rfp# 09-19 p3n and phg q&a log - pa

RFP# 09-19 P3N and PHG Q&A Log

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RFP Section Question Answer

1 Funding

What is the estimated funding source, or budget for this project? Has funding been secured, or is that expected to take place at a later date?

This project has been approved by CMS for an MMIS enhanced Federal Financial Participation (FFP).


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Incumbent Contract

Is this a new requirement? Or is there an incumbent vendor providing these services? If so, what is the contract number, vendor name, and term of the contract?

There is an incumbent vendor providing P3N services. Contract Number: 4400021268 (originally 4400011233) Vendor Name: IBM Watson Health Term of Contract: 5 years plus 5 option years


3 Award timeline

Is there a timeline for when this project must be started or awarded?

The planned award date is before the end of calendar year 2021. Transition of legacy system by April 2022.


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I-11. Conflicts. My name is Brandon Neiswender and I am the Chief Operating Officer at CRISP (Maryland’s State Designated HIE). We have been in discussion with P3N to facilitate Cross State Data exchange using the P3N infrastructure but have not connected. CRISP has a subsidiary organization (CRISP Shared Services) that delivers HIE services similar to those being procured by the Commonwealth and wanted to make sure our organizations would not be disqualified under the following section of the Technical Submittal: HIOs using P3N services are precluded from being selected for negotiations or contract award with respect to this RFP. HIOs using P3N services are also precluded from being a subcontractor for the selected Offeror for this RFP.

If the HIO is using P3N Services, they are precluded from being considered for this RFP. If the responding organization is a subsidiary of an HIO that is using P3N Services, they are also precluded from consideration for this RFP. Likewise, the selected Offeror will be precluded from using P3N Services for their HIO.

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5 Pre-Bid Meeting Attendance

Can you post the Pre-bid Meeting attendance for this RFP?

Please refer to Addendum 1.


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Technical Submittal The term P3N participants is used throughout the document and defined as: HIOs and organizations that have connected their healthcare systems to the P3N (page 8 of Technical submittal). Please specify this definition: 1. Is our interpretation correct that the participants of the HIOs are not considered (direct) participants of the P3N in this definition? 2. Can you specify the organizations that "have connected their healthcare systems to the P3N", please provide a list of (type of) organizations that connect their healthcare systems to P3N? 3. Can you provide the number of P3N participants per the categories specified in the two sub-questions above?

1. Yes 2. Please see the following: https://www.dhs.pa.gov/providers/Providers/Documents/Discrete%20Data_DEC182020.xlsx 3. Please see the following: https://www.dhs.pa.gov/providers/Providers/Documents/Discrete%20Data_DEC182020.xlsx


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The RFP states that the prime must commit to 50 percent of hours but could the Commonwealth specify if that 50 percent is from implementation hours, total deal value, cost of professional services, etc.

Please refer to Description Section 18. The prime contractor must perform services with a total value of at least 50% of the contract’s total value.


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Section I-8, B. Provider Directory and G. System Connectivity

Please specify the format in which the mentioned sources provide the provider data for the provider directory via sFTP.

CSV files are imported from a sFTP site into the Provider Directory. File layout specifications that include provider descriptive information will be provided to the Selected Offeror.


9 Section I-8, C. Patient Portal, Item 16

Can you confirm that the patient portal’s messaging center intends for patients to contact all individual providers and provider organizations?

The messaging center is intended to enable patients to contact all providers that use the Provider Portal.

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https://www.dhs.pa.gov/providers/Providers/Documents/Discrete%20Data_DEC182020.xlsx









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Section I-8, C. Patient Portal, Item 16

Please specify what digital contact information from the provider directory should be used to contact the provider.

The requirement is based on the final rule (CMS-9115-F), which does not explicitly define digital contact information, but does include examples such as Direct address, FHIR server URL, query endpoint, or other digital contact information.


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Section I-8, D. Provider Portal, Item 1

Please provide the SSO specifications for integrating with PROMISe™ and of any other Commonwealth services you want SSO-integration with.

The PROMISe™ system is currently being replaced with the MMIS 2020. Details for Provider authentication will be provided to the Selected Offeror, when available.


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Is the “provider association” requested intended to enable care-collaboration clinical workflows (multiple care givers collaborating on a single patient), or does this request serve another purpose?

For the purpose of identifying what individual providers are associated with what organizational providers.


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Please clarify whom (user types) must be given this access, and specific types of “information” being referred to regarding non-healthcare providers

The Provider Portal will be available to any provider of services or healthcare worker registered to use the portal. Non-healthcare providers may review their demographic and license information for accuracy and see what other providers are linked with persons they are associated with.


14 Section I-8, D. Provider Portal, Item 18

Can you provide a list of sample provider support organizations?

Examples include community-based organizations that provide services to help address an individual’s needs


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around the Social Determinants of Health that are identified in the MMIS module, the PA Resource and Referral Tool.


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Can you specify the format of the data made available to the P3N from provider supports organizations?

MMIS resources and services will be available via messaging through the MMIS Data Hub. The MMIS Data Hub project is currently in-process and messaging service specifications will be provided to the Selected Offeror, when available.


