Due to an overwhelming response we are requiring IOOs to complete an Executive Summary about their business for the RFI. Please complete the one page summary and return it with your RFI submission by November 23rd at 9:00am. Download the summary>>
Request for Information from Implementing Optimization Organizations
The Massachusetts eHealth Institute (“MeHI”), a non-divisible component of the Massachusetts Technology Collaborative (“MTC”) is issuing this Request for Information from Implementing Optimization Organizations (“RFI”) (No. 2010-eHR-01) to seek information from these organizations (“IOOs”) that are capable of carrying out the deployment of a large number of electronic health record systems (“EHRs”) at distributed provider sites in Massachusetts. Based on the provisions of the American Recovery and Reinvestment Act of 2009 (“ARRA”) described in the RFI, IOOs will concentrate their activities primarily on assisting primary care physicians and entities that serve a significant number of low income persons to achieve “meaningful use” of certified EHRs, with particular focus on: 1) individual and small group practices (ten or fewer professionals with prescriptive privileges); 2) Public Hospitals and Critical Access hospitals; 3) Community Health Centers and Rural Health Clinics; and 4) other settings that predominantly serve uninsured, underinsured, and medically underserved populations.
RESPONDENTS PLEASE NOTE: This RFI is not a procurement process but rather an information gathering process that may inform any requests for proposals or qualifications or certifications that may follow MTC’s receipt of ARRA funds, as described in the RFI.
Please submit questions or comments regarding the RFI to info@maehi.org. All questions and comments will be posted on this webpage. Responses/clarifications from MeHI will be posted within 2 business days of receipt. All questions and comments are due no later than 5:00 pm on November 13, 2009.
Schedule:
October 30, 2009: RFI Issued
November 13, 2009: Questions & Comments Due
November 23, 2009: Responses Due, including Executive Summary
Due to an overwhelming response we are requiring IOOs to complete an Executive Summary about their business for the RFI. Please complete the one page summary and return it with your RFI submission by November 23rd at 9:00am.
Download Request for Information (PDF)
Dowload Executive Summary to be completed by respondents
1. Question: Is MeHI looking for IOOs that are all encompassing and provide all services as identified in the RFI?
Response: MeHI is looking for IOOs that are qualified to facilitate the implementation of EHRs. MeHI will consider IOOs that have a distinct set of core competencies and expertise and are willing to partner with other organizations. In your response, please be specific about the services that you can provide and those services that might be provided through another source.
2. Question (on RFI Section 2): In our response to the last sentence of this question, do we have to name the provider entities?
Response: No, you do not need to name the provider entities.
3. Question (on RFI Section 5): Please define what you mean by “implementation guide.”
Response: An implementation guide is a formal document describing the process you use to support the implementation of an EHR in a provider practice.
4. Question (on RFI Section 12): With respect to the term “HIE Implementation”, do you mean connectivity/ interfacing from an EHR to the HIE or implementation of the actual HIE?
Response: We are referring to connectivity/interfacing from an EHR to the HIE.
5. Question (on RFI Section 15): What specific information would you like with respect to the references?
Response: Please describe the nature of the reference including the name, key contact at the organization; the relationship you had with the organization and services provided to the organization.
6. Question (on RFI Section 9): Can you describe further what you mean by types of incentives? And do you see this as instrumental to the recruitment process?
Response: MeHI plans to incent IOOs based upon key provider specific milestones.
- Signed technical assistance contracts with provider
- Documentation of Go-Live status on a certified EHR, with active quality reporting and electronic prescribing;
- Meeting the meaningful use criteria established by the Secretary
IOOs will be expected to identify and recruit priority primary care providers to provide EHR implementation services. MeHI will staff a Clinical Relationship Manager(CRM) on each certified IOO implementation. CRMs are the key MeHI client-facing individuals responsible for facilitating collaboration between MeHI, IOOs and the provider clients, ensuring compliance with state and MeHI policies, effective use of MeHI-appropriated funds and monitoring provider satisfaction and adoption.
There is no additional financial remuneration to the IOO from MeHI other than the payments made to the REC by the federal government to support the implementation of the priority primary care providers.
7. Question (on RFI Section 12): Please clarify “provide your top five implementation scenarios”. Is this intended to be based on types of practices or where a practice in phase of implementation or other?
Response: We would like to know both the type of practices that you have implemented and the various phases of implementation that you have been involved in with a practice.
8. Question: Can you provide any guidance in regards to MeHI’s desired length of the RFI response?
Response: Your responses to the RFI should provide enough information for MeHI to understand your organization’s core competencies and experience. Additionally, we have provided an Executive Summary sheet that has been posted on the web site and we are asking IOOs to complete that document as well and submit it with the RFI response.
9. Question: We are already on an "approved vendor" list with MeHI from responding to an earlier RFI in the Spring. As such do we need to provide the same level of detail to this RFI that was previously provided? What is the relationship between the RFI?
Response: This RFI for IOOs is unrelated to any prior RFI/RFP/RFQ. Therefore, questions should be answered for this document.
10. Question: Are Large Clinics and hospitals in-scope for IOOs?
Response: Yes.
