Duke Heart Center
Cardiac Cath Lab Image Server RFP
Request For Proposal: DICOM Digital Integrated Cardiac Record System original author: Jon Gardner (June 2001) revised for Duke Intranet posting by: James Tcheng (July 2001) Purpose: This system will be used for online, near-online & long-term DICOM (Digital Imaging and Communications in Medicine) archiving, review and processing of cardiac cath studies & other clinical imaging modalities in a network configuration. The system will function primarily in a local area network (LAN) configuration to meet the on-site needs of the Duke Heart Center (DHC) & secondarily in an Enterprise & Wide Area Network (WAN) throughout Duke Health System (DUHS) & strategic alliances. This equipment must be adaptable with the imaging & clinical database systems used within DUHS (including systems from Philips, General Electric, Toshiba, Quinton, Marquette, Prucka, and Hewlett Packard). Guidelines: This system must meet ACC/ACR/NEMA, ASE & HIPPA standards. In order to achieve the mission and goals of the Duke University Health System and the Duke Heart Center, we will partner with in an appropriate venture(s) with the selected vendor(s) to improve, position, and adapt advances in image processing, electronic storage technology, database management, and DICOM technologies. Application Specifications: A. Complete DICOM digital network Provide a complete and integrated digital software and hardware solution for the acquisition, storage, retrieval, and display of cardiac catheterization imaging data throughout the Duke University Health System environment. This will include remote locations (such as the Mobile Cath Labs), with complete and unrestricted (but controlled) access to the appropriate patient records. Be scaleable to permit the integration of other clinical reporting and imaging modalities, including: cath lab reports, IVUS images, echo reports & images, EKG reports & waveforms, ETT tracings & reports, Holter reports, pacemaker & event monitoring ECG reports, Nuclear images &
reports, and hemodynamic waveforms obtained during cardiac cath procedures. Provide for the transmission, viewing, and editing of the entire cardiac record (including dynamic images) to multiple review station locations. B. Concurrent Review Permit simultaneous access and concurrent review of stored information at an unlimited number of locations. Allow multi-user, concurrent access to an individual patient study. Allow individual user access to multiple patient studies. Will not lock out one or more users when accessing the same or different studies during acquisition of stored data. C. On/Line Access and Storage Networked online review of any selected study in one second or less at the site of original record for studies up to 6 months old. Remote review of any online selected study within 7 minutes or less when accessed from the WAN (i.e. via T1, ATM, DSL or comparable digital data transfer highway). Long term storage of images required at remote sites via the WAN is required, with ability to file site-specific information in the image management database. Option for bi-directional transfer via wireless, cellular, high-speed digital phone line, cable, or satellite providers Long term-archived capacity should be virtually unlimited, with the ability to increase capacity as storage needs increase to maintain access times of 30 seconds or less at site of original record. D. Information Compression All raw data will be stored in a loss-less, DICOM format. There will be non-destructive loss of original acquired data when restored for post processing or viewing (according to ACC/ACR/NEMA & ASE standards). E. Dynamic Post-Processing of Images (angiograms, Echo, IVUS & Nuclear) Image enhancement and software applications will be similar or the same relative to what is available in the respective departments during real-time acquisition. F. Images Should Have Highest Resolution Display with Total Digital Path Images seen on review station will be identical to images seen real-time during the procedure. The original digital data will be immediately & directly transferred to long-term archiving media while a “copy” will be simultaneously available for online access.
There will be no analog to digital reconversions of data. G. Non-Review Station Image Availability Ability to copy/duplicate images individually or dynamically onto the following media: 1. Photo printer 2. Laser paper printer 3. SVHS recorder tape 4. CD ROM (DICOM) 5. DVD 6. standard file formats for electronic display (e.g., .jpeg, .avi formats) 7. Magnetic optical 8. DLT-9840 9. Floppy & ZIP disc/drive H. Security of Integrated Record Permanent, uncompressed raw data on “hands free” selected media. Ability to provide multiple levels of access to end users (i.e. password protected view, view/edit, view/edit/copy etc.) I. Disaster Recovery A HIPPA compliant disaster recovery process-system will be provided with assured duplication & reproduction of the identical DICOM record The ACC approved exchange CD and long-term archival media (DVD, MOD, DLT, etc.) will have the software applet imbedded on each CD to allow off-the-shelf PC hardware to read DICOM CD without requiring proprietary OEM software preloading. Hardware: Image Review/Processing Stations Duke Heart Center: 10-12 high resolution review workstations placed strategically throughout the Heart Center Duke Heart Center: unlimited number of viewing workstations via the PC platform over the Common Services Network The complete cardiac record will use “off the shelf” non-proprietary PC hardware. CD/DVD Writer To enable user friendly seamless duplication of all patient studies. Long Term Archiving Device Images will be stored in a carousel or juke box configuration to house all patient studies enabling efficient management. Remote network accessibility to the digital patient record.