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Section I-8, D. Provider Portal, Items 17 & 20

Please highlight the material differences of these requirements, and the desired nature of the integration between the “messaging center” and “digital contact information in the provider directory.”

The messaging center will allow providers to notify other providers with messages within the Provider Portal. The digital contact information within the Provider Directory can be used for communications, outside, not within the Provider Portal.


17 Section I-8, D. Provider Portal, Item 20

Please specify what digital contact information from the provider directory should be used to contact the provider.

See answer to question 10.


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Section I-8, E. Accessibility, Item 2

Can you provide or link to the specific Commonwealth ITBs related to accessibility standards?

Please see Attachment 1 within Appendix H, Requirements for Non-Commonwealth Hosted Applications/Services.


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Section I-8, F. XDS and CDR, Item 8

Please provide specifications for all the listed data types on the format the data will be made available in and the standards used to exchange this data: o MA claims data (837s), o Social Determinants of Health data, o Care Plans from MA Care Managers, o Obstetrical Needs Assessment forms, o access to the Resources and Referral Tool, and o the Department’s Electronic Visit Verification system.

MA claims data (837s): Specifications can be found in the public domain. Care Plans from MA Care Managers: Structured and unstructured data formats. Obstetrical Needs Assessment forms: The ONAF can be found at https://www.dhs.pa.gov/providers/Providers/Documents/MA/d_003632.pdf. Social Determinants of Health data, access to the Resources and Referral Tool, and the Department’s Electronic Visit Verification system: See answer to question 15.


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Regarding “query messages to the P3N”, is our interpretation correct that this refers to the XCA queries from the P3N to the HIOs? If not can you specify the correct interpretation of “query messages to the P3N”?

Query messages to the P3N from HIOs, and from the P3N to HIOs, include both XDS (IHE ITI-18) and XCA (IHE ITI-38) transactions.


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Can we assume that clinical data related to a self-pay encounter is always labeled (e.g. via metadata) as being associated with a self-pay encounter?

The query response will not include clinical data associated with restricted self- pay from the P3N. P3N Participants do not send clinical data associated with restricted self-pay to the P3N.


22 Section I-8, G. System Connectivity, Item 4

Please specify the number of I systems that needs to be connected to the CDR

In addition to the transition of the current P3N Participants that use the CDR, 3 potential systems are named in

https://www.dhs.pa.gov/providers/Providers/Documents/MA/d_003632.pdf

https://www.dhs.pa.gov/providers/Providers/Documents/MA/d_003632.pdf


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Section I-8, G. System Connectivity, Item 4.


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Section I-8, G. System Connectivity, Item 4

Please confirm that the connections with the I system are established using XDS, if not please specify the connection with the I systems.

Confirmed, Section I-8, G. System Connectivity, Item 4, specifies EHR systems which will connect to the P3N using PIX and XDS.


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To help guide accurate estimates on the workload required to fulfill this request, can a list and of the eight potential HIOs and an expected scope of magnitude for these organizations be shared?

These onboarding slots are reserved for potential HIOs and have yet to be determined. A range can be estimated based on existing HIO patient counts found in Section I-8, A. Enterprise Master Patient Index (“MPI”).


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This requirement requests a FHIR interface for all P3N services, we want to confirm our interpretation of “all P3N services”. Our interpretation includes documents available in the P3N and P3N participants’’ XDS document repositories; information available via MMIS; information submitted to the PHG; clinical information extracted from CCD documents available in the P3N and P3N participants’’ XDS document repositories. Please correct this interpretation when incorrect.

Yes, interpretation is correct. This information is to be available from the P3N using query and retrieve transactions through FHIR APIs.


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Please provide specifications for all the listed data types on the format the data will be made available in and the standards used to exchange this data o MA Beneficiary Data o MA Providers and Enrollment o MA Claims Data o MA Prior Authorizations o Human Services Licensing o Social Determinants of Health o Eligibility Verification System data o Care Plans (FFS, OCDEL, Pennsylvania Department of Aging, ODP, OLTL)

This data will be represented in both structured and unstructured formats and available from the MMIS Data Hub. The MMIS Data Hub project is currently in-process and messaging service specifications and data formats will be provided to the Selected Offeror, when available.


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Section I-8, I. System Administration, Item 3

Can a list of the requested “IT Standards” be shared? See answer to question 18.


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Section I-8, K. SPD Tagging and Filtering, Item 4

Is the Consent2Share already implemented, and does the solution needs to integrate with Consent2Share, or does the solutions need to include a Consent2Share? If the solution needs to integrate Consent2Share, please provide the specifications for integration.

Consent2Share is not already implemented. Please note the Consent2Share requirement was included in anticipation of FHIR resources to represent and persist patient consent for treatment, research, or disclosure (e.g. 42 CFR Part 2, Title 38). Comparable sensitive data access control functionality can be achieved using FHIR and other standards. Please describe how this requirement will be satisfied to allow patients to determine which information they would like to share and not share with their providers.


