RFP155-10 Addendum 1

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RFP155-10 Addendum 1

  1. 1. PURCHASING DEPARTMENT 2211 Lomas Blvd., NE Albuquerque, New Mexico 87106 ADDENDUM NUMBER 1 Date: April 19, 2010 Proposal Number: 155-10 Name of Buyer: Cindy Guest Due Date: April 30, 2010 Due Time: 3:00 PM MST Addendum: See Below Clarification Questions for RFP 155-10 Dictation and Transcription Solutions. Notice to all respondents: This addendum becomes part of the Contract Documents and modifies, as noted below, the original Bidding Documents. i. Please see the following list of Question and Answers. ii. All other terms and conditions remain the same. ***************************************************************************** 1. Albeit is stated only once in the document and I want to be sure I understand this correctly. You are looking for the technology and systems to capture dictation and the platform for transcribing only. You are not looking for a service that provides that and the actual work of transcribing. You have an in-house staff for that purpose. Correct. We are looking for Dictation system to replace our aging system and Transcription technology for in-house transcription staff. 2. Do you intend to keep your in house transcriptionists, totally outsource the transcription, or a combination of the two? We intend to keep your in house transcriptionists. We currently outsource 10% overflow and will need to continue with an outsource company for the overflow 3. Is it UNM Hospital’s preference for an ASP model or the purchase of the dictation / transcription system? ASP is preferred. a. If ASP is preferred would you entertain hosting at your site for your exclusive use As long as the system meets all of UNMH specifications and requirements. RFP No. 155-10 Addendum one 1
  2. 2. b. Would you entertain providing your own hardware Yes we would entertain this option. c. How many physical locations (sites) are there at UNMH that use dictation Estimated is 100 (all inhouse staff work from home) we have over 50 locations with the Radiology portion of existing system. 4. What is your current diction system type (i.e. Lanier, Dictaphone, etc.) and model? Medquist/Lanier d. How many ports are there currently available 28 dictation ports e. How many doctors use the call-in system estimated is 900 providers f. How many radiologists we have at one time 39 avg up to 50 radiologists logged in. g. How many pathologists Not applicable h. Do the transcription use call-in ports They currently use VXP to download their voice files. i. How long do you wish to retain dictation (voice files) after it is transcribed for (by work type please) 6 months j. How many minutes of dictation are dictated by department (i.e. medical records, radiology, pathology, clinics and ER) HIM volume dictated about 2 million minutes per year (medical records, clinics, ER) radiology? (speech Q in place) k. Is there currently any dictation done on other systems (i.e. out sourced, hand held digital recorders, etc.) and what volume No. 5. What is your current transcription system and model? Lanier VXP (voice); Cerner transcription a. Is the transcription system based on MS Word and what version Yes, MS Word in Cerner Transcription v 2003 b. Do you current use an electronic spell checker and which one (i.e. Stedmans) and which version Stedmans currently 2006, need new version c. Do you have separate transcriptionists in radiology and pathology No. d. Do you use at home transcriptionists and how do they connect to your system today Yes. Connected through a secure VPN connection to UNMH LAN to use Cerner Transcription. e. What type of Internet connection is typically used by the at-home transcriptionists (cable modem, DSL, etc.) All of the above. f. How are your transcriptionists currently paid (per hour and production) By the Line (0.105/line + 30% benefits). There are approximately 10 transcriptionists working in house (management, QA, flag jobs, difficult dictators, etc. salary $17-25/hour) g. What is your QA policy for transcribed work In house staff reviewing 5% transcriptionists work per month. All documents with more than 3 blanks are "flagged" for a Sr. Transcriptionist review (in-house hourly staff) 6. What PACs system do your radiologists use? Phillips ISite a. How many PACs stations are there in use 35 diagnostic reading stations, web based application (this is pointed out as there are medquist stations set up in doc offices) RFP No. 155-10 Addendum one 2
