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					                     VENICE FAMILY CLINIC


                                AUGUST 2009




                      REQUEST FOR PROPOSALS

                                     FOR

                 AN ELECTRONIC HEALTH RECORDS AND

                    PRACTICE MANAGEMENT SYSTEM




RESPONSES DUE:      2:00 p.m. local time
                    Tuesday, September 29, 2009

DELIVERY ADDRESS:   Venice Family Clinic
                    Electronic Health Records and Practice Management System
                    Attention: Fred Hornbeck; RFP
                    Information Technology Department
                    604 Rose Avenue
                    Venice, CA 90291
                                           TABLE OF CONTENTS




1.     INTRODUCTION .................................................................................................... 1
2.     BACKGROUND ....................................................................................................... 7
3.     SOFTWARE TO BE PROVIDED................................................................................ 8
4.     SERVICES TO BE PROVIDED ................................................................................ 11
5.     METHOD OF SELECTION ..................................................................................... 14
6.     INFORMATION REQUIRED FROM PROPOSERS ..................................................... 16
7.     CONCLUSION ...................................................................................................... 20



APPENDICES

I      Functional Requirements
II     Sample Letter of Transmittal
III    Technical Proposal Evaluation Forms
IV     Cost Proposal Evaluation Forms




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1.     INTRODUCTION

       Venice Family Clinic (“VFC” or the “Clinic”) is soliciting written proposals from suitably
       qualified organizations (“Proposers”) to provide software and services to implement
       an Electronic Health Records and Practice Management System (“EHR/PMS”). The
       system should include the following capabilities in accordance with the instructions
       and requirements set out in this Request for Proposals (“RFP”):

       1.      Billing
       2.      Appointment Scheduling
       3.      Patient Data Management
       4.      Provider Ordering
       5.      Prescribing
       6.      Progress Notes
       7.      Laboratory Test Results Processing
       8.      Reporting

       The implementation of the EHR/PMS is intended to support the needs of all
       departments at VFC. VFC is most interested in a fully integrated response, providing
       all necessary software and services to complete the project, but is willing to consider
       software and services for any one or more of the applications. A fully integrated
       response will have a competitive advantage over other alternatives.

       VFC is willing to consider all possible solutions to the requirements, but it is desired
       to implement a “standards-based” and “open-systems” alternative, which will meet
       the on-going needs of VFC well into the future. As such, systems using technologies
       that comply with widely accepted industry standards or best practices will have a
       competitive advantage over other alternatives. In addition, VFC has adopted certain
       technology standards of its own and systems based on technologies that comply with
       these Clinic-specific standards, as listed in the system requirements, will have a
       competitive advantage over other alternatives.

       It is also an objective, in so far as it may be possible, to purchase “off-the-shelf”
       software which is currently in use by a number of organizations that are similar to
       the environment at VFC. Therefore, proposals with a number of comparable current
       references using the same applications will enjoy a competitive advantage.

       Under the terms of this RFP, Proposers are not being asked to provide any non-
       proprietary computers or related hardware. As part of this project, Proposers will be
       required to specify the necessary additional hardware for direct acquisition by VFC
       through VFC’s regular procurement processes. However, for budgeting purposes,
       Proposers should include the estimated cost of additional hardware required to run
       the proposed applications effectively. It should be assumed that all necessary server




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       hardware and imaging hardware (e.g. scanners) will be newly procured for this
       project.

1.1    Objectives

       VFC is seeking proposals to implement an integrated Electronic Health Records and
       Practice Management System. The system is intended to:

              support the work of all clinical staff, and specifically the physicians and
               medical personnel that provide patient care

              provide appointment scheduling for all patient visit types

              support billing functions to recover the cost of services provided

       The software products and services requested in this RFP are intended to meet these
       objectives. In composing responses, Proposers should consider these objectives
       and, as far as possible, propose solutions that maximize the achievement of them.

       The system should fulfill a vision of Electronic Health records such that work
       conducted by staff could be completed by reference to electronic patient charts
       rather than the paper equivalent. A centralized repository is required for all patient
       data and the EHR/PMS will serve as this central repository and allow retrieval at the
       click of a button.

       Additional benefits resulting from this project will include:

              The ability to store medical data in a secure repository that provides security,
               access control at chart level, access history and full text search capabilities

              Significant reduction in time spent searching for charts

              Ability to destroy paper charts after scanning, significantly reducing the
               amount of space required for paper chart storage

              Ability to easily determine the status and disposition of lab results and other
               orders

              Support for disaster recovery and business continuity projects and initiatives.

       The EHR/PMS is expected to interface seamlessly with other systems to allow
       ordering of medications, laboratory results and specialty services. The system will
       include clinical workflows suitable for internal use as well as use by external
       specialists and providers.



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       The objective of this RFP is to provide sufficient information to Proposers to enable
       them to respond in a manner that presents factual information about their
       organization, products and services, and to facilitate VFC’s selection of the most
       suitable vendor.

1.2    Scope of Work

       This section provides Proposers with a brief overview of the nature and magnitude of
       the project. Statements in this section are intended to assist respondents to ensure
       that their proposals encompass all aspects of the project.

       This section may not list all required Proposer tasks and/or responsibilities.
       Statements made in this section in no way limit the responsibilities of the Proposer
       and, where conflicts with other statements or requirements in this RFP occur, the
       statement resulting in the greatest benefit to VFC should be deemed the binding
       one.

       The project will implement the Electronic Health Records and Practice Management
       System throughout VFC. Proposers should provide all necessary services for the
       design, development, installation, configuration, testing, support and maintenance of
       the system for at least three years.

       Proposers should assist VFC to acquire the necessary hardware infrastructure
       necessary to operate the system. VFC will directly acquire all workstations, servers,
       printers, scanners, operating system software, database software, desktop office
       automation software and other "commodity items" via a separate procurement
       process. Proposers will be required to specify such commodity items and thus may
       be restricted from supplying hardware and software. These items will not be
       procured until the VFC Board has selected the winning Proposer, and the agreement
       is authorized and executed. As part of the services provided under the agreement,
       the successful Proposer is expected to ensure that hardware and equipment
       specifications are fully compatible with the proposed system.

       Proposers should also specify any specialist, proprietary or specially configured
       hardware necessary for the operation of the system under their proposal. Proposers
       may be required to supply VFC with such proprietary hardware, although Proposers
       should consider that “open” technology solutions are the preferred option.

       As an integral part of this project, the selected Proposer shall:

              Specify required application servers, workstations and other peripherals
               for separate procurement by VFC
              Develop any necessary design documents or artifacts
              Install and configure integrated application software


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               Develop and implement required modifications to the application software
               Test the application software, including any required modifications, to
                ensure that it is working correctly with satisfactory response times
               Develop and implement required interfaces to VFC’s other systems
               Provide necessary system and user documentation
               Provide training to:
                -      system administrators
                -      IT help desk staff
                -      medical records staff
                -      administrative staff
                -      clinical staff
               Provide on-going support and maintenance

        A complete turnkey solution is required. Proposers should assume that they are to
        provide all services in conjunction with this RFP other than the provision of the
        commodity hardware items described above. VFC staff will specify the data formats
        required for interfacing to existing in-house systems but will not be available to assist
        with hands-on work.

        VFC wishes to enter into an agreement with a single legal entity for the purposes of
        this project. Where a number of organizations wish to combine their responses as a
        single proposal, a prime-sub consultant relationship should be proposed.

 1.3    Schedule of Events

        The following tentative schedule has been established for the selection process and
        is subject to change by VFC:

 PROJECT MILESTONES                                             DATE

Release of Request for Proposal (RFP)                         08-18-2009
Pre-proposal conference (OPTIONAL)                            09-08-2009
Deadline for Questions                                        09-15-2009
Proposal Due Date                                             09-29-2009
Finalists Notified                                            10-13-2009
Interviews and Demonstrations                          10-27-2009 to 11-10-2009
Final Recommendation Determined                               11-17-2009
Award of Contract by VFC                                      12-08-2009




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1.4    General Information

       This section outlines some of the most important aspects of this RFP. Failure to
       comply with any of the conditions will be grounds for rejection of the proposal as
       non-compliant.

       A pre-proposal conference will be held on Tuesday, September 8, 2009 in the
       Simms/Mann Health and Wellness Center Conference Room at 2509 Pico Blvd.,
       Santa Monica, CA 90405. Attendance at the pre-proposal conference is optional
       but Proposers are strongly encouraged to attend. The meeting will begin
       promptly at 10:00 am local time and is not expected to last more than 90
       minutes. Attendees will be required to sign-in at the pre-proposal conference. A
       dial-in conference call number will be provided to Proposers that request the
       ability to join the meeting by telephone. Requests for dial-in access should be
       made via e-mail to vfcehrpms@mednet.ucla.edu prior to 5:00pm on Monday,
       September 7, 2009.

       Proposals must comply with the format detailed in Section 6 of this RFP.

       Proposals will be received in Venice, California, until 2:00 P.M. on September 29,
       2009. The postal and delivery address is:

                      Venice Family Clinic
                      Electronic Health Records and Practice Management System
                      Attention: Fred Hornbeck; RFP
                      Information Technology Department
                      604 Rose Avenue
                      Venice, CA 90291

       Proposers must submit eight (8) proposal documents (1 original and 7 copies) in
       sealed, clearly labeled envelopes (or boxes). Failure to meet the deadline will
       result in proposal disqualification without review.

       Questions regarding this RFP should be directed to:

       E-mail:                vfcehrpms@mednet.ucla.edu

       Postal Address:        Venice Family Clinic
                              Electronic Health Records and Practice Management System
                              Attention: Fred Hornbeck; RFP
                              Information Technology Department
                              604 Rose Avenue
                              Venice, CA 90291




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       Inquiries via e-mail are preferred. Questions will be accepted up to 14 days prior
       to the proposal due date, i.e. 2:00 P.M. on September 14, 2009.

