom similar or larger scope services are currently being provided. Include a contact person and telephone number for each reference. 6. Information demonstrating the Proposer's financial stability (financial statements, annual reports, or similar data for the last three years). 7. Information demonstrating the Proposer’s understanding of the nature and scope of this project as specified in 2.1 of this RFP. 8. Any other information deemed pertinent by the Proposer including terms and conditions which the Proposer wishes considered. PART III EVALUATION The following criteria will be evaluated when reviewing the proposals. The proposal will be evaluated in light of the material and the substantiating evidence presented to XXX, not on the basis of what may be inferred. The vendor must meet each of the following criteria, in addition to the financial, technical and functional portions of this RFP: 1. Have as reference at least two (2) multi-entity sites in a single enterprise environment (i.e. a multi (>7) hospital network or RHIO like XXX) that is performing 400,000 clinical radiology procedures or more per year. Tasks should include image capture from the stated modalities, image viewing, archiving, web image distribution and interfaces to all stated clinical modalities (HIS, Clinical Repository, …); 20 V7 2. Have offered radiology-specific PACS in the market for at least three (3) years and have at least five (5) sites performing over 200,000 procedures per site; 3. Have performed and have fully operational at least two (2) interfaces to the Hospital Information System (HIS); 4. Have demonstrated interfaces to a verity of Storage Area Networks (SANs), including the EMC’s Centera and others; 5. Can meet all stated deadlines including site visits, on-site demonstrations, technical reviews and the start of the contract negotiations; 6. Have adequate existing (non-contracted) resources to start the installation within 90 days of contract signing and complete the installation within 12 months, including the completion all interfaces. 7. Have no concerns about meeting the stated objectives of XXX in a timely fashion, which if not met, would have a negative impact on the overall operations of the radiology departments within XXX. The scores for the Financial and Technical Proposals will be combined to determine the overall score. The Proposer with the highest overall score will be recommended for award. 3.1 - Financial Proposal (Value of 50 pts) USE VALUES APPROPRIATE TO YOUR SITE The following financial criteria will be evaluated: 1. Pricing must include unlimited or concurrent mammography licenses. 2. Pricing must include unlimited or concurrent Voice Recognition licenses. 3. Pricing must include unlimited or concurrent PACS software licenses. 4. Pricing must include all unlimited or concurrent software licenses required for other applications such as 3D visualization, Lung, Mammo and Colon CAD (Computer Aided Diagnosis), seamless decision support, ED and CTRN (Critical Test Results Notification), centralized monitor calibration software and any dashboards. 5. Pricing must include any applicable modality connection and modality worklist fees. 6. Pricing must include all RIS hardware (see equipment requirements in Appendix C Equipment Requirements for hospital specific hardware). 7. Pricing must include RIS and PACS training for both users and system administrators, including advanced training. 8. Pricing for PACS hardware must include disk space for at least 5 years of permanent image storage on the SAN, as well as, a complete disaster recovery solution proposed and identified disk space on distributed PACS servers. 9. Pricing must include any separate hardware required for speech recognition, 3D visualization, Lung, Mammo and Colon CAD (Computer Aided Diagnosis), decision support, ED and CTRN, centralized monitor calibration and dashboard systems. 21 V7 10. Pricing must reflect the number of concurrent seat licenses for the diagnostic platform, clinical platform, and web distribution, and the cost of additional concurrent seats if the amount purchased requires increasing. 10.1. Please describe your licensing model and, as appropriate, a per unit cost for each type of license offered, if concurrent (seat licensing will Not be considered). 10.2. Please indicate if you offer an unlimited web client license and if so, include it in the pricing. 10.3. Do inter-process communications use a license and if so, what type of license does it use. 10.4. If another web application connects to the RIS/PACS/VR, does it use a license and if so, what type of license does it use. 11. Pricing must reflect a disaster recovery, replicated, load balancing architected solution. 11.1. It is preferable that the configuration be a load balancing solution. 11.2. The architected solution should include an automated failover/redundant PACS at each hospital with 12 months of near-line storage that will be able to operate should network connectivity to the RIS be interrupted. 12. Pricing must include interfaces into and out of the RIS/PACS/VR including HL7 interfaces (detailed in Appendix D) and modality connections (detailed in Attachment YYY) including all licenses and fees. 13. Pricing must reflect the number of DICOM modalities performing the DICOM Store function, and the ability to add additional devices with the stated cost for each additional modality. 14. Pricing must include hardware necessary to add functionality to modalities that are non-MPPS compatible. E.g. Gateway that provides Work list, MPPS (Modality Perform procedure step), Print function, … 15. Pricing must include all necessary costs to migrate legacy DICOM and non-DICOM studies onto a failover EMC Centera archive SAN. 16. Pricing must include all implementation costs including the project management team and the clinical applications team. This must be listed as a fixed fee, not to exceed a certain cost. Listing a percentage amount of the total cost as the project management cost is not acceptable. 17. Pricing must include a service/support contract pricing for five years of a contract to include onsite and 24-hours a day, 7-days a week, remote support. 18. Pricing must include 3D/Advanced Visualization, Lung, Mammo and Colon CAD (Computer Aided Diagnosis), Quantitative and Statistical Analysis and Orthopedic Templating. If this is not a standard offering, please quote the cost separately. This should be server based and available to radiologists and clinicians alike at any workstation. It should also include pricing for ED/Critical Test Result Reporting, support Dashboard system, integrated Radiologist decision support systems, and any other software requested but not included in your system. 19. Pricing must include the annual maintenance costs and the percent it will increase each year for the next five years for the items included in the vendor’s proposal, provided those items do not change over said time period. The maintenance costs should not increase by more than 3 percent each year, provided the contracted items do not change. 22 V7 20. Pricing must include the cost of integration and certification of any existing SAN hardware or PACS hardware that can be used with the new RIS/PACS system. 21. Pricing must include a per report fee for vendor report writing, of any existing RIS reports that are not part of the default reports provided in the new RIS, but are currently in use and required or needed by XXX. 22. A commitment and detailed agreement regarding handling data migration should be included. 23. XXX will independently purchase all clinical workstation hardware. Prices proposed by the Proposers should be submitted on the price schedule furnished in Appendix A. Prices proposed shall be firm. The information provided in response to this section will be used in the Financial Evaluation to calculate lowest evaluated cost. (Alternate, if applicable: …will be used in the Financial Evaluation Model to calculate lowest evaluated cost.) A proposer’s base cost score will be based on the cost information provided in Appendix A and computed as follows: USE VALUES APPROPRIATE TO YOUR SITE BCS = (LPC/PC X 50) Where: BCS = Computed cost score (points) for proposer being evaluated LPC = Lowest proposed cost of all proposers PC = Total cost of proposer being evaluated Note: The proposer must include an itemized listing of all expenses or fees, if applicable, (including travel) that are expected to be paid by the agency. 23 V7 3.2 - Technical Proposal (Value of 50 Points) USE VALUES APPROPRIATE TO YOUR SITE The following criteria are of importance and relevance to the evaluation of this RFP and will be used by the Evaluation Committee in the evaluation of the technical proposal. Such factors may include but are not limited to: 3.2.1 Vendor background/Financial stability ( 5 points) References shall be evaluated to determine if the software has demonstrated successful implementation in organizations of similar size, scope, and complexity to XXX’s environment. Information of proposer’s financial stability and disclosure of failed contract performance shall be evaluated to determine the proposer’s ability to deliver the required software, services, and level of support. 3.2.1.1 Please describe a general overview of your company. Please include the following: 3.2.1.1.1 When was your company founded? Please provide information related to the company’s ownership. 