STATEWIDE HIO. Request for Proposal

STATEWIDE HIO Request for Proposal Yolande Calhoun, Chris Davis, Kyle Johnson, Joanne Rimac & Natalie Schwartz 2/8/2011

Table of Contents 1. Introduction:... 5 1.1 Description of Current Situation:... 5 1.2 Statement of Problem:... 5 1.3 Project Objectives:... 6 2.Technical Requirements... 7 2.1 Architecture/Interoperability... 7 2.2 Integration and Adapter Framework... 9 2.3 Data Standards... 10 2.4 Data Aggregation, De-identification, Re-identification, and Anonymization... 11 2.5 Analytics and Reporting... 11 2.6 Privacy and Security... 11 2.7 Reliability of system... 12 2.8 Disaster recovery plan... 12 2.9 Programming Language... 12 2.10 Host Computer... 12 2.11 Documentation... 12 3. Administrative Information... 12 3.1 Respondent Qualifications... 12 3.2 Clarification and Information Requests... 13 3.3 The Intent to Bid... 13 3.4 Questions... 13 3.5 Submission of Proposals... 14 3.5.1 Number of Copies...14 3.5.2 Packaging and Delivery...14 3.5.3 Closing Date...14 3.6 Proposal Selection Criteria... 14 3.7 Other Administrative Information... 15 4 Pricing Information... 15

4.1Implementation Costs... 15 4.2 Software Pricing (additional details)... 16 4.3 Professional Services Pricing... 16 4.4 Hardware and Hosting Pricing... 17 5. Referenced Documents... 18 5.1 Standards... 18 5.2 Product Literature... 19 6. Required Deliverables:... 19 6.1 Documentation... 19 6.2 Software... 19 6.3 Training... 20 6.4 Hardware and Equipment... 20 6.5 Warranty... 21 6.6 Development and Test Tools... 22 7. Proposal Format:... 22 7.1 Cover Letter... 23 7.2 Table of Contents... 24 7.3 Business Profile and Organization... 24 7.3.1 Company Information...24 7.4 Response to Technical Requirements/ Technology... 25 7.5 Response to Standards Support and Commitment... 26 7.5.1 IHE Integration Profiles:...26 7.5.2 Message Standards and Transport Protocols...26 7.5.3 Clinical Terminology Standards...26 7.6 Response to Provider Workflow... 26 7.7 Response to Hosting... 26 7.8 Response to Implementation and Support... 26 7.8.1 Core Infrastructure Roll-Out...26 7.8.2 Data Source and Participation Integration...27 7.8.3 Support and Training...27

7.9 Response to Vision of Statewide HIO... 27 7.10 Response to Experience and References:... 27 7.11 Response to Pricing... 28 7.12 Statement of Work... 28 8. Submission and Decision Schedules... 28 9. RFP Terms and Conditions... 28 9.1 Proposal Response... 28 9.2 Confidentiality... 29 9.3 Formal Contract... 29 9.4 Maintaining Pricing... 29 9.5 Cost of Proposal Preparation... 29 9.6 Applicable Law... 29 Appendix A... 29 Attachments... 30 References... 30

1. Introduction: 1.1 Description of Current Situation: Statewide Health Information Organization (Statewide HIO) is a non-profit organization established by the state legislature and supported by the governor in July of 2010. Our mission is to provide the state with a Health Information Exchange (HIE) in order to improve the quality, safety, and efficiency of healthcare, to reduce healthcare disparities, to improve care coordination, to ensure security protections for personal health information, to engage patients and families, and to improve population and public health. With a population of 10 million, 25,000 physicians and 175 acute care hospitals serve the state. Approximately 25 % of the physician offices and 40 % of acute care hospitals use some form of an Electronic Health Record (EHR). 1.2 Statement of Problem: Statewide HIO has secured funding under the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act (ARRA) of 2009 to create a statewide HIE. A vendor is being sought to partner with Statewide HIO to provide the HIE infrastructure, software, implementation, and ongoing service to support the HIE. We invite you to submit your proposal in accordance to the requirements, terms, and conditions as outlined by the RFP below. A multidisciplinary board of directors governs statewide HIO. Members of the board include a mix from public, private, and non-profit organizations. Key stakeholders include expertise in the areas of privacy, security, information technology, clinical, finance, legal, and compliance. There are four full time employees, the CEO, two project managers, and an administrative assistant. Current IT architecture includes a modest local area network (LAN) to support basic business functions. The LAN is served by a T1 line provided by a local Internet service provider (ISP).