       VFC requests that no Proposer contact them or any member of clinic
       management or staff, other than as detailed above, in conjunction with this RFP.
       Any contact with a member of the VFC Board or staff will be grounds for
       rejection of a response to this RFP.




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2.     BACKGROUND

       This section provides Proposers with a brief background on VFC and an overview of
       the EHR/PMS Project.

2.1    Venice Family Clinic

       Founded in 1970 in a borrowed storefront dental office, the Clinic has grown into the
       largest free clinic in the nation. Founder Phillip Rossman, MD, and co-founder Mayer
       B. Davidson, MD, called upon friends and colleagues to help. That spirit of
       volunteerism prevails today with more than 1,500 volunteers and $11.3 million in-
       kind contributions from hospitals, laboratories, specialty-care providers and
       pharmaceutical companies.

       The Clinic provides comprehensive primary health care, specialty care, dental care,
       mental health services, health education and child development services, as well as
       public insurance enrollment to more than 23,500 patients, including approximately
       5,800 children, who make nearly 100,000 visits annually. Prescription medicines are
       provided at no charge.

       Patients, most of whom live and work in the Westside neighborhoods of Venice, Mar
       Vista, Santa Monica, Culver City, and Inglewood, are low-income and lack private
       health insurance. Sixteen percent of the Clinic’s patients are homeless.

       Additional information can be found on VFC’s website at www.venicefamilyclinic.org.

2.2    The EHR and PMS Projects

       VFC has embarked on structured program of Health Information Technology projects
       that is referred to by VFC as the “Get Phit!” Program. Both the Practice Management
       System and Electronic Health System Projects are a part of the Get Phit! Program.
       The program is intended to run from early 2009 to late 2012. Other aspects of the
       program relate to disaster recovery, infrastructure, reporting, change management,
       etc. There are 12 Get Phit! Projects in total and each project has an appointed
       Project Manager and Project Sponsor. The program is also supported by a Program
       Office which reports to the Program Manager. The Program Manager reports top the
       Program Sponsor who is advised by the HIT Steering Committee.




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3.     SOFTWARE TO BE PROVIDED

       In response to this RFP, Proposers are asked to propose integrated application
       software and necessary modifications for a system for Electronic Health records and
       practice management. Further information about the system, including functional
       requirements, is provided in Appendix I.

       The system is intended to support the following clinical processes:

              Appointment Management
              Patient Check-in/Registration
              Vitals
              Provider Visit
              Lab Order
              Rx Order and Processing
              Immunization Order and Processing
              Referrals Order and Tracking
              Patient Discharge

       In addition, the system should support, either directly or indirectly, the following
       general or administrative activities:

              Billing and Claims Processing
              Performance Reporting
              Population Health Management
              Management Reporting
              Patient Self Management

       VFC also has a number of other systems that will need to interoperate with the
       EHR/PMS:

              Los Angeles Immunization Network for Kids (LINK)
              Labtracker
              Patient Electronic Care System (PECS)
              Labworks (Atlas Labs)
              Fox Leadtracker
              Foundation Systems Inc (FSI Pharmacy System)
              Los Angeles County Referral Processing System (RPS)

       Proposals should describe existing software in terms of the requirements in Appendix
       I, and should address the evaluation factors related to software, see Section 5.1,
       Evaluation Criteria. Services required for data migration and the design, delivery,
       development, upgrade, modification, installation, training, maintenance and support
       of software are detailed in Section 4, Services to be Provided.


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       As a minimum, the proposed software should provide the following
       features/modules:

              a medical records repository, providing access control, version control and
               retention control over patient medical charts.
              a provider desktop interface providing an integrated view of the patient
               chart and all data entry and ordering functionality
              patient scheduling functionality
              billing functionality
              a clinical workflow capability for routing tasks to the appropriate clinical
               staff
              a document image capture capability with optical character recognition
              archive facilities
              backup facilities

       The software will be used throughout VFC, in all departments, including grants and
       development, and by VFC volunteers that may access the system remotely. A
       breakdown of users by division or location is provided in Table 3.1. The system is
       estimated to have up to 185 primary users and 10 occasional remote users. Access
       for occasional users should be provided via a web browser interface that does not
       require support from information systems personnel. Access for primary users
       should provide a high level of functionality including desktop integration with
       standard desktop applications such as Microsoft Word.

       Table 3.1 – Total User Count

            Department/Location                             System Users
             604 Rose Avenue                                    90
             622 Rose Avenue                                    10
             Robert Levine                                      12
             Simms/Mann                                         60
             Mar Vista                                          10
             Mobile Clinic                                      3
             Remote Users                                       10

            Total                                               195


       In the table below the total user count is broken down by user role. The breakdown
       is approximate and subject to change.




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       Table 3.2 – User Count by Role

            Department/Location                             System Users
             Front Desk                                         18
             Laboratory                                         6
             Medical Assistants                                 24
             Registered Nurses                                  5
             Care Coordinators                                  30
             Call Center                                        5
             Medical Records                                    10
             Health Educators                                   4
             Mental Health Social Workers                       7
             Psychiatrist                                       1
             Mental Health Interns                              2
             Providers                                          33
             Dentist                                            1
             Dental Coordinator                                 1
             Dental Assistants                                  2
             Pharmacy                                           9
             Security                                           6
             Billing                                            7
             Health Insurance                                   5
             Administration                                     10
             Children’s First Program                           9

            Total                                               195


       VFC will require some volume or production document imaging capabilities in the
       Medical Records Department. However, it is intended that any large quantity of
       document imaging will be outsourced. Document scanning within the clinic is
       intended to be on an individual document, self-serve basis.

       The Medical Records Department currently maintains approximately 50,000 patient
       charts and creates an additional 4,000 charts per annum. These charts represent
       approximately 500,000 pages. The Medical Records Department has ten staff.




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4.     SERVICES TO BE PROVIDED

       The following sections outline the required services. Proposers are free to suggest
       additional services as part of their response. This section also describes the
       information required from Proposers as part of their response.

       A description of the implementation methodology and experience of using the
       methodology in implementing similar systems must be provided.

       A detailed schedule for all proposed tasks should be provided, specifying the party or
       parties responsible for completion of each task.

4.1    Design Services

       A design for the system should be prepared that clearly articulates each component
       of the system and how that component is to be configured or deployed. The design
       would be expected to include definitions for system components such as user
       interfaces, system interfaces, databases, processing functions and reports. The
       design should also include a final specification of required hardware.

       Propose any required system design services. Identify all documents or design
       artifacts you will provide to VFC as part of the design approval process.

4.2    Delivery, Installation and Configuration

       The selected vendor will be expected to deliver, install and configure all required
       software other than server operating system and database software that is provided
       by VFC under existing software licenses. In the case of server operating system and
       database software, the selected vendor will be expected to make any configuration
       changes as needed to support the efficient operation of vendor provided application
       software.

       Propose all services required for delivery, installation and configuration of the
       proposed software products, including acceptance tests to be attended by clinic staff.
       Test data for the acceptance tests will be provided by VFC.

       Include all services required to co-ordinate your activities with VFC’s Information
       Technology Department.

4.3    Software Modifications, Development and Integration Services

       Propose all services required to design and develop software, or modify existing
       software, to meet the needs of VFC, including integration of the proposed



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       applications, and acceptance tests to be attended by clinic staff. Test data for the
       acceptance tests will be provided by VFC.

4.4    Data Migration

       VFC currently maintains approximately 90,000 patient records in the existing QSI
       Practice Management System. Proposers should include services required to convert
       these records to the new system.

       Propose any services required to migrate the existing billing to the proposed
       application system. Migration services will not require the imaging of paper charts or
       the import of existing medical records into the new system.

4.5    Training

       VFC believes that thorough, effective training will be critical in attaining its objectives.
       Training may be proposed for:

              System Administrators
              IT Help Desk staff
              Medical Records Staff
              Administrative Staff (Billing, Registration, Call Center)
              Clinical Staff
              “Training the Trainers”

       Proposers may assume that VFC will provide access to a training facility with
       networked computer workstations, suitable for training up to 12 persons at a time.

       Describe how you will help VFC become self-sufficient within a period of two years in
       administering and supporting the proposed system. The number of users to be
       trained is approximately 185.

4.6    Software Maintenance

       Propose any necessary upgrade and maintenance services for all package and
       custom application software, and the date it will start, including the office locations
       from which the maintenance services will be provided. Propose services for software
       updates and enhancements to application and other software. Describe how
       subsequent versions of the software will accommodate any custom written routines.




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4.7    Support

       Propose all on-going applications support that you are able to provide. Describe the
       types of applications support you offer (for example, on-site, telephone, dial-in),
       hours of availability, guaranteed response and problem resolution times.
       Comprehensive support should be proposed for the first three years, after which time
       VFC staff may be expected to be trained to take over day to day support duties.

       Detail the proposed response to major system failures.

4.8    Other Services

       Propose any other services that are considered necessary to complete this project in
       a turnkey fashion.




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5.     METHOD OF SELECTION

       All proposals received as specified will be evaluated by VFC in accordance with
       evaluation criteria that are set out below. The evaluation process will have five
       steps:

       1.      Proposals will be reviewed to ensure compliance; non-compliant proposals
               will be rejected.

       2.      Proposals will receive a technical evaluation where only the technical
               proposals are considered.

       3.      Proposals will receive a commercial evaluation where the cost proposals
               are considered.

       4.      A number of shortlisted Proposers will be selected for interview and
               demonstration of the proposed software. Any necessary clarification will
               be sought at this time. Proposers are advised that, due to the extent of
               the software required, the discussion and demonstration may require
               more than a single meeting. VFC may require an on-site visit and tour of
               the vendor's place of business and/or visits to reference facilities. During
               this process, shortlisted Proposers may be requested to update their
               technical proposal in line with any discussions that have occurred and
               present a “best and final” cost proposal based upon the updated technical
               proposal.

       5.      Following the interview and a review of any updated proposals, a
               recommendation will be made to VFC management. Final selection of the
               Proposer and authorization of the agreement will be made solely by VFC
               management. However, VFC reserves the right not to make an award, to
               make multiple awards, or to make a partial award.