3.2.1.1.2 Please provide your last three financial statements. 3.2.1.2 Please provide information related to your entry into the PACS market. Please include the following: 3.2.1.2.1 When was your first PACS product installed? 3.2.1.2.2 How many versions of your PACS product have been released? 3.2.1.2.3 Is the core software developed in-house, did you purchase your product or are you in an OEM agreement? If OEM, how long has this agreement been in force and for how long will the company provide support contractually, if the agreement is ended? 3.2.1.2.4 What percent of total revenues are dedicated to research and development? 3.2.1.2.5 Please provide your PACs revenues for the last three years. 3.2.1.3 Please provide information related to your PACS market share. Please include the following: 3.2.1.3.1 How much of the PACS market share do you current have? 3.2.1.3.2 How many installations are installed? 3.2.1.3.3 How many of your installations are filmless? 3.2.1.3.4 Please describe your ability to interface your product to other vendor modalities and HIS, CIS, and EMR and provide at least three examples where you have done an interface like this. 3.2.1.4 Please provide three references whose implementations are similar to ours. Please include a description of the project and how your company helped their institutional objectives. 3.2.1.5 Do you have a user’s group? If so, please describe its function related to development of your products. How often does it meet? 3.2.1.6 Please provide your standard payment terms? 3.2.1.7 From a vendor perspective, what strengths do you offer above and beyond the other PACS vendors? 24 V7 3.2.2 Training/Continuing Education (5 points) The Proposer shall be evaluated on the proposer’s ability to offer multiple training options and provide a high level of support to XXX personnel in the implementation and use of the RIS/PACS. 3.2.2.1 Please describe your training approach and how you propose to train the following groups: 3.2.2.1.1 Trainers 3.2.2.1.2 System/Project Managers 3.2.2.1.3 Technical Staff 3.2.2.1.4 End Users e.g. Radiologists, radiographers, clerical staff and clinicians. 3.2.2.2 Please provide a job description for a PACS Administrator. 3.2.2.3 Do you provide any follow up training? If so, describe. 3.2.2.4 Please provide a description of supplemental training you offer for a PACS Administrator or PACS Super User. These costs must be included in the Financial Proposal. 3.2.2.5 What documentation is included with the purchase of the system? 3.2.2.6 Does your support center provide end user application support? If so, what are the hours of operation? 3.2.2.7 Do you provide a help utility integrated into your applications? Please describe its features? 3.2.2.8 Please describe your training staff qualifications? 3.2.2.9 Where will training take place for all groups? 3.2.3 Implementation Plan (5 points) The Proposer shall be evaluated on the complexity of the implementation plan and its timeline. 3.2.3.1 Describe your implementation strategy. 3.2.3.2 The vendor will be required to be the system integrator for all components, including third party ancillary systems. Do you have any issues being the system integrator for all components? 3.2.3.3 During the system implementation, what types of assistance are provided by the vendor at our site? 3.2.3.4 After the system has successfully been installed, how many people are required to support the system? What skills are required? 3.2.3.5 Provide a job description for the people required to support the system? 3.2.3.6 Provide resumes of the individuals who will be assigned to help us with our implementation. 3.2.3.7 What assistance can you provide to our IT department with respect to analyzing our current infrastructure and its ability to support the increased network traffic? Please describe. 25 V7 3.2.3.8 When can you begin implementation of the RIS/PACS project? How long does a typical installation take? 3.2.3.9 How soon after contract signing can implementation begin? 3.2.3.10 Describe your experience integrating to ZZZ’s HIS. 3.2.3.11 Provide a sample implementation statement of work. 3.2.4 Technical Services and Support (10 Points) The Proposer shall be evaluated on the provision of services and support offered including whether support is 24 hours a day X 7 days a week by 365 days a year and the turnaround time for responding to issues. 3.2.4.1 Please describe your RIS and PACS product support offering for problem resolution 365 days a year, 7 days a week, 24 hours a day, remotely. 3.2.4.2 What is your remote assistance response time? 3.2.4.3 What on-site response time do you guarantee? 3.2.4.4 What is your standard warranty for your RIS and PACS solution? 3.2.4.5 Please provide your processes for solving customer issues reported to your service center? 3.2.4.6 What system monitoring tools do you provide with your RIS and PACS solution? 3.2.4.7 Can you support any Virus protection software or are we required to use the virus protection software that you provide? 3.2.4.7.1 Does the system allow for the installation of virus and spyware software on the workstations and servers? If not, what is your strategy for guarding against computer viruses and spyware? 3.2.4.8 What is the strategy for applying Microsoft Operating System patches and updates? 3.2.4.9 The vendor shall supply a QC procedure and any required images and calibration equipment to assure that the test and calibration requirements in this Section are met. 3.2.4.10 How long will your RIS and PACS solution be supported by your service team? What was your last product that was sunset (product name, year) and how long did you support it after the product was discontinued from commercial availability? 3.2.4.11 How often is your software upgraded (version upgrade with new features and functionality)? Do you require an onsite presence when installing an upgrade? 3.2.4.12 How often is your software updated (bug-fix update, etc.)? Do you require an onsite presence when installing an update? 3.2.4.12.1 Do you charge an additional licensing fee for software updates, upgrades, or new releases? 3.2.4.12.2 Describe your formal problem escalation procedures. 26 V7 3.2.4.12.3 Are upgrades included within the cost of annual maintenance? 3.2.4.12.4 What is the required scheduled downtime for routine system maintenance, including frequency, duration, and time of day? 3.2.4.13 Please describe the location of the nearest replacement components to your proposed solution. 3.2.4.14 What is the maximum on-site response time for a hardware replacement? This should include the component being on-site for replacement. 3.2.4.15 Describe your capability for remote diagnostics and its scope. 3.2.4.16 Do you guarantee a % uptime? 3.2.4.16.1 Define “downtime” and how it is calculated to include when it begins and ends. 3.2.4.16.2 Please describe if there are any financial ramifications to your company should your guaranteed % uptime not be achieved on any given month. 3.2.5 Functional Systems Design - System Capabilities and Approach (25 points) The following criteria are of importance and relevance to the evaluation of this RFP. Such factors, not listed in any order of importance, may include but are not limited to: Items that are marked with a “√” are required. 3.2.5.1 System Requirements 3.2.5.1.1 √ The PACS MUST support commercially available Hierarchical Storage Management software? Which products are supported? 3.2.5.1.2 √ The system MUST ensure that there is not a single point of failure. How does your system architecture ensure that there is not a single point of failure? What is your solution for backup and disaster recovery? 3.2.5.1.3 √ The PACS MUST provide 12 months of short-term storage of images in a redundant configuration at each hospital. 3.2.5.1.4 √ The PACS archive MUST keep 2 copies of all images for 5 years, with minor’s images being kept for 7 years past the age of majority for minors, and mammography images for lifetime. Please recommend how you would ensure we have access to pediatric data for 23 years and mammography data for the life of the patient. Describe any Life Cycle Management capabilities. 3.2.5.1.5 √ The RIS/PACS system MUST be able to provide connectivity to non-DICOM compliant equipment. Identify the methodology for connecting all existing non-DICOM compliant equipment to the proposed PACS network. (See Attachment 1 for a list of modalities.) 3.2.5.1.6 √ The RIS/PACS system must be able to function with a Master Patient Index (MPI). 3.2.5.1.7 √ The RIS/PACS system MUST have the ability to synchronize time with the central time servers used on the network. 27 V7 3.2.5.1.8 √ The RIS/PACS system MUST be compatible with the following Computer Radiography (CR) equipment and digitizers: 3.2.5.1.9 √ Please describe how your PACS solution uses compression for image storage and transferring data. The system MUST support loss-less compression. Please provide us with the performance a remote user could expect when accessing a CT study of 50 images and a chest study (AP and Lateral views) 3.2.5.1.10 Specify minimum and preferred network connectivity requirements for all devices listed in the RFP, as well as provide these specifications for other required connections not listed in the table if applicable to the Proposer’s proposed solution. 