The HIE shall provide seamless exchange of information between a wide variety of clinical sources of information. These services shall meet all Phase 1 requirements of Meaningful Use. We realize that the current IT architecture of Statewide HIO is not sufficient to effectively run an HIE of this magnitude. Additionally, current staffing is also insufficient for a project of this magnitude and while Statewide HIO will be expanding its staffing in the future, the vendor will need to supply sufficient staff to implement the HIE. Statewide HIO Project Governance Structure: 1.3 Project Objectives: The core objectives that will need to be met by the HIE shall include, but are not limited to, the following: Exchange of clinical information in a standard format, such as Continuity of Care Document (CCD). Exchange of clinical messaging and referrals between participants of the HIE. The ability to connect to the following entities through virtual or HL7 gateways: o Hospitals o Physician offices o State Public Health agencies (for immunization, syndromic surveillance and

reportable lab registries) o eprescribing entities o Payers Provide security of clinical information in a HIPAA compliant fashion. Conform to national standard vocabularies and code sets being established by the HIT Standards Committee Vocabulary Task Force, the HIT Standards Implementation Workgroup, and the ONC Standards and Interoperability Framework Contractors. Provide technology which delivers high availability of the HIE services. Provide the ability to connect to HIEs in other regions, states, and with a National Health Information Network (NHIN). Support the information technology needs of the HIO (internet, email, web services). Additional objectives needed to support Phase 2 and 3 of Meaningful Use shall include, but are not limited to, the following: Provide an electronic consent repository. Provide directory services for providers, payers, and public health entities. Provide Public Key Infrastructure (PKI) to allow for more sophisticated secondary authentication. Provide the ability to electronically submit quality reporting to state and federal agencies. 2. Technical Requirements The selected HIE application vendor will need to be able create a statewide backbone for seamless exchange of clinical data among providers. In addition, the vendor will need to provide details on how they will accomplish the objectives in section 1.3. Vendors are encouraged to consider these objectives in providing a response to the following sections. 2.1 Architecture/Interoperability The statewide HIO desires a standards-based, hybrid architecture with federated and centralized applications, centralized and de-centralized data. The database solution should be based on an Open System Architecture design to be able to connect directly to the data via ODBC or similar database connectivity standards. Provide details on how your solution will meet these objectives.

System Architecture Design: Provide a formal description of your health information exchange system and a detailed plan of the system at a component level for each of the following: a. Business (or business process) architecture b. Application architecture c. Data architecture d. Technical architecture e. Security architecture f. Other System Architecture Design: Provide content, including diagrams, that gives an overview of your system architecture. Indicate which components are centralized, which ones are distributed (de-centralized), which ones are replaceable, and which ones are customizable. System Architecture Design: The HIO desires an integrated master person and patient identification, and record locator services based on probabilistic matching algorithms in compliance with standards specified, adopted, or endorsed by the FHA, NHIN, and ONC. Describe your proposed Health Information Exchange system s services capabilities related to the following: a. Registry and Directory Services b. Person and Entity Identification c. Record Locator and Search Services d. Identity Management e. Consent Management f. Secure Data Transport g. Data De-Identification and Aggregation h. Analytics i. Referral Services

The vendor s architectural solution should leverage existing regional and state resources that can advance HIE such as HIOs, payer clearinghouses and Medicaid Management Information System (MMIS). Describe how your solution allows for the use of shared directories for providers, health plans, etc. thus allowing HIE stakeholders access and use of shared services including: Patient matching, provider authentications, consent management, secure routing, advance directives and messaging. Describe the process for database update, change or modification of data fields and data requirements. Product Roadmap: Describe your HIE product roadmap. Please include information about the planned release schedule for the product, planned functionality, and the corresponding timeline. Describe how you plan to enable Meaningful Use requirements (base your response off of the current definition but include how you will handle shifting definitions). 2.2 Integration and Adapter Framework What is your architecture and strategy with respect to integration of the HIE with common EHR systems? Provide details regarding inbound and outbound interfaces. In particular, discuss your integration capability and experience with the following EHR systems: Allscripts/Misys McKesson Epic eclinicalworks MEDITECH NextGen GE Centricity Cerner Do you have any HIE Adapters (interfaces) built for the systems mentioned above? What transactions do the adapters support? Give an overall description of your adapter portfolio. (Specific adapter information can be included in the pricing spreadsheet of this response). What is your process of building a new set of Adapters? Is your Adapter Framework API documented and open to third-party developers? List the kinds of interfaces with which you have integrated in the past. For example:

Event-driven service interfaces Multiple protocols and standards (including legacy HL7) Client API technologies Message oriented middleware Asynchronous, loosely coupled interfaces 2.3 Data Standards Describe your adherence to semantic interoperability and coding; and where such standards have been implemented. Indicate your system s ability to support the most widely adopted semantics including, but not limited to RxNorm, NDC, LOINC, SNOMED-CT, CPT, ICD-9/10, HCPCS and CDT. The HIT Standards Panel s Clinical Operations Workgroup developed vocabulary standards to address Meaningful Use. Describe your solution s ability to promote the use of the coding standards as recommended by the Workgroup. The Office of National Coordinator (ONC) issued State Health Information Exchange Cooperative Agreement Program specifies a HIE technical infrastructure that supports electronic eligibility and claims transactions. Describe how your solution provides for the following HIPAA transaction code sets: a. Code set 270 / 271 Eligibility Inquiry and Response b. Code set 276 / 277 Claims Status Inquiry and Response c. Code set 278 Prior Authorization and Referral d. Code set 835 Remittance Advice e. Code set 837 Health Care Claims for Dental, Professional and Institutional Describe how your solution adheres to a core set of messaging, transport and integration standards and protocols including: Health Level 7 (HL7), Digital Imaging and Communications in Medicine (DICOM), Electronic Data Interchange X12 (EDI X12), National Council on Prescription Drug Plans (NCPDP), Standard Object Access Protocol (SOAP), Extensible Mark-up Language (XML), Secure Socket Layer (SSL), and Transport Layer Security (TLS). Data Source and End User System Requirements: a. Workstation: End user system requirements should be browser based and compatible with all platforms. Describe your end user system requirements. b. Data Source Connections: Describe your infrastructure strategy and architecture requirements for interoperability with provider systems.

2.4 Data Aggregation, De-identification, Re-identification, and Anonymization Describe your product s capacity to accumulate aggregated data for secondary use such as clinical analytics while it handles individual transactions. Does your product have the capacity to strip identifying information from data being passed through the HIE? Please explain. Does the product have the capacity to de-identify data in a manner that can be re-identified upon request from an authorized user? Does it have the capacity to de-identify data in a manner so that it cannot be re-identified? Please explain. 2.5 Analytics and Reporting What analytics and reporting functionality comes standard with your system? How does your reporting system allow for custom reports? 2.6 Privacy and Security The HIO requires compliance with and support for encryption, networking and connectivity standards specified by the ONC. All vendors are required to secure all protected health information by means of encryption and destruction in accordance with HHS 74 FR 19006. Please provide details on how your system utilizes these standards and means to secure all protected health information. The number of logins users of the system need to remember should be minimized. Therefore, any portal services or access methods should utilize shareable authentication technology. Please provide a description of your solutions single sign on approach. Provide details on your solutions ability to implement the following user provisioning: Unique User IDs for each user Role based security Automated workflow Encryption on passwords Capability to reset passwords Provide details on your system s ability to log all data access and transmission events. Provide details if your system includes log search and reporting components. Does your system have the ability to both proactively and reactively mine and report against audit information? Please provide details. Can the audit data be used to identify a user who consumed specific PHI? Is the logging customizable to meet the statewide HIO requirements? Describe the process for user identification and authentication in your system. Does your product support single sign on when integrated with other third-party applications (e.g., EHR solutions)? If so, elaborate. What is your authorization (access control) model? Describe the model in the context of users, roles, resources, and privileges. Describe how the system controls user access to patient data. How does the system enable administration of authentication and authorization?

The vendor should document its ability to comply with HIPAA and should provide in their response the following key information: Names of Chief Privacy Officer, Chief Security Officer, and Chief Information Officers (Resumes should be provided for each.) Provide copies of existing privacy and security policies and procedures. 2.7 Reliability of system Once the statewide HIO is implemented, the system will operate on a 24/7 schedule and will have routine maintenance during off-peak hours. Provide details on your plans to make the system reliable with a 99.999% uptime. Include details on redundant services, backup services and maintenance agreements that will be used to meet the performance requirements. 2.8 Disaster recovery plan In the event of a disaster, provide details on Disaster Recovery (DR) methodologies to include HA/Clustering, TSM tape backup, or availability of a secondary data center. If a secondary data center is available, what types of DR services are provided hot, warm, cold? Please describe. Also, provide details on restoration processes. 2.9 Programming Language Provide details on the programming languages used to develop the solution. Provide tools used to manage the development process. 2.10 Host Computer Provide details on the types of host computers/servers that will be used in this system. 2.11 Documentation How do you provide system/technical documentation, technical training, and materials? (Online, CDs, etc ) 3. Administrative Information 3.1 Respondent Qualifications The respondents will be evaluated alongside the following list of criteria. The vendor respondents must adequately meet the select criteria in order to proceed to the next phase of the selection process. The respondent vendors who fail to meet the minimum criteria set forth will not be considered for selection. Respondent Qualifications:

The vendor must have experience within the last 2 years in HIE business planning and development, technical planning and design, implementation and operations support. The response must provide the details of each area of expertise and the exact years of experience. The vendor must be the prime vendor in the operation of at least three HIE installations. The vendor must provide the basic HIE components- clinical messaging and referrals, inquiry, e Prescribing, public health reporting and alerts, EMPI, and record locator service. The vendor must conform to the most current national standards at the time the project begins, and thereafter, and must have a process for monitoring, selecting, managing, and implementing versions of the standards. The vendor must comply with the privacy and security requirements for operating an HIE. 3.2 Clarification and Information Requests Please use the following name and address for all communication with the HIO in reference to this RFP. Vendor respondents who seek information about this RFP either directly or indirectly from other sources will be eliminated for consideration. All correspondence must be directed to: Mr. J.R. State, Project Manager Statewide HIO Highway 66, Suite 105 Capital City, State X 55555 Voice Mail: 215-555-5555 Fax: 216-555-1234 JR@hio.state.x.gov 3.3 The Intent to Bid The respondent vendor must sign and return the Intent to Bid to the address in Section 3.2 or to JR@hio.state.x.gov no later than 5:00 P.M. CST March 2, 2011, the date identified in the RFP Schedule. The notice of the intent to bid is a part of the RFP. 3.4 Questions Submit questions to JR@hio.state.x.gov. Questions via telephone will not be accepted. Vendor respondents should refer to the specific RFP paragraph number and page and should quote the verbiage being questioned. To respect the privacy of the respondent vendor the HIO will delete names from the text of questions and the answers being sent. The HIO will respond to questions and post answers to respondent vendors at http://www.statexhio.org

3.5 Submission of Proposals 3.5.1 Number of Copies Each proposal must be submitted with five signed original copies and one sent in PDF format to JR@hio.state.x.gov 3.5.2 Packaging and Delivery Proposals should be delivered in person or via US Postal Service or other approved delivery service in a sealed package (box or envelope), with the following label: SEALED PROPOSAL STATE X STATEWIDE HIO - VENDOR RESPONDENT NAME The package must also contain the name, address, and telephone number of the proposing vendor. A proposal delivered by mail must contain an inner envelope marked as directed above. Address all proposals to: Statewide HIO Project Attention: Mr. J.R. State, Project Manager Statewide HIO Highway 66, Suite 105 Capital City, State X 55555 3.5.3 Closing Date Proposals are due April 15, 2011 at 5:00 P.M. Central Standard Time. The Statewide HIO reserves the right to extend the Closing Date by posting a notice of the extended date on the following website: http://www.statexhio.org 3.6 Proposal Selection Criteria On behalf of State X, the Statewide HIO is interested in obtaining a high quality, cost efficient, technically robust solution to the requirements in this RFP. The HIO will provide a complete and objective review to those proposals that adhere to the proposal instructions and requirements. The proposals that are received after the deadline, do not adhere to proposal instructions nor do not follow mandatory requirements will not be given any consideration by the HIO. The Statewide HIO will evaluate proposals by means of a number of factors described in the technical, project management and pricing sections of this document. Please refer to Appendix A for selection criteria scoring.

3.7 Other Administrative Information For the purpose of the RFP, the words must, shall or will denotes a mandatory requirement. Attached is the RFP Agreement Form.doc 4 Pricing Information 4.1Implementation Costs Statewide HIO is requesting a clear accounting of all implementation and post-implementation costs associated with HIE implementation project. We have prepared a pricing spreadsheet that we would like you to populate with all of the applicable costs we would expect to incur. Please provide the cost for software, hardware, implementation & maintenance labor, software maintenance fees, upgrades, shipping, handling, training, travel, or other miscellaneous fees, which Statewide HIO should expect during the life of this contract period. Any fees not clearly defined in this section will be excluded from the agreement. Attached is the HIE RFP TCO & Pricing Sheet.xls template to be used when submitting costs for this proposal. The pricing sheet tab is named implementation costs. Total Cost of Ownership information should be reflected in a multi-year TCO model. Please provide the combined costs for software, hardware, implementation & maintenance labor, software maintenance fees, upgrades, shipping, handling, training, travel, or other miscellaneous fees, which Statewide HIO should expect during the life of this multi-year contract period. These costs should be totaled and placed on the appropriate implementation labor or implementation non-labor lines of the TCO tab. Statewide HIO is also looking for your estimate of the non-it labor expectations. This might include any clinical or other non-it labor required to support the implementation and maintenance phases of this project. Attached is the HIE RFP TCO & Pricing Sheet.xls template to be used when submitting TCO costs for this proposal. The pricing sheet tab is named TCO. Both spreadsheets must be completed and returned with the final proposal.

