8998 Route 18 North, Suite 209 Old Bridge, NJ Phone: Fax:

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1 August 18, 2010 ehealthconnecticut, Inc. Attn: Mr. Steve Ruth 1111 Cromwell Ave Building 201 Rocky Hill, CT Dear Steve, Medical Communication Systems (MCS) appreciates the opportunity to provide ehealthconnecticut a response to their Regional Extension Center Request for Information. MCS looks forward to presenting their award winning EHR solution; coupled our extended IT solution suite. This integrated standards based solution suite is includes: ipatientcare EHR/PM (CCHIT 2011 Comprehensive Certification) Patient portal Health Information Exchange Enterprise Analytics Reporting Mobile Point-of-Care Solution MCS appreciates the process you have engaged and we look forward to a follow-up discussion regarding both your goals and how our product and services assist your efforts. We are confident you will find our solution a compelling offer that will further serve the ehealthconnecticut community. Sincerely, Udayan Mandavia President & CEO 8998 Route 18 North, Suite 209 Old Bridge, NJ Phone: Fax:

2 Response to Questions: VENDOR PROFILE Name Any Previous Names MCS-Medical Communication Systems, Inc N.A. Address (Headquarters) 8998 Route 18 North, Suite 209 Main Telephone Number Website Corporate Status (Publicly Traded, Privately Held, For Profit, Not for Profit) PARENT COMPANY Name Old Bridge, New Jersey Privately Held MCS-Medical Communication Systems, Inc Address 8998 Route 18 North, Suite 209 Telephone Number CONTACT PERSON Name Title Old Bridge, New Jersey Thomas Foley VP Sales and Marketing Address 8998 Route 18 North, Suite 209 Telephone Number Address: MARKET DATA 1. Number of years as EHR vendor 9 years 2. Total customer sites live and in process to go live a. Nationally 523 b. Connecticut None Old Bridge, New Jersey tfoley@medcomsys.com 3. Breakdown of sites by number of providers (Solo, 2-5, 6-9, >10) Solo = = = 36 >10 = 8 ehealthct Regional Extension Center Request for Information 2

3 4. Provide the number of installed sites by specialty and size a. Provide the names and contact information for 3 CT reference sites. 5. How Many De-Installations in last 36 months? 6. Please describe your relationship(s) with other ONC funded REC s 7. Additional Comments on Market Data Questions PRODUCT INFORMATION Primary Care Solo = = = 29 >10 = 6 Specialty Care Solo = = = 7 >10 = 2 1. Product name and version # ipatientcare 10.8 We have been working with many sites to establish our product portfolio; however, do not have any reference sites as of today in Connecticut. We would be more than happy to provide other references. Not aware of any practice that has de-installed ipatientcare due to deficiencies in either the product or MCS services Currently a finalist with the Ponce School of Medicine, as well as the Georgia Health Information REC. Being evaluated as a secondary vendor for Virginia REC. MCS is one of those quiet organizations that continue to grow its product suite and client base. MCS was part of the first group to achieve CCHIT certification in 2006; MCS continues to maintain that leadership by getting CCHIT 2011 Certified by December-2009, coupled with a robust product offering that serves MU requirements and so much more. 2. When is your next version release? We provide a major upgrade every year and a number of minor upgrades during the year. Considering the requirements of Meaningful Use, we would ensure that ipatientcare 10.8, which is currently CCHIT 2011 Certified, also achieves certification by one of the ATCBs then released. Any future release would be planned keeping an eye on Stage-2 of Meaningful Use requirements and specific user needs, such as, DRT enabling, specialty focus, and P4P reporting/analytics. ehealthct Regional Extension Center Request for Information 3