3.2.5.1.11 Describe how you handle studies that require images shot on multiple modalities and shot at different times. Ex. Fluoroscopy with small bowel follow-through. Flouro performed first on flouro unit, but then as the contrast progresses through the body, plain film are shot to get the follow-through of the small bowel. The plain film could be shot hours later. 3.2.5.1.12 Specify which database engines you support. 3.2.5.1.13 Describe how your PACS product has been implemented with an open architecture? Does your architecture support thin client? 3.2.5.1.14 Please provide us with the monitor options that can be configured on a workstation that our radiologists can select from? Can your workstations be configured to support a dedicated RIS terminal as well as a monitor dedicated to advance post-processing of images in color? 3.2.5.1.15 How does your PACS product support us in being HIPAA compliant? Do you provide a GUI to inspect HIPAA Audit trails as well as provide reports? What is the mechanism for export to a centralized audit repository? 3.2.5.1.16 How does your PACS product support our healthcare system in being DICOM compliant? What SOP’s do you support? Please provide us with a copy of your DICOM Conformance Statement. 3.2.5.1.17 Please describe your capabilities to support Pathology, acquisition of digital Dental images, and Cardiology including ECG waveforms, and Holter Event monitor data. 3.2.5.1.18 Please identify your preferred 3-D vendor. What other vendors do you support and are there any added costs, benefits, features, etc. to using another vendor? 3.2.5.1.19 What IHE Integration profiles do you support? 3.2.5.1.19.1 3.2.5.1.19.1.1 3.2.5.1.19.1.2 3.2.5.1.19.1.3 3.2.5.1.19.1.4 3.2.5.1.19.1.5 3.2.5.1.19.1.6 28 V7 Describe how you implement the base set of IHE profiles described in the 2006 IHE Technical Framework? These include: Scheduled Workflow (SWF) Patient Information Reconciliation (PIR) Consistent Presentation of Images (CPI) Presentation of Grouped Procedures (PGP) Access to Radiology Information (ARI) Key Image Note (KIN) 3.2.5.1.19.1.7 Simple Image and Numeric Report (SINR) 3.2.5.1.19.1.8 Charge Posting (CHG) 3.2.5.1.19.1.9 Post-Processing Workflow (PWF) 3.2.5.1.19.1.10 Reporting Workflow (RWF) 3.2.5.1.19.1.11 Evidence Documents (ED) 3.2.5.1.19.1.12 Portable Data for Imaging Integration (PDI) 3.2.5.1.19.1.13 NM Image Integration (NMI) 3.2.5.1.19.2 Describe how you utilize the IHE IT Infrastructure Profiles for security and for crossenterprise access to patient information. If you do not utilize these profiles, describe how your system handles this, particularly in regards to how it ensures that ALL relevant information for only that patient will be found. Consistent Time must be supported. The ATNA profile should be available for implementation for all connections that can support it. 3.2.5.1.19.3 How are you implementing the new Cross-enterprise Document Sharing for Imaging (XDS-I) Profile? 3.2.5.1.19.4 How are you implementing the new Nuclear Medicine Image Profile NMI with Cardiac Option? 3.2.5.1.19.5 How are you implementing the new Mammography Image (MAMMO) Integration Profile? 3.2.5.1.19.6 How are you implementing the new Image Fusion (FUS) Integration Profile? 3.2.5.1.19.7 How are you implementing the new Import Reconciliation Workflow (IRWF) Profile? 3.2.5.1.17.8 How are you implementing the new Teaching File and Clinical Trial Export (TCE) profile? 3.2.5.1.20 Describe how PACS can continue to be used at the local level if network access to the central RIS/mammography/VR system is unavailable. 3.2.5.1.21 Please describe in detail the proposed configuration of servers, workstations, storage components and additional devices that would comprise the entire PACS system. 3.2.5.1.22 Describe the scalability of the system to accommodate additional procedure volume, users, transactions and/or additional local/remote sites. Do we need to contact you as the vendor to scale the system? 3.2.5.1.23 Please describe your mechanism for retrieval of images or data from long-term storage including length of time required to retrieve images. 3.2.5.1.24 Please describe your experience in supporting a SAN. What storage vendors have you used with your PACS product? 3.2.5.1.25 Describe safeguards in place to prevent the system from automatically deleting from the online storage of any exam without operator intervention. 3.2.5.1.26 Please describe how your CD importing system will provide the following: 3.2.5.1.26.1 Thumbnails for viewing before the exam is sent to PACS 3.2.5.1.26.2 The ability to modify DICOM header information 3.2.5.1.26.3 The ability to automatically alter header information based on DICOM MWL selection or a PACS query 3.2.5.1.26.4 The ability to help determine the problem when exams fail to import 3.2.5.1.27 Do you offer a software-only solution? 3.2.5.1.28 Please describe your experience in migrating data. 29 V7 3.2.5.1.29 From a system architecture perspective, what strengths do you offer above and beyond the other PACS vendors? 3.2.5.1.30 Describe any value added services, such as continuing education opportunities provided to technologists, on-line training opportunities, incentives on products and services used by the Radiology department, etc. that your organization will include in this proposal. 3.2.5.2 Security Requirements 3.2.5.2.1 √ The RIS/PACS/VR MUST support single sign-on. 3.2.5.2.2 √ RIS/PACS/VR MUST integrate with Microsoft Active Directory. 3.2.5.2.3 √ Security Groups MUST be used. 3.2.5.2.3.1 √ Security Groups MUST be customizable. 3.2.5.2.3.2 √ How granular are security groups? 3.2.5.2.3.3 Do changes to a group automatically affect all users in the group? 3.2.5.2.4 √ RIS/PACS/VR MUST provide the customer with the ability to define security classes that combine view only, update, and approval options. 3.2.5.2.5 √ The application MUST support row level security. Describe how row level security is implemented. 3.2.5.2.6 √ The application MUST allow for the re-issuing of logon ids. 3.2.5.2.6.1 Does this interfere with audit logs? 3.2.5.2.7 √ The application MUST support separation of duties between System Administrators and Security Administrators. 3.2.5.2.8 √ The application MUST support auditing and logs in order to provide HIPAA compliance. 3.2.5.2.8.1 Is Logon/logoff logged? 3.2.5.2.8.2 Are changes to security logged? 3.2.5.2.8.3 Are changes to data logged? 3.2.5.2.8.4 Is reading data logged? 3.2.5.2.8.5 Is export of exam or image information via CD or other external storage device logged, including whether the exam was anonymized (all PHI removed)? 3.2.5.2.9 √ The application MUST support customizable automatic inactivity logoff. 3.2.5.2.10 Does the application close if the user fails to enter a valid user id and password after a given number attempts? 3.2.5.2.11 Does installation require service accounts? If so, can the service accounts be renamed and can their password be changed? 3.2.5.2.12 Describe in detail how user access security can be configured to limit access to both specific Patient Exam data and system functionality. 3.2.5.2.13 Describe how users are granted access to the data. Must users have database logins. 30 V7 3.2.5.2.13.1 If so, how do these logins relate to the user’s AD User ID? 3.2.5.2.14 Are Schema changes required? 3.2.5.2.15 Describe how users are granted access to the application. 3.2.5.2.16 What flexibility is provided? 3.2.5.3 Interface Requirements 3.2.5.3.1 Describe what key features your RIS interfacing and integration offers to help our radiology department improve its service? Are there any other benefits concerning our support staff? 3.2.5.3.2 Has your system been integrated with speech recognition systems? If so, with which vendors have you interfaced/integrated? 3.2.5.3.3 Please describe how reports are accessed on PACS. Are they stored on the PACS system? 3.2.5.3.4 Please describe the criteria used to verify that the patient demographic and examination information sent from the modality is matched with data sent to PACS from the RIS? If data does not match, how is the PACS administrator notified to resolve these examinations? 3.2.5.3.5 Do you provide API for interfacing to an EMR? Please describe. 3.2.5.3.6 From an interfacing perspective, what strengths do you offer above and beyond the other PACS vendors? 3.2.5.4 Workflow Requirements 3.2.5.4.1 Describe what key features your system offers to help our radiology department improve its service once we install your system. Please include any “proof” statements from your current customer base that reflect their service improvements. 3.2.5.4.2 Please describe how your system can help ensure that an adequate reason for exam (ICD-9 code) will be required for an order to be processed. 3.2.5.4.3 Please describe the mechanisms available for the technologist to display and perform editing of patient data and examining images at the time the exam is performed. 3.2.5.4.4 Please describe the capabilities you offer to compare a new to an old case. 3.2.5.4.5 Can a radiologist or physician select from multiple on-line old exams for comparison. Please describe these capabilities available for radiologists as well as other physicians? 3.2.5.4.6 Please describe the system’s ability to automate the retrieval of historical cases. 3.2.5.4.7 Please describe your film printing capabilities. 31 V7 3.2.5.4.8 Please describe your enterprise work list capability and how it facilitates the various user groups (attending ICU or ED physicians, remote physicians, technologists, radiologist, and residents). 