  3. 3. b. Is your dictation currently interfaced to the PACs system and how Radnet (Cerner) c. Is all radiology reading done on the PACs Yes d. What type of RIS system is used Cerner Radnet e. Is bar coding currently used No f. Is transcription typed directly into the RIS Typed into SpeechQ for mammo and cardiology 7. What LIS (Lab) system do your pathologists use? All lab reports are imported by our Lab service provider into Cerner. Not done onsite. a. How many pathology locations are there for dictation b. Is transcription typed directly into the LIS c. Is there any dictation done in an autopsy room d. Is bar coding currently used 8. What is your hardware vendor of choice (i.e. Dell, IBM, HP, etc.)? Dell and IBM a. Do you use thin clients Yes b. Do you use Citrix presentation manager Yes c. Where is your data center located and is there a backup site Remote hosting through Cerner d. What operating system is typically used (i.e. Windows Server 2003 / 2008) Windows 2003 e. Do you use MS SQL and what version Remote hosted through Cerner and remote desk top through speech q server. f. Do you prefer a redundant system implementation based on MS clustering? up to the vendor. YES g. What is the typical desktop used and what are the specifications and OS Windows XP. Specifications: fully patched, secure, HIPAA compliant, and complete system password protection. h. What backup mechanism and software is currently used For transcriptionists, local PC images with standard images throughout. Back up assist used for backup of sql server speech magic i. What is your corporate anti-virus software used McAfee Enterprise 9. Misc. questions a. Where do you see front-end voice recognition being used? Direct entry by providers into the Cerner EMR. b. How doctors do you anticipate using voice recognition for front-end and then for back end Unknown. Depends on how well the product works with Cerner. c. Do you currently use any voice recognition and if so what model Less than 50 providers utilizing Dragon Naturally Speaking Medical Version 10; Backend development with overflow company underway in less than 10% of our volume. d. What percentage of your doctors are native speaking Unknown. We have a diverse population of providers (primarily English-speaking, Spanish, Asian) e. Do your doctors currently correct their own reports electronically and on what system All documents are available online for e-signature with the option to correct prior to signing.Radiologists edit SQ RFP No. 155-10 Addendum one 3
  4. 4. f. On what system do your doctors currently electronically sign their reports from Cerner. Radiologists do in SQ 10. What is the brand/model of the current Dictation / transcription solution in place today? Medquist/Lanier Voicewriter /VXP for HIM and Cancer Treatment Center Staff. RadNet (Cerner), Speech Q system, Philips ISite PACS for Radiology. 11. Is this system located on-site at UNMH? or other campus? Yes 12. Does the current system support telephone dictation access? If so, how many ports are currently supported for simultaneous dictation (only)? Yes, 28 ports. 13. Of the estimated 95 in-house transcriptionists, what is the estimated number of PC’s that might be used for transcription (total) and how many of these might be in use at any one time? (Concurrent). 105 PCs assigned (includes Cancer Center), all may in use at one time (no set transcriptionist schedules) 14. Does the current system support the Radiology department at this time? Is so, can you indicate the number of Radiologists and the estimated number of concurrent workstations (PC’s)that would be needed to support the Radiology Departments dictation. In other words, how many reading stations and how many are needed at any given time? HIM supports the transcriptionist staff needed. 40 current work stations 15. Do these numbers include the Cancer Research and Treatment Center? There are 2 workstations Radiologists use in that space by the Radiologists. 16. Are the Radiology reading stations PACs ? if so what brand? Are there any reading stations that are NOT supported by PACs? If so how many? Not understanding this question as we answered above. 17. Does the current system support the acute care hospitals, provider clinics and Carrie Tingley Hospital? If not, please indicate if another system is used, or this represents an increase in the amount of dictation / transcription to be supported. Yes, all facilities included in volume dictation, except Cancer Center and Radiology. 18. You estimate 21,000,000 ASCI lines per year excluding the Cancer Center and Radiology; do you have the information for these departments as Radiology and Oncology are listed in the report type listings? The average Cancer Center volume is 2,110,680 lines per year. We have not been able to get any Radiology data. 19. You mentioned outsourced staff; will you want to keep your existing outside service vendors with the new system or are you anticipating changing them? Both options will be considered. 