5.1    Evaluation Criteria

       The technical evaluation will consider the following factors:

              Vendor’s Experience and Overall Qualifications, including:
               -     Financial stability
               -     Southern California area presence
               -     Implementation methodology and experience of implementing
                     similar systems
               -     Training and support capabilities
               -     References



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              Software to be Provided
               -     How well the proposed software meets or exceeds VFC's RFP
                     requirements, including:
                     ∙      Functionality, as determined by responses to the
                            requirements listed at Appendix I
                     ∙      Ease of use
                     ∙      Range of pre-programmed software
                     ∙      Extent of software modification / development required
                     ∙      Flexibility to meet changing demands in the future
                     ∙      Package documentation and “Help” facilities
                     ∙      Required computer environment, that is, hardware,
                            database, development tools, etc.
                     ∙      Availability of source code
                     ∙      Security and audit facilities
                     ∙      Completeness of response

              Services to be Provided
               -      Demonstrated understanding of VFC's needs
               -      Quality of the overall work plan
               -      Quality of the staff proposed to assist VFC
               -      Completeness of response

       The technical evaluation will be based upon determination by VFC’s Evaluation
       Committee members as to how well each proposal meets VFC's requirements as
       presented in this RFP.

       The commercial evaluation will additionally consider:

              Reasonableness of Price, including:
               -     Package software license costs
               -     Costs of any required custom software and modifications to existing
                     software
               -     Service cost prior to the maintenance period
               -     Service cost during the maintenance period
               -     Training costs
               -     Additional proposed service costs
               -     Total cost over 3 and 5 years

              Contractual arrangements

       The evaluation is not binding on VFC management who, at its absolute discretion
       and judgment, has the authority to make final decisions regarding this RFP.




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6.     INFORMATION REQUIRED FROM PROPOSERS

       VFC is interested in proposals that illustrate an ability to develop, install, configure,
       maintain, provide training, and support for a period of three years a system that
       meets the needs of VFC. VFC will be impressed by concise, well-written explanations
       of proposed products, services and benefits. Lengthy narrative is discouraged.
       Proposals should clearly express the turnkey nature of the implementation.

       Proposers should be aware that the specifications and requirements stated in this
       RFP are minimum requirements.

       Proposals should be submitted in 8 1/2" x 11" size, using a simple method of
       fastening. Proposals should be typed and need not be unnecessarily elaborate.
       Proposers may additionally include any promotional material relating directly to their
       software products.

       Proposals should comprise two separate documents:

       1.      A technical proposal
       2.      A cost proposal

6.1    Technical Proposal

       The technical proposal must be organized as follows:

       1.      A letter of transmittal
       2.      Qualifications, related experience and references
       3.      Staffing and project organization
       4.      Proposed software specification, including responses to the list of required
               functionality, set out in Appendix I, that the software does and does not
               provide
       5.      Proposed services and a work plan for services to be supplied
       6.      Details of any required hardware
       7.      Other supporting material

       The requirements for each of these inclusions are detailed in the sections below.

       6.1.1 Letter of Transmittal

               The letter of transmittal shall be addressed to VFC and must, at a minimum
               contain the following:

                     Identification of the offering organization, including name, address and
                      telephone number



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                     Acknowledgement of receipt of RFP and RFP addenda, if any
                     Name, title, address and telephone number of contact person during
                      the period of proposal evaluation
                     A statement to the effect that the proposal shall remain valid for a
                      period of not less than one hundred and twenty (120) days from the
                      proposal due date
                     A statement certifying that there is no known conflict of interest
                     Signature of a person authorized to bind the offering organization to
                      the terms of the proposal.

               A sample transmittal letter is included at Appendix II.

       6.1.2 Qualifications, Related Experience and References

               This section of the proposal should establish the ability of the Proposer to
               provide the range of required goods and services satisfactorily.

               The section should include:

                     A summary of your business activities
                     Products and services offered by your organization
                     Number of years providing those products and services
                     Number of employees
                     Size and composition of customer base
                     Southern California area presence
                     A list of all existing customers
                     A list of contracts that were terminated early, with explanation as to
                      the reason for early termination
                     Annual Financial Statements for the past three years and the current
                      fiscal year to date

               This information should also be provided for each sub-consultant that will
               provide goods and services under the agreement.

               As part of their response to this section, Proposers must complete the
               Proposer Information Form included at Appendix III.

               Proposers, including any proposed sub-consultants, must be able to
               demonstrate that they have carried out the range of services required under
               this agreement for at least three years.

       6.1.3 Staffing and Project Organization

               Identify the key personnel proposed to perform the work on the project, and
               indicate major areas of subcontracted work, if any. Include an organization


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               chart showing the roles of the personnel, resumes of key personnel, and the
               time and duration that it is estimated that each will spend on this project.

       6.1.4 Proposed Software Specification

               Provide all non-pricing information requested in Section 3 of this RFP.

               Explain why you are proposing specific software products and the benefits to
               VFC over any similar competing products.

       6.1.5 Proposed Services to be Supplied

               Provide all non-pricing information requested in Section 4 of this RFP.

               This section must include a work plan detailing the proposed tasks and
               schedule for the services to be provided.

       6.1.6 Details of Additional Required Hardware

               Identify additional hardware that will be necessary in order to complete
               the implementation of the system, including minimum server, client and
               network requirements for satisfactory response times for 100, 200 and
               250 concurrent users

               If your proposal is based on any assumptions other than those set forth in
               this RFP, state those assumptions explicitly in your proposal.

       6.1.8 Contractual Terms and Conditions

               Proposers should propose and provide any license agreements or professional
               service agreements that they wish to use as a part of this project.

       6.1.8 Insurance Requirements

               Proposers should note that they will be required to demonstrate that they
               possess appropriate general and professional liability insurance.


       6.1.9 Other Supporting Material

               Information considered by the Proposer to be pertinent to this project, and
               which has not been specifically solicited in any of the aforementioned
               sections, may be provided to support the proposal. Proposers are cautioned,
               however, that this does not constitute an invitation to submit large amounts
               of extraneous material; supporting material should be relevant and brief.




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                                                                                       Page 19


6.2    Cost Proposal

       Proposers should provide an itemized list for all software products to be provided
       listing the quantity, unit price and extended price.

       In addition, the cost proposal should provide pricing in the formats set forth in
       Appendix IV, which contains the following schedules:

              Software Cost Schedule
              Service Cost Schedule, identifying:
               -      Service costs prior to the maintenance period (initial costs)
               -      Service costs during the maintenance period (annual recurring costs)
              Estimated Hardware Cost Schedule
              Cost Summary Schedule

       Notes should be used to explain or qualify any of the prices quoted in the software
       list or schedules.

       The cost proposal should be in a separately sealed envelope and clearly marked as
       such.




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                                                                                   Page 20


7.     CONCLUSION

       VFC thanks Proposers in advance for their participation in this process.




Electronic Medical Records and Practice Management System                Venice Family Clinic
                                                                       Appendix I - Page 1


APPENDIX I – FUNCTIONAL REQUIREMENTS

This appendix details the functional requirements for the Electronic Health Records and
Practice Management System. The system is intended to support the work of 185 primary
users and approximately 10 occasional remote users at the Venice Family Clinic.

Vendors are requested to use the enclosed matrix as a part of their response.

The requirements in the response matrix have been organized into the following sections:

   1. Practice Management Requirements
   2. Electronic Health Records Requirements

In some cases additional information has been included to further explain the requirement.




Electronic Medical Records and Practice Management System                 Venice Family Clinic
                                                                                                         Appendix I - Page 2


                                         SYSTEM REQUIREMENTS RESPONSE MATRIX

 Vendors must use the Vendor Response Codes listed below to complete the “Vendor Response” column for all requirements
 listed below. Please enter comments to explain or expand upon your response in the “Vendor Comments” column. For any
 functional requirements that you feel may be ambiguous, please include your Vendor Response, and provide your assumptions
 or clarifications under the Vendor Comments section.

 Vendor Response Codes:

        F = Fully supported “out of the box”
        CU = Custom Coding required (changes to underlying source code)
        CO = Configuration (no changes to underlying source code)
        NV = Provided in the Very Next Version (include release date in Vendor Comments)
        R = Provided with a Reporting Tool
        NA = Not Available
        TP = Third Party Software Required

 For all responses identified as CO, TP, or CU, the additional cost for the third party software and/or custom development and
 configuration must be included in your completed Pricing Matrix.

1. Practice Management Requirements
ID     Requirement                                                              Vendor          Vendor Comments
                                                                                Response

A      General System Requirements
       General System Features
1.     Support an integrated and bi-directional interface with an EHR
       system, providing the capability to import/create, review, update, and
       delete patient demographic information as well as other non-clinical
       information from the patient record in both PMS and EHR.

2.     Have the capability of importing patient demographic data via HL7
       interface from an existing Practice Management System, Patient


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                                                                                                     Appendix I - Page 3


1. Practice Management Requirements
ID     Requirement                                                               Vendor     Vendor Comments
                                                                                 Response
       Registration System, or any such system used for patient registration
       and/or scheduling.

3.     Interface and exchange data with other electronic systems conforming
       to published standards (the HL7 Continuity of Care Record
       specifications, HITSP standard and otherwise) Examples include:
       Clinical Lab Systems, Pharmacy Systems, and Chronic Disease
       Management Systems.

4.     Support and have the ability to regularly update the following
       vocabulary standards and also provide automatic translation of codes
       to data, including but not limited to: ICD-9-CM, CPT (4 and 5), ICD-
       10, and SNOMED CT.

5.     Utilize SNOMED CT (Systematized Nomenclature of Medicine--
       Clinical Terms) as the integrated standard nomenclature of clinical
       terms.

6.     Support the HIPAA Standards for Electronic Transactions.

7.     Provide an archive and restore capability that permits the selection of
       inactive patient accounts for storage and the removal of archived data
       from active data files. Restore process must allow for selective
       restoration of data.