3.2.5.4.9 Please describe how billing flows for the separate hospitals, or any groups within hospitals, will be handled when the exam can appear on any worklist and be read by any Radiologist. 3.2.5.4.10 Please provide a list of the various fields that a worklist filter can be configured? Can these filters be configured by an individual user? Can they be sorted? 3.2.5.4.11 Please describe your capabilities to customize the image review process for specific physicians? Are these configuration options available to any user or do their preference settings need to be maintained by a PACS Administrator? 3.2.5.4.12 Please describe the radiology resident’s workflow with your system. 3.2.5.4.13 Please describe how our Operating Rooms would be configured with your system to support our Department of Surgery, Neurosurgery and Orthopedics physicians? 3.2.5.4.14 Please provide us with your various methods for importing and exporting images from PACS on CDs/DVDs to other Microsoft applications. 3.2.5.4.15 Please provide us with a list of your image manipulation tools available to the radiologist. Are there any differences in the functionality available to a radiologist when he is on site or at home? (i.e. on-call teleradiology) 3.2.5.4.16 Please describe the post-processing applications available with your product. Are these applications tied to a specific piece of hardware? We may want to offer some of these capabilities to our physician users. How can you support these users without a dedicated workstation? 3.2.5.4.17 Describe how you plan to support the orthopedic surgeon and their surgical template requirements. What templates does your software support? 3.2.5.4.18 Please provide a description of any radiologist efficiency tools or capabilities of the workstation that would improve our overall report turnaround time. This should include VR/dictation, Lung, Mammo and Colon CAD (Computer Aided Diagnosis), seamless decision support, and teaching file and clinical trail export. 3.2.5.4.19 From a workflow perspective, what strengths do you offer above and beyond the other PACS vendors? 3.2.5.4.20 What tools do you offer to facilitate communication between a radiologist and an ED physician? How does the ED physician communicate the preliminary read to the radiologist? 3.2.5.4.21 What tools do you offer for Critical Test Result Notification to facilitate communication between the radiologist and the clinician? 32 V7 3.2.5.4.22 Do the above three questions provide the ability to notify clinicians via customizable methods? Do they track sending and receipt times/users, automatic notification of radiologists within customizable time frames, and reporting for history and PI? 3.2.5.4.23 Please describe how outside exams can flow through the system, including reading worklists, reporting and billing, without having to store the exams permanently. This is to facilitate reading exams for other entities. 3.2.5.4.24 Please describe the tools available for enterprise wide workflow monitoring and system administration and what forms of error notification are included in the system. Is this a dashboard based monitoring system? 3.2.5.4.25 Please describe any abilities for the following 3D/Advanced Visualization/Quantitative and Statistical Analysis features. Include a description of any other features you provide. 3.2.5.4.25.1 3.2.5.4.25.1.1 3.2.5.4.25.1.2 3.2.5.4.25.1.3 3.2.5.4.25.2 3.2.5.4.25.2.1 3.2.5.4.25.2.2 3.2.5.4.25.2.3 3.2.5.4.25.2.4 3.2.5.4.25.2.5 3.2.5.4.25.2.6 3.2.5.4.25.3 3.2.5.4.25.3.1 3.2.5.4.25.3.2 3.2.5.4.25.4 3.2.5.4.25.4.1 3.2.5.4.25.5 3.2.5.4.25.5.1 3.2.5.4.25.5.2 3.2.5.4.25.5.3 3.2.5.4.25.5.4 3.2.5.4.25.5.5 3.2.5.4.25.5.6 Regions of Interest and Volumes of Interest VOI circular, rectangular, freehand, intensity (level set) VOI propagation Statistics generator Algorithms Brain surface extraction Volume rendering Multiplanar reconstruction Registration Segmentation Edge detection Utilities Math operations: add, subtract, divide, multiply, log Maximum intensity projections Images Color scales (NIH) Special Software Cerebral perfusion calculation Cerebral diffusion: ADC maps T2 and T1 calculation MRS calculation fMRI maps Statistical parametrical imaging 3.2.5.5 Clinical/Web Requirements 3.2.5.5.1 Does your web solution offer the same feature/functionality available to your diagnostic workstation user? Please describe any differences? 3.2.5.5.2 Can remote users use your advanced post-processing capabilities? Please describe the PC requirements required to support these users? 3.2.5.5.3 Can your remote physicians access the entire PACS database of images? Does your web solution require that images are stored on the web server disk to offer optimal performance for your web users? 33 V7 3.2.5.5.4 From a clinical image distribution perspective, what strengths do you offer above and beyond the other PACS vendors? 3.2.5.5.5 Are enterprise work lists and teaching folders available to your remote users? 3.2.5.5.6 What functionality can be supported on handheld devices? Describe how this can be used in the clinical environment. 3.2.5.6 Migration Requirements 3.2.5.6.1 Please describe the migration of existing data objects, including you migration partners, if you do not handle the migration in-house. The vendor will still be expected to oversee the migration process. 3.2.5.6.1.1 Pixel (image) data. 3.2.5.6.1.2 Reports. 3.2.5.6.1.3 Gray Scale Soft Copy Presentation States. 3.2.5.6.1.4 Key Image Notes 3.2.5.6.1.5 Database creation 3.2.5.6.2 Please respond to the following in regard to a potential future migration of data from your system to another vendor’s system. 3.2.5.6.2.1 Describe how the radiology reports are stored in your PACS, including the nature (format) of the object and where it is physically stored. 3.2.5.6.2.2 Please provide a response to each of the following regarding grayscale softcopy presentation state (GSPS). 3.2.5.6.2.2.1 Please describe the GSPS object (format) created by your PACS and where it is physically stored. 3.2.5.6.2.2.2 Is this object exported as a DICOM GSPS object when queried by a DICOM-conformant system? 3.2.5.6.2.2.3 What (if any) technical assistance will be required of your professional services group, when the time comes to migrate this GSPS object to the next PACS? 3.2.5.6.2.2.4 Estimate the professional services fee you would charge to migrate to the next PACS (as DICOM GSPS objects) the GSPS objects that will be associated with all of the radiology images that will be committed to your PACS in the next five years. 3.2.5.6.2.3 Please provide a response to each of the following regarding key image notes (KINs). 3.2.5.6.2.3.1 Please describe the KIN object (format) created by your PACS and where it is physically stored. 3.2.5.6.2.3.2 Is this object exported as a DICOM KIN object when queried by a DICOM-conformant system? 3.2.5.6.2.3.3 What (if any) technical assistance will be required of your professional services group, when the time comes to migrate this KIN object to the next PACS? 3.2.5.6.2.3.4 Estimate the professional services fee you would charge to migrate to the next PACS (as DICOM KIN objects) the KIN objects that will be associated with all of the radiology images that will be committed to your PACS in the next five years. 3.2.5.6.2.4 Please respond to each of the following regarding scanned documents. 3.2.5.6.2.4.1 Please describe the scanned document object (format) created by your PACS and where it is physically stored. 34 V7 3.2.5.6.2.4.2 Is this object exported as a DICOM object when queried by a DICOM-conformant system? 3.2.5.6.2.4.3 What (if any) technical assistance will be required of your professional services group when the time comes to migrate this scanned document object to the next PACS? 3.2.5.6.2.4.4 Estimate the professional services fee you would charge to migrate to the next PACS (as DICOM objects) the scanned document objects that will be associated with all of the radiology images that will be committed to your PACS in the next five years. 3.2.5.6.2.5 Please provide a response to each of the following questions regarding any other proprietary data objects stored in the PACS Directory database, or proprietary meta data objects stored either in Private Tags in the DICOM header or stored in any Private Tag with proprietary encoding. 3.2.5.6.2.5.1 Please list and describe all of the major data objects created by your PACS that would be required by another PACS to properly display the image or post-process the image that are not stored and/or exported as DICOM-conformant objects. For example LUT values, image acquisition parameters, etc. Please include in your description where each of these data objects are physically stored in the PACS. 3.2.5.6.2.5.2 Please list and describe all of the major data objects created by your PACS that would qualify as work products created by the radiologist or technologist during their work with the images that are not stored and/or exported as DICOM-conformant objects. For example text notes, preliminary report, etc. Please include in your description where each of these data objects are physically stored in the PACS. 3.2.5.6.2.5.3 Please list and describe all of the major data objects like those in 1 and 2 above that are stored in the DICOM header in Private Tags or using proprietary encoding. 