11. Question: Confirmation on who will contract with the physician practices? Will IOOs only contract for Implementation Services?
Response: IOOs will contract directly with providers to provide services. As part of the IOO certification process, IOOs will be required to use a standardized contract when providing services to a provider that MeHI works with the IOOs to develop. IOOs can contract with a provider for any or all services related to advancing the provider to meaningful use.
12. Question: Who's responsible for seeking the targeted physician practices? Is it the IOO or MeHI?
Response: IOOs will be expected to identify and recruit providers to work with. However, MeHI will be employing Clinical Relationship Managers (CRMs) who will also be available to assist IOOs with provider recruitment, if necessary.
13. Question: What will be the role of IOOs during vendor selection for EMRs, H/W, S/W, connectivity etc?:
- Will MeHI be looking to the IOOs for assistance in EMR vendor selection process?
- Is the intent to only have a few approved EMR vendor list for physicians to pick from?
- Who will negotiate pricing with the EMR Vendors?
Response: To the extent possible, certified IOOs should be involved in all aspects of helping a provider in their selection of a certified EHR, HW, SW etc., if that provider requires that level of assistance. MeHI is exploring a preferred pricing arrangement for certified EHRs through an RFI (issued Nov. 12, 2009).
14. Question: a. Will MeHI be awarding to one organization to be the IOO or several?
b. If several organizations will be awarded IOO responsibility, is MeHI looking to designate by region, by scope of services (EMR rollout, training, HIE), by provider type (solo practice, large practice, etc.)?
Response: MeHI intends to identify and contract with multiple IOOs to carry out this work. No decisions have been made with regard to dividing the IOOs by geography or scope of services. MeHI will analyze the IOO responses, the core competencies and geographic reach/ capabilities.
15. Question (on RFI Section 8): Can you clarify Question 8 on page 5?
"Please describe your organization's composition of staff for practice support:
- Budget
- Staffing
- Financial planning"
Response: Question # 8 is specifically requesting if there is staff appropriated and skilled for practice support in terms of the following:
- Budget
- Staffing
- Financial planning
- Procurement and contracting
- Governance
- Communication and outreach
16. Question: Please define the scope of "full implementation services" by an IOO, as illustrated in Attachment B. What are MeHI's expectations regarding an IOO's relationship with EHR vendors. The executive summary and the RFI request information that reflects an EHR installation versus an implementation and/or optimization, which involves so much more.
Response: IOOs will be expected to provide full support to provider practices to achieve meaningful use of an EHR and qualify for their incentive payments and meet the requirements of Chapter 305. Implied is the need for implementation and optimization of a certified EHR.
17. Question (on RFI Section 7): Please clarify what is meant by the "capacity and performance optimization" referred to in #7.
Response: Question # 7 is specifically requesting if there is staff appropriated and skilled from the IOO for capacity and performance optimization as the IOO team is built to support an EHR implementation at a practice.
18. Question (on RFI Section 6): Please clarify MeHI's position regarding the IOO incentives mentioned in the answer to Question # 6. Who is eligible to receive those incentives? What are the parameters around the ability of an IOO to charge additional fees for their services above the $5,000/physician federal monies provided by the REC? Will practices be expected to shop for IOOs to obtain the best deal?
Response: The IOO will negotiate services with provider practices and MeHI/REC will provide a percentage of the incentives to IOOs based upon achieving specific milestones that have been identified by the federal government.
- Signed technical assistance contracts with provider
- Documentation of Go-Live status on a certified EHR, with active quality reporting and electronic prescribing;
- Meeting the meaningful use criteria established by the Secretary of Health and Human Services
It will be up to the IOO to negotiate with providers and ultimately providers will select an IOO based upon needs, fit and price.
19. Question: What is the goal of this initiative? As indicated, the RFI seems to address EHR installations, but does not mention the optimization aspect of this initiative necessary to achieve meaningful use. Many physicians have a vendor installed product, but are unable to use their EHR to improve the care they deliver in a way that would meet meaningful use criteria. To what extent should IOOs work with physicians who have an EHR to get them to meaningful use?
Response: Two goals of the initiative are to get all primary care priority providers to meaningful use so that they can qualify for the maximum incentive dollars available through Medicare/Medicaid and meet the requirements of Chapter 305. In some cases it will require taking a provider from paper to a certified EHR and in other circumstances it may be taking a provider already using an EHR to meaningful use. Both types of scenarios are in scope for IOOs.
20. Question: The RFI released is a great tool for gathering information on IOO's that will be able to support the State HIE plan as well as Regional Extension Centers in MA. However from the RFI it is not clear how an organization that supplies State-wide shared services should respond. What approach should be taken in that case?
A couple of specific services and/or tasks serve as an example below:
1. Determining high need physicians both planning and contacting. How would this type of service be proposed and fit within the RFI format.
2. Providing and maintaining a Massachusetts wide provider database that would include identifiers (state license info, NPI) as well as provider practice relationships (i.e. group practice location information, contact information, demographics...for EMR implementations, for State-wide HIE, for consumer directed consent and auditing information etc.
Response: These questions are important and necessary to inform this process moving forward; however, this RFI specifically focuses on IOOs assisting providers with their EHR implementation and optimization.