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Section I-8, N. PHG Please provide the integration specifications for all listed public health reporting systems: o Pennsylvania Cancer Registry o Pennsylvania Electronic Lab Reporting o PA SIIS o PDMP o Pennsylvania Syndromic Surveillance o DHS Electronic Clinical Quality Measures

Please find information for public health reporting on the PA DOH website: https://www.health.pa.gov/topics/Reporting-Registries/Pages/Reporting-Registries.aspx. DHS eCQM data extracted from EHRs can be found in the public domain. PHG messaging format and requirements will be provided to the Selected Offeror.

https://www.health.pa.gov/topics/Reporting-Registries/Pages/Reporting-Registries.aspx




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Given the existence of provider and patient portals currently offered by regional HIOs and provider organizations in the Commonwealth, what is the P3N’s vision for how the requested solution will offer views for provider and patient portals, and which users would be logging in to the new solution to view data? Additionally, if a proposed vendor solution were able to leverage the existing provider and/or patient portals of HIOs in the Commonwealth and allow those existing portals to view data from all data sources within the Commonwealth, would that solution sufficiently support the P3N’s vision and requirements for provider and patient portals requested in the RFP?

The Patient and Provider Portals will be available to persons who wish to use these available services. Regional HIO Portals do not satisfy all of our requirements. Examples include allowing the opt-out of patients from the P3N and uploading and maintaining Care Plans and Advance Care Planning documents that cannot be made available through integration.


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Please provide clarification, in the Description document item 13.B states, ”Each proposal shall consist of the following five separate submittals,” however, the slides from the pre-proposal conference state, “Each proposal must have 5 separately sealed submittals.” The latter implies that hardcopies of the entire proposal are desired not just the References. Are both electronic and hardcopies requested of the entire proposal or separate files in the portal only with exception to the hardcopies of the references?

Please abide by the instructions in the Description document. The five separate submittals must be submitted electronically via the JAGGAER portal. We are only requesting sealed hardcopies, and hardcopies only, of the reference questionnaires.


32 Can you provide a list of vendor attendees at the pre-proposal

conference? Please refer to Addendum 1. Vendor/company names were not requested for registration.


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Section I-4 Training what is the approximate size of the training audience (i.e., number of users)? If possible, please differentiate between DHS users and external users (e.g., HIOs).

Size of training audiences will vary based on the type of training (System Administration, Portal User Access and Navigation, etc.). DHS users are operational staff that use the P3N system daily. The legacy P3N uses a hierarchal, role based access that allows


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DHS to assign HIOs limited administration access to manage their own users of the P3N web interfaces.


34 Section I-4 Training

Does DHS currently have a breakdown of users by role/number for the current P3N system?

In addition to the legacy vendor that has super user privileges, DHS has 3 System Administrators to manage Opt-outs and user access; 16 Fee for Service Case Managers; and 1 HIO with 2 personnel that have Consent Management permissions.


35 Section I-4 Training Are users centrally located or disbursed throughout the Commonwealth? Please respond both for internal DHS users and external users (e.g., HIOs)

Users, both internal and external, can be centrally located or disbursed throughout the Commonwealth.


36 Section I-4 Training

How many modules/system processes does DHS anticipate users will need to be trained on?

Training materials are required for all P3N web accessible interfaces including System Administration and the Provider and Patient Portals.


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Regarding the Commonwealth public health registries currently connected as part of the existing Public Health Gateway platform: Is it a correct assumption that all currently connected public health registries are each based on unique vendors and solutions specific to each registry? And/or, are any of these current registry applications and connectivity based on solutions developed and managed by the Commonwealth?

Yes, each public health registry is based on unique vendors and solutions specific to each registry. Some registries are vendor based and some use a combination of vendor products with software developed by the CDC.


38 Are there any major software functionality/version upgrades or code-freezes currently scheduled for any of the connected registries?

We anticipate changes at the registries but specific dates and times are not yet set.


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Are there any software solutions replacements/procurements currently on the schedule for any of the registries now connected to the Public Health Gateway, particularly during the first year of the new P3N project that would have impact to integration planning/scheduling and management of the new P3N project?



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Section I-8, C.1 Is it accurate to expect that a patient would not be able to log in to the Patient Portal without first establishing Keystone credentials that will be used to facilitate the login?

Yes. Please refer to Appendix J, Customer Service Transformation for requirements of the Keystone Login Initiative.


41 Section I-8, C.2 What types of authorization and authentication flows are supported

and/or required as part of the RESTful services auth? (e.g., SMART on FHIR, Oauth2 + Open ID Connect)



42 What are the login flows across and between systems? Is the user already credentialed? What bearing does this have on where the user starts in terms of the login flow?



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Does Keystone credential the patient? Or does Keystone leverage existing credentials from patient portals or other systems where the patient has been previously credentialed to initiate an authorization workflow? If not, will the patient portal need to handle credentialing for users?



44 Section I-8, C. Is the association to the MPI happening via a relationship between the

Keystone login and the MPI? Yes.


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If the user reviews their demographics and finds errors, what are the expectations around remedying that. Are the patients expected to make updates within the patient portal? If so, do the corrections flow back to the MPI? If not, where are the errors reported?

Errors in demographic data found by users can be reported via Support methods. DHS will follow up with the sources that contribute to the person record for updates.


46 If updates are made to the MPI outside of the patient portal, are those updates expected to flow to the patient portal and be published within the patient portal?

Yes.


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Section I-8, C.4 What is the relationship between the administration of users in this requirement and the administration of users through the Keystone Login Initiative?