3.2.5.6.2.5.4 What (if any) technical assistance will be required of your professional services group when the time comes to migrate any of the major data objects that you have listed in your response to 1, 2 and 3 above to the next PACS? 3.2.5.6.2.5.5 Estimate the professional services fee you would charge to migrate to the next PACS (as DICOM objects or as Public Tags in the DICOM header) any of the data objects that you have listed in your response to 1, 2 and 3 above. 35 V7 3.2.5.7 Functional Requirements The functional requirement checklist section provides a list of general and/or specific features or functions required by XXX. Each function has five columns in which to respond. The criteria for each column is explained below: Met Fully - The function is available and completely operational. Custom-Developed - The function will be custom-developed during installation. Under Development - The function is planned for a future release. Not Available - The function is not available in the current software, future software releases, and will not be custom-developed. For those features marked Custom-Developed or Under Development, provide a time frame for development or an availability date for the schedule release of the function. 1.0 Patient Registration 1.1 1.2 1.3 Register inpatients and outpatients on the radiology system Provide full integration to HIS Maintain patient profile information to include: 1.3.1 Patient name 1.3.2 Patient identification number 36 V7 1.3.3 1.3.4 1.3.5 1.3.6 1.3.7 1.3.8 1.3.9 1.3.10 1.3.11 1.3.12 Patient medical record number Patient social security number Patient film number Patient type (i.e., inpatient, outpatient, emergency room) Patient diagnosis Patient date of birth Patient sex Patient admission height Patient admission weight Patient visit/admit date and time 1.3.13 1.3.14 1.3.15 1.3.16 Patient allergies Admitting physician Attending physician Patient pregnant Not Available Under Developmen t Custom Developed Functional Requirements/Features Met Fully Any comments for each requirement should be entered directly beneath the requirement. 1.4 1.5 1.3.17 Date of last menstrual period Automatically notify the appropriate area of the need to transport patients at the appointed times to the Radiology Department View location of patient from any workstation 1.6 1.7 1.8 1.9 Update master files on-line based on user security access Create and print user-defined notices Generate labels based on user-defined format Does the system provide an ability for scanning paper documents to be maintained as part of the historical record? 1.10 Electronic signature pads to track patient, guardian and employee signatures on critical documents such as consent forms, authorizations 2.0 Order Entry 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 37 V7 Interface with the hospital's order entry system to accept orders for radiology procedures Enter orders online in the radiology system Allow for inquiry by: 2.3.1 Patient name 2.3.2 Medical record number 2.3.3 Social security number 2.3.4 Patient account number Record the identity of order entry person for each order entry transaction Change orders previously entered without having to cancel and reorder Allow for the backdating of exam orders with a user-specified time for recovery after system downtime Generate charges at order entry or results reporting Create a user-defined order requisition Cancel order with reason Generate a user-defined notice of cancellation Automatically print Pull List Generate user-defined flash cards for film identification Automatically print patient prep instructions upon order entry Support work lists (i.e., order automatically appears on technologists work list with ability to notate when order is completed) Access to work lists from any workstation based on user security access Automatically update work lists based on updated scheduled or cancellations CPT coding Display the current status of all patients and ordered examinations Not Available Under Developmen t Custom Developed Met Fully Functional Requirements/Features 3.0 Scheduling 3.1 Multi-resource scheduling, which provides the following: 3.1.1 Room, procedures, physicians, equipment 3.1.2 Time schedule of each room for daily scheduling, holidays, weekends, and downtime 3.1.3 Days of the week that particular procedures can be performed 3.1.4 Time periods within the day that particular procedures can be performed 3.1.5 Select alternative rooms/times during scheduling without exiting data entry 3.1.6 Predetermined procedure duration as defined by the department 3.1.7 Duplicate exams Online display of the schedule is available (i.e. day, week, room, equipment, etc.) Automatically finds the next available appointment based on criteria entered Ability to override the automatic selection of the first available appointment and manually assign an appointment Display alerts or questions to ask the patient when scheduling an appointment Maintains patient preparation instructions and displays these patient preparation instructions when the exam is scheduled Ability to print, fax or e-mail prep instructions or appointment notices Accepts over-booking Ability to change the schedule without having to re-enter all data Records name or initials of the person entering or revising the appointment Scheduling information is displayed graphically Ability to confirm schedules First available date, time and room for exam is automatically selected by the system Multiple exams can be automatically scheduled to be performed sequentially and without conflict Block times for a physician, room, piece of equipment, etc. Change the time allotted for a procedure during the scheduling process Allows advance scheduling up to 15 months in advance Patients can be placed on a wait list if a day’s schedule is full Schedule report by resource and/or patient Daily report of exams scheduled but not performed 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 38 V7 Not Available Under Developmen t Custom Developed Met Fully Functional Requirements/Features 3.21 No-show report and letter 3.22 Interface with third-party scheduling system 4.0 Patient Tracking 4.1 Please indicate data elements captured by the system: 4.1.1 Date and time order was placed 4.1.2 Date and time patient arrived in department 4.1.3 Initials of transporter 4.1.4 Exam start date and time 4.1.5 Exam completion date and time 4.1.6 Technologist identification (must capture at least 3) 4.1.7 Actual procedure(s) performed 4.1.8 Actual supplies used (i.e. contrast, catheters, wires etc,) 4.1.9 Number of films taken 4.1.10 Size of films used 4.1.11 Number of repeats with reason 4.1.12 Exam room used 4.2 Capture all tracking data using barcode technology/ touchscreen/handheld 4.3 Identify all personnel associated with a procedure. 4.4 Ability to provide detail as to why procedures were added or changed. 4.5 Modify, add or cancel procedures capturing reasons via barcode/keyboard entry and automatically update order history on the HIS on a real-time basis for patient billing purposes 4.6 View/display all patients tracked into the department who have remained at a tracking step too long, via a tracking monitor 4.7 Tracking monitor that will refresh automatically at user defined time periods 4.8 Transmit any procedure status on a real- time basis to HIS 4.9 Provide a view of an individual patient itinerary within Radiology with up to date status of each exam ordered 4.10 Track components of a multiple step procedure such as an IVP or nuclear scan (i.e., injection, 1st x-ray/scan, 2nd x-ray/scan, etc.) 4.11 Provide statistical reports on: 4.11.1 Total procedures by technologist 4.11.2 Total procedures by exam room 4.11.3 Total repeat procedures by exam 4.11.4 Total repeat procedures by reason 4.12 Send patient exam status updates from RIS to HIS 4.13 Capture radiographic technique such as, MA, MAS, time, KV, distance) for any examination 39 V7 Not Available Under Developmen t Custom Developed Met Fully Functional Requirements/Features 4.14 Track reactions including what caused reaction, what medications were given to counteract reaction, volumes, intervening physician, and severity 4.15 A method of monitoring and reconciling the exams ordered with the exams actually performed 4.16 User must be able to change the content and layout of the tracking monitor. 