Data Mining / Data Analysis for measuring and improving hospital quality and cost effectiveness

REVISED 07/07/2014 This is a COMBINED SOLICITATION/SYNOPSIS for commercial items prepared in accordance with the format in FAR subpart 12.6 as supplemented with additional information included in this notice. This solicitation has been prepared with the intent to negotiate a Firm Fixed Price (FFP) contract, utilizing procedures under FAR part 13, for Commercial Services for Measuring and improving hospital quality and cost effectiveness at Naval Medical Center San Diego. The requirement calls for performance to commence 01 OCT 2014 through 30 SEPT 2015. Contractor is responsible for providing the requirements in accordance with the statement of objectives. This announcement constitutes the only solicitation, quotations are being requested and a written solicitation will not be issued. PAPER COPIES OF THIS SOLICITATION WILL NOT BE AVAILABLE. The solicitation number is N00259-14-T-0188 and is issued as a Request for Quotation (RFQ). The solicitation document and incorporated provisions and clauses are those in effect through FAC 2005-74. The closing date is 22 SEPT 2014 at 06:00AM Pacific Standard Time. It is the contractor's responsibility to be familiar with the applicable clauses and provisions. The clauses may be accessed in full text at these addresses: www.acq.osd.mil/dpap/dars/dfars/index; www.acquisition.gov. The North American Industry Classification System (NAICS) Code for this acquisition is 518210; Size: $30,000,000. This procurement shall be full and open competition within the small business set-aside. All qualified, responsible sources may submit a quote that shall be considered by the agency. Vendors are advised that they are responsible for obtaining amendments. Naval Medical Center San Diego intends to award a purchase order for the procurement of measuring and improving hospital quality and cost effectiveness. It is required that all contractors submitting a quote review the attached STATEMENT OF OBJECTIVES (SOO) to review all requirements. All vendors submitting a quote shall be required to meet the requirements found in the SOO. All questions must be sent to Christopher.jennen@med.navy.mil on or before June 13, 2014. Answers will be posted 02 SEPT 2014. Electronic submission of Quotes: Quotations shall be submitted electronically by email only to christopher.jennen@med.navy.mil. The submitter should confirm receipt of email submissions. All quotations shall include: A.) Cover Sheet: a.) Tax Id Number (TIN) b.) Cage Code and or Dun and Bradstreet Number (DUNS) c.) FSS Contract number (if available): d.) Contact Name e.) Contact Email f.) Contact Phone Number g.) Complete Business Mailing Address h.) Statement of businesses socio-economic status B.) Technical quotation 1.) Vendor shall demonstrate that they are adequately staffed to perform all aspects of the SOO and, 2.) Vendor must demonstrate an approach to developing quantities and qualitative methods for collecting, organizing analyzing and reporting data as defined in the SOO and, 3.) The technical approach provided by the vendor will establish their understanding of the requirement. Any vendor submitting a quote to this RFQ must submit documentation that allows the evaluation team to determine the vendor technically acceptable. This documentation can be in the form of a written narrative, but in no instance shall the documentation exceed ten (10) pages. C.) Price Quote: Total price tiny_mce_marker _________________ NOTE: The Government shall not compensate the vendor for any quotation development costs related to this solicitation. D.) Past Performance: Each vendor shall complete and submit summaries for not more than three (3) relevant projects. Relevant projects are those that are similar in scope to those requested for this requirement. All references should be either ongoing or completed within the last three (3) years. The relevant projects summaries shall include the following information not to exceed one (1) page for each project. Total page limit not to exceed three (3) pages: - Project Name - Date of Contract - Type of Contract - Dollar value of contract - Period of Performance - Description of services provided - Name, email and telephone numbers for the points of contact. POC must be current. - Describe the relevance to the current requirement being solicited. Vendors must either provide the above information or affirmatively state that it possesses no relevant, directly related, or similar past performance. If no past performance references are submitted, then a rating of neutral will be assigned. The Contracting Officer reserves the right to consider past performance information that is obtained from additional sources. This solicitation incorporates the following FAR and DFARS Clauses/Provisions: 52.204-7 Central Contractor Registration (JUL 2006) 52.204-13 Central Contractor Registration - Maintenance (DEC 2012) 52.212-1 Instruction to Offerors-Commercial Items (FEB 2012) 52.212-3 Offeror Representations and Certifications-Commercial Items (APR 2012) 52.212-4 Contract Terms and Conditions-Commercial Items (FEB 2012) 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive orders-Commercial Items (JAN 2013) 52.222-50 Combating Trafficking in Persons (FEB 2009) (22 U.S.C. 7104(g) 52.233-3 Protest after Award (Aug 1996) (31 U.S.C. 3553) 52.233-4 Applicable Law for Breach of Contract Claim (Oct 2004) (Pub.L. 108-77, 108-78) 52.204-10 Reporting Executive Compensation and First-Tier Subcontract Awards (JULY 2010) 52.219-28 Post Award Small Business Program Representation (JUN 2007) 52.222-3 Convict Labor (June 2003) (E.O. 11755) 52.222-19 Child Labor-Cooperation with Authorities and Remedies (July 2010) (E.O. 13126, 52.222-21 Prohibition of Segregated Facilities (FEB 1999) 52.222-26 Equal Opportunity (Mar 2007)) (E.O. 11246) 52.222-35 Equal Opportunity for Veterans (SEP 2010)(38U.S.C. 4212) 52.222-36 Affirmative Action for Workers with Disabilities (Oct 2010) (29 U.S.C 793) 52.222-41 Service Contract Act of 1965 (Nov 2007) (41 U.S.C. 351, et seq) 52.223-18 Contractor Policy to Ban Text