Keystone Login is for authentication and access. User type permissions (what users are authorized to do) are managed by System Administrators.


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Section I-8, C.10 What is the expectation around “transmit?”

Transmit, in this context, is the ability for the patient to take ownership of the data they downloaded and share using electronic methods available to them.


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Section I-8, C.12 What are the specific healthcare provider details that should be available to the patients within the portal?

Healthcare provider details are maintained in the Provider Directory. A link to each named provider associated with the patient is available from the Patient Portal.


50 Section I-8, C.18 What level of Audit Logs are required to be exposed? On what cadence

are those logs expected to be accessible? Logs should be available on-demand and include times and dates of the activities performed on the Portal.


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Activities include viewing and downloading.


51 Design Principles and Requirements item 1.b

How are authentication and authorization differentiated within the implementation of the Keystone Login initiative in the P3N scope?



52

What is the size of the total population that the P3N solution will serve?

The P3N will support the total population of Pennsylvania (currently at ~13M) and anyone who receives treatment or services in Pennsylvania that lives in another state (currently at ~5M).


53 Section G. System Connectivity, Item 11

What is the intended use for the FHIR interfaces?

FHIR interfaces can be used by P3N participants for P3N services such as Patient Registration and Query, Document Query and Retrieve, and access to the Provider Directory. Provider Directory and Patient access via mobile app is also required.


54 Section G. System Connectivity, Item 13

What is the intended use for the FHIR bulk interfaces? See answer to question 53.


55 What is the Commonwealth’s estimated budget or budget range for the project’s first year?



56 What is the Commonwealth’s estimated budget or budget range per year for years two through five?



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57 How do we obtain the list of vendors and attendees who were on the Feb. 11 pre-proposal conference call?

Refer to Addendum 1. Vendor names were not requested for registration.


58

Technical Submittal / Page 5

Regarding this statement: “A minimum of three client references must be identified for the following Key Personnel: Executive Account Director, the Project Manager, and the Technical Manager.” Do you require 3 references for each of the three personnel listed or 1 reference for each?

3 references for each of the 3 Key Personnel.


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The MPI volume for legacy P3N is provided and the requirement states: “The Department expects the number of sources that will contribute to the MPI will increase to include new P3N Participants joining our program along with citizen demographics from other state agencies.” Can you please provide the estimated number of new patients that will be added for each year of performance?

See answer to question 52 for the maximum number expected persons within the P3N MPI.


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The Provider Directory volume for legacy P3N is provided and the requirement states: “The current P3N Provider Directory distinguishes individual and organizational providers. DHS expects the number of sources that will contribute to the P3N Provider Directory will increase to include data from connected P3N Participants, other agencies, and DHS. DHS intends to add all MA Providers to the P3N Provider Directory.” Can you please provide the estimated number of new providers or organizations added for each year of performance?

The P3N Provider Directory will support a total number of Providers estimated between 5M to 6M. The CMS National Plan and Provider Enumeration System alone currently contributes ~5M providers to the Provider Directory.


61 Technical Submittal / Page 27-28

Item B. Provider Directory lists 4 current data sources for the provider directory, but then sub item 9 states “The selected Offeror’s Provider

This functionality is not available in the legacy P3N.


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Directory must provide the ability for P3N Participants to upload and download from the P3N Provider Directory using APIs.” Does this indicate current functionality that needs to be migrated (if so, how many participants send this data today) or is this a reference to future capability?


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Item B. Provider Directory sub item 10 states “The selected Offeror’s Provider Directory must provide a utility or method to identify and resolve and reconcile erroneous provider directory data.” Is the intention that existing department staff use this utility as part of their management of the Provider Directory or is the Offeror expected to provide this service on an ongoing basis?

It’s the intention that existing department staff use this utility as part of their management of the Provider Directory.


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Item C. Patient Portal sub item 2 states “The selected Offeror’s Patient Portal shall leverage the Keystone Login Initiative to identity-proof and allow citizens access to the Patient Portal.” Can you provide more specific details on what authentication/authorization APIs the Keystone Login initiative supports today?



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Regarding the statement from Item D: “Currently, provider user accounts, which are required for any P3N Participant or Provider to use the P3N Provider Portal, can be issued by either the Department or P3N Participants.” Can you please provide the total current users for Provider Portal in legacy P3N? Can you please provide the estimate for number of users to be added for each year of performance?

There are no current users of the legacy P3N Provider Portal. Since the requirement allows for Providers to self-register, it is unknow at this time how many Providers will use this portal.


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Item D. Provider Portal sub item 1 states “The self-service portal shall provide Single Sign-On, allowing user access with credentials already given to providers accessing other Commonwealth services (e.g., Medical Assistance Providers using PROMISe™).” Can you provide details on what single sign-on standards other Commonwealth services (Oauth, SAML, etc.) currently support, as well as whether a single common identity provider already exists for all these services?

Single sign-on information for Providers accessing other Commonwealth services will be provided to the Selected Offeror, as it becomes available.