8.     Support automated systems, programs or scripts/macros that can
       perform unattended system functions, specific functions within
       modules, and data backup operations on a user-scheduled basis.

9.     Support a multi-facility/site environment.


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                                                                                                    Appendix I - Page 4


1. Practice Management Requirements
ID     Requirement                                                              Vendor     Vendor Comments
                                                                                Response

10.    Interface with and receive data directly from various hardware
       devices (scanners, signature tablets, etc.) and include this data
       directly in the patient record.

11.    Provide detailed context-sensitive help in various methods (e.g. pop-
       up windows, searchable help libraries, etc) for all system screens,
       operations, and data fields.

12.    Provide extensive on-line tutorials that provide self-paced tools for
       learning the software.

13.    Provide pop-up and drop-down menus for all data fields that have a
       large number of possible, but fixed, values. And allow for changing
       the method of sorting for the data display (e.g. by code or
       alphanumeric).

14.    Ability to toggle between various system modules while retaining
       active reference point (e.g. patient record). For example, move
       between pre-registration, appointment scheduling, and insurance
       information screens for a given patient.

15.    Assign mandatory or required fields that must be filled in to complete
       a given function or data entry screen.

16.    Quick-select or stop a search as soon as it comes up with desired
       values without having the search to complete.

17.    Support system and user-definable edit checks on data fields and
       consistency checks between data fields to reduce data entry errors


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                                                                                                      Appendix I - Page 5


1. Practice Management Requirements
ID     Requirement                                                                Vendor     Vendor Comments
                                                                                  Response
       including but not limited to ICD-9 (Check diagnosis against gender,
       age, other as necessary), ICD-9 (procedure checking against
       diagnosis), and extensive date checking for validity as well as
       ensuring a valid chronological order of events (dx before treatment,
       scheduling after birth, etc.).

18.    Provide some means of tracking paper charts as long as they remain
       active (in use), including detailed history of use/location.

19.    Support the integration of third party coding programs.

20.    Query and receive Electronic Health insurance eligibility information.

       Alerts and Notes
21.    Allow for user customizable alert screens / messages, enabling
       capture of alert details, including, but not being limited to: text
       describing the alert, date and time of the alert, printing report upon
       demand.

22.    Provide real-time alerts or notifications to specified or targeted users
       and groups (call center, front desk, etc), based on ICD-9 codes and
       other user-defined parameters.

23.    Have the capability of forwarding the alert to a specific authorized
       user via secure electronic mail or by other means of secure electronic
       communications.

24.    Track the user‟s response to an alert.

25.    Allow the user to document rationale for following/not following an


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                                                                                                       Appendix I - Page 6


1. Practice Management Requirements
ID     Requirement                                                                 Vendor     Vendor Comments
                                                                                   Response
       alert.

26.    Support internal forms and notes functions that can be used
       throughout the system to provide additional details and
       documentation. Specifically this functionality will be available in
       (but not limited to) the appointment scheduling module, for
       Medication Refill Requests, etc. And this information can be
       configured to automatically display in pertinent screens.

       System Administration and Security
27.    Control access to and within the system at multiple levels (e.g. per
       user, per user role, per area, per user group, per data set(s)) through a
       consistent mechanism of identification and authentication of all users
       in accordance with the „Role Based Access Control‟ (RBAC)
       standard.

28.    Maintain a detailed audit trail for all system transactions including
       look-ups (read only) of patient/account data.

29.    Limit/prevent a user‟s ability to deny (repudiate) an electronic data
       exchange originated, received, or authorized by that user.

30.    Maintain a detailed record/log of all intra-system data transfers.

31.    Provide automatic/automated analysis of audit trails and alerting of
       unauthorized access attempts.

32.    Support strong password requirements and have the system prompt
       new user to change initial temporary password to a new password
       that is 6-16 characters long.


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                                                                                                     Appendix I - Page 7


1. Practice Management Requirements
ID     Requirement                                                               Vendor     Vendor Comments
                                                                                 Response

33.    Use the information stored in the Provider Profile File for scheduling,
       billing, and reporting purposes on provider type and schedule.

34.    Configure how many computers staff/users can be logged into
       simultaneously.

35.    Configure number of days or an exact date for password/account to
       expire.

36.    Utilize unique numeric code(s) to identify providers.

37.    Change, add, delete or modify provider‟s information including
       deleting the provider from a group or making provider inactive.

38.    Support mechanisms for defining provider hours (schedule).

39.    Import a schedule from another day, another provider, or another site.

40.    Support review of provider scheduling templates prior to activating.

41.    Support creation of an alternate provider schedule using the same
       process as when creating a new provider schedule grid.

42.    Support creation of multiple columns in the provider appointment
       book.

43.    Determine what dates the appointment book becomes available for
       scheduling.



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                                                                                                   Appendix I - Page 8


1. Practice Management Requirements
ID     Requirement                                                             Vendor     Vendor Comments
                                                                               Response
44.    Create user defined appointment types and assign times for each
       appointment type.

45.    Block portions or days of the provider appointment book and provide
       a reason for the action as well as restrict who can have access to do
       this action.

46.    Support provider profile page with the following fields:
        Clinic tax id
        Provider license
        Provider specialty type
        Various billing related ID‟s such as managed care provider
          numbers or UPIN numbers
        Site or sites they work out of
        Provider teams they belong to


B      Patient Scheduling
47.    Collect limited demographic information in order to create a pre-
       registration record prior to scheduling a patient; once the patient
       comes in for an appointment the Front Office will complete the
       Registration Process.

48.    Maintain a unique and single record for each patient, but allow for
       links and reference to other family members and to copy or pre-
       populate demographic information utilizing an already existing
       family member.

49.    Maintain patient demographic and registration information per
       HITSP standards and to allow for user-definable fields within system


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                                                                                                     Appendix I - Page 9


1. Practice Management Requirements
ID     Requirement                                                               Vendor     Vendor Comments
                                                                                 Response
       patient demographic records.

50.    Alert if patient is already registered in system, based on name
       (including soundex/similar spellings) and/or DOB.

51.    Support a user verifiable record merge function (when duplicate
       patient entries or records are identified) and purging of incomplete or
       partial records.

52.    Capture and maintain statistical data via user definable and editable
       data sets.

53.    Search for patients by one or more unique and configurable
       identifiers (e.g. Name, DOB, SSN, phone number, insurance ID).

54.    Schedule new and established patients.

55.    Automatically indicate the patients Primary Care Provider (PCP) and
       home/site, but allow for manual override of either.

56.    Search available appointments by:
          1) provider or group
          2) appointment type (pediatric, adult, specialty, etc)
          3) site or multiple sites
          4) specific dates or date ranges, and to toggle between search
              options.

57.    View all up-coming appointments and appointment history for a
       specified patient.




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                                                                                                      Appendix I - Page 10


1. Practice Management Requirements
ID     Requirement                                                                 Vendor     Vendor Comments
                                                                                   Response
58.    Interface with Cisco VOIP phone system and Call Center System so
       that if caller ID information is available, the patient record screen can
       be brought up automatically.

59.    Cancel and re-schedule appointment without having to search for the
       patient again.

60.    Assign specific cancellation and no-show codes based on reason.

61.    Access, view, schedule, reschedule and cancel directly from
       individual provider appointment book.

62.    View all available appointments for specified date(s) based on
       providers, groups or sites.


C      Patient Registration
63.    Automatically calculate sliding fee schedule based on Federal
       Poverty Levels.

64.    Provide tracking mechanisms for patient signing of HIPAA and other
       forms including any HIPAA restrictions and if patient has refused to
       sign forms and why.

65.    Ability to flag a patient if they belong to a special program or special
       population group.

66.    Print registration form for patient signature.

67.    Pre-populate demographic info into insurance fields.


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                                                                                                      Appendix I - Page 11


1. Practice Management Requirements
ID     Requirement                                                                 Vendor     Vendor Comments
                                                                                   Response

68.    Sort and track according to active or inactive insurance status as well
       as by eligibility dates.

69.    Pre-populate Insurance Plan info (billing address, etc) based on
       selection of plan numbers.

70.    Indicate guarantor and relationship to the patient.

71.    Enter primary and alternate insurance (if applicable).

72.    Manage and display patient‟s PCP in the insurance info.

73.    Manage and display of PCP effective dates for managed care patients.

74.    Verify eligibility of active insurance plans via direct system interface.

75.    Prompt for verification of Medicare insurance for patients who are
       65 and over.

76.    Prompt for verification of Medi-cal for all patients with SSN
       regardless of age.

77.    Provide automatic notification of expired insurance.

78.    Create a unique care slip (encounter) number of at least 10 digits.

79.    Print provider‟s appointment list that may include(but not limited to):
            patient‟s name
            patient ID


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                                                                                                   Appendix I - Page 12


1. Practice Management Requirements
ID     Requirement                                                              Vendor     Vendor Comments
                                                                                Response
              date and time of appointment

80.    Track information regarding reminder calls to indicate the following:
           confirmed
           left voice mail message
           message left with family member
           no answer
           phone disconnected

81.    Display and/or generate a real-time report of how many patients have
       checked in, how many are late, and how many are no-shows.

82.    Print mailing labels with patients name and address

83.    Generate automated reminder calls in both English and Spanish


D      Cash Flow Process
84.    Record cash payment/donations in patient‟s account.

85.    Interface directly with POS (card swipe) system for patients who
       choose to give payment/donations using ATM or Credit Card.

86.    Post credits and debits and create a report of all transactions at the
       end of the day.

87.    Print receipt of cash donation with patients name, amount
       payed/donated, date and name of registration representative.

88.    Produce productivity report for each employee based on


 Electronic Medical Records and Practice Management System                                            Venice Family Clinic
                                                                                                      Appendix I - Page 13


1. Practice Management Requirements
ID     Requirement                                                                 Vendor     Vendor Comments
                                                                                   Response
       payment/donations collected.


