Vendors

DHIN Projects

On occasion, the Delaware Health Information Network issues requests for vendors to consider supporting DHIN’s needs on a particular project. Those requests will be shared here.

Request for Proposal: Assessment of the Impact and Value of DHIN (posted 3/31/20)

Request for Proposal: Strategic Planning (posted 3/31/20)


Response to Vendor Questions

Questions asked in response to a DHIN Request for Proposal will be answered here.

Please note: Responses to both RFPs may be submitted electronically by 5 pm on Friday, May 29th to jan.lee@dhin.org, with a cc to randy.farmer@dhin.org. Hardcopy submissions are not required.

Questions received in response to both RFPs listed above (posted 4/16/20, updated 4/21, 4/24)

Current Capabilities, Metrics and Services

Q. What DHIN data exchange and metric data is currently available for analysis?

A. DHIN’s monthly report for its Board of Directors, which includes metrics for all services. Additional metrics may be made available upon further discussion.

Q. What external data is available for use in the analysis (e.g. statewide acute care/ambulatory care/public health databases)?

A. The Delaware Division of Public Health has had the opportunity to connect claims with their external data. This has been done already with the Lung Cancer Registry information. 

DHIN continues to focus on enhancing its claims data to improve analytic ease and utility of the collected data.

Q. Can you provide more specific definitions of services offered on page 11 of RFP 1 (Evaluation)?

A. Please see DHIN’s current service catalogue, available here.

Q. Please list other HIEs with whom DHIN is currently exchanging data or sharing services.

A. CRISP (Maryland, DC and West Virginia); NJSHINE (South Jersey) and HSX (limited to 6 facilities in SE PA, ED visits only by Delaware residents who are under active care of a DE provider)

Q. What were the goals of the 2013 program?

A. The goal of this study was to conduct a rigorous evaluation of the data exchange program to assess the nature and extent to which DHIN had an impact on important patient safety, quality processes, and outcomes within the state. By way of background, the 2013 assessment was a requirement of the HIE Cooperative Program (by the Office of National Coordinator – ONC). There were specific things that ONC wanted measured, in addition to those items that DHIN wanted measured.

Q. How exactly was the value of the program evaluated or measured in 2013?

A. Please see the Maestro Final report, here, for these insights.

Q. Would you like to continue to track any of the insights from the 2013 work? If yes, which elements?

A. Yes, we would look to review all of the elements that were reviewed previously (as outlined on slide 6 of the final report, with additional stakeholders (e.g. Payers, Public Health, the other 3rd party users of clinical data such as life insurance companies, clinical researchers, other state agencies, etc.). This will be expanded upon and detailed with the successful research company.

The successful bidder will not just be executing a DHIN-defined measurement plan, but rather will collaborate with us and our stakeholders to identify and then measure (qualitatively and quantitatively) possible value streams. There may be things we couldn’t measure in 2011 and 2013 that we can now, and the whole value proposition may be different than it was then due to a different national landscape and competitive market.

Q. Who do you anticipate your future competitors to be?

A. Large hospital-based EMRs, Large consumer tech companies getting in to health IT (Apple, Google, etc.) and national networks that could commoditize our core service(s) of results delivery, the community health record and coordination of care services. That being said, the successful bidder will need to provide an evaluation of the marketplace and supply their insights and conclusions from this analysis.

Q. For our understanding of the platform, would you be able to provide the DHIN HIE architecture model?

A. Please see both the high level overview and the data flow here

Administrative and Organizational

Q. What are the travel and expense policies required for out-of-pockets associated with the engagement?

A. Mileage at IRS rate, other travel and out-of-pocket expenses to be cleared in advance 

Q. Will DHIN provide administrative support for scheduling interviews, focus group, on/off-site interactions?

A. Yes

Q. Will all questions from all submitters be available for view?

A. Yes, here on DHIN’s website

Q. What DHIN committee structures are currently in place and what are their purposes?

A. DHIN Committees

Board of Directors: DHIN Board members play an important role in the strategic planning and oversight of DHIN. Members ensure that the Mission, Vision and Goals of the Delaware Health Information Network are carried through, in addition to setting the primary goals which serve as the basis for interoperability among all health care providers in the state of Delaware. The Board is appointed by the Governor to act on behalf of all Delaware stakeholders.

Executive Committee: The Executive Committee oversees the operations of the DHIN and the Board of Directors. In addition, the Executive Committee evaluates the performance of the CEO and assists the CEO with leadership and management matters. The Executive Committee guides the development of and review and authorize personnel policies and procedures and is empowered to act
on such personnel issues as may be brought forward by the CEO.