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Item D. Provider Portal sub item 11 states “The selected Offeror’s Provider Portal shall allow access to provider records, where applicable, to the Department’s Program areas:

a. Office of Mental Health and Substance Abuse Services b. Office of Long-Term Living (“OLTL”) c. Office of Development Programs (“ODP”) d. Office of Children, Youth, and Families e. Office of Medical Assistance Programs f. Office of Child Development and Early Learning (“OCDEL”)”

Can you provide details on whether common APIs exist that integrate with each of the systems listed above? If not, can we assume that each organization will be responsible for developing these APIs?

Access to other Department Program data will occur through the MMIS Data Hub, currently under development. Care Plans and other data may be available on-demand or maintained within new P3N Registry and CDR.


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Item D. Provider Portal sub item 12 states “The selected Offeror’s Provider Portal must allow the Department’s service providers to upload and retrieve clinical data associated with each patient.” Can you provide additional details on what types of clinical data you expect a provider to be able to upload?

Examples include uploading consent decision forms (opt-out, opt-back-in), advance care planning documents, and Care Plans.


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Item D. Provider Portal sub item 14 states “The selected Offeror’s Provider Portal must allow users to setup customized views to filter and retrieve documents of interest. These views must be related to user specialty (Nutritionist, Cardiologist, Payer, etc.) and provide a discrete, combined history of medications, labs, radiology reports, claims, etc.” Can you provide the number of unique user specialties that we will need to provide customized views for?

The number of specialties and views will be determined during the implementation phase of the project. The Selected Offeror will provide a small set of views from which additional, custom views may be created.


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Item D. Provider Portal sub item 20 states “The selected Offeror’s Provider Portal must provide a messaging center for provider-to-provider messaging for providers who are using the P3N Provider Portal and through the digital contact information maintained in the Provider Directory.” Does this requirement include messaging between the P3N Provider message center and other providers via Direct Secure Messaging? If so, does P3N already have a HISP in place that facilitates this messaging and if not, are you looking for the Offeror to include HISP services as part of its overall solution?

HISP services are not required. If a Direct address is specified in the digital contact information of a Provider, that address can be copied and used with any HISP services in which a provider already participates.


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Regarding “Item F. Cross-Enterprise Document Sharing (“XDS”) Registry and Clinical Data Repository (“CDR”).” Can you please provide the current size of the CDR? What is the footprint of the CDR in terms of storage? Can you please provide the total number of XDS documents in the XDS repository for legacy P3N? Can you please provide the estimated number of XDS documents added for each year of performance? Can you please provide the average size of the XDS documents?

The current Registry and CDR are hosted and maintained by the legacy P3N vendor and will be provided during the transition phase of the project. Total number of structured and unstructured documents in the CDR is estimated to be less than 40K. Future estimates will depend on the additional documents from onboarding described in Section I.8.G.4,5.


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Documents can range in size from 90KB to 1.2MB. Average size is 1.3 KB.


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Item F. Cross-Enterprise Document Sharing… sub item 10 states “The selected Offeror’s system must have the capabilities to access individual discrete documents and generate a single longitudinal record from all P3N structured clinical data sources, that has been aggregated, code set normalized, and deduplicated.” Is the expectation that the Offeror will provide code set normalization for all coded structured clinical data elements as part of its services?

Yes.


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Technical Submittal / Page 34-35

Item G. System Connectivity states: “P3N Participants and state agencies that make clinical data available to the P3N connect via IHE and HL7 interfaces.” Can you please provide the total number of HL7 messages received by legacy P3N? Can you please provide the total number of sources sending HL7 messages to legacy P3N? Can you please provide the estimate for HL7 messages added for each year of performance?

Total HL7 ADTs received to date is ~25M. 5 HIOs representing 109 hospitals currently send HL7 ADTs to the P3N ADT Service. Cannot estimate additional HL7 messages at this time because this is dependent on the HIOs schedule to make available additional ADTs to the service.


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Item G. System Connectivity states: “The legacy P3N brokers XCA query and retrieve requests to all connected P3N Participants.” Can you please provide the total number of XCA requests served by legacy P3N? Can you please provide the estimate for number of XCA requests added for each year of performance?

For the month of January 2021, the count of XCA queries (ITI-38) was 221,832 and XCA retrieves (ITI-39) was 214,403. The number of additional XCA requests cannot be estimated at this time as that


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is dependent on HIO membership added to the network.


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Item G. System Connectivity sub item 5 states: “The selected Offeror shall onboard up to eight HIOs in addition to the five HIOs and the Pennsylvania Department of Corrections that will be transitioned to the new P3N.” Can you please provide the transaction volume details for each HIO? Should we assume that onboarding of the additional 8 HIOs happen in years 2-5 and implementation costs associated with this will be part of the 10,000 hours a year of services assumptions?

For the month of January 2021, existing HIO Patient queries, XDS, and XCA transaction counts were as follows: HIO1: Patient queries 900545, XCA transactions 6040, XDS transactions 1816035 HIO2: Patient queries 2987, XCA transactions 3028 HIO3: Patient queries 243194, XCA transactions 940 HIO4: Patient queries 67843, XCA transactions 426227 HIO5: Patient queries 61862, XDS transactions 675900 See answer to question 24 with respect to the 8 potential additional HIOs. In response to the second question, no, the 10,000 hours is for addressing potential out-of-scope Change Requests and/or enhancements.