E      Patient Discharge and Referral Process
89.    Maintain a detailed in-house Specialty patient recall list (waiting list)
       to include the following;
            Patient name
            Chart number
            Date of entry
            New or follow-up
            Referring Provider name or code (drop down to select)
            Specialty Name/Code (drop down to select)
            Comment field

92     Generate recall reports based on specialty name or code

93     Separate specialty clinic names/codes by OPEN or CLOSED

94     Maintain referral tracking system with the following:
           Specialist name
           Specialist address
           Phone number
           Name of Specialty
           Contact information
           Comments field for special instructions regarding services
              they provide

95     Provide reports with details and numbers of patients referred to a
       specific specialist/site.




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                                                                                                     Appendix I - Page 14


1. Practice Management Requirements
ID    Requirement                                                                 Vendor     Vendor Comments
                                                                                  Response
96    Print return appointment slip with the following information:
           Patients name
           Chart number
           Date of appointment
           Name of provider who will see the patient
           Specialty type (if applicable)
           Name and address of site/location where patient has
              appointment
           Clinic Appointment Line phone number
           General instructions based on appointment type (if applicable)

97    Alert based on pre-determined threshold of number of patients
      already on recall list.

98    Have ability to define and print forms for patients. Examples include:
          Back to school note
          Appointment Agreement
          Specialty appointment acknowledgement
          Ability to Pay Plan (ATP)
          Mental Health walk-in hours
          Referral Forms
          Lab slips/orders

99    Support direct interface with LA County Referral Processing System
      (RPS).


F     Billing
100   Print super bill accountability report for a given date range by
      provider or group of providers, or by site, indicating status (e.g. open,


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                                                                                                 Appendix I - Page 15


1. Practice Management Requirements
ID    Requirement                                                             Vendor     Vendor Comments
                                                                              Response
      re-open, voided or closed).

101   Generate/batch encounters to be processed by insurance, site and or
      providers.

102   Check insurance eligibility by number of digits, letters or a
      combination of both and alert if digits or numbers are missing.

103   Track specific CPT-Codes that have already been entered per
      individual patient and apply known rules and regulations.

104   Maintain restrictions on CPT codes that are excluded from coverage.

105   Recognize and accept only allowed procedure and diagnostic codes.

106   Ability to post by entering patient‟s account number or care slip
      number.

107   Display the following in posting screen:
          insurance effective/cancelled date next to insurance name or
             insurance number
          insurance ID number, type of insurance and whether it is
             primary or secondary.
          all active insurance plans for that patient for date of service.
          provider name or number who saw the patient

108   Support transaction comments entered while posting to clarify
      transaction.

109   Override the defaulted provider name.


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                                                                                                   Appendix I - Page 16


1. Practice Management Requirements
ID    Requirement                                                               Vendor     Vendor Comments
                                                                                Response

110   Record both the resident or code and the name or code of supervising
      physician.

111   Allow fixed rate to be entered for insurance types and default to NA
      for most commonly used codes.

112   Run electronic claims or printed manual claims by billing record
      number, claim status, service or posting date and batch number.

113   Maintain CHDP-160 template with the two digit CHDP codes and
      other requirements and a library of billing forms.

114   Assign a claim number to all billable visits seven days after the visit
      posting date.

115   Setup and update insurance plans fee schedule, billed fee schedule
      and patient fee schedule.

116   Generate a batch based on service location from the insurance plan
      settings.

117   Generate claims based on fix rate code, dollar amount and or with
      usual and customary fees (UCF) per procedure (VISITS).

118   Generate two claims at once for managed care plans in order to be
      able to submit one claim to the managed care plan and the other to
      Medi-Cal for the interim rate portion.

119   Sustain a claim submission log with a total number of claims in


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                                                                                                    Appendix I - Page 17


1. Practice Management Requirements
ID    Requirement                                                                Vendor     Vendor Comments
                                                                                 Response
      queue.

120   Generate and test electronic claims in order to fix any rejection errors
      and actual data collection, must display patient account and claim
      numbers.

121   Identify via report or otherwise, incorrect or rejected claims, run and
      view claims with proper identifiers (Account, plan, claim number and
      status) and correct them as needed prior to submission.

122   Run Care Slip Control Log and view before printing with the
      following options:
           Alpha
           Numeric
           Care slip number
           Option to enter the start and ending date
           By one or more providers including ALL providers
           Employee number (if claims have been posted)
           Status (open, closed, voided, re-opened, all)

123   Flag accounts with SSN numbers in the policy number field when
      billing programs/fields are accessed and when the system transfer
      happens so that the policy number can be fixed.

124   Generate two claim numbers for the Managed Care Plan and the
      Interim Rate and also able to track when the claim was re-done and
      submitted to each plan.

125   Keep track when the insurance record/claim/payment account history
      was modified, what changes were made and by whom, all dates when


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                                                                                                  Appendix I - Page 18


1. Practice Management Requirements
ID    Requirement                                                              Vendor     Vendor Comments
                                                                               Response
      the claim was submitted and re-submitted electronically or manually
      (paper).

126   Enter the rendering and supervising provider at the same time prior to
      entering services rendered for accuracy.

127   Require entering only valid CPT and DX codes.

128   Flag excluded codes for certain insurance plans (PPP, Medi-cal)
      when those codes are entered as primary diagnosis.

129   Alert and or restrict entering non-contracted or non-covered providers
      in depending on the plan.

130   Restrict users from posting payments if provider‟s PIN numbers have
      been deactivated or expired.

131   Restrict certain spoolers from being deleted to avoid losing
      information by accident (electronic reports, files etc).

132   Categorize and number comments posted in an account history for
      reporting and tracking purposes.

133   Support the option of displaying only one requested insurance record
      number under account history.

134   Set various claim audits depending on the insurance plan.

135   Support multifunctional codes. Codes can be set as CPT or internal
      codes for reporting.


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                                                                                                   Appendix I - Page 19


1. Practice Management Requirements
ID    Requirement                                                               Vendor     Vendor Comments
                                                                                Response

136   Summarize a given spooler‟s/batch processing content.

137   Fix electronic rejection errors directly without having to use separate
      (external) programs (examples: PALMETTO, OFFICE ALLY, or the
      WEB).

138   Generate log of all electronic rejection errors including plan name,
      number of claims, amount submitted.

139   Keep the following forms in a separate file and accessible from any
      billing function.
            PM-160 Confidential Screening/Billing Report
            UB-04
            CMS-1500
            PPP Pharmacy Claim Form
            Medi-Cal Claim Inquiry Form
            Medi-Cal Appeal Form
            Medi-Cal Claim Attachment Control Form
            AIA 1500 Dental Care Form
            Medicare Appeal Form
            Medicare Redetermination/Reopening Request
            Medicare EDI Cover Sheet
            VFC Check Request Form

140   Enter Insurance payments with the following fields:
          Date of Remittance Advice (RA)
          Multi Pay for multiple accounts
          Check (RA amount)
          Posted payments


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                                                                                                Appendix I - Page 20


1. Practice Management Requirements
ID    Requirement                                                            Vendor     Vendor Comments
                                                                             Response
             Plan number – RA page number
             Payment code
             Patient account
             Employee number and password

141   View partially paid claims.

142   Support option to bill other insurance only when there is secondary
      coverage.

143   Run a Payment/Adjustment summary report in order to identify and
      correct any discrepancies.

144   Have reason/denial code displayed in the account history and linked
      to a certain procedure (not the whole claim).

145   Support a method of changing the payment code during “MultiPay”.

146   Assign correct payment codes to payments during electronic payment
      posting even if the insurance plan is the same but the visit code is
      different.

147   Run a report by warrant number for posted RA‟s to get payment
      Details like:
               account number
               claim number
               procedure
               amount paid

148   Check rates against allowed amounts and flag under and over


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                                                                                                   Appendix I - Page 21


1. Practice Management Requirements
ID    Requirement                                                               Vendor     Vendor Comments
                                                                                Response
      payments (based on insurance allowable amounts for date of service).

149   Support option of setting restrictions on non-contracted or deactivated
      providers to prevent billing their services.

150   Restrict certain procedures from being entered for certain providers.

151   Support closing and generation stream of materials for billing
      databases/records individually or by pre-defined and editable job sets.

152   Support multiple generation streams be created per database,
      containing any combination of reports, statements and insurance.

153   Support configurable timing of the closing process.

154   Support logging of billing activity after the closing and generation of
      materials.

155   Support automated spooling/batch processing of generated materials
      to electronic files and/or printers.

156   Support log itemizing contents of generation stream.

157   Apportion statements to multiple printers (to speed printing).

158   Initiate end of month processing on any schedule desired.

159   Ability to limit EOM processing to calendar end-of-month.




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                                                                                                  Appendix I - Page 22


1. Practice Management Requirements
ID    Requirement                                                              Vendor     Vendor Comments
                                                                               Response
G     Reporting and Data Management

160   Support a user-friendly and customizable report generator which
      allows end-users to run the reports themselves.

161   Support a “pick list” when possible for all of the reporting criteria.

162   Generate reports for printing or to various electronic file formats.

163   Support direct connection to system databases to run various queries
      using client software like MS-Excel, MS-Access, Crystal Reports,
      MS-SQL, etc.

164   Run reports by site or all sites combined.

165   Export the patient demographic and encounter data so customized
      reports can be generated.

166   Support multi-tasking (utilizing other system features and modules)
      while running a report.

167   Sort/define reports by various parameters such as all encounters
      created for X-provider in the a.m. only or at Y site only.

168   Run reports than can summarize on the number of encounters (care
      slip) as well as number of unduplicated visits.

169   Run reports on user-defined fields that are available and reportable
      criteria and demographics for example:
           Homeless status


Electronic Medical Records and Practice Management System                                            Venice Family Clinic
                                                                                                 Appendix I - Page 23


1. Practice Management Requirements
ID    Requirement                                                             Vendor     Vendor Comments
                                                                              Response
             Race/Ethnicity
             Hispanic/Latino origin
             Language, etc.