20. If anticipating changing outside service vendors, how many lines do they transcribe monthly and what types of work do they provide? Overflow/outside vendor is contracted for 10% of our current volume. 21. How many physicians do you anticipate utilizing front-end speech recognition? Not sure. Using front-end speech without transcriptionist intervention I suspect would have a low percentage adoption rate at UNMH. –all radiology 22. What is the maximum number of transcriptionists you anticipate working concurrently on the new system? Approximately 95-100 23. Can we possibly get a statement of your minimum security requirements? UMN Hospitals controls and minimum security standards are based on the appropriate NIST or ISO 27002 standard. Example: Transport Layer Security Processes must meet NIST 800-52. *All vendors are aware of these standards required by best practices and federal regulations such as HIPAA. 24. Section V is structured as a series of questions without indication as to which are absolute requirements and which are optionally desirable. We are capable of implementing nearly everything listed but there is cost *HIPAA and best practices require the items listed. The vendor should state what controls they have in place. RFP No. 155-10 Addendum one 4
  5. 5. Extra cost to meet the requirements of HIPAA of any given control should be clearly explained by the vendor. associated with each item. We would like to be cost conscious and only propose what you will require. 25. Do you presently own and operate VMware virtual infrastructure products? Yes a. If so, which version of ESX do you utilize? Not sure b. Do you utilize Site Recovery Manager? Not sure c. Do you utilize VMware View (virtual desktops) or are they in consideration? Or do you utilize any thin-client architecture in the hospitals? Desktops no; thin- clients yes. 26. Do you have or intend to install a VoIP network? Yes (Have now -or- intend to install) (IF 'have now' is it through Verizon Business?) Yes we currently have VoIP; we manage this inhouse. 27. Is UNMH presently a Verizon Business customer? (I can explain the reason for this question if requested to do so) Yes 28. Do you utilize Cerner for Radiology? Laboratory? Please list which products you utilize. Radiology--Yes. Lab is not part of the UNMH Dictation services. Cerner Radnet ISite PACS 29. Do you wish to have bi-directional communication between the dictation system and Cerner to notify Cerner when jobs have been opened in the dictation system? Yes 30. Do you have a Wireless network throughout the different facilities? Yes. (Is this also from Verizon?) Throughout most of the UNM facilities; managed in house. 31. Do you utilize Dell/Perot Systems at all currently? No 32. What % of the 21 million line currently transcribe per year is outsources to a service. We currently outsource 10% overflow and will need to continue with an outsource company for the overflow. 33. Of the work sent out, please define the work types. All 34. Do you expect any increases or decreases in volumes outsourced in the next year. Some growth in outpatient clinics expected. 35. Please identify the current identifying information the originators input before dictation. Ex- 3 digit doctor I.D. + 2 digit work type + a 6 digit patient ID. 7 digit MRN, 2 digit work type 36. In Section 5, the questions states: can you model merge both voice and text for ease of report Q.M. Could you please define the expectation. Ability to hear the voice file and read the text in one application for quality assurance reviews. 37. What is the current price per line at UNM Hospital? By the Line (0.105/line + 30% benefits). There are approximately 10 transcriptionists working in house (management, QA, flag jobs, difficult dictators, etc. salary $17-25/hour) 38. Since UNM Hospital has an in-house staff of about 95 transcriptionists, approximately how many lines should vendors expect to receive for transcription? See RFP. 39. The RFP mentions that it is looking for a Dictation/Transcription system to be used by in- house staff. Is this RFP just for a system or also to obtain service from a vendor’s transcriptionists? System only. 40. Section V, Evaluation Criteria, states Primary Evaluation criteria is "the need for competent and high quality medical transcription services and compatibility with our Cerner Millennium product". Section VI, Scope of Services Background states, "Scope of services for this RFP includes dictation and transcription solutions...Additional Dictation and Transcription services considered for review at this time..." Please clarify, is this RFP for dictation and transcription technology, or transcription services or a combination of dictation and transcription technology and services? RFP No. 155-10 Addendum one 5