Messaging While Driving (Sept 2010) 52.225-13 Restrictions on Certain Foreign Purchases (FEB 2006) (E.O.s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of Treasury) 52.232-33 Payment by Electronic Funds Transfer-Central Contractor Registration (Oct 2003) (31U.S.C. 3332) 52.237-2 Protection of Government Buildings, Equipment, and Vegetation (APR 1984) 252.225-7002 Qualifying Country Sources as Subcontractors (Apr 2003) 52.252-1 Solicitation Provisions Incorporated by Reference (FEB 1998) 52.252-2 Clauses Incorporated By Reference (FEB 1998) 252.212-7001 Contract Terms and Conditions Required to Implement Statutes or Executive Orders Applicable to Defense Acquisitions of Commercial Items (OCT 2006) 252.225-7001 Buy American and Balance of Payment Program (DEC 2012)(41U.S.C. chapter 83, E.O. 10582) 252.225-7002 Qualifying Country Sources as Subcontractors (DEC 2012) 252.232-7003 Electronic Submission of Payment Requests and Receiving Report (MAR 2008)(10U.S.C.2227) Quotations will be evaluated based on technical capability, past performance, and price. Technical capability and past performance when combined are more important than price. The Government will only consider firm fixed price quotations. Offeror must complete and submit with the quotations FAR provision 52.212-3 Offeror Representations and Certifications-Commercial Items (APR 2012). The provision can also be submitted at https://www.sam.gov. Contractor must be registered to the System for Award Management (SAM) prior to award. A nine digit Data Universal Numbering System (DUNS) number provided by Dun and Bradstreet is required to register. The website address for SAM registration is https://www.sam.gov STATEMENT OF OBJECTIVES Measuring and Improving Hospital Quality and Cost Effectiveness 30 May 2014 The Government is providing its requirements in the form of a Statement of Objectives. The contractor shall submit a proposal to include a Performance-based Work Statement (PWS) and Quality Assurance Surveillance Plan (QASP) shall be evaluated by the Government. In the PWS the contractor shall describe the technical approach necessary to achieve the Government's performance objectives identified herein. Background: Variation in clinical practice is known to lead to significant difference in the cost of medical care. As indicated in the literature, using validated data at the individual provider and service level, variation will be reduced or eliminated over time to dramatically reduce costs and improve the experience of care for the patient. The Naval Medical Center San Diego (NMCSD) does not possess a well-defined mechanism to identify and quantify clinical variation and is seeking a solution from an outside source. The offeror is encouraged to present innovative recommendations and approaches in their proposal as well as detailed costs involved. Objectives: 1. Objectively improve the major metrics of inpatient quality and save significant costs by reducing clinical and operational variations at the individual provider (e.g., physician, physician assistant, nurse practitioner, independent duty corpsman, etc.), clinical service, and hospital levels. 2. Data analysis: a. Work with the NMCSD Information Management and TRICARE Operations Departments to access and analyze the available clinical and resource consumption data. Data analysis will be performed on the NMCSD campus only. No remote access to military health system data is available. The contractor may also use publically available data for their analysis. b. Use risk-adjusted methodology to assess multiple years of patient-level data to identify clinical variations of individual providers and clinical services. 3. Based on the data and Command's recommendation, select two services to participate in a pilot to identify drivers of clinical variation and produce the highest quality, most cost efficient outcomes. 4. Provide individual providers with actionable information to target cases with most effective and efficient outcomes to replicate best practices: a. Provide each provider with objective, risk-adjusted data that demonstrates their resource consumption variation for each of the functional service groups (lab, pharmacy, etc.). b. Provide each provider with resource consumption variations data for comparing performance and variation reduction with their peers. c. Provide each provider and each clinical service with data for highest quality and most cost efficient resource consumption by clinical cohort (DRGs) for to develop or modify clinical practice guidelines based on patient acuity level. d. Information provided will be in the form of charts and tables that display data including but not limited to costs associated to episodes of care grouped by primary diagnosis, orders (type and frequently) placed during each episode of care, length of stay, charges vs. length of stay comparison, individual variation reduction, service variation reduction, etc. e. Provide clinical and operational data in an educational, non-threatening format to providers and hospital personnel. 5. Assess providers' diagnostic documentation and medical record ICD coding accuracies. 6. As providers begin to modify their practices, assess hospital operations and make recommendations for improvements where appropriate. 7. Develop a dashboard for providers to facilitate tracking optimal outcomes over time to secure and improve upon quality gains and cost reductions. The dashboard will provide real time data on improvements in clinical indicators by provider and by service to maintain a focus on continuous best practice improvements. The dashboard data should include but not be limited to physician (as a code, not name), ED decision to admit in hours, time from presentation in ED to procedure, critical care management, non-related procedures, promptness of consults, no orders or changes in 48 hours, chronic disease management, readmits, etc. 8. Work with the quality and productivity staff to enhance reporting and educational formats and hand off these data and educational functions for future implementations as appropriate. 