HIS Hardware Hardware & operating system must also support non-digital integrated cardiac record software applications, in a multi-tasking environment (i.e. word processing, spreadsheet, etc.). Accepting Testing: Upon completion of installation, operational verification data shall be taken, documented and presented to the hospital prior to acceptance and first clinical utilization. At the hospital’s option, acceptance testing may be performed to verify the specifications and clinical operation. Final resolution of compliance with specification and clinical operation must be made before final acceptance by the hospital. New Models or Enhancements Prior to Delivery: The intent of this purchase is to procure "state-of-the-art" equipment. Introduction of new models of equipment and accessories may occur after the acceptance of the P.O. The hospital reserves the right to modify any purchase up to 30 days prior to delivery. The vendor must submit new equipment announcements immediately, up until the installation date to allow the hospital to evaluate any new technologies. The vendor shall inform the hospital in writing of any manufacturer's additions or modifications to the equipment that is being purchases as a part of this package. Any of these additions or modifications developed or available for use after the date of the official purchase order for each system in the package shall be available to the hospital, at their option, with no additional increase in the price of the equipment. Performance Guarantees: Guarantees on equipment, materials, and workmanship shall not commence until acceptance by the owner. If the installed equipment does not comply with the agreed upon performance specification, the vendor shall upgrade the system to meet the agreed upon performance specifications within 30 days at no additional cost to the hospital. If within one year of formal acceptance the vendor is notified in writing by the owner that the equipment, materials, and/or workmanship has proven defective or that is has degraded until it is not meeting the specification requirements, the vendor will replace, repair, or otherwise correct the deficiency without cost to the owner within 30 days of notification. Should the equipment be unable to achieve satisfactory performance within the 30-day period, the hospital reserves the right to order the equipment removed at the vendor's expense. This will be limited to expense of equipment removal.
Response Time Guarantee: Response time to service problems is an important element in our choice of product. We require that the manufacturer provide the following information. 1. 2. 3. 4. 5. Manufacture's telephone service number Is this a national service dispatcher or local office? Hours this number will be in service (for the hospital's time zone) Average phone and on-site response time to hospitals Guaranteed phone and on site response time to hospitals
These guarantees must be provided in writing and be acceptable to the hospital before a purchase order is issued. Failure of the manufacturer to meet the guaranteed on site response time during the product's warranty period will result in the hospital's receiving a one week extension on their warranty for each occurrence. Site and Utility Modifications: Proposals must include complete disclosure of site and utility modifications necessary prior to installation. These modifications as presented by the successful vendor will be performed by the hospital or its contractor. Modifications required by the vendor and not specified in the proposal response will be the sole responsibility of the vendor. If a site visit is necessary to prepare this disclosure accurately, it shall be the vendor's responsibility to do so. The hospital desires to obtain use of this equipment as soon as possible. Delivery and installation times will be considered during the evaluation. Include with your proposal a detailed delivery and installation schedule for each component offered. Vendor shall insure goods to the point of delivery. (FOB Duke) Uptime Guarantee: During the one- (1) year warranty period, the vendor is required to maintain the equipment in original operation condition at no charge to the hospital except for utilities and disposables used by the equipment. It is expected that this equipment will operate with at least a 99% uptime during routine hours of service. If the unit can not be maintained above this level, the hospital is not obtaining expected performance from the equipment.
Downtime is defined as the time between notification of the vendor of the equipment being INOPERABLE for clinical use and recorded in the unit log, and the time the service report is signed indicating that the unit is available for clinical use. Uptime below 95% per month demonstrates significant downtime and loss of service. It also indicates abnormal service problems with the equipment. This condition will result in the extension of the warranty at a rate of one week for each unit of downtime. Uptime below 95% for two consecutive months or below 75% in any one-month will require that the hospital be given the use of an equivalent loaner unit at no cost and the option of exchanging the current equipment for a full refund. All preventative maintenance will be done after operational hours at vendor's expense. The warranty period will be one year, at no extra charge to the hospital with any service to be at vendor's expense for overtime and regular service hours. Software Update: Vendor shall supply, at no cost to the hospital, any pertinent software innovations for a period of four years from installation. This shall include installation and training. Manuals: Two sets of operation and two sets of technical schematic manuals shall be made available to the hospital, at the time of installation. Training (Technical Staff): Training shall be provided at no cost. On-site training shall be made available to all hospital staff for a period of three weeks, at no cost to the hospital. Follow-up visits/training shall be made available at the user's discretion to insure optimum operation of the equipment and image quality. Payment: 80% upon delivery 20% upon acceptance 2 - 3 months delivery upon receipt of purchase order 1 week installation time FOB Duke University Hospital