HCCD Committee: The Health Care Claims Database Access Committee reviews requests to access data from the Health Care Claims Database and is composed primarily of representatives of the payers, hospital reps. and general employers.

Advisory Groups

CIO Advisory Board: The CIO Advisory Board, consisting of CIOs or senior IT representatives from DHIN data senders, provides a forum for strategic communications with DHIN stakeholders at the technical level.

Project Management Working Group: The Project Management Working Group, consisting of project managers from Delaware data senders, provides a forum for communications with the DHIN at the tactical and operations level. 

Q. Will you provide “warm” introductions to all stakeholders as identified in RFP 2 (Strategy)?

A. Yes

Q. As long as it is deemed safe, does DHIN have a preference for having at least one of our team members frequently available on site at DHIN or is virtual communication equally preferred?

A. If we are still under travel restrictions when this engagement begins, it is essential that the successful bidder is able to conduct the entire engagement remotely, and we expect the proposal to reflect how that will be accomplished. Even if travel restrictions and restrictions on public gathering are lifted, we would expect the successful bidder to exercise mature judgment as to whether the goals of the engagement require on-site contact or could equally well be accomplished by web or teleconferencing.

Q. Please let us know of any important interim milestones (management meetings etc.) that have already been scheduled for 2020/21 for us to factor into the work plan.

A. Please see below:
*Weekly manager meetings – focus on the tactical/operational issues
*Monthly 2-day manager off-sites – focus on the strategic/tactical issues
*Quarterly Board meetings in late July, October, January, and April – CEO reports progress against current year goals any other items for board decision or information.

Q. Please expand on the impact DHIN may experience given the potential threats and opportunities posed by the newly released rules by ONC and CMS in support of the interoperability and information blocking requirements of the 21st Century Cures Act and the emerging Trusted Exchange Framework and Common Agreement (TEFCA). Threat assessment generated from TEFCA related changes includes potential increase in competition from national-hospital based EMR’s, Commercial players (e.g. Apple, Google, etc.), as well as the growth and adoption of national networks (eHealth exchange, CommonWell, etc.).

A. This is part of what DHIN wants the successful bidder to evaluate after fully understanding DHIN’s current services, level of adoption and utilization, and our business model. DHIN expects the selected bidder to understand the national landscape, which includes the listed law and regulations, and we expect them to help us evaluate our current services and business model in light of that understanding and to be able to provide suggestions or options for strategies for our continued success in view of these new market conditions.

Q. Our assumption is that in order to answer the following aspects of the benefit evaluation, we will need input from the stakeholders noted. Can you provide feedback on the specific pairings of outcomes and pertinent stakeholders listed below?

A. Patient care, such as reductions in readmissions, preventing admissions, avoiding adverse events, quality/cost of care analysis

  • Data senders – quality management officers within hospitals, labs, imaging groups – HIE within each system
  • State agencies such as the Division of Public Health, the Division of Services for Aging and Adults with Disabilities, the Division of Medicaid and Medical Assistance, the Division of Substance Abuse and Mental Health, State Employee Benefits Committee, Data sub-committee for brain trauma, Child Death Review Committee
  • Payors
  • ACOs

Overall health care costs, such as elimination of duplicate tests or procedures, reduction in ER visits, decline in average cost per case by diagnosis, reduction in overall hospitalization days per 1000 population, reduction in 30-day readmissions.

  • Data sender hospitals – quality management officers – HIE within each system
  • State agencies listed above
  • Payors
  • ACOs

Population health, care coordination and chronic disease management activities such as reduced admissions or ER visits based on specific diseases, reduced cost of care per case for specific diseases, comparison of DHIN community to risk databases (e.g. BFRSS), increased reach of patients in the community for preventive and screening procedures and tests 

  • Data senders centers – quality management officers – HIE within each system
  • State agencies listed above
  • Payors
  • ACOs
  • Other HIEs (CRISP, HSX, NJSHINE)
  • Consumer Advocacy Groups

Provider efficiency and satisfaction such as reduced cycle time from order to results, reduced wait time for patient history to support care decisions, increased physician time spent with patient, improved and timely access to information 

  • Data senders, both large and small (hospitals, labs, imaging groups)
  • Ambulatory providers and the Medical Society of Delaware Members
  • Payors
  • ACOs

Patient/consumer satisfaction such as eliminating redundancy in providing information between providers, easier access to health care information, reduced time to receive results 

  • Consumer advocacy groups
  • Ambulatory providers and the Medical Society of Delaware
  • Payors
  • ACOs
  • Patients

Administrative costs for information sharing and management including reduction in resource costs to manage paper, technology costs avoided, productivity gains 

  • Data centers – quality management officers – HIE within each system
  • Ambulatory providers and the Medical Society of Delaware
  • Payors
  • Insurance and claims processing industry (life insurance underwriters, workman’s comp claims processing companies, Social Security disability claims processing orgs)
  • ACOs

Specific benefits to State agencies, such as Division of Public Health, Division of Medicaid and Medical Assistance, Division of Substance Abuse and Mental Health, the Delaware Healthcare Commission, the State Employee Benefits Committee, and perhaps others.