  6. 6. Current RFP is for dictation and transcription technology. We plan to keep our internal transcription staff. 41. Section VII, m. "List of all litigation..." Please clarify, current litigation or past litigation, both? If past, how far back, 1 year, 2 years? Please include past litigation; 2 years is acceptable. 42. Please provide a definition of the UNMH unit of measure, ASCII Line without headers and footers. Is this a 60 character or 65 character ASCII line, does it include white spaces? Please be specific. 65 character line with spaces. 43. 21,000,000 ASCII lines for hospital and clinics. Please identify how many lines are hospital and how many lines are clinic. Not applicable. All clinics are part of the UNMH system and treated as one system. 44. 21,000,000 ASCII lines, how many lines are transcribed in house? How many lines are outsourced? How many outsource vendors are currently utilized? 90% lines completed by in house staff; 10% contracted to vendor. 45. What if any are the issues or challenges you are currently experiencing with Cerner? Interface issues? Upload or down load issues? What specifically are you looking to emulate, resolve or improve? Cerner Transcription is basically a word product; there are few timesaving features for transcriptionists. There is no current interface to Cerner; transcriptionists are hand-typing the Cerner Properties Box (patient ADT information) into the reports. Transcriptionists experience Cerner slowness issues because they are working directly in the Cerner EMR. 46. What is the annual volume of reports generated at UNMH hospital? What is the average number of lines per report? Average turnaround time? What is the percentage of STATs? FY09 = 437,040 reports transcribed. 47. What is the annual volume of reports generated at UNMH clinics? What is the average number of lines per report? Average turnaround time? What is the percentage of STATs? Included in above numbers; not counted separately. Average lines per report is not available. Average TAT for clinics is 72 hours; wishing to decrease to 24-48. All work type TATs range between 8 hours and 72 hours. Stat TAT is 2 hours. Low percentage of stats. 48. How many providers currently dictate at UNMH hospitals? How many are employed by UNMH? How many have an attending/resident relationship? Attending #? Residents #? Approximately 600 providers routinely dictate. Most dictations are by residents and attending who are part of the UNMH staff. 49. How many providers currently dictate at UNMH clinics? How many have an attending/resident relationship? Attending #? Residents #? Same as above. 50. Please identify the type of management reporting required and/or desired at UNMH. i.e. TAT; Provider generated STAT's; volume per worktype; average TAT per worktype; blanks per provider; demographic changes per provider (i.e. incorrect worktype; incorrect patient demographic info, etc.), please provide as much detail as possible. TAT, Individual reports showing all reports not meeting TAT by service and/or work type; volume reports by work type, QA stats, blanks per provider would be nice. Our reports to date are minimal, we are seeking more detail. 51. Front end speech recognition, which providers within the UNMH system do you anticipate utilizing FESR technology? What are their report volume estimates? We currently have 50 Dragon licenses in use by providers. We have no way to capture usage in Cerner. Radiology 50+ 52. What is the UNMH standard for retention of voice files? Data files? 90 days. 53. Please describe the current UNMH disaster recovery plan as it relates to contingency plans for uninterrupted provider dictation in support of ongoing patient care, in the event RFP No. 155-10 Addendum one 6
  7. 7. of a regional or national interruption of telecommunication or internet services. Does the disaster recovery plan include the inclusion of premise based voice capture, voice transfer and voice retention, to mitigate possible disruptions? All text files are backed up Cerner (remote hosting). Voice files are retained for 90 days on our Medquist/Lanier system; I am not sure what the disaster recovery plan is for Medquist/Lanier. –Back up process through back up assist 54. Section V Security Requirements o. “Support data level access controls that allow assignment of security data level in files?” Ability to differentiate access (and edit functionality) to data by job position. 55. Transcription Requirements and Workflow Diagram How would your company propose getting the transcribed documents electronically into our Cerner EMR without the benefit of an HL7 interface? Are you planning a non-HL-7 interface?? Please clarify this question. Our experience is mainly with HL-7 for CERNER. We have done files with Headers containing meta data that is parsed and merged into HIS or EMR. Is that what is being asked here?? HL7 is our preference. 