4 3. Is your product a Client Server, ASP or Hosted model? Describe each offering. ipatientcare is a multi-tenant SaaS model. It is offered as a hosted solution however, the same can be deployed in the same form as an in office server configuration which would operate on an intranet instead of the Internet. 4. Are Clinical Components Integrated? Yes a. If yes, list integrated components (e.g. e- prescribing, lab, etc) b. If no, list non-integrated components 5. Are Practice Management components mbox for Auto Reminders of appointments Ambir Technologies for MedicScan Card Scanners for scanning Insurance Cards / Drivers License Topaz Technologies for Signature Pads MidMark Corporation for medical equipment for (a) Vitals (b) Spirometry (c) EKG (d) Holter Welch-Allyn for medical equipment for (a) Vitals (b) Spirometry (c) EKG (d) Holter First Databank for Drug Reference Database and Drug Interactions Database LexiComp for Drug Handouts in 18 languages MediMedia for Health Plans Reference Database for Formulary Checks SureScripts/RxHUB for New Prescription, Refill, Medications History, and Formulary/Benefits LabCorp, Quest Diagnostics, Bio-Reference, and numerous Lab Information Systems with national level agreements in place for lab orders and results interoperability CodeCorrect and MDeSolutions for CCI Edits AMA Code Sets for ICD-9 and CPT HEDIS based Health Maintenance, Disease Management, and Clinical Order Sets Dragon Naturally Speaking (Medical Edition) DRT (Digitally Reportable Transcriptions) Many third-party content/guidelines through Knowledge Management functionality Yes integrated? 6. If yes, list all components. Patient Registration Patient Demographics Appointment Scheduling ehealthct Regional Extension Center Request for Information 4

5 Eligibility verification Charge Capture Claims processing electronic and paper Claims status inquiries Posting EOB including scanning EOBs Posting Electronic Remittance Advices Patient Ledger/Statement Accounts Receivables Management Reporting & Analytics 7. If no, list non-integrated components 8. Do you offer a Revenue Cycle Management or Billing Service for your clients? a. If yes, please describe 9. Describe your patient portal offerings and plans, if any. Any third-party Practice Management System interfaced through: o Patient Registration & Demographics [HL7 ADT] o Appointment Scheduling [HL7 SIU] o Patient Billing [HL7 DFT] Third-party EHR, PHR, and HIE Systems [HL7 CCD] Yes. We collaborate with some of the best RCM companies who are our Channel Partners, quite well trained with our software solutions, to deliver services to end customers. Providing secure communication between patients and healthcare providers is an important step towards proactive healthcare. Additionally, empowering patients to report their complaints through structured questionnaires and access to their own personal health record is nothing but real enhancement to quality of patient care. ipatientcare provides an easy-to-use portal for patients to interact through Internet or kiosks. ipatientcare EHR interoperates with any CCD compliant Personal Health Record systems, as its objective is not to replace a PHR but to augment it by focusing on workflow efficiencies and relationship management. Through our patient portal, a patient can self-register, update demographics, request an appointment, request a refill, answer questions pertaining to the complaints, get pro-active health alerts, view lab reports, and view cumulative patient record. ehealthct Regional Extension Center Request for Information 5

6 CERTIFICATION 1. Is the product CCHIT certified? Yes. 2. Version, Year and Type (Comprehensive or Modular) of CCHIT Certification 3. List any other current or planned Certifications CCHIT 2011 Comprehensive EHR Certification, December 2009 Other Certification: Surescipts (Eligibility/Formulary, Reporting, Medication History, Prescription Routing) Planned Stage 1 Certification: ASAP upon finalization of ATCB Planned Stage 2 Certification: No later than July 2012 MEANINGFUL USE 1. Do you offer a Meaningful Use Guarantee? a. If yes, describe the level of financial risk Yes, MCS commits to achieve ONC-ATCB certification. MCS will return the subscription fees. you will share with provider customers. 2. Describe your plans and timelines to become Meaningful Use Certified by ONC? We are CCHIT 2011 certified; once the interim certification bodies are identified, we will immediately engage to be certified. HEALTH INFORMATION EXCHANGE (HIE) 1. Describe your HIE capabilities and experience with HIE implementations. MCS s HIE standards based architecture facilitates a holistic view of a patient s record captured at various ambulatory clinics, integrated with hospital system and as updated by the consumer. Our HIE provides three essential functionalities, namely, (a) MPI (b) CDR (c) Integration Brokers 2. What HIE connections and interfaces if any are included with your product. Patient Registration & Demographics [HL7 ADT] Lab Results [HL7 ORU] SureScripts/RxHUB Medications History Third-party EHR, PHR, and HIE Systems [HL7 CCD] MCS s is committed to meeting ehealthconnecticut HIE technical specifications found on the ehealthconnecticut website at ehealthct Regional Extension Center Request for Information 6

