CALIFORNIA PULSE+EMS INITIATIVE TO ADVANCE · PDF filecomplete the grant requirements within...

CALIFORNIA PULSE+EMS INITIATIVE TO ADVANCE HIE IN EMS HELD DECEMBER 18, 2015

Funded by Cooperative Agreement Grant #90IX0006/01-00 U.S. Department of Health and Human Services, Office of the National Coordinator for Health Information Technology

PULSE+EMS Project to Advance HIE in EMS California Emergency Medical Services Authority

• Ground Rules

• Overview and Goals

• Application

• Awards Process

• Questions and Answer

Agenda


Ground Rules

1. Any verbal answers given here are not official answers binding on the state.

2. Questions asked here will be captured and additional written questions will be accepted at [email protected] until 5 p.m. December 21, 2015.

3. Private questions cannot be answered. Ask all questions to the panel or send questions in writing.

4. Written answers to all questions asked here and those sent in to EMSA by the deadline, will be posted on EMSA’s website and blog December 23rd.

5. An attendee roster and a copy of this presentation will be posted on EMSA’s website and blog.

mailto:[email protected]


EMS is a full participant in health information exchange

with the ability to securely send, receive, find and use

relevant patient information.

Connecting EMS to the broader healthcare system

Vision


Support technical and administrative infrastructure

development to enable EMS providers and hospitals to

securely share electronic patient information via health

information organizations.

Strategy


PULSE+EMS Grant from ONC

Funded by Cooperative Agreement

Grant #90IX0006/01-00

Office of the National Coordinator,

U.S. Department of Health and Human Services

• Total Project Budget: $3,668,904

• Federal Share: $2,751,678 (disbursed at milestones)

• Non-Federal Share: $917,226 (matching dollars)

• Contractual: $2,281,522


Contractual Services

• 1 Contract Subject Matter Expert Advisor services (CAHIE)

• Minimum of 2 Contracts for local +EMS implementation (LEMSA, HIO, emergency ambulance service provider, hospital)

• 1 Contract for PULSE interoperability based upon PULSE architecture

• Minimum of 4 HIO Contracts for PULSE interconnectivity and Exchange

• 1 Contract for Disaster Healthcare Volunteers (DHV) Interface

*All contracts will follow federal and state procurement policies and requirements


+EMS Use Case

1. The use case begins with a 911 call to respond to a medical emergency.

2. Dispatch sends an ambulance to the call location and provides any available demographic information.

3. The ambulance crew may enter patient information provided by dispatch into ePCR to SEARCH the local HIO for a match.

4. The ambulance arrives on scene and obtains a driver license or verbal ID and uses the ePCR to SEARCH the local HIO and finds a match.

5. The ambulance crew receives the patient’s critical health information into the ePCR, including current medications, allergies, health problems, recent encounters, possibly POLST, and possibly additional demographic information (to confirm the match).


+EMS Use Case (cont)

6. The ambulance crew assess and prepares the victim for transport, documenting the response in the ePCR.

7. Enroute to the ED, the ambulance crew sends an ALERT to the ED with critical information about the incoming patient which is displayed on the ED dashboard.

8. Upon arrival at the ED, the EMS crew transfers care of the patient. The ePCR on the encounter is FILED into the EHR during or following transition of care from EMS to ED.

9. The ED team provides emergency care for the patient, documenting activity in the EHR.

10. Once the patient is released from hospital care, the hospital sends NEMSIS eOutcome information, perhaps from the EHR or HIE, to the ePCR to RECONCILE the episode (optional provision).


• Better patient outcomes and experiences

• Improved transitions of care

• More complete longitudinal patient record

• Greater ability to aggregate and analyze system data

Purpose


S SEARCH:

PARAMEDICS and EMTs may look up and display patient problem list, medications, allergies, POLST and DNR in field on ePCR screen

Improve clinical decision making

Improve patient care

A ALERT:

Display patient Information on hospital dashboard at ED to alert and share incoming patient information to assist in time-sensitive therapies

Improve decision support

Better transitions of care

Improve patient care

F FILE: Incorporate ePCR data into hospital EHR in HL7 format (using NEMSIS 3.4 CDA standards)

Build better longitudinal patient record

R RECONCILE: Receive patient disposition information from hospital EHR to add to EMS provider patient record

Improve population health


• The period of performance shall be upon approval though June 30, 2017.

• There will be no extensions beyond the contract end date and all deliverables must be submitted before that date.

Period of Performance


• Total amount available for the +EMS projects will be approximately $700,000.

• Possibility for additional funding.

• The Emergency Medical Services Authority anticipates that there will be multiple awards at various levels of funding.

Amount


Key Actions Dates Time

Application Released to Prospective Applicants

December 11, 2015 5:00 p.m.

Bidders’ Conference December 18, 2015 10:00 a.m.

Written Questions Submittal Deadline December 21, 2015 5:00 p.m.

Final Date for Proposal Submittal January 19, 2016 5:00 p.m.

Evaluation Process January 20, 2016

Notice of Intent to Award January 25, 2016 TBD

Protest Period January 26 – February 1, 2016 NA

Proposal Award Date February 2, 2016 NA

Anticipated Contract Date March 1, 2016 NA

Key Action Dates


• The applicant’s match requirement is $1 for every $3 federal dollars awarded.

• This is a soft match requirement, so the contractor may elect to meet the match requirement in the form of non-federally funded in-kind contributions.