4.17 Associate and track supplies associated with each procedure and automatically decrement inventory at any tracking step 5.0 Film Management 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 Provide table look-up of all possible film loan locations Loan films to any specified area or borrower Provide for film loans utilizing either bar code or terminal entry Generate bar codes for: 5.4.1 Authorized borrowers 5.4.2 Locations 5.4.3 Master folders 5.4.4 Sub-folders Provide for identification of borrower by identification number or partial name Immediate on-line access to determine location on file folders, within and outside of the department Ability to perform mass entry of films returned or removed from the library Maintain a film move history/audit trail of previous locations Capture user ID's for all transactions (moving jacket, updating, creating jackets/folders, and so forth) Automatically send user-defined reminder letters for film returns Ability to merge duplicate folders Ability to specify return dates based on individual borrower with automatic defaults Ability to access/display folders by patient name or number Track films and manage a file room to include 5.14.1 Automatic generation of pull notices 5.14.2 Pull list for files to be moved to off-site storage 5.14.3 Pull list for archive candidates 5.14.4 Support multiple master jackets 5.14.5 Support sub-specialty jackets in each master jacket 5.14.6 Overdue film report 5.14.7 Bar code labels on demand 5.15 Track films from other hospitals and institutions 40 V7 Not Available Under Developmen t Custom Developed Met Fully Functional Requirements/Features 5.16 5.17 5.18 5.19 5.20 6.0 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 41 V7 Reserve films for a specific physician if the films are already checkedout Automatic creation of subfolders and master jacket based on user definable criteria Provide a PACS solution Display an on-line image indicator within your film management system Support a web-based solution for image distribution Results Reporting Full word processing capabilities Includes various dictation methods (i.e., result reporting through selection of drop down menus, voice recognition, or conventional result reporting through phone dictation Ability for radiologists to maintain their own passwords Each radiologist has sophisticated, intuitive work list filtering, sorting, and column control tools, giving each radiologist the ability to tailor the work lists as desired Enable radiologist to enter results for transcription and electronic distribution by bar code and manual entry Enable radiologist to directly enter normal results for transcription Report libraries for physician-specific reports and also for departmental use Use of coded templates that can be modified as required Warnings during result entry such as previous reactions to contrast Allow the radiologist to have the ability to access each work-list and select one or more specific reports for verification without having to go sequentially through an entire queue Automatic queuing of reports typed by transcriptionist for radiologist review Method to notify radiologists and administration of the number of reports needing to be signed Enable the radiologist the ability to access their transcribed reports from remote computer stations for review and verification Resident readings with radiologist review and approval Enable the attending radiologist to send a corrected report back to a resident so that the resident can review it for teaching purposes Online display of preliminary and final report Allow supervisors with the appropriate security to query the system for a listing of reports in radiologist’s queues that have not been finalized Support multiple attending radiologists on a single report Support multiple addresses for physicians based on a single physician number to aid sending of patient results to the appropriate location. Post a note from web signoff Create addendum without re-registering patient Not Available Under Developmen t Custom Developed Met Fully Functional Requirements/Features 6.22 Automatic and on-demand print of reports with multiple formats and multiple copies 6.23 Automatic printing of report at defined locations upon electronic verification by radiologist 6.24 Cases flagged by date for patient follow-up or ear-marked for teaching or other files 6.25 Automatically e-mail/page the referring physicians or patient’s location within the facility alerting them of unexpected finding. 6.26 Auto-fax, and auto-e-mail, to referring physicians/clinics 6.27 Support for the Peer Review process 7.0 Transcription 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 42 V7 Integrate with an off-the-shelf word processor, such as Microsoft Word Intuitive graphical front end to all functionality required for radiologists to create, review, and verify reports electronically Free text ability and coded phrase capabilities that expand to full text Text editor contains spell checking functionality Integration of medical terminology dictionary Associate multiple requisitions with one report Formatting of transcribed reports to be varied according to facility Function to allow transcriptionist to transcribe report without reentering patient and physician demographic information Maintain complete online audit trails clearly indicating who has accessed the report and the date and time the report was edited, reviewed, approved and printed to include both transcriptionist and radiologist Audit trail of amended reports, including second transcription, second radiologist, and second date/time approved Collect the following data for reports: 7.11.1 Transcriptionist ID 7.11.2 Exam performed 7.11.3 ACR codes 7.11.4 Detailed findings 7.11.5 Dictating radiologist 7.11.6 Dictating resident 7.11.7 Time dictated 7.11.8 Time transcribed 7.11.9 Time verified Track report editing, such as author, editor date, editor time Batch printing and on-demand requests for reprinting Print batch reports according to various sorts, to include: 7.14.1 Referring physician Not Available Under Developmen t Custom Developed Met Fully Functional Requirements/Features 7.15 7.16 7.17 7.18 7.19 7.14.2 Department or nursing unit 7.14.3 Other locations, such as medical records Display or report on status of report, for example, transcribed, unverified, final, etc. Retain and store transcribed reports on-line for a minimum of 60 months Transcription productivity reports, including: 7.17.1 Corrections report by day/week/month 7.17.2 Transcription lines by transcriptionist - daily/weekly/monthly Support remote transcription The system provides a means for electronic communication between the various caregivers. 8.0 Mammography 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 9.0 9.1 Mammography module is fully integrated with RIS Capture mammography medical history Mammography suite provides embedded image call-up, document management, clinical alerts Pathology capture and reporting manually or through an optional interface Show graphical representation of pathology site Mammography module is MQSA compliant Mammography module supports BIRADS Atlas ACR statistical reports Standard quality assurance audit logs (e.g., referral, detection, interpretation, and recommendation profiles) Allow patient report customization based on patient demographics, medical history, and risk factors Letter stream management including user-defined follow-up and notification letters Print address labels for mammography letters Identify false/positive results in a yearly, monthly and user-defined period Audit trail of patient follow-up actions Management Reporting Activity for patient including: 9.1.1 Patient check-in time 9.1.2 Exam start and stop time 9.1.3 Procedure 9.1.4 9.1.5 9.1.6 43 V7 Room Equipment used Non-procedural charges Not Available Under Developmen t Custom Developed Met Fully Functional Requirements/Features 9.1.7 Department/section 9.1.8 Dictated reports 9.1.9 Transcribed reports 9.1.10 Final reports status 9.1.11 Radiologist 9.1.12 Technologist 9.2 Generate productivity reports for department and/or institution by: 9.2.1 Physician 9.2.2 Technologist 9.2.3 Transcriptionist 9.2.4 Shift 9.2.5 Transporter 9.3 Order activity by referring physician 9.4 Departmental/section statistics for: 9.4.1 Visits by patient by location 9.4.2 Procedures by type and location 9.4.3 Totals by patient type for completed orders 9.4.4 Totals by patient type for canceled orders 9.4.5 Procedures by exam, room, radiologist, technologist, and sub-department 9.4.6 Room/equipment utilization by shift 9.5 Produce procedure reports including: 9.5.1 Average time of procedure per technologist 9.5.2 Average time of procedure in department 9.5.3 Average duration of procedure by technologist, radiologist, and examination type 9.5.4 Number of procedures by technologist, room/equipment, department/sub-department or section 9.6 Turnaround time statistics for each patient and procedure including: 9.6.1 From order to started 9.6.2 From started to arrived on PACS 9.6.3 From arrived to verified 9.6.4 From verified to dictated 9.6.5 From dictated to transcribed 9.6.6 From transcribed to sign off 9.7 Repeat analysis studies 9.8 No-show reports 9.9 Cancellations with reasons 9.10 Incomplete examinations 44 V7 Not Available Under Developmen t Custom Developed Met Fully Functional Requirements/Features 9.12 Delinquent result reports 9.13 Wait time analysis and average patient waiting times by department/section, technologist, and shift and/or time of day 9.14 Exams completed, but not dictated; dictated-but not transcribed; transcribed-but not signed out 9.15 Exams charged but no dictation pending or verified 9.16 Exams dictated or verified but not charged 9.17 Incomplete exams – no dictation 9.18 Selected reports to run automatically on a daily, weekly, or monthly basis within the system operations parameters 9.19 Extract any type of data elements resident within the RIS or PACS database 9.20 Display and calculate current performance of selected quality indicators 9.21 Provide online ad hoc report writer. Please describe. 9.22 Allow utilization of external report software such as MS Access or Crystal Reports. 