7 MCS as an organization is quite ahead in the curve of interoperability and participating in HIMSS Interoperability Showcase by implementing HITSP schemas and a strong follower and advocate of IHE. Incidentally, MCS achieved first honors for implementing ASTM CCR in its EHR and demonstrated successful implementation to a panel of judges at TEPR MCS does plan to participate at the highest commitment level at HIMSS 2011 Interoperability Showcase to demonstrate its commitment to IHE. As far as specific responses, with regards to patient registration and query transactions (PIX/PDQ) are concerned, MCS has been implementing HL7 ADT feeds for more than 8 to 9 years. As part of our own Interface Server, we have a repository of HL7 schema. In this particular requirement, we shall utilize HL7 ADT v We have implemented all variations of HL7 ADT feed, such as, 01 / 04 / 05 / 08 / 39. We understand the need to query the PIX/PDQ with an HL7v2.5 PIX Query or HL7v2.5 PDQ Query, and generate and submit audit log as per the IHE ATNA profile. MCS shall comply with these requirements. We support XDS transactions as it follows HL7 CCD as a standard. MCS is CCHIT 2011 Certified and inherently, it has demonstrated full compliance to HL7 CCD using CCHIT s Project Laika. We understand the requirement of generating a CCD as per IHE XDS.b specification to interact with the XDS components, and we submit herewith that this would be complied. We would also generate relevant metadata for the CCD, implement IHE IT-Infrastructure transaction 41, and provide support for TLS mutual handshakes to generate and submit audit log data. As far as BPPC is concerned, we would work through preloaded configuration file within the community we work for, and interpret/code BPPC policies and functional roles. Pricing and Related Services 1. Are you willing to have us publish your pricing on our website? 2. Describe your software pricing in detail, including all components for which a practice may be charged. 3. Are you able to offer a discount for customers of the ehealthconnecticut REC? a. If yes, please describe 4. Do you bundle or arrange for any other related services such as hardware, network, and ISP purchasing and support? a. If yes, please describe all such relationships and services Yes. Please refer Exhibit A. Yes MCS pricing is already position to motivate adoption MCS will further discount pricing listed in Exhibit A by 20% MCS will provide turnkey management for the deployment of its award-winning platform, including, but not limited to: hardware, in-office infrastructure, hosting, billing, and support. We are your HealthIT partner and not a product vendor only. Please refer to Appendix B for a list of MCS partners. ehealthct Regional Extension Center Request for Information 7