• For example, if $100,000 in federal funds is requested, then the minimum match requirement is $100,000/3 or $33,333.

Match Requirement


• The prime applicant must be a LEMSA

• Applications must represent a coalition of participants including:

– At least one LEMSA

– At least one HIO

– At least one emergency 9-1-1 ambulance provider, and

– At least one hospital offering emergency department services.

Eligibility


• The adoption of Electronic Patient Care Reports (ePCR), in a NEMSIS 3/HL7 format

• The ePCR system must use NEMSIS 3-compliant products by the time milestones are achieved

• LEMSAs selected to receive funding for this project must agree to submit data to the California EMS Information System

Eligibility (cont)


• Description of the coalition’s preparedness to complete the grant requirements within the grant period including:

– progress towards NEMSIS 3 implementation,

– existing HIE integration and query-based HIE activities

– HIO CTEN participation as a query member (not required)

• Description of proposed work with methodology for achieving SEARCH, ALERT, FILE and (optionally) RECONCILE functionality

Application Content (Readiness)


• Work plan including tasks to be accomplished and schedule for each task

• A list of coalition participants, short descriptions of their capabilities, and roles in the project

• Commitment to execute Service Level Agreements among participants

• The project team including participants and roles

• Letters of support from all project participants

Application Content (Work Plan)


• A description of the area served including:

– the approximate population and geographic area

– the number of hospitals with EDs in the area

– the number of ambulance companies responding to emergency 9-1-1 calls and an approximate number of 9-1-1 calls

– This, along with the work plan, will establish metrics: Baseline number (current), denominator (all potential), target number (based on participating partners)

Application Content (Metrics)


– Expected dates of and plan for reporting on metrics, milestones and deliverables

– A description of how each milestone metric will be achieved

– Respondents that do not achieve the required milestone metrics and deliverables will not receive payment. Organizations should consider the risk of this project.

Application Content (Milestones/Deliverables)


• Adoption milestone is met by

– Entering into Service Level Agreements between HIO, ambulance, hospitals, and or vendors

– Testing functionality for Search, Alert, and File functions

• Exchange milestone is met by

– SEARCH and ALERT functions with ePCR

– Transmission of 10% of eligible records to hospital ED dashboard ALERT

• Interoperability milestone is met by

– File (and Reconcile) functions between ePCR and EHR

– Incorporation of external information from EMS ePCR to Hospital for 10% of eligible records

Milestones


• Service Level Agreements between LEMSA, HIO, ambulance, hospitals, and/or vendors by April 2016

• SEARCH and ALERT functions among all required stakeholders demonstrated in production no later than April 2017

• ALERT with 10% success rate by November 30, 2016

• SEARCH with 10% success rate by April 30, 2017

• FILE with 10% success rate by May 31, 2017

• (Optional) RECONCILE with a 10% success rate by June 30, 2017

Deliverables (Tied to ONC Dates)


• The project must also provide the following additional deliverables:

– Monthly progress reports against the project plan

– A final report documenting the project objectives, implemented solution, and accomplishments

Deliverables (cont)


– A budget summary, narrative and justification

– A project budget/cost worksheet in Microsoft Excel format

– Acknowledgement that a 3:1 match is required

– The budget must include a plan for the match requirement

Application Content (Budget)


– Focus on SAFR functionality

– Flexibility in design/structure

– Technical solutions may be very different

– Leverage previous and ongoing work

– Consistency with Interoperability Roadmap

– Collaborative solution addressing local system design and resources

Key Points for Scope of Work


Scoring Criteria (1 of 4) Max

Points

Preparation for completion of grant within grant period: • Progress towards NEMSIS 3 • Existing HIE integration activities • Prior work on query-based health information

activities • Estimated completion dates • Realistic timeline • HIO CTEN Participation (Query)

20


Scoring Criteria (2 of 4) Max

Points

Scope of Proposal: Description of the proposed project Coalition participants Project team Impact of project/broad participation

o Size of area population o # of hospitals participating out of # of eligible hospitals and

% of area EMS transports received by participating hospitals.

o # of EMS services participating out of those eligible and % of area EMS transports by EMS participants.

o # of LEMSAs participating out of # of LEMSAs eligible Alignment with EMSA intent per ONC Grant 90IX006/01-00 Implementation of SEARCH, ALERT, FILE and (optional but

preferred) RECONCILE functionality Plan for measuring metrics, reporting milestones and

deliverables

50


Scoring Criteria (3 and 4) Max

Points

Budget (Excel format) Budget summary, narrative and justification Amount Cost/value 3:1 match plan

20

Commitment of participants, including local HIO/HIE Letters of support Commitment for 3:1 match from all participants Commitment to submit NEMSIS 3 data to EMSA Commitment to sign a participation agreement.

10


Ground Rules

1. Any verbal answers given here are not official answers binding on the state.

2. Questions asked here will be captured and written questions will be accepted at [email protected] until 5 p.m. December 21, 2015.

3. Private questions cannot be answered. Ask all questions to the panel or send questions in writing.

4. Written answers to all questions asked here and those sent in to EMSA by the deadline, will be posted on EMSA’s website and blog December 23rd.

5. An attendee roster and a copy of this presentation will be posted on EMSA’s website and blog.

mailto:[email protected]

Contact Information [email protected] [email protected] [email protected] (916) 431-3723 Website: www.emsa.ca.gov/HIE Blog: hieinemsinca.com

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