4.2 Software Pricing (additional details) In this section, please define the pricing structure for the software costs, which may include either: license fees, subscription fees, or other pricing methods. Also, include other costs to be incurred for other features such as annual software/subscription maintenance, upgrades, professional services, training costs, etc. Use the attached HIE RFP TCO & Pricing Sheet.xls, tab named implementation costs to provide software license, software maintenance and any third party cost related to the purchase of the software. Next, describe to Statewide HIO your methodology for how you determine price. Is it based on concurrent users, number of physician users, or number of encounters? Please describe clearly the metrics used to calculate your pricing model. If you offer an unlimited use license or subscription, this proposal should be included as well and also describe the methodology used to arrive at an unlimited cost license model. In addition, please include the cost associated with any additional license purchased in the future as a result of growth of the HIE. Please include any discounted pricing information if additional licenses are purchased in certain size increments of users (e.g. 100 licenses = 20% discount off of single license purchase price). Your pricing methodology and growth pricing should be described in a separate document submitted with the final RFP. 4.3 Professional Services Pricing Please include the pricing associated with any and all professional services that will be required for implementation and post-implementation support of this application software. Statewide HIO anticipates using professional services from your organization and/or other consulting firms in the market. Please include the titles, and types of roles needed for implementation and support and the hourly rates and hours expected for each of the roles. Please include the

total hours estimate that you anticipate the implementation and post-implementation support to consume. These hours should also include the non-it hour s estimate, which will be captured in the TCO tab. We will be asking each vendor for a completed project plan that supports the hours proposed. Once we have final sign off on the project plan, that will serve as a not to exceed plan for implementation hours. Please find attached the spreadsheet to be populated with all professional fee information HIE RFP TCO & Pricing Sheet.xls, implementation costs tab. Statewide HIO plans to implement the application in two phases (See Statement of Problem and Project Objectives). Please structure your project plan and professional services costs anticipating our planned, phased approach. If there are other approaches to the project that make more sense based on your experience with other implementations, Statewide HIO expects you to raise those issues and ensure your project plan and pricing reflects the agreed upon approach to phases of implementation. Please describe these assumptions in a separate document submitted with the final RFP. 4.4 Hardware and Hosting Pricing Statewide HIO would like to explore both self-hosted and remote hosted models for hardware and support services. Today, Statewide HIO has a limited IT staff and currently outsources its network and desktop services. Please describe the pros and cons for both approaches. Describe for us what you have seen in the industry thus far. Is there a preference toward remote hosted vs. self-hosted or is the opposite true? Statewide HIO would like to understand your thoughts of why there is a preference in the market toward one approach vs. the other. Statewide HIO would like (if available) for your organization to propose both hosting model approaches self-hosted and remote-hosted. Please do a side-by-side comparison so that Statewide HIO is able to make an informed decision. If we were to choose the self-hosting model, what other resources and equipment would be needed that Statewide HIO does not have today? Please provide a separate price quote and technical configuration for both types of environments. The costs for the technical configurations should be captured in spreadsheet HIE RFP TCO & Pricing Sheet.xls, implementation costs tab. A separate detailed price quote and technical

configuration schematic is required for each configuration proposed. Statewide HIO assumes if a self-hosted model is proposed, the vendors will communicate necessary local network and infrastructure requirements needed to support a self-hosted HIE. 5. Referenced Documents The Statewide HIO has developed a website in conjunction with State X, which contains information about the organization mission, vision, strategic plan and objectives. The history of HIE s in the United States and peer reviewed information related to electronic sharing of healthcare information is also available for use at http://www.statexhio.org. 5.1 Standards The Statewide HIO is committed to comply with industry standards pertaining to the exchange of healthcare information within the HIE. Message Standards and Transport Protocols CCD CCR DICOM EDI X12 Administrative transactions HL7 V2.x Hl7 V3 NCPDP SOAP (Web Services) SSL/TLS XML Clinical Terminology Standards CPT HCPCS ICD -9/10 LOINC RxNorm SNOMED-CT

5.2 Product Literature The StatewideHIO performed an Internet search using the terms Vendors and HIE and found the following industry leaders who are in the business of supporting HIEs throughout the United States. Statewide HIO also reviewed the most recent KLAS report on HIE applications available in the U.S. and found the same list provided below to be the top HIE contenders. www.axolotl.com www.epic.com www.medicity.com www.relayhealth.com 6. Required Deliverables: 6.1 Documentation (To be submitted with final contract) System specifications that support the performance, functionality, and interoperability requirements of the project Hardware requirements Technical Manuals Manager and user reference manuals User operator/system administrator manuals Configuration and implementation documents Training manuals (initial and ongoing user self-training) All other user instructions regarding the capabilities, operation, installation, and use of the Licensed Software, including all online help files and other user instructions 6.2 Software Is documentation provided with the system? Is it available in hardcopy and on CD-ROM?