9. Prepare and present a plan to extend clinical variation reductions across additional services and a plan to roll out clinical variation services to additional hospitals within the Region. 10. From date of award contractor will be able to complete the objectives within 12 weeks. The contractor may propose a shorter schedule that will be evaluated. 11. Written summary report: Provide written reports of data collected, results, actions taken, and recommendations along with bi-weekly status reports. 12. Contractor will provide onsite review of the program for suggestions and adjustments as needed to ensure success six months and one year from the date of award. 13. Contractor will remain available for telephonic consultation for one year from the date of the award. 14. Software/computer hardware: If the contractor solution includes software or computer that will be installed on Government owned computer assets: a. Software and hardware must be DON Application and Database Management System (DADMS) approved. Systems that are not DADMS approved must be standalone and not tied to the NMCSD network. b. Contractor shall provide complete as-built network diagrams of the system to include all make/model, serial number, location, network address and OS/Firmware version of each piece of equipment. These as-built network diagrams will be sent to the Contracting office, IT department, Security department, and Facilities. All network devices shall be configured in accordance with all applicable Security Technical Implementation Guides (STIGs), including but not limited to Wireless STIG 6, Release 4. STIGS exist for desktops, servers, web servers, etc. Web servers will be PKI enabled with a valid DOD PKI Certificate. All work will be performed IAW the applicable reference for Electronic Security Systems (UFC 4-021-02NF). c. Updates and patching to maintain system security authorization levels will be provided and supported by the vendor at the site as required by DoD policies. d. The maintenance agreement will include replacement of system software in the event of physical loss or system failure. It will also include software updates that are required for proper system function. All software updates must be DADMS approved. e. System must include the capability to perform system backup and restore IAW DoD continuity of operations support. f. The contractor will provide on-site training that will acquaint applicable NMCSD personnel with user operator training. Also, the contractor will provide IMD personnel with system maintenance training. Upon completion of training, contractor is responsible to furnish training manuals for IMD and users. g. Contractor will include full maintenance agreement for one year at a fixed cost, to include scheduled tests and inspections four (4) times per year. Maintenance begins following system acceptance. On site troubleshooting: While on site, technicians will diagnose any errors directly ensuring accuracy of any corrective actions taken. The agreement shall include travel and mileage. h. The contractor must respond within 48 hours on weekdays between 0730 and 1600 for On Site Service in the event of a problem or service request. The contractor is responsible for telephone technical support: Technical support representatives available to answer questions on weekdays between 0730 and 1600. If the problem is unresolved the vendor will provide on-site service within the 48 hours after the conclusion of the trouble call. 15. Contractor will furnish all labor, materials, tools, equipment, and documentation required for a complete and working system. 16. Contractor shall provide product and labor warranties for a minimum of one year. 17. Contractors shall provide a performance specification for the proposed system that will include the following information: System Description Work Included Scope of System Product Characteristics Hardware and Software Characteristics if applicable Application Software Description if applicable Delivery, Installation, and Training Description as applicable Warranty Information Recurring and Emergency Maintenance Description as applicable 18. Contractors must register through Rapid Gate at no cost to the Government in accordance with Naval Base San Diego - Rapid Gate process. Details can be found at http://www.cnic.navy.mil/regions/cnrsw/installations/navbase_san_diego/om/force_protection/rapid_gate.html. 19. Contractor shall include security clearance information on installation and test personnel. Installation and test personnel must be U.S. citizens. This precludes the use of Permanent Residents and Non-U.S. persons. 20. All associated system administration and controls must have clearance levels associated with DoD requirements. Quality Assurance Surveillance Plan The Contractor will be evaluated monthly against a Quality Assurance Surveillance Plan (QASP). The QASP communicates the principal basis to evaluate the contractor's performance. The QASP is to be proposed by the contractor and negotiated with the Government as a key part of the resulting task order. The QASP shall contain the following primary evaluation categories and weights. QASP Element Percentage Pre-Data Collection and Analysis Support: Provide data collection and analysis planning that ensures successful system testing 10% Data Collection and Analysis: Collect and analyze appropriate data in a timely manner 20% Post-Data Review Report: Results of data analysis communicates all issues, observations, and conclusions 20% Documentation Support: Documents are current, accurate, complete and well-received 10% Implementation: Provide support/guidance with implementation of recommendations 15% Monitoring/Course Correction: Provide progress review and course correction suggestions 10% Configuration Management: Ensure software/systems function with existing systems and comply with regulations 2% Installation/Fielding: Ensures software/systems are installed and operators are trained 5% General Engineering Support: Provide System Matter Expertise to include establishing system architectures and documenting power configurations. 3% Maintenance: Ensure software/systems are fully operational and HiPPA compliance. 5% Total 100%