170   Run provider productivity visit reports based on their unique code.

171   Run federal reports in standard formats such as UDS and OSHPD.

172   Run payments/adjustments distribution by provider or multiple
      providers
          This report can also be used to analyze amounts paid and or
             adjusted in a specified date range for charges posted in the
             same or another date range.
          It can also summarize by reimbursement sources (insurance
             plans and or by service locations)

173   Print a list of specified payments, adjustments and procedures posted
      by specified employees.
           These transactions can also be queried by designated
              transactions like:
                   o referring providers
                   o account types
                   o locations
                   o insurance plans
                   o amounts
                   o denials
           In addition transactions are queried by a specific service or
              posting date range
           The transaction report can be printed in either a summary or
              detail



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                                                                                                  Appendix I - Page 24


1. Practice Management Requirements
ID    Requirement                                                              Vendor     Vendor Comments
                                                                               Response

174   Generate Encounter (care slip) report that tracks the number of
      patients encounters based on specified criteria

175   Have the Encounter report consider an encounter as one or more
      charge transactions posted for a single date of service for a face-to-
      face visit between a health care provider.

176   Have entries within fill-in-fields on patient forms to be included in
      the queries.

177   Exclude certain service codes and or diagnosis code ranges on
      reports.

178   Support use of internal codes for special tracking/reporting purposes
      (non billable codes).

179   Query reports by primary diagnosis or multiple diagnosis of the
      medical visit.

180   Report by special population or programs such as:
          Family Planning
          Homeless In-Clinic
          Santa Monica HS
          Street Outreach
          Homeless Outreach
          Westside Partner

181   Report on CHDP assessments done on children.




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                                                                                                  Appendix I - Page 25


1. Practice Management Requirements
ID    Requirement                                                              Vendor     Vendor Comments
                                                                               Response
182   Run reports based on number of patients who cancelled their
      appointments.

183   Print blocked schedule report (provider cancelled, patients need to be
      re-scheduled).

184   Run a report on patients that haven‟t had an office visit within a
      designated time.

185   Track when patients complete their Mental Health treatment plans
      with a termination summary.

186   Track what types of screens/questionnaires have been completed by
      patients for example; PHQ9, anxiety, depression, Domestic Violence,
      etc, and their scores.

187   Keep track of lab specimens and generate reports.

188   Track of patients who come in through homeless triage, how many
      are scheduled, how many are asked to return

189   Keep track on the number of patients who are turned away on a daily
      basis and by whom.

190   Keep track of duplicate callers and turn away patients when no
      appointments available.

191   Keep track of volunteers by department.

192   Log Health Education Outreach encounters, like patient‟s name,


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                                                                                                  Appendix I - Page 26


1. Practice Management Requirements
ID    Requirement                                                              Vendor     Vendor Comments
                                                                               Response
      DOB, type of HE discussed, and type of incentive given, even if the
      patient is not enrolled as VFC patient.

193   Keep track of Health Education classes and number of participants.

194   Run reports for a specific provider with the following:
          Number of patients scheduled
          Patients scheduled with non-PCP provider

195   Link with County Referral Processing System (RPS) and be able to
      run specific specialty reports or number of referrals submitted to one
      site or all sites within a period of time.




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                                                                                                    Appendix I - Page 27



2. Electronic Health Records Requirements
ID     Requirement                                                               Vendor     Vendor Comments
                                                                                 Response

A      General Functions
1.     Provide the ability to create a single patient record for each patient.

2.     Provide the ability to merge patient information from two patient
       records into a single patient record.

3.     Provide the ability to link the charts of family members.

4.     Provide the ability to record patient and clinical data using the
       following types of input:
            Structured, coded and validated input
            Template-based text input
            Free text input
            Speech/voice input

5.     Record standardized codes, lists and data sets as follows:
           Allergies/Sensitivities
           Patient Demographics
           Diagnoses (Problem List)
           Diagnostic tests (Labs)
           ICD9 Codes
           Complexity (RVS Codes)
           Immunizations
           Locations (clinics)
           Formulary
           Licensed Providers
           Medication list (formulary, non-formulary and patient
             assistance program)


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                                                                                                   Appendix I - Page 28


2. Electronic Health Records Requirements
ID     Requirement                                                              Vendor     Vendor Comments
                                                                                Response
              System Users

6.     Provide facilities to record encounter data for the following visit
       types:
            Adult Primary
            Pediatric
            Nursing
            Chronic Disease Management
            Pre-Natal
            Osteopathic
            Women‟s Health
            Teen and Adolescent Care
            HIV
            Homeless
            Pharmacy
            Mental Health
            Optometry
            Dental
            Specialty

7.     Provide facilities to add new forms and templates for new visit types
       as needed in the future.

8.     Provide the ability to work with multiple charts (at least two) charts
       simultaneously for occasions where two patients must be seen
       together (e.g. siblings or couples). (Note: It would be useful to have
       some clear indication of which chart is which e.g. two different color
       backgrounds).

9.     Provide a listing of checked-in patients in the order they are to be



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                                                                                                      Appendix I - Page 29


2. Electronic Health Records Requirements
ID     Requirement                                                                 Vendor     Vendor Comments
                                                                                   Response
       seen. The list should be able to be sorted in both the order patients
       were scheduled and the order they arrived.

10.    Provide a clear indication that a patient is ready for examination by a
       provider.

11.    Record the patient location so that a user may identify a patient chart
       before entering an examination room.

12.    Provide rapid access to the problem list, last progress note, lab
       results, pending consults and list of prescribed medications.

13.    Provide a listing of outstanding requests for medical records or
       consult reports from other providers.

14.    Provide the facility to correct inaccurate or incorrect patient data and
       maintain a record of the changes that were made.

15.    Provide the ability to pre-populate a template form (e.g. progress
       note) with certain data from a previous visit in order to assist the data
       entry process. (Note: In order to eliminate the possibility of errors
       introduced by not capturing the current data, only data that doesn‟t
       change should be pre-populated).

16.    Provide the ability to edit notes and use cut and paste facilities for
       text input.

17.    Provide the ability to dictate notes.

18.    Provide the ability to scan paper documents and record them in a


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                                                                                               Appendix I - Page 30


2. Electronic Health Records Requirements
ID     Requirement                                                          Vendor     Vendor Comments
                                                                            Response
       patient chart.


B      User Interface
19.    Provide a user interface that is easy to navigate and includes
       immediate access to the following functionality:
           Scheduled Appointments
           Patient Charts
           Clinical Tasks

20.    Provide the ability to view the following areas of a patient chart
       separately:
           Medical
           Dental
           Optical

21.    Provide immediate access to the following functionality inside a
       patient‟s chart:
            Problem list
            Medications list
            Lab Results
            Patient Demographics
            Prescribing
            Provider Ordering
            Encounter Notes
            Specialty Reports
            Other Documents


C      Patient Demographic Data


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                                                                                                  Appendix I - Page 31


2. Electronic Health Records Requirements
ID     Requirement                                                             Vendor     Vendor Comments
                                                                               Response
22.    Record demographic information as part of the patient record,
       including:
            Name
            Address
            Phone Number(s)
            E-mail
            Date of Birth
            Social Security #
            Driver‟s License #


D      Consents and Directives
23.    Provide the ability to store, display and print consent forms for
       completion by the patient.

24.    Record patient or parental consent forms e.g. for:
           treatment
           transfer of medical records to/from other
             organizations/providers
           decline to vaccinate
           hormonal birth control methods
           consent for procedures
           against medical advice (AMA)
           participation in the CHDP, CDP and CCS programs
           immunizations
           participation in clinical trials
           photographs/videos
           publication

25.    Provide the ability for patients to electronically sign consent forms


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                                                                                                      Appendix I - Page 32


2. Electronic Health Records Requirements
ID     Requirement                                                                 Vendor     Vendor Comments
                                                                                   Response
       using currently available digital signature standards. Electronically
       signed consent forms should be maintained within the patient medical
       record.

26.    Provide the ability to store and display patient consents associated
       with a specific clinical activity and provide the ability to link to that
       event in the patient‟s electronic chart.

27.    Provide the ability to indicate that a patient has been provided an
       advanced directive form and record any completed advanced
       directive(s).

28.    Provide the ability to indicate the type of advanced directives, such as
       living will, durable power of attorney, or a "Do Not Resuscitate"
       order.

29.    Provide the ability to record consent for teenagers under the age of 18
       requesting confidential services without a parental consent.


E      Vitals Entry
30.    Record patient intake data (“vitals”) for each visit as follows:
           Reason for Visit
           Weight
           Height
           Blood Pressure
           Heart Rate (Pulse)
           Temperature
           Respiration
           Blood Glucose (FBS and RBS)


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                                                                                                 Appendix I - Page 33


2. Electronic Health Records Requirements
ID     Requirement                                                            Vendor     Vendor Comments
                                                                              Response
              Pulse Oximeter Reading
              Peak Flow
              Pain Scale
              Routine UA
              Last Menstrual Period
              Pregnancy test
              Hemaglobin

31.    Provide the ability to integrate equipment used to measure vitals in
       order that vitals may be automatically recorded in the system.

32.    Calculate a body mass index (BMI) based on measured vitals and
       record it on the patient record.

33.    Provide the ability to graph height, weight and body mass index over
       time.

34.    Provide the ability to compare body mass index to standard norms for
       age and sex over time.

35.    Be capable of indicating to the user when a vital sign measurement
       falls outside a preset normal range. Only authorized users should be
       able to set the normal ranges.

36.    Provide the ability to display other discrete numeric clinical data
       elements, such as blood pressure, weight/BMI, peak expiratory flow
       rate or pain scores, in tabular and graphical form.