10.0 Inventory and Equipment Maintenance 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 11.0 45 V7 Inventory control functions Link standard supplies to procedures and track automatically Alert staff when inventories reach reorder points User-defined supply codes Update inventory supply levels when supplies are received Capture supply code and quantity, and also generate a charge through the patient tracking function Interface with the HIS to transmit supply usage/billing data Equipment maintenance function Maintain a resource availability schedule, provide notification of due dates for equipment maintenance and automatically block out time for maintenance in scheduling Manage and track service requests Manage and maintain equipment contracts and purchase agreements Report on equipment failure with reasons over user-defined timeframes by room? Provide a preventive maintenance schedule and history on existing equipment Show cost of maintenance per room or equipment Report on service costs by room Report on service costs by service type Quality Assurance Not Available Under Developmen t Custom Developed Met Fully Functional Requirements/Features 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 12.0 RIS must automatically update radiology director or department head of incidents Identify incidents within department through on-demand report Provide film repeat analysis report Provide average time of procedure in the department report Document reactions to contrast material administered including material used, amount used, symptoms exhibited Support teaching file with ACR codes Provide a waiting time analysis by patient type report Provide a result report turn-around time analysis report PACS Integration 12.1 RIS must have an interface to a PACS (Picture Archiving and Communication System) 12.2 Provide a brokerless, integrated PACS solution. Please describe. 12.3 Demographic data must be available from the RIS to PACS 12.4 Retrieve and route digital images for viewing with the transcribed report via RIS or HIS 12.5 Support study/Image routing to multiple workstations 12.6 Support exam order entry transfer from the RIS/HIS to the PACS to support prefetching 12.7 RIS must contain references to individual images in the imaging archive 12.8 Your solution must provide web based image distribution. Please describe. 12.9 Solution must support Modality Worklist 12.10 PACS solution must be DICOM compliant 12.11 The RIS/PACS solution MUST support IHE Integration profiles 12.12 Does solution support a RIS/PACS interface with a lifetime clinical record to identify available images? 13.0 Miscellaneous 13.1 Ability to place policy and procedure manuals and other reference materials on help menus. 13.2 Ability to link to websites and patient education videos 13.3 Clinical Alerts to help reduce medical errors and facilitate optimal patient care. Prevents users from proceeding with certain activities depending upon the situation. 13.4 Method to create paper forms using an electronic document, enabling users to enter all critical information through the use of radio buttons, drop down menu entries, checkboxes or as free-text fields. 13.5 Provides an internal electronic mail feature to send messages to individuals or groups having access to the RIS. Information is stored, making it available for reports and clinical alerts. 46 V7 Not Available Under Developmen t Custom Developed Met Fully Functional Requirements/Features PART IV. PERFORMANCE STANDARDS 4.1 - Performance Requirements • RIS/PACS software shall be delivered that supports the functional and technical requirements specified in this RFP. • There shall be no system corruption of data due to the processing of information by the RIS/PACS SYSTEM software. Note: User data input errors are not considered system corruption of data. • The Contractor shall install and configure all software to operate within the policies and guidelines set forth by XXX’s applications and network environment. 4.2 - Performance Measurement/Evaluation Overall system compliance with specified functional and technical specifications will be verified through acceptance testing of the RIS/PACS software and hardware. The timeframe for acceptance shall be 30 days from completion of installation and configuration of the software by the contractor. 47 V7 Appendix A Price Schedule Please provide prices for the categories below in the provided spreadsheet (Attachment “Price Schedule.xls”). Please add any additional items as you find necessary. Where a price can be broken down by hospital please do so. Where an item might be an enterprise category then please specify. E.g. Shared SAN Archives, RIS Shared Servers. 1 RIS, MAMMOGRAPHY, VOICE RECOGNITION (VR), TRANSCRIPTION LICENSES List your sites. 2 PACS LICENSES List your sites. 3 RIS HARDWARE (Servers, SANs, Workstations, Monitors, Gateways, any Hardware/Software needed to provide the required configuration, Shipping, and any other hardware related cots) List your sites. 4 PACS HARDWARE (Servers, SANs, Workstations, Monitors, CD/DVD Copier, any Hardware/Software needed to provide the required configuration, Shipping, and any other hardware related cots) List your sites. 5 RIS IMPLEMENTATION/INSTALLATION (Please include expected travel costs) Enterprise List your sites. 6 PACS IMPLEMENTATION/INSTALLATION (Please include expected travel costs) List your sites. 7 RIS TRAINING (Should include proposed number of days and number of staff to be trained; Include whether training is onsite or offsite and all expected related costs) List your sites. 8 48 V7 PACS TRAINING (Should include proposed number of days and number of staff to be trained; Include whether training is onsite or offsite and all expected related costs) List your sites. 9 RIS ANNUAL SUPPORT/MAINTENANCE (Include whether onsite or offsite and all expected related costs) List your sites. 10 PACS ANNUAL SUPPORT/MAINTENANCE List your sites. 11 OPERATIONS/TRAINING MANUALS List your sites. 12 INTERFACES into and out of the RIS/PACS/VR including HL7 interfaces (detailed in Appendix D). List your sites. 13 ANCILLARY APPLICATIONS List your sites. 14 DATA MIGRATION List existing stores, exam counts and storage. Exam counts are effective (specify date) and will increase before migration date. Per study migration cost for the remaining facilities for any DICOM studies collected before go-live on the RIS/PACS/VR system. 49 V7 Appendix B Network Maps as of 10/15/2007 List your network diagrams here. 50 V7 Appendix C Equipment Requirements Hardware Requirements Detailed requirements concerning actual equipment required by the XXX hospitals will be provided to ensure an equivalent configuration is supplied by each Proposer. The equipment specifications are detailed first and then a list of the equipment needed at the enterprise level and the equipment needed per facility follows. Proposers should be encouraged to deviate from the required equipment listed if they believe an alternate configuration would best address the XXX hospital’s requirements, or might be a better solution from a cost standpoint. These alternative configurations can be provided as options in the Proposer’s response or can be mutually derived during contract negotiations. All medical grade monitors must link to the same central monitoring server. We do not want to maintain multiple monitoring servers for the different versions of medical grade monitors. Please indicate a per unit cost for each type of workstations needed, as the final number may fluctuate somewhat. All equipment pricing MUST include: 1. Shipping (FOB destination) 2. Installation services 3. All cables and power necessary for installation Radiology Reading Workstation Intel Quad Core Xeon, 2.66 GHz, 2x4MB cache, 1333 MHz Front Side Bus 4GB RAM 300GB 7200rmp SATA II HDD 100/1000 Ethernet NIC Floppy Disk Drive 49 X CD/DVD ROM Default Video Card (not part of medical grade display, which has own video card) No Monitor Included (monitors listed separately) 5 Year Onsite Support Verification Workstation Intel Core 2 Duo, 3.0 GHz, 4MB cache, 1333 MHz Front Side Bus 4GB RAM 300GB 7200rmp SATA II HDD 100/1000 Ethernet NIC Floppy Disk Drive 49 X CD/DVD ROM NVidia Quadro4 200 MVS 64MB AGP No Monitor Included (monitors listed separately) 5 Year Onsite Support 51 V7 Image Export Workstation (Only workstation with CD/DVD burner) 8. PC Requirements • Intel Core 2 Duo, 3.0 GHz, 4MB cache, 1333 MHz Front Side Bus • 2GB RAM • 7200rmp SATA II HDD • 100/1000 Ethernet NIC • Floppy Disk Drive • CD/DVD Burner • 256MB Dual DVI Discrete Video • 2.0 megapixel 20” flat panel color display • 5 Year Onsite Support 9. One (1) digital hard copy DICOM CD burner distribution solution • Use the IHE-PDI profile to create up to 100 CD’s per day with CD-R and DVD-R recording as well as a mono-color or full color thermal print technology. Combination CD/DVD writer with (3) 100 disc input bins to record both CD-R and DVD-R interchangeably. Integrating the Healthcare Enterprise/Portable Data for Imaging (PDI) • Ability to act as an onsite archive with full reporting and auditing capabilities. • Ability to surface label each CD-R/DVD-R with patient and study demographics, facility logo and unique audit trail identifier • Ability to easily import studies/images from CDs or DVDs received from outside institutions, including full reporting and auditing capabilities. • Provide a simple interface to allow users to import selected patients and/or studies while ensuring the correct patient and study information is applied to the imported exam. Thumbnails for the images should be available for review before the studies/series are imported. • Ability to query modality work lists or PACS for patient selection, taking advantage of the IHE-IRWF integration profile to