  • Key legislators and the Delaware Healthcare Commission
  • Office of the Governor
  • State agencies listed above

Benefits to payers, both direct and indirect, such as gains from leveraging the Community Health Record to facilitate HEDIS chart reviews and general care coordination activities as well as general benefits from efficiencies generated in the broader state health care ecosystem.

  • Payors
  • ACOs
  • Key legislators and the Delaware Healthcare Commission
  • Office of the Governor
  • DHIN’s board of directors
  • DHIN management and staff
  • Ambulatory providers and the Medical Society of Delaware

The value and return on DHIN’s considerable investment in ITIL-IT Service Management training and certification for its staff and management team. 

  • DHIN’s board of directors
  • DHIN management and staff
  • DHIN IT suppliers
  • DHIN IT counterparts at large data sending organizations

Questions specific to Strategic Planning Facilitation RFP (#2020-002) (posted 4/21, updated 4/24)

Q. Is there an existing long-term strategy that you would like us to review before starting the strategic planning (or) would you like us to design an approach that includes a completely new strategy?

A. We are entering the last year of a five year strategic plan and are looking for a new plan to enact for the subsequent five years. Details on the previous plan will be provided to the successful candidate to facilitate the in-depth research process that will be essential for creating the next plan.

Q. Please advise on expectations you have of us to help with some of the activities following the strategic planning, especially with financial planning and execution of the strategic plan? If yes, please let us know the level of detail we need to get to on these areas?

A. DHIN is not contemplating assistance with implementation at this time. This will depend largely on the adopted and agreed upon objectives of the next plan.

Q. Has any part of the strategy planning already been initiated that you would want us to consider as we think about the approach?

A. Not in terms of responding to the RFP as this is more of a question to be addressed after the contract for the service has been awarded. DHIN has conducted its own environmental scan and SWOT analytics for our FY20 planning that we will be glad to provide to the successful bidder. These items will be updated and refreshed for FY21 and will forward as part of this engagement.

Q. If we are to do the strategic planning process, what kinds of documentation are you able to share with us – prior strategic plan, ongoing initiatives and resources already invested there?

A. Yes to all of these and other essential documents, as needed.

Q. Who is to be actively included in the development of a strategic plan? Is it fair that the key stakeholder groups (board of directors, management and staff, data senders, ambulatory providers and MSD, payors, key legislators, state agencies, Office of the Governor and consumer advocacy groups) should be queried for input, but not necessarily included in the strategic plan development? Do you have access to members of these key stakeholder groups?

A. Access to our stakeholders is a reasonable expectation and can be assumed for most if not all of these stakeholders plus others as deemed appropriate. That being said, the DHIN management and board (in that order) are those who will have the most input into the actual development of the strategic plan, with other stakeholders consulted for input.

Q. Does DHIN have constraints or preferences on the types of individuals / organizations we can reach out to gather inputs and insights (esp. among payors, legislators, advocacy groups)?

A. Yes access to these contacts will be coordinated as deemed essential to the development of the strategic plan.

Q. At what level of detail should the organizational evaluation and potential restructuring be part of the strategic plan?

A. At minimum, the strategic plan should include organizational modifications at any level that is deemed essential to the implementation of the plan. The current structure should not be assumed as fixed and unchangeable, but restructuring should only be recommended if it is important to enable us to accomplish the goals of the strategic plan.

Q. Are there any adjustments being made to the overall timelines or the process structure to factor the impacts of COVID-19?

A. No changes to the timeline currently being contemplated at this time. We will factor that in when we develop our approach, but wanted to understand how DHIN is approaching this so that we can best support you.

Q. Does DHIN have a specific budget for this project that the proposal should not exceed?

A. This is not something that is appropriate to share at this point in the process. 

Thank you for your interest in DHIN, Delaware’s statewide health information exchange.

Testimonials

“I think it has saved a lot of money particularly for my practice. I’m not getting duplicate faxes sent to me and from other facilities and that’s been a huge resource in terms of time. My staff is not spending time on the phone trying to get results sent. Instead we can just log onto DHIN, verify the patient, and have access to all of that in less than 30 seconds.”

– Sherin Ibrahim-Howett, DO, Sleep and Internal Medicine – The Pearl Clinic

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