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Item G. System Connectivity sub item 18 states “The selected Offeror’s system must initially support the exchange of the following, selected data, from the MMIS 2020 Platform:

• MA Beneficiary Data • MA Providers and Enrollment • MA Claims Data • MA Prior Authorizations



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• Human Services Licensing • Social Determinants of Health • Eligibility Verification System data • Care Plans (FFS, OCDEL, Pennsylvania Department of Aging,

ODP, OLTL)”

Can you provide details related to the expected APIs or messaging standards that will be used to integrate with each of the systems listed above?


76 Is it the state’s intention to create an independent HIE for hospitals and providers that are not currently connected to one of the three HIOs?

No.


77 Will P3N actively engage national networks or border state connectivity to help track PA residents across state lines?

Yes.


78 Is the plan for the P3N HIE to connect to existing HIEs for clinical data – or to create direct connections with hospitals?

The plan is for the P3N to connect to existing HIEs for clinical data.


79

What is the planned governance structure for the P3N? Will there be a board comprised of members from the existing hospitals and stakeholders?

The Pennsylvania eHealth (Pa eHealth) Partnership Program falls under the leadership of the DHS Office of Medical Assistance Programs (OMAP). A Pa eHealth Advisory Board of statewide leadership meets quarterly and a HIE Trust Community Committee meets monthly.


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Regarding requirement “K. SPD Tagging and Filtering”, it specifically calls out SAMHSA’s “Consent2Share” (requirement #4).

The Consent2Share requirement was included in anticipation of FHIR resources to represent and persist patient consent for treatment, research,


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In the 2020 ONC Interoperability Standards Advisory (ONC ISA), Consent2Share was labeled “In Development” and “Pilot” status in terms of maturity. https://www.healthit.gov/isa/sites/isa/files/inline-files/2020-ISA-Reference-Edition.pdf Further, Consent2Share appears to have been deprecated from the latest ONC 2021 ISA. https://www.healthit.gov/isa/sites/isa/files/inline-files/2021-ISA-Reference-Edition.pdf Therefore, if comparable sensitive data access control functionality can be achieved using FHIR and other standards and portal functionality, is the actual Consent2Share application required (or can you please clarify this requirement)?

or disclosure (e.g. 42 CFR Part 2, Title 38). Comparable sensitive data access control functionality achieved using FHIR, other standards, and portal functionality is acceptable. Please describe how this requirement will be satisfied to allow patients to determine which information they would like to share and not share with their providers.


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Regarding requirement “K. SPD Tagging and Filtering”, it describes “SPD code lists” (requirement #2) that can be enabled/disabled to filter messages in transit. Is it possible to see the current “SPD code lists” (or alternatively get a better description to better understand the magnitude of this requirement (for example: X data domains (e.g. Diagnoses or Lab Results), Y codes per data domain (e.g. there are 150 “SPD” ICD10 diagnosis codes). Also, does the “SPD code list” include free text terms (and common misspellings) that are expected to also be filtered during in-transit filtering? Lastly, if filtered in-transit, is there an expected error response?

An ICD-10 codes list and key words as determined by the community of P3N Participants will be provided to the Selected Offeror. If filtered in transit, yes, a notification or log entry is required.


82

Description File, Page 3, Section C. Future State P3N

The RFP states that all patient and provider data will be migrated to the new system. Please provide an estimate of the size/volume of data to be migrated.

Patient and Provider volumes of the legacy P3N are detailed in Section I-8. Requirements, of the Technical Submittal.

https://www.healthit.gov/isa/sites/isa/files/inline-files/2020-ISA-Reference-Edition.pdf







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83

Description File, Page 5 – 8 Section, SDB and VBE Participation

Can a single company with appropriate credentials be named as both the SDB and VBE or does the state require two unique companies to meet the requirements?

SDB and VBE participation goals are separate and distinct. Therefore, Offerors must meet both participation goals in full or seek a good faith efforts waiver from any unmet portion of the goals. However, an Offeror may meet both the SDB and VBE participation goals through use of a single firm, if that firm is DGS-verified as both an SDB and a VBE. See, Appendices G and H, SDB-1 and VBE-1, Section 11.4. Dually verified firms.


84

Description File, Page 5 – 8 Section, SDB and VBE Participation

If a single company can fill both roles (SDB and VBE), is the total contract value goal equal to 25% or 28%?

If a prime Offeror utilizes a subcontractor that is DGS-verified as both an SDB and VBE, the same work performed by that subcontractor can count toward meeting both the SDB participation goal and the VBE participation goal. See, Appendices G and H, SDB-1 and VBE-1, Section 11.4. Dually verified firms. Since the goals are not cumulative, in this example the total contract value goal would be 25%.


85

Cost Submittal File, Various Tabs

The Cost Submittal Hosting Fee tab total column (L) appears to sum only the first 4 years. Will the State please amend the tab to reflect the total sum of columns G-K? Similarly, the Licensing tab total column does not appear to sum columns G-K.

A revised Cost Submittal has been posted with Addendum 2.


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86

Technical Submittal File, Page 24, Section 13. Support

Please provide an estimate of the anticipated volume of contacts for the help desk – including calls, webforms and emails.

The legacy P3N had minimal help desk support due to limiting legacy P3N web interface user access to department staff. Estimates of anticipated contact volume will be determined during implementation as public facing services become available.