streamline the import process in finding patient and study information. Ability to manually correct customer selectable fields in the DICOM header. Integrating the Healthcare Enterprise/Import Reconciliation Workflow (IRWF) • Ability to troubleshoot exams that do not import properly so that issues with the DICOM header or file structure can be identified. • 24 hour X 7 days a week X 365 days a year Support 52 V7 Dual 5.0 MegaPixel Medical Grade GrayScale Displays (Dual 5MP GS Displays) • • • • • • • • • • • • User configurable auto-calibration software that will link to a central server application for centralized monitoring, problem notification and auditing/reporting. This will work in conjunction with integrated hardware sensors to provide standard, scheduled, auditable calibration checks. Front side sensors are preferred where available. Maximum luminance of 800-1000 cd/m2 Maintain a 500 cd/m2 DICOM calibrated luminance. The contrast ratio should be between 700 and 1000 The display LUT should be 12 bit utilizing DVI output. Uniform luminance and ambient light compensation with a 170 degree viewing angle. The displays should be able to be installed on workstations using either Intel or AMD architectures. Diagnostic displays should be comprised of a matched pair of medical grade monitors. Vendor provided video card (PCIe x16 dual DVI preferred) to drive them. The displays should be factory calibrated as a pair with the video card. Utilize the DICOM Gray Scale Display Function standard to ensure consistent representation of images. Five (5) year standard warranty Single 6.0 MegaPixel Medical Grade Color Display (Single 6MP Color Display) • • • • • • • • • • • 53 V7 User configurable auto-calibration software that will link to a central server application for centralized monitoring, problem notification and auditing/reporting. This will work in conjunction with integrated hardware sensors to provide standard, scheduled, auditable calibration checks. Front side sensors are preferred where available. Maximum luminance of 500-800 cd/m2 Maintain a 500 cd/m2 DICOM calibrated luminance. The contrast ratio should be between 400 and 500 The display LUT should be 30 bit color utilizing dual DVI output. Uniform luminance and ambient light compensation with a 170 degree viewing angle. The displays should be able to be installed on workstations using either Intel or AMD architectures. Diagnostic displays should have dual DVI input so each 3MP part of the screen can be driven independently. Vendor provided video card (PCIe x16 dual DVI preferred) to drive them. The displays should be factory calibrated with the video card. Five (5) year standard warranty Dual 3.0 MegaPixel Medical Grade GrayScale Displays (Dual 3MP GS Displays) • • • • • • • • • • • • User configurable auto-calibration software that will link to a central server application for centralized monitoring, problem notification and auditing/reporting. This will work in conjunction with integrated hardware sensors to provide standard, scheduled, auditable calibration checks. Front side sensors are preferred where available. Maximum luminance of 800-1000 cd/m2 Maintain a 500 cd/m2 DICOM calibrated luminance. The contrast ratio should be between 700 and 1000 The display LUT should be 12 bit utilizing DVI output. Uniform luminance and ambient light compensation with a 170 degree viewing angle. The displays should be able to be installed on workstations using either Intel or AMD architectures. Diagnostic displays should be comprised of a matched pair of medical grade monitors. Vendor provided video card (PCIe x16 dual DVI preferred) to drive them. The displays should be factory calibrated as a pair with the video card. Utilize the DICOM Gray Scale Display Function standard to ensure consistent representation of images. Five (5) year standard warranty Dual 3.0 MegaPixel Medical Grade Color Displays (Dual 3MP Color Displays) • • • • • • • • • • • 54 V7 User configurable auto-calibration software that will link to a central server application for centralized monitoring, problem notification and auditing/reporting. This will work in conjunction with integrated hardware sensors to provide standard, scheduled, auditable calibration checks. Front side sensors are preferred where available. Maximum luminance of 400-800 cd/m2 Maintain a 500 cd/m2 DICOM calibrated luminance. The contrast ratio should be between 400 and 500 The display LUT should be 30 bit color utilizing DVI output. Uniform luminance and ambient light compensation with a 170 degree viewing angle. The displays should be able to be installed on workstations using either Intel or AMD architectures. Diagnostic displays should be comprised of a matched pair of medical grade monitors. Vendor provided video card (PCIe x16 dual DVI preferred) to drive them. The displays should be factory calibrated as a pair with the video card. Five (5) year standard warranty Dual 2.0 MegaPixel Medical Grade GrayScale Displays (Dual 2MP GS Displays) • • • • • • • • • • • User configurable auto-calibration software that will link to a central server application for centralized monitoring, problem notification and auditing/reporting. This will work in conjunction with integrated hardware sensors to provide standard, scheduled, auditable calibration checks. Front side sensors are preferred where available. Maximum luminance of 250 cd/m2 Maintain a 180 cd/m2 DICOM calibrated luminance. The contrast ratio should be between 600 and 800 The display LUT should be 30 bit color utilizing DVI output. The displays should be able to be installed on workstations using either Intel or AMD architectures. Diagnostic displays should be comprised of a matched pair of medical grade monitors. Vendor provided video card (PCIe x16 dual DVI preferred) to drive them. The displays should be factory calibrated as a pair with the video card. Utilize the DICOM Gray Scale Display Function standard to ensure consistent representation of images. Five (5) year standard warranty Dual 2.0 MegaPixel Standard Color Displays (Dual 2MP Color Displays) • • • The displays should be able to be installed on workstations using either Intel or AMD architectures. Dual DVI video card (PCIe x16 dual DVI preferred) to drive them. The displays should be factory calibrated as a pair with the video card. Single 2.0 MegaPixel Standard Color Displays (Single 2MP Color Display) • The displays should be able to be installed on workstations using either Intel or AMD architectures. ENTERPRISE 1. All PACS hardware necessary for a redundant PACS configuration at each hospital with 12 months of short-term PACS Image Storage. 2. Long-Term PACS Image Storage SAN in a failover/replicated/load balancing configuration that will provide 5 years of storage, 23 years of storage for minors, and life-time storage for mammography images. a. A SAN will be at a production datacenter and a backup/failover datacenter. 3. All RIS Hardware necessary to provide a failover/replicated/load balancing configuration a. Include VR Hardware and any other required hardware to provide your RIS solution such as radiologist portal servers, fax servers, print servers, etc in a failover, backup, or redundant configuration. b. A RIS Server configuration will be located at a production datacenter and a backup/failover datacenter. 4. HIS to RIS patient demographic interfaces for all CR and FD equipment included in the configuration as well as existing modalities that are DICOM modality worklist compliant. Must be 55 V7 compatible with CR and other radiology equipment being used by the hospitals (See Attachment YYY). 5. Centralized calibration tracking and quality assurance reporting of all Medical Grade monitors. 6. All necessary hardware required for modalities that are not modality performed procedure step (MPPS) compliant (See Attachment YYY). Site I 18 Radiology Reading Workstations 14 – Dual 3MP GS Displays 4 – Single 6MP Color Display 18 – Single 2MP Color Displays 29 Verification Workstations 11 – Dual 2MP GS Displays 18 – Single 2MP Color Displays 2 Image Export Workstations List other sites/requirements 56 V7 Appendix D HL7 Interfaces XXX will need a per interface cost listed in the vendor’s proposal, for each of the facility interfaces listed below. The following list of interfaces is a starting point for interface needs. Site I Interfaces List any additional sites and Interfaces. 57 V7 Appendix E Implementation Schedule Implementation will begin within 90 days of RFP award. It is XXX’s expectation that the selected vendor will be ready and able to provide a detailed, specific timeline of any and all activities, events and deadlines, both on the part of the vendor and XXX, associated with implementation as being the most ideal for XXX in terms of meeting project goals and budget. XXX would prefer a pre-staged server install, where the RIS/PACS/VR system is setup and tested at the vendors pre-staging facility, and only shipped to XXX when all system operational testing is complete. If the vendor supports pre-staging, then XXX would prefer to bring all sites up at one time. Should the vendor not support pre-staging, the following implementation schedule should be followed. RIS will be implemented in the order below: List your facility order. After each RIS implementation the PACS implementation will follow for that site and take place simultaneously with the next hospital’s RIS implementation. 58 V7