F      Provider Order Entry


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                                                                                                      Appendix I - Page 34


2. Electronic Health Records Requirements
ID     Requirement                                                                 Vendor     Vendor Comments
                                                                                   Response
37.    Provide the ability to enter an order for:
           Nursing procedures and tests
           Injections/Medications to be given in clinic
           Laboratory
           Immunizations
           X-ray/Imaging
           Referrals and consults
           Stock items e.g. aero chambers, peak flow meters, glucose
              monitor, etc.
           Patient education materials
           Medical items e.g. oxygen.

38.    Provide the ability to schedule dental, optometry, mental health and
       specialty referrals to in-house facilities.

39.    Provide the ability to order a referral for external specialists.

40.    Provide the ability to associate a problem or diagnosis with an order.

41.    Provide the ability to capture the ordering provider for all test orders.

42.    Provide the ability to capture applicable co-signatures for all test
       orders and referrals.

43.    Provide a view of active orders for an individual patient.

44.    Provide the ability to define a set of related orders that can be
       subsequently ordered as a group on multiple occasions.

45.    Provide the ability to create standing orders for nursing procedures


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                                                                                                  Appendix I - Page 35


2. Electronic Health Records Requirements
ID     Requirement                                                             Vendor     Vendor Comments
                                                                               Response
       for a specific clinic.

46.    Provide the ability to order the following tests to be conducted by
       nursing staff:
           Hemoglobin
           Blood Sugar
           Urine Pregnancy Test
           UA Dip

47.    Provide the ability to order the following procedures to be conducted
       by nursing staff:
            EKG
            Spirometry
            Pulse Oximeter
            Peak Flow
            Inhalation tx Treatment
            Irrigate Ears
            Audiometry
            Typanometry
            Visual Acuity
            Measure for Ted Hose, Calf or Thigh
            Shower
            RID (Lice)
            Dressing Change
            Clothes
            Health Education
            Set up for PAP
           
48.    Provide the ability to order the injections to be administered by
       nursing staff, for example:



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                                                                                                 Appendix I - Page 36


2. Electronic Health Records Requirements
ID     Requirement                                                            Vendor     Vendor Comments
                                                                              Response
              FLU
              Infant FLU
              Insulin
              DepoProvera
              Pneumovax
              HPV
              ROTAV
              Comvax
              Varicella
              HBV
              Certriaxone
              Ancef
              Toradol
              Penicillin VK
              Benadryl

49.    Provide proactive alerts, for patients on a given medication when
       they are due for required laboratory or other diagnostic studies, to
       monitor for therapeutic or adverse effects of the medication.

50.    Provide the ability to generate alerts based on patient age.


G      Medications List and Prescribing
51.    Provide the ability to create and maintain a patient-specific
       medication lists.

52.    Provide the ability to display medication history for the patient.

53.    Provide the ability to exclude a medication from the current


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                                                                                                     Appendix I - Page 37


2. Electronic Health Records Requirements
ID     Requirement                                                                Vendor     Vendor Comments
                                                                                  Response
       medication list (e.g., marked inactive, erroneous, completed,
       discontinued) and document reason for such action.

54.    Provide the ability to display and print current medications only.

55.    Provide the ability to record the reason why any medications were
       stopped.

56.    Provide the ability to create prescription or other medication orders
       for filling by one of the internal dispensaries. The system should be
       able to identify automatically the dispensary location associated with
       the patient visit.

57.    Provide the ability to maintain a coded list of all medications
       available for prescribing.

58.    Provide the ability to search the list of available medications using
       both generic and brand names.

59.    Provide the ability to identify items available on the clinic
       dispensary‟s formulary.

60.    Provide the ability to identify medications available to the patient via
       a Patient Assistance Program.

61.    Provide access to the required forms for the Patient Assistance
       Program either directly from the system or as a link to an external
       source.

62.    Provide the ability to capture the following details at the time a


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                                                                                                    Appendix I - Page 38


2. Electronic Health Records Requirements
ID     Requirement                                                               Vendor     Vendor Comments
                                                                                 Response
       prescription is ordered:
            Strength
            Sig
            Quantity
            Refills

63.    Provide the ability to record user and date stamp for prescription
       related events, such as initial creation, renewal, refills,
       discontinuation, and cancellation of a prescription.

64.    Provide the ability to capture the identity of the prescribing provider
       for all medication orders.

65.    Provide the ability to cosign medication orders.

66.    Automatically update the medication history with the newly
       prescribed medications.

67.    Provide the ability to reorder a prior prescription without re-entering
       previous data (e.g. administration schedule, quantity).

68.    Provide the facility to print a prescription that can be handed to the
       patient for fulfillment at a pharmacy of the patient‟s choosing. (Note:
       An electronic signature could be useful for this function).

69.    Provide the ability to fax prescriptions.

70.    Provide the ability to re-print and re-fax prescriptions.

71.    Provide connectivity with ePrescribing systems for submission of


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                                                                                                    Appendix I - Page 39


2. Electronic Health Records Requirements
ID     Requirement                                                               Vendor     Vendor Comments
                                                                                 Response
       electronic prescriptions.

72.    Provide general prescribing information at the point of prescribing.

73.    Provide the ability to check for daily dose outside of recommended
       range for patient age (e.g., off-label dosing).

74.    Provide the ability to check for dose ranges based on patient age and
       weight.

75.    Provide the ability to display a dose calculator for patient-specific
       dosing based on weight and age.

76.    Provide the ability to display patient specific dosing
       recommendations based on age, weight and renal function.

77.    Provide drug alerts, at the time an order for medication is placed, as
       follows:
            Drug dose defaults
            Drug dose checking
            Allergy checking
            Drug interaction checking(including non-prescription
              remedies and international drug names)
            Drug lab checking
            Drug condition checking
            Drug diet checking

78.    Provide the ability to create provider specific medication lists of the
       most commonly prescribed drugs with a default dose, frequency, and
       quantity.



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                                                                                                    Appendix I - Page 40


2. Electronic Health Records Requirements
ID     Requirement                                                               Vendor     Vendor Comments
                                                                                 Response

79.    Provide the ability to check for potential interactions between
       medications to be prescribed and current medications and alert the
       provider at the time of medication ordering if potential interactions
       exist.

80.    Provide the ability to check for potential interactions between
       medications to be prescribed and medication allergies and
       intolerances listed in the record and alert the user at the time of
       medication ordering if potential interactions exist.

81.    Provide drug-disease interaction alerts at the time of medication
       ordering.

82.    Provide the ability to set the severity level at which drug interaction
       warnings should be displayed.

83.    Provide the ability to prescribe a medication despite alerts for
       interactions and/or allergies being present.

84.    Provide the ability to update drug interaction and allergy information.

85.    Provide alerts if the drug interaction and allergy information is
       outdated.

86.    Provide support for completion of patient assistance program
       applications.

87.    Provide an indication of medications that are covered by the patient‟s



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                                                                                                       Appendix I - Page 41


2. Electronic Health Records Requirements
ID     Requirement                                                                  Vendor     Vendor Comments
                                                                                    Response
       insurance plan (c.f. Epocrates on the Internet).

88.    At the time a prescription is entered, provide an alert for any increase
       or decrease in previously prescribed medication.

89.    Provide the ability to “hold” or “discontinue” a prescription.

90.    Provide the facility to enter a patient‟s request to refill a prescription
       and notify the relevant provider.

91.    Support special requirements (from DEA and Medical Board) for the
       prescribing of narcotics, including the National Provider
       Identification (NPI) number.


H      Patient Education
92.    Record patient instructions and education materials used for patient,
       family and caregiver education.

93.    Provide access to patient instructions and patient, family and
       caregiver educational materials through links to external sources.

94.    Provide support for patient education in the patient‟s native language.
       Support should be as follows:
           English
           Spanish

95.    Provide access to patient medication instructions either directly from
       the system or through links to external sources.



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                                                                                                       Appendix I - Page 42


2. Electronic Health Records Requirements
ID     Requirement                                                                  Vendor     Vendor Comments
                                                                                    Response
96.    Provide access to test and procedure instructions that can be
       customized by the physician. These instructions may reside within
       the system or be provided through links to external sources.

97.    Provide the ability to create patient specific instructions.

98.    Provide the ability to record that patient specific instructions or
       educational material were provided to the patient.

99.    Provide the ability to record patient attendance at health education
       classes.


I      Progress Notes
100.   Provide the ability to capture, store, display, and manage patient
       history.

101.   Provide the ability to record patient history and other clinical data as
       follows:
            Structured and coded input
            Template-based input
            Free text input
            Speech/voice input

102.   Provide the ability to generate “flow charts” based on entered data.

103.   Provide the ability to save a note “in progress” prior to finalizing or
       sealing the note.

104.   Provide the ability to finalize or seal a note, i.e., change the status of


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                                                                                                    Appendix I - Page 43


2. Electronic Health Records Requirements
ID     Requirement                                                               Vendor     Vendor Comments
                                                                                 Response
       the note from “in progress” to “complete”, so that any subsequent
       changes are recorded as such.

105.   Provide the ability to record the identity of the user finalizing each
       note and the date and time of finalization.

106.   Provide the ability for an attending physician to “sign-off” or co-sign
       on progress notes generated by a resident physician. Additionally,
       record the identity of the attending physician signing-off the note and
       the date and time of sign-off.

107.   Provide the ability to addend and/or correct notes that have been
       finalized. Also, provide the ability to identify the full content of a
       modified note, both the original content and the content resulting
       after any changes, corrections, clarifications, addenda, etc. to a
       finalized note. Additionally, record the identity of the user making
       the addition and the date and time of the addition.

108.   Provide drug-disease interaction alerts at the time of entering a
       problem.


J      Laboratory Orders and Results
109.   Record results for:
           Laboratory (hematology, chemistry, microbiology, etc.)
           Consults
           Mammograms
           Radiology
           EKG
           Pap Smears


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                                                                                                   Appendix I - Page 44


2. Electronic Health Records Requirements
ID     Requirement                                                              Vendor     Vendor Comments
                                                                                Response

110.   Provide real-time notification of lab results received to the ordering
       provider with a visible indication of “panic levels”.