56. Sample Reports & Costs (10%) Explain all chargeable units and how they are defined, to include: Costs incurred for “stat” report requests and penalties to UNMH when stat reports are not completed in the contracted time frame. This is a RFP for technology platform and not for Transcription services. If that is true, how does this question fit into the RFP and what is expected. You are correct. This does not apply for technology platform. 57. What platform do the UNM transcriptionist currently work on? Cerner 58. Are all transcriptionist in-house or do they work from home? Work from home 59. What % of the 21 million line currently transcribe per year is outsources to a service. approximately 10% 60. Of the work sent out, please define the work types. All 61. Do you expect any increases or decreases in volumes outsourced in the next year. Some growth in outpatient clinics expected. 62. Please identify the current identifying information the originators input before dictation. Ex- 3 digit doctor I.D. + 2 digit work type + a 6 digit patient ID. 7 digit MRN, 2 digit work type 63. In Section 5, the questions states: can you model merge both voice and text for ease of report Q.M. Could you please define the expectation. Ability to hear the voice file and read the text in one application for quality assurance reviews. 64. What volume of work is to be handled by UNMH internal transcription staff and the vendor? 90% of volume will be handled by internal transcription staff. 65. What approximate percentage of the work per month is for STAT and TAT? What turnaround time is expected for STAT and TAT job? All work has defined TATs between 8-72 hours. Stat TAT is 2 hours. 66. Do you expect the work on this contract to be on-shore or off-shore? Domestic only. No off-shore services are allowed. 67. How do you define lines (65 characters with spaces or Without spaces? 65 characters with spaces. 68. Who is the current vendor and what is the current rate or cost per line? Not applicable. Inhouse transcripionists. 69. How much time is expected to complete an interface with Cerner EMR system? I am told the IT schedule is 18 months out. 70. Will front end speech recognition be wanted across all specialties, or just certain ones like Pathology and Radiology? Would like the option across all specialities. RFP No. 155-10 Addendum one 7
  8. 8. 71. Do you have front-end speech rec now? Across which specialties? Limited Dragon use. Radiology almost 100% front-end. Only 1doesn’t use it 72. If you presently use front-end speech outside of pathology and radiology, what percentage of physicians use front-end speech rec across all other specialties? Minimal usage (50 licenses in use) 73. Section VII.g, h, and i are questions about our medical transcriptionists. While we are happy to reply, we want to be certain that transcription services are not required. You are correct. We are looking for technology; we plan to keep our in house staff. 74. Do you utilize Dell/Perot Systems at all currently? No 75. Who is the current vendor for transcription at UNM hospital? Cerner Transcription. Dictation system is Medquist/Lanier 76. What is the current price per line at UNM Hospital? We pay our transcriptionists 0.105 per line + 30% benefits. 77. Since UNM Hospital has an in-house staff of about 95 transcriptionists, approximately how many lines should vendors expect to receive for transcription? See RFP. 78. The RFP mentions that it is looking for a Dictation/Transcription system to be used by in-house staff. Is this RFP just for a system or also to obtain service from a vendor’s transcriptionists? System only. 79. Will front end speech recognition be wanted across all specialties, or just certain ones like Pathology and Radiology? Would like the option across all specialities. 80. Do you have front-end speech rec now? Across which specialties? Limited Dragon use. Radiology almost 100% front-end. 81. If you presently use front-end speech outside of pathology and radiology, what percentage of physicians use front-end speech rec across all other specialties? Minimal usage (50 licenses in use) 82. Section VII.g, h, and i are questions about our medical transcriptionists. While we are happy to reply, we want to be certain that transcription services are not required. You are correct. We are looking for technology; we plan to keep our in house staff. 83. Can you please tell us who is the current vendor and what is the current rate or cost per line? Current equipment vendor is Medquist/Lanier. Our in-house (at-home) transcriptionists are paid $0.105 cents/line plus benefits (approximately 33%). RFP No. 155-10 Addendum one 8
  9. 9. RFP No. 155-10 Addendum one 9
  10. 10. RFP No. 155-10 Addendum one 9

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