6.3 Training Description of the types of training offered (end user, systems administrator, installer) How often is training offered? Set times or as needed? Duration of each type of training Location of training Associated costs Recommended number of people who should attend training Ongoing training programs Training approach for physicians Training approach for user personnel: classroom, one-on-one, computer-based, self-study? 6.4 Hardware and Equipment Server Requirements- Operating system (version) Database type (version) CPU type and speed (GHz) RAM size (GB) Hard disk size, type and configuration Storage type and capacity Client/ PC Requirements- Operating System (version) CPU type and speed (GHz) RAM size Hard disk size

External drives Monitor Port requirements Navigational devices Peripherals (wireless) Peripherals Document scanners Storage devices/media Communications Network requirements Wireless requirements 6.5 Warranty Include all system component warranties Performance Warranty Service Warranty Warranty of compliance with Applicable Law- that the software complies with HIPAA and all federal, state, local laws, rules, and regulations Knowledge-based warranty that the software does not infringe on the intellectual property rights of any third party Virus warranty Warranty against disabling mechanisms Third party software warranty Warranty that the vendor has the authority to enter into a license agreement with Statewide HIO Warranty that there is no pending litigation against the Vendor interfering with its right to use the product

Warranty protection for future releases and versions of the software. 6.6 Development and Test Tools Describe automated software testing tools to test your product s functionality, reliability, and scalability. Non-production environment to test upgrades and other system changes Training environment 7. Proposal Format: This section provides the specific instructions for the information to be included in vendor proposals. Proposals must be submitted using font with an 11-point pitch. Each proposal must be formatted according to the Proposal Response Format Table below, in the order provided within this table, and according to the specific instructions for each requirement. Failure to respond to a specific requirement may result in disqualification of the proposal. Responses to this RFP will be appended to the contract of the vendor chosen for the project. PROPOSAL RESPONSE FORMAT TABLE Title Format/ Page Limits Reference Section Cover letter Maximum 2 pages 7.1 Table of Contents 7.2 Response to Company Information Response to Company Viability Response to Technical Requirements/ Technology No more than 3 pages, not including tables Audited Financial statements can be included in appendices No more than 40 pages. Diagrams may be included in Technical Diagram appendix 7. 3 2 7.4

Response to Standards Support and Commitment No more than 10 pages 2.3 7.5 Response to Provider Workflow No more than 3 pages 7.6 Response to Hosting No more than 3 pages 7.7 Response to Implementation and Support No more than 3 pages. Resumes can be included within the appendices. 7.8 Response to Vision for Statewide HIO Response to Experience and References No more than 5 pages 7.9 No more than 5 pages 7.10 Response to Pricing Statement of Work Appendices -Financial report of organization -Technical diagrams -Resource Resumes -Pricing Spreadsheets -Acceptance of Terms -Standard Contract No more than 5 pages. Pricing spreadsheet to be included in appendices (HIE RFP TCO Pricing Sheet.xls) No more than 15 pages, including charts, tables, and graphs Executed copy of Acceptance of Terms document included in RFP Copy of your company s standard contract 4 7.11 7.12 7.1 Cover Letter Include a letter on the company s letterhead, signed by the company representative with the legal capacity to contract with the Statewide HIO.

The letter should include the following, and be properly dated and signed. RFP number Name of the Vendor Corporate Headquarters Vendor s office address Vendor email address Vendor telephone number Organization s Internet Home Page Authorized contact person to speak on behalf of the Vendor, and phone number Statement that the person signing the proposal is authorized to make all decisions for the company, regarding proposed products, services, and quoted prices. Statement that the company acknowledges and agrees to the rights of the HIO, including all terms and conditions specified within the RFP. Identification of all subcontractors by name, address, and telephone number. Each subcontractor will be required to sign a similar cover letter legally binding it to the terms and conditions of the RFP. 7.2 Table of Contents Include a word document with table of content. 7.3 Business Profile and Organization In this section, we are looking for information regarding your business organization that will demonstrate the ability, experience, and vision to meet the requirements of this project. Provide the following information regarding your organization: 7.3.1 Company Information Company overview Number of locations and data centers Number of years in operation Description of the main line of business and related businesses State in which the company is organized to do business Provide an organizational chart and profile of senior management Include a discussion of any anticipated change in ownership or control within 12 months following the due date of this proposal. Include the details of any previous relationships the vendor, or its sub-contractors; have had with the Statewide HIO, its Board of Directors, or the Statewide HIE project over the previous 24 months. Total number of company employees. How many of those employees are focused on the HIE solution offering? State the name and position of any party listed in this proposal that is, or was, an employee of State X within the past 12 months. Company s HIE market position Commitment to research and development