8 IMPLEMENTATION TRAINING AND SUPPORT 1. Briefly describe your Implementation Plan. Address issues such as on-site versus website training, workflow analysis, existing data conversion, who is trained, and software and template customization SETUP WORKPATHS 1 - Preparing the Technology - Whether set up in Client/Server or hosted SaaS Model configuration, a tech support individual is responsible for putting the necessary technology pieces in place. For small practices, MCS strongly recommends the ASP approach in order to reduce complexity and ongoing technical responsibility for the practice. 2 - Clinical Setup - This is a process of configuring the practice's database for the particular clinical needs of the practitioners. This may involve loading of specialty specific codes, medications, procedures, labs, diagnostics, histories, physical exams, documents, patient education, and so on. 3 - Billing Setup - This is process of connecting the medical records system to either the ipatientcare or to an outside billing system as well as setup of clearing house, collections, and reporting if the practice chooses MCS's integrated EHR/PM combination. 4 - Data Interfaces / Loading / Conversion - In situations where interfaces are required or where there is a conversion from an existing database, MCS will assist in converting the existing data to the ipatientcare products. 5 - Workflow Setup - This step is where the ipatientcare products are configured for maximum efficiency in the new client practice once a workflow assessment has been conducted and reviewed with practice stakeholders. The result of these 5 setup steps the system is ready for use. From this point onward the practice will be trained in 6 major segments: TRAINING WORKPATHS 1 - Preparing the chart for the practitioner - this involves all steps to put the necessary information into a patient chart so that the practitioner can see the patient with the necessary information at hand. 2 - Training the practitioner to record encounters in the patient's electronic chart and to create indicated orders, referrals, and other follow-up activities. 3 - Preparing the staff to be able to perform requested follow-up activities as specified by the practitioner. ehealthct Regional Extension Center Request for Information 8

9 4 - Trailing all practice members in workflow and administrative functions such as scheduling, messaging, and reporting. 5 - Training relevant personnel on use of the billing functionality. 6 - Meaningful Use Consultation - Once the practice is successfully performing basic functionality with their new system, they can access additional consultation and training in order to be certain that they are using the products in conformance with Meaningful Use criteria. 2. Provide the normal length of implementation by practice size (solo, 2-5, 6-9, >10) 3. Describe your ongoing support post implementation. 4. Describe your training and support pricing structure. Solo 4 weeks 2-5 Providers 6 to 8 weeks 6-9 Providers 8 to 12 weeks >10 More than 12 weeks The ipatientcare platform provides online help in the following context: ipatientcare Online Help provides the following capabilities: Search by Index: Users can type partial words for which they are looking for help, and the complete index is displayed with appropriate filtering applied for the search Search by topic: ipatientcare online help manuals provide major topics for users to search and select Note: The online help is also invoked as context sensitive help. Post implementation is the most critical timeframe of any deployment. Coupled with the online help outlined above each practice also has 24/7/365 access to our Support Center. Our Support Center personnel have access to state-of-the-art tools to enable recording and tracking of reported incidents. As well, we have a trigger regarding the first 90 days of a new client (critical window of success) including the assigned PM does touch base with the practice during this same timeframe to ensure everything is running according to plan. The hosted SaaS model is a subscription-based model and the support services is part of the monthly fee. If the practice opts to deploy the solution onto a local server than the Support fee would be $2,100 for an EMR/PM and $1,500 for just the EMR. Training is a comprehensive offering with a ehealthct Regional Extension Center Request for Information 9

10 curriculum that serves the interest of specific user groups. Training is provided onsite or over the web in a small group setting at $1,000/day (plus travel). We also offering supplemental services (trainer on call) at a rate of $125/hour MCS provides a basic user training for the EHR and Billing. There is a single session for Administration. These are the minimum amount of training which is required by MCS with the purchase of ipatientcare. It is highly recommended that additional training be purchased. Supplemental Training sessions are also listed below. MCS would be please to customize the training curricula to meet the particular needs of ehealthconnecticut. EHR - BASIC TRAINING EHR e-chart Basics - (2hr session) train the practice on the basics of the electronic patient chart - how to find information, favorites and how to maintain patients medications, allergies, problems. EHR Scheduling (2hr session) trains the front desk and administrative personnel on scheduling, check-in, handling insurance EHR Document Image Management (1hr session) - train on document image management. EHR Creating Notes - (2hr session) trains the clinical staff on creating notes and documenting in them. EHR Rx and Orders - (2hr session) trains the clinical staff on e-prescribing and orders and results EHR Workflow - Personal Dashboard - (1hr session) trains the practice on use of the Personal Dashboard and Flags to handle messaging and document flow within the office. EHR Workflow - Practice Dashboard - (1hr session) trains the practice on use of the Practice Dashboards to track patient flow within the office. EHR Correspondence - (2hr session) is to train the practice on techniques for creating correspondence from patient chart, demographic and billing information. EHR Templates - (1hr session) trains the user to customize their own templates EHR Advanced Templates - (2hr sessions) trains ehealthct Regional Extension Center Request for Information 10