87 Technical Submittal File, Page 24, Section 13. Support

Please clarify any language support other than English required for the help desk.

English is the only language required for support by the help desk.


88

Technical Submittal File, Page 29, Section, C.7

The selected Offeror’s Patient Portal must provide consent management by providing multiple methods by which citizens may designate the status of their consent (e.g., mail, email, phone, etc.). How does the P3N envision using email, or phone for managing consent? Is this a manual process to a help desk to be managed and staffed by offeror, or P3N staff?

Department staff will manually process patient opt-out requests submitted by email or phone.


89


In the past, P3N did not support a patient portal because this was a function reserved to providers and the HIOs, and indeed the RFP states that the portal “is not intended to be a replacement for patient portals [of] practices, health plans, and P3N participants.” Requirement C10, however, states that the portal “must allow patients to view, download, and transmit their clinical data that is available through P3N”. Does the P3N patient portal exclude information not held within commonwealth systems (i.e. from federated P3N participants)? Are there restrictions on who may access the patient portal to avoid potential conflict with other partners’ portals?

The P3N Patient Portal will not exclude information not held within Commonwealth systems. There are no restrictions at this time to limit access to the Patient Portal. Any data accessed by the P3N from other systems should reflect data available to patients, from those systems.


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90


The RFP notes that the provider portal will allow providers to opt patients in and out with the patient’s permission. Will this functionality be available to any entities other than through the portal (i.e. integrated with I capability)? If so, what is the intended transactional model for this?

Yes, patients can be opted out by providing and registering an opt-out Basic Patient Privacy Consent (BPPC) document at the P3N using the XDS. Currently PA Dept. of Corrections opts-out patients using this method.


91


The selected Offeror’s Patient Portal must allow patients to view, download, and transmit their clinical data that is available through P3N, including discrete data (demographics, insurance, medications, allergies, visit history, immunizations, diagnosis, procedures, results data, and Continuity of Care Documents) in a patient friendly format. Does the P3N have any limitations as to whom patients can transmit records?

Once a patient downloads their clinical data, they assume responsibility for the data they downloaded and whom they transmit and share these records.


92

Technical Submittal File, Page 33, Section E. Accessibility

The RFP requires support of the most commonly used browsers and in the list includes Internet Explorer. As IE is no longer supported by Microsoft, and therefore presents a security risk, please confirm browser support requirements.

Microsoft Edge should be considered in place of Internet Explorer.


93

Technical Submittal File, Page 34,

Section F – Cross-Enterprise

Document Sharing (“XDS”) Registry and

Clinical Data Repository (“CDR”)

Item 6

The select–d offeror shall migrate all data from the existing P3N XDS Registry and Repository to the new system. 1) How many documents are in the registry and repository today that will require migration? 2) By what method will the legacy vendor provide such data?

See answer to question 70. The methods the legacy vendor will use will be provided to the Selected Offeror during the transition phase of the project.


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94

Technical Submittal File, Page 35, Section G. System Connectivity / Item 5

System Connectivity / bullet 5 states “shall onboard up to eight HIOs in addition to the five HIOs and PA Department of Corrections”. Does the eight include interstate, federal agencies and other networks discussed separately in bullet 10?

These eight onboarding slots could be used to onboard health information exchange with contiguous states, the Department of Veterans Affairs, the U.S. Department of Defense, and other exchange networks.


95

Appendix H – Requirements for non-Commonwealth Hosted Applications

Please clarify and provide the reference to Attachment 2-A cited in Appendix H.



96 Pre-Proposal Conference

Please provide a list of the attendees who participated on the February 10th GoToWebinar – P3N RFP Pre-Proposal Conference hosted by the state.

Please refer to Addendum 1.


97

Description File, Page 1, Determination to use Competitive Sealed Proposal Method, Section 2

Please clarify that the technical and cost volumes will only be uploaded electronically. Does the state have any specific requirements to provide “sealed” versions of any electronic submissions, and if so please clarify.

Yes, all submittals other than the references will only be submitted electronically. We request sealed hardcopy submittals only of the references.


98

What is the expected relationship for the EMPI between MMIS, P3N and the HIOs – many of which have EMPIs already? Who will be the master EMPI, and is a P3N person identifier to be created or used as the primary identifier within P3N?

MPIs are used and maintained within each local system. The P3N maintains and links patients to a single person (P3N Patient Identifier) from patients in each of the connected MPIs.


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99

What is the current lead time for self-certification as a Small Business? Could a business not currently certified meet the requirement to hold certification by March 31, 2021?

To become a DGS-verified SDB, vendors must first register in the PRiSM application as a Small Business via the self-certification process. Once that step is complete, the business must submit in PRiSM a valid third-party certification from one of the following certifiers: o Unified Certification Program (UCP) (Any state; this links to the PA UCP) o Woman’s Business Enterprise National Council (WBENC) o National Minority Supplier Development Council (NMSDC) o United States Small Business Administration (SBA) 8(a) Program o Vets First Verification Program (Service-Disabled Veteran only) o Disability:IN (formerly US Business Leadership Network (USBLN)) o National LGBT Chamber of Commerce (NGLCC) Once DGS reviews the third-party certificate and any additional required information, they will issue a SDB verification. Once DGS issues the SDB verification, the firm will be considered a DGS-verified SDB.