Positioning, with regards to sales and support Marketing and Sales history Data center Company s certificate of insurance Indicate if your company is currently being investigated by a governmental agency Submit details of any contract termination during the past 72 months, due to default of your company, or its sub-contractors. Indicate if your company is currently in litigation with any organization regarding failure to fulfill contractual obligations, performance, or for copyright and patent infringement. Disclosure of any actual or potential conflicts of interest I. Subcontractor Relationship(s): Complete the following table for each subcontractor Organization Name Area Outsourced Partnership Length Name of Previous Successful Effort Together % Of Total Offering (as measure II. Company Viability All proposals must include the following documents for the company, as well as for anticipated subcontractors who will perform at least 20% of the contracted work: Gross and net revenues in 2008, 2009, and 2010. Projected 2011 revenue. Most recent annual report and 10 K form Percentage of revenue attributable to your HIE solution. Provide audited financial statements for 2009 and 2010, as an appendix, including an income statement, state of cash flows, balance sheet, and opinion statement of an independent certified public accountant. Current Dun and Bradstreet Comprehensive Insight Plus Report on the company Is the company privately held or publicly traced? Bankruptcies filed, if any Current litigation issues Litigations within the past 5 years Committed projects, in the next 12 to 18 months, with revenues over $100K. 7.4 Response to Technical Requirements/ Technology Describe your understanding of the requirements set forth in the Technical Requirements section (section 2) of this RFP, and provide detailed solutions. Technical diagrams may be included within the appendices.

7.5 Response to Standards Support and Commitment 7.5.1 HIE Integration Profiles: Elaborate on the HIE integration profiles your product currently supports. How do you intend to keep up with improvements and new relevant profiles? List Connectathon results from over the past 2 years, including connected system names, and descriptions of data connections and integration types. 7.5.2 Message Standards and Transport Protocols Describe your company s ability to support standards and transport protocols, and its process for evaluating and implementing additional standards. 7.5.3 Clinical Terminology Standards Describe how your company supports clinical terminology standards. 7.6 Response to Provider Workflow Describe the process of the provider s ability to access, publish, and consume HIE data from within the EMR. In addition, detail any provider organization requirements for its EMRs to be able to access, publish, and consume data from your HIE solution. 7.7 Response to Hosting Do you have the ability to host the solution or does your company have an existing relationship with a host provider? If not, describe your suggested hosting approach. How will the hosting solution impact implementation timelines and costs? 7.8 Response to Implementation and Support 7.8.1 Core Infrastructure Roll-Out Provide a project plan including key milestones, dependencies, timeframes, and resources. Discuss the variables that will drive implementation timeframes. Discuss the process for controlling costs if scope changes are necessary to meet the requirement. Describe the number and type of resources you would assign and their technical and functional roles. Describe your testing process.

7.8.2 Data Source and Participation Integration Present a project plan for deploying a local edge device Present a project plan for deploying a central hosted repository, and the level of effort anticipated. 7.8.3 Support and Training Describe your issue escalation process and process to classify defects How will you support the HIE throughout various exchange service implementations? Do you offer 24 x 7 x 365 support? Will there be dedicated support staff? Is there call center support? Do you offer product training to our HIE technologists? How much training is required to develop proficiency? 7.9 Response to Vision of State X Describe your vision for a Statewide HIE in State X in the short term and in 10 years. How do you see this HIE interacting with a NHIN? What unique features of your company support your ability to meet your vision? 7.10 Response to Experience and References: Description of the company s experience in the development and implementation of all HIEs, including those similar in size, scope, and complexity based on this RFP. List all the HIE s your company has been involved with, currently and in the past, and the status of those implementations. Include each of the customer s names, a description of the HIE project, the launch and production dates of those projects, the products installed, the current deployment status, relevant metrics around success, and approximate number of organizations and providers connected directly, or indirectly, to each of those projects. Your proposal must include the contact names and contact information of, at least, three customers, who can comment on your company s participation in projects similar in nature and size to the project described in this RFP. All listed customers must be external to your organization and corporate structure. These customers will be contacted as references, should your company be selected as a finalist, and selected site visits will be conducted. Your company will be responsible for obtaining permission for the Statewide HIO to contact each listed reference.