11 the user in advanced template techniques EHR Reporting for PQRI and Meaningful Use - (2hr session) EHR Immunizations - (1hr session) is to train the practice on the basics of the electronic patient chart - how to find information and how to maintain patients medications, allergies, problems. EHR Clinical Alerts - (1hr session) trains clinical personnel the setup and use the clinical alert functions EHR Order Sets - (1 hr session) EHR Patient Record Interchange - (1 hr session) EHR Live Handholding sessions or additional supplemental training - 6 Hours OTHER ISSUES 1. Do you utilize other companies or services in the process of bringing a process through the implementation and go live process? 2. What is your current wait time to begin an installation in Connecticut? 3. Are you willing to help sponsor ehealthct MCS believes small office IT infrastructure (e.g. routers, switches, wireless networking, internet connectivity, etc ) is not our core expertise therefore seek will utilize local expertise to provide this type of services. If a practice already has a relationship with a specific vendor, we will provide them the specifications required and include them on project calls to ensure synchronization of effort. MCS would be ready to immediately engage with the understanding it will require some aspect of the team to be enhanced. MCS is persistent at evaluating internal and external skill-sets and will take appropriate step to progressively engage our new partners in Connecticut. Yes REC promotional activities and conferences? a. If yes, describe MCS assumes ehealthct would conduct community based webinars, local conferences or even a golf outing. MCS would certainly look to support our partners in this effort. MCS offers a full suite of HealthIT offering: 4. Any other information you would like to provide? ipatientcare EHR/PM (CCHIT 2011 Comprehensive Certification) Patient portal Health Information Exchange Enterprise Reporting and Analytics Reporting Mobile Point-of-Care Solution We are currently in beta release with advanced feature ehealthct Regional Extension Center Request for Information 11

12 sets, such as: Command Level Support to Dragon Naturally Speaking (Medical Edition), and Digitally Reportable Transcriptions (DRT) interfacing to leading Transcription Platforms Release 2.0 of our HIE Our offering also serves acute, sub-acute, emergency, long term care and home care settings. We promote the Patient Centered Medical Home framework and provide the interoperable tool-set necessary to achieve this objective; including working with other platforms. MCS was one of the first vendors to show case interoperability between vendor offering back in ehealthct Regional Extension Center Request for Information 12

13 EXHIBIT A: PRICING AND REVENUE SHARING A. Please contact MCS ehealthct Regional Extension Center Request for Information 13