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The process for becoming a DGS-verified VBE is the same except the third-party certifying entities are: o Vets First Verification Program o Disability:IN (Disabled or Service-Disabled Veteran only) Once DGS reviews the third-party certificate and any additional required information, they will issue a VBE verification. Once DGS issues the VBE verification, the firm will be considered a DGS-verified VBE. SB self-certification as a SB Small Business can be completed via an online application in as little as 15 minutes. Obtaining a 3rd party certification can take from 90 days up to one year to attain from some 3rd party certifiers. Although BDISBO SDB/VBE verification can take up to 14 days to be completed, vendors may submit a request to expedite the SDB/VBE verification by contacting BDISBO directly.


100 Are the web services provided by MMIS to which P3N is expected to

integrate, both documented and available for review within this procurement?



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101

In Section I-8, “Requirements,” in item D4 on p. 30 of the Technical Submittal, it states, “The selected Offeror’s Provider Portal must also allow providers to assign delegates.”

What are delegates able to do? Does this extend to messaging? Would it make more sense to take a different approach?

Providers can assign delegates to perform work on their behalf. Examples include uploading consent decision forms and advance care planning documents, along with confirming the accuracy of provider data reflected with the P3N Provider Directory.


102

In Section I-8, “Requirements,” in item L, “Encounter Notification Services,” on p. 40 of the Technical Submittal, could you please let us know the desired provider messaging points that the vendor would need to integrate with?

The P3N ENS Service receives and forwards ADTs to HIOs using this service, based on patient matching. The P3N and HIOs require a pair of receiving and sending endpoints, test and production environments.


103

Could you please tell us more about the technical side of the authentication mechanisms you would like us to support?

Data exchange connections will support Transport Layer Security (TLS) 1.2 mutual authentication and VPN. For authentication for access to the Patient Portal, see the answer to question 11.


104 Is there an expectation that the Patient Portal is used as the MMIS Patient Portal?

No, the P3N Patient Portal is independent of any MMIS service websites.


105 Can you give insight on the amount (volume/file size) of historical data in the existing system that needs to be migrated to the new system?

There are ~1.5M XDS Registries entries to be migrated.


106 Can you give additional information on the integration to the new MMIS system? Are you planning on leveraging the P3N EMPI system as the EMPI for the MMIS?

The P3N resources and services will exchange data with other MMIS


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resources and services via the MMIS Hub.


107 When is the proposed start date? The Department is targeting a start date before the end of calendar year 2021.


108

Can you be the prime respondent on one response, and a subcontractor on another response?

Yes. Per SDB/VBE - 1 item #5 - Participation by SDB/VBE firms as prime bidders/Offerors or subcontractors: An SDB (or VBE) may be included as a subcontractor with as many prime contractors as it chooses in separate bids or proposals and a prime contractor may not prohibit an SDB (or VBE) from committing to any other prime contractor.


109 Is DHS planning on holding finalist interviews and presentations? Yes, these will also include demonstrations.


110

What do they want for XDS? – Rick can you provide any more context to this question as to what we need to know about XDS based on our conversation yesterday?

The P3N will allow HIOs to connect using Cross-Enterprise Document Sharing (XDS) specifications for query and retrieve of clinical documents.


111 The HIOs/HIEs connecting to P3N – do they have the same set of regulatory frameworks for connecting to P3N/PHG but also for connecting throughout the state?

Federal and State Regulatory requirements apply independent of connectivity.


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112

Do you have a list of feeds and connections, so we can establish a scope for onboarding?

The legacy P3N supports endpoints for PIX, XCPD, XDS, XCA, and HL7 ADT connectivity. Single P3N endpoints are used to connect multiple P3N Participants to these endpoints.


113

Under Patient Portal – the ONC does not want to provide funding for Portals – would PA be willing for Velatura to provide guidance on where the industry is going, as patients can use whatever portal is currently available?

All work contemplated in conjunction with this RFP is detailed within the RFP.


114 Can we get a copy of the SLAs associated with this project? SLA’s are identified as Performance

Standards, Section I-10, of the Technical Submittal


115

Will there be a posting of the pre-proposal attendees? If so, can you include any information provided by the attendees with regards to Prime, Sub, SDB, VBE, contact info....?

Please refer to Addendum 1. Attendees were not required to provide information other than name and email address; however, the following was provided via the chat box during the SDB/VBE portion of the presentation: • Louis Bullock-SQN Systems-Certified

SDB and VBE - [email protected]

• David Grinberg, President of DynaVet Solutions, a SDVOSB. Email me at [email protected] or call me at 443-844-1824.

• 360 Management LLC is a PA Certified SDB with the

mailto:[email protected]





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Commonwealth of PA. Our Contact info is [email protected] Phone 717-281-1190. We can provide resources for the project.

• If anyone is interested in a Small Business Vendor, please contact Steven Kastell, 732.431.1703, 732.513.8525 or [email protected]

• Tremayne Terry; A2Z Diversity Solutions; [email protected]; 717-379-3802


116 Can a single vendor fulfill both the SDB and VBE role? Yes, as long as they are DGS verified as

both an SDB and a VBE. See the Answer to Question 83.