7.11 Response to Pricing Provide complete and comprehensive pricing for all implementation costs, software, and professional services within the Pricing Sheet appendix, as described in Section 4 of this RFP. These spreadsheets will be utilized to compare proposals between vendors and to administer the contract after vendor selection. 7.12 Statement of Work All proposals must include a statement of work that defines your understanding of the objectives of the Statewide HIO and the major activities that must be performed to complete the work. You must provide your solution to all the service and system requirements defined in this RFP. This will include a high level work plan and work breakdown structure, as well as a milestone-based project schedule. 8. Submission and Decision Schedules DESCRIPTION DATE RFP Release Date February 2, 2011 Intent to Respond Due Date March 2, 2011 Vendor Questions and Clarification Requests Due March 16, 2011 RFP Due Date April 15, 2011 RFP Selection Committee Review Complete May 29, 2009 Vendor Demonstrations May 30 June 16, 2011 Award Announcement July 1, 2011 9. RFP Terms and Conditions 9.1 Proposal Response Statewide HIO reserves the right to reject any/all proposals received in response to this RFP. Applicants will be notified of all decisions, but the Statewide HIO is under no obligation to explain the reasons for any individual decisions. Statewide HIO may negotiate with multiple applicants in parallel processes, until a final contracting decision is made.

9.2 Confidentiality All proposals become the property of Statewide HIO and will not be returned. There is no guarantee made by Statewide HIO to preserve the confidentiality of the material submitted in response to this RFP. Proposals will be distributed or made available to members of the Statewide HIO, its advisory bodies and committees, and governmental oversight entities. Proprietary information should be marked as proprietary, not confidential. 9.3 Formal Contract An applicant receiving a positive response to their proposal should be prepared to immediately begin negotiations of final terms. However, this does not guarantee to the applicant that a contract will be entered into with Statewide HIO. Statewide HIO may discontinue negotiations with the applicant at any time, at its sole discretion. PROVIDE A COPY OF YOUR STANDARD CONTRACT WITH YOUR RESPONSE. 9.4 Maintaining Pricing Pricing must remain valid for at least ninety (90) days from the closing. 9.5 Cost of Proposal Preparation The vendor will assume all vendor costs for proposal preparation and negotiations. 9.6 Applicable Law The appropriate terms and conditions, laws and regulations of Statewide HIO will apply to any contract that may arise from this RFP. The successful vendor must agree to jurisdiction and legal venue in Statewide HIO. Appendix A Selection Criteria Category Score Price of the system 15 Vendor respondent experience 15 Vendor qualifications meet the Minimum Requirements stated in the RFP 10 Response to requests for additional information from vendor respondent 10 Scalability of the proposed system to meet future growth of the HIE 15 Vendor respondent ability to provide all aspects of the RFP: 15 Infrastructure, design and host services Usability of the system for end-users and IT staff maintenance within the 10 HIE Vendor References 10 Total Score 100

Attachments HIE Features and Functions v1 2-3-11.x HIE RFP TCO & Pricing Sheet_project RFP Agreement Form.doc References Chesapeake Regional Information System for our Patients (CRISP), Request for Proposal. HIE Core Infrastructure, November 16, 2009. hsd.aphsa.org/issues/.../maryland- CRISPCoreInfrastructureRFPFINAL.pdf KLAS. (2009). Health Information Exachanges: The Reality of HIE Adoption. KLAS. Missouri Health Information Organization (MHIO) Request for Proposals-Technical Services Partner, November 12, 2010, www.dss.mo.gov/hie/action/pdf2010/rfp_11122010.pdf North Carolina Healthcare Information and Communications Alliance, Inc. (NCHICA) Request for Proposals, February 25, 2010, hsd.aphsa.org/issues/docs/2010/northcarolinagatewayrfp.pdf Porter-Roth, B. (2002). Administrative Requirements. In B. Porter-Roth, Request for Proposal A guide to Effective RFP Development (pp. 61-96). Indianapolis, IN: Pearson Education, Inc. (Washington State HIE HUB OneHealthPort RFP, 2010) Solicitation to Assist the North Carolina Health Information Exchange Develop a RFP for Statewide HIE Services. Request for Proposals RFP# 201101-01, https://www.scio.nc.gov/.../nchie_rfp_201101-1 Addendum_1 Consultant_Request_for_Proposals.pdf Trinity Health PMO library, HIE RFP TCO & Pricing Sheet.xls, 2011.

Trinity Health Project Management Office (PMO) Library, HIE Features & Functions.xls, 2011. Washington State HIE HUB OneHealthPort RFP. (2010, August 11). Retrieved January 30, 2011, from http://www.onehealthport.com. West Virginia Health Information Network (WVHIN), Request for Proposal as Amended. December 22, 2009. www.wvhin.org/.../wvhin_request_for_proposal_addendum_12-22- 09-_