14 EXHIBIT B: Description of Technology Partnerships MCS collaborates with many leading technology and clinical services providers for evolving an integrated EHR solution: SureScripts/RxHUB Surescripts is dedicated to giving healthcare providers secure, electronic access to prescription information that can save their patients lives, improve efficiency and reduce the cost of healthcare for all. It operates the country s largest electronic prescribing network. Available during emergencies or routine care, the Surescripts network is used every day by thousands of prescribers across all 50 states to electronically access prescription information and route prescriptions. The Surescripts network connects these prescribers to all of the nation s major chain pharmacies (e.g. Walgreens, CVS/pharmacy, Rite Aid, Wal-Mart), many of the nation s leading payers and PBMs (e.g. Aetna, CVS Caremark, Express Scripts, Medco, Wellpoint) and over 10,000 independent pharmacies nationwide. Surescripts is the result of a 2008 merger between the country s two leading health information networks: RxHub and Surescripts. RxHub was founded in 2001 by the nation s three largest PBMs CVS Caremark Corporation, Express Scripts, Inc., and Medco Health Solutions, Inc. The National Association of Chain Drug Stores (NACDS) and the National Community Pharmacists Association (NCPA) formed Surescripts in MCS' connection to the SureScripts network comes as the result of a significant certification process to ensure that it meets the standards of connecting. As a result, we are pleased to say that MCS has been recognized as a SureScripts Certified Solution Provider. For more information go to: NewCrop MCS utilizes innovative and content-rich Web services provided by NewCrop LLC for providing clinical decision support at the point-of-care. For more information go to: Primetime Medical Software Primetime Medical Software has been compiling the ultimate medical knowledgebase for computerized patient interviewing. Designed originally by physicians for immediate use in their facilities, the knowledgebase contains questionnaires for more than four thousand distinct patient complaints, including more than 55 self-rating scales from the archives of medical literature. For more information go to: Midmark Diagnostics Group Midmark Diagnostics Group is a leading medical technology innovator that offers digital diagnostic medical devices through its IQmark product line. MCS EHR accepts vital signs, EKG, spirometry, and holter outputs directly into its EHR, thus saving numerous hours of clinician s time otherwise wasted entering data, as well as, reduce errors in transferring data from paper to computers. For more information go to: Welch Allyn, Inc. Welch Allyn, a leading manufacturer of frontline medical products and solutions, to bring you an innovative way to electronically capture patient vital signs data while improving productivity and lowering costs. This powerful connectivity option interfaces MCS EHR with the Welch Allyn devices for capturing Vital Signs, ECG, Spirometry, and Holter device to create an efficient, reliable method for providers to enter patient vitals into the mmd.net software saving valuable staff time and eliminating manual entry risks. For more information go to: ehealthct Regional Extension Center Request for Information 14

15 1.1.6 Quest Diagnostics and LabCorp Quest Diagnostics and LabCorp are the nation's leading provider of diagnostic testing, information, and services. Their clients include patients and consumers, physicians, hospitals, health insurers, employers and government agencies. They have the world's largest private database of clinical test results to help identify best practices in healthcare services across populations of patients, and develop clinical support tools and HEDIS reporting requirements. For more information go to: and Bio-Reference Laboratories, Inc. BRLI is a multi-faceted Health Services and Information Company as well as the largest regional clinical laboratory in the North East United States. It has major market position in physician offices, industry, nursing homes, and correctional institutions. Its toxicology division performs employee drug testing for major corporations nationwide, as well as drug treatment centers and psychiatric hospitals. For more information go to: Microsoft Gold Certified Partner and Microsoft Solution Provider As a Gold Certified Partner and Microsoft Solution Provider, we are motivated and inspired every day by how our customers use our software to find creative solutions to business problems, develop breakthrough ideas, and stay connected to what is most important to them. Microsoft provides us updated technology tools to develop our application solution. For more information go to: Fujitsu Fujitsu is a leading provider of customer-focused information technology and communications solutions for the global marketplace. Pace-setting device technologies, highly reliable computing and telecommunications platforms, and a worldwide corps of systems and services experts uniquely position us to deliver comprehensive solutions that open up infinite possibilities for our customers' success. For more information go to: AutoRemind AutoRemind works with a number of Practice Management Systems including mmd.net. This solution is integrated within the scheduling component of those software packages and works seamlessly with them with no real need for you to train your staff on its usage. AutoRemind is approved by all US cellular carriers. There is no need to obtain approval from patients to remind them of their appointments via phone messages. AutoRemind will collect all the approvals and will inform the patients of how they can block further messages, as well as, how to maintain their profile which will determine which types of reminder messages they will receive at what time of day. AutoRemind is HIPAA compliant. The U.S. Department of health and human services states clearly that reminders can be sent without requiring any prior patient authorization. For more information, please visit: ehealthct Regional Extension Center Request for Information 15