111.   Record the date and time of provider review of the lab results and
       actions taken as a result.

112.   Forward lab results to a “covering provider” for periods where the
       ordering provider is “away” (vacation, illness, etc.)

113.   Provide multi-media support for:
           Images
           Sounds
           Pictures
           Video
           Scanned documents (scanned documents should be of
              sufficient resolution that an accurate diagnosis can be made
              e.g. EKG print-outs)

114.   List all pending labs results and consults.

115.   Identify requests for labs (including mammograms) and consults for
       which results have not been received but are overdue. The system
       should also be capable of sending a request for results that have not
       been received.

116.   Provide real-time surveillance and notifications to detect:
           Adverse events
           Mis-calibration of diagnostic equipment
           Disease outbreak, in particular:


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                                                                                                  Appendix I - Page 45


2. Electronic Health Records Requirements
ID     Requirement                                                             Vendor     Vendor Comments
                                                                               Response
                  o Epidemic Influenza
                  o Listeriosis
                  o Swine Flu
                  o Avian Flu
                  o Pandemic Flu
                  o West Nile Virus
              Bioterrorism

117.   Provide clear visual indication for lab results that are outside of
       defined (according to clinic guidelines) normal ranges (i.e. “panic
       levels”).

118.   Provide notification to the ordering provider of an abnormal lab
       result (as defined by clinic guidelines).

119.   Provide the ability to require administrator approval for certain lab
       orders.


K      Immunization
120.   Provide the ability to document administration of immunizations.

121.   Provide the ability to document, for an immunization:
           immunization type
           dose
           time of administration
           route
           site
           lot number
           expiration date


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                                                                                                 Appendix I - Page 46


2. Electronic Health Records Requirements
ID     Requirement                                                            Vendor     Vendor Comments
                                                                              Response
              manufacturer
              person administering

122.   Provide the ability to record an adverse patient reaction to an
       immunization.

123.   Provide the ability to alert a user at the time of ordering that the
       patient had a prior adverse reaction to that immunization.

124.   Provide the ability to records reasons that a vaccine was not
       administered, such as:
           not in stock
           declined
           contraindicated due to allergy (egg allergy for flu vaccine)
           not eligible for vaccine due to age (HPV etc for free vaccines)

125.   Communicate with the LINK system for transfer of immunization
       data. [The LINK system records child immunizations]


L      Clinical Requirements

L.1    Adult Primary
126.   Provide reminders according to standard of care preventative
       guidelines for required health screening studies.

127.   Provide reminders according to standard of care preventative
       guidelines for required immunizations.

128.   Provide diagnostic decision support.


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2. Electronic Health Records Requirements
ID     Requirement                                                              Vendor     Vendor Comments
                                                                                Response

129.   Provide the ability to document a patient encounter.

130.   Provide access to standard care plan, protocol and guideline
       documents when requested at the time of the clinical encounter.
       These documents may reside within the system or be provided
       through links to external sources.

131.   Provide facilities for connectivity with medical devices, for example,
       glucose monitors, EKG, vitals, spirometry and audiometry.


L.2    Pediatric
132.   Allow the birth weight to be recorded.

133.   Record additional vitals data at every visit, as follows:
           Head Circumference

134.   Allow parents' height, head circumference to be recorded and
       graphed.

135.   Automatically generate a growth chart based on measured data.

136.   Provide an alert when blood pressure or peak flow falls outside of the
       normal range for age and height.

137.   Allow screening exams to be recorded as follows:
           Hearing
           Vision
           PEDS Self Assessment Tool


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                                                                                                  Appendix I - Page 48


2. Electronic Health Records Requirements
ID     Requirement                                                             Vendor     Vendor Comments
                                                                               Response
              Immunization screening (completed by patient)
              Lead

138.   Record patient education delivered relating to:
           Calorie information
           Weight loss strategies
           Suicide Contract
           Domestic Violence Plan

139.   Provide support for pediatric asthma clinic by recording the
       following data:
            Yearly action plan
            Self Management Goals
            Environmental Assessment (Smokers in home, dust, mold,
              etc.)
            Family History
            Illness Assessment
            Underlying Severity and Control

140.   Provide support for CHDP requirements by providing alerts for
       covered condition (e.g. poor weight gain for newborns) and providing
       support for anticipatory guidance provided on the following topics:
           Nutrition Counseling
           Safety information
           Domestic violence
           Smoking
           Maternal depression

141.   Provide the ability to record a lifestyle log that provides detailed
       information about diet and other factors such as hours of television.



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2. Electronic Health Records Requirements
ID     Requirement                                                             Vendor     Vendor Comments
                                                                               Response



L.3    Chronic Disease Management
142.   Provide reminders according to standard of care guidelines for
       chronic disease management, as follows:
           Diabetes
           Asthma
           Overweight/Obesity
           Cardio Vascular Disease (Hypertension)
           Depression
           Chronic Kidney Disease
           Congestive Heart Failure

143.   Provide integration with the PECs system in order to transfer chronic
       disease information in the disease registry.

144.   Provide disease registry capabilities for reporting on patient
       populations diagnosed with a chronic illness.

145.   Provide reporting per provider on:
           Number of patients in provider‟s registry
           % of DM patients >40 y.o. on ASA
           % of DM patients > 55 y.o on ACEI
           % of DM patients with Blood pressure at goal of SBP< 130
              DBP < 85
           % of DM patients with retinal exams in the last year
           % of DM patients with a foot exam in the last year
           % of DM patients over 40 y.o. on a statin
           % DM patients with two HgA1C 91 days apart
           % DM patients with pneumococcal vaccines


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                                                                                             Appendix I - Page 50


2. Electronic Health Records Requirements
ID     Requirement                                                        Vendor     Vendor Comments
                                                                          Response
              % Asthmatic patients with spirometry in last year
              % of Asthmatic patients with flu vaccine
              % asthmatic patients with pneumococcal vaccines
              % asthmatic patients with asthma education given
              % DM patients with microalbumin test
              % of patients with self management goal
              % of patients with health education
              % of patients with dental exam
              % of patients with documented BMI
              % of patients for which ASA, ACEI and statin medications
               are contraindicated
              % with depression screening
              % with HIV test
              % with LDL <100
              % with TG <150

146.   Provide a trended report across multiple years for:
           Number of patients in registry
           % of DM patients >40 y.o. on ASA
           % of DM patients > 55 y.o on ACEI
           % of DM patients with Blood pressure at goal of SBP< 130
              DBP < 85
           % of DM patients with retinal exams in the last year
           % of DM patients with a foot exam in the last year
           % of DM patients over 40 y.o. on a statin
           % DM patients with two HgA1C 91 days apart
           % DM patients with pneumococcal vaccines
           % Asthmatic patients with spirometry in last year
           % of Asthmatic patients with flu vaccine
           % asthmatic patients with pneumococcal vaccines



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                                                                                                    Appendix I - Page 51


2. Electronic Health Records Requirements
ID     Requirement                                                               Vendor     Vendor Comments
                                                                                 Response
              % asthmatic patients with asthma education given

147.   Provide the ability to record a diabetic foot screening using
       appropriate diagrams of the feet.

148.   Provide a “PECs-like progress note” displaying the key clinical data,
       as follows:

              Demographics: age, gender, housing.
              Allergies
              Vitals: Listing last visit and current visit, including weight,
               BMI, Blood pressure, pulse, temperature, blood sugar
              Relevant Co-Morbidities: Obesity, Hypertension,
               Dyslipidemia, Nephropathy, Retinopathy, CAD, PVD, CVA,
               Neuropathy, Depression
              Relevant Labs with Calculator function, ability to indicate
               date, result, declined: A1C, Creatinine, Potassium, GFR, Chol
               panel, AST, ALT, TSH, Hgb, RUA, Microalb/Cr. ratio, HIV
              Screening Tests appropriate for age/gender. i.e. if woman
               over 40, mammogram.
              Also the universal screening tests for diabetic patients: EKG,
               PPD, Retinal photo if no retinopathy, or Ophthalmologic
               exam if ineligible due to retinopathy.
              Immunizations: Td/Tdap, Flu, Pneumovax, Zoster
              Medication List

149.   Provide a calculator function for predicted peak flow.

150.   Provide the ability to add a picture of a retinal screening.




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2. Electronic Health Records Requirements
ID     Requirement                                                              Vendor     Vendor Comments
                                                                                Response
151.   Provide a visible indication (for example, a flashing indicator) if a
       required element for the appropriate standard of care has not been
       completed.


L.4    Prenatal
152.   Provide the ability to transmit Medi-cal cards and Medi-cal
       applications for a patient to a hospital system.

153.   Provide the ability to record completion of prenatal intake checklist
       items.

154.   Provide support for completion of paperwork related to the following
       programs:
           AFP
           WIC
          
155.   Provide the ability to record a Comprehensive Perinatal Services
       Program (CPSP) Prenatal Combined Assessment/Reassessment.

156.   Provide the ability to record pre-natal intake screening interview.

157.   Create a printable view of all visits, labs, due date, ultrasound,
       problem list and plans which can be given to a patient for purposes of
       communicating with providers on a Labor and Delivery floor.

158.   Provide a separate prenatal lab and studies section rather than having
       prenatal activities displayed with the general labs and studies.

159.   Prompt the provider with the intervals during which to order prenatal


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2. Electronic Health Records Requirements
ID     Requirement                                                              Vendor     Vendor Comments
                                                                                Response
       labs and studies.

160.   Provide the ability to record patient declined labs and studies.

161.   Provide the ability to order the following prenatal labs:
           the pre-natal panel, which includes
                  o CBC
                  o Blood Type/Rh/Antibody,
                  o RPR
                  o HIV
                  o Rubella Antibody
                  o HepBsAG
           Urine Culture
           Pap
           GC
           CT
           1st Trimester screen (10-13 6/7 weeks)
           Nuchal Lucency
           2nd Trimester Screen (15-20 weeks)
           1 hour Glucola (24-28 weeks)
           CBC and RPR in the third trimester
           Group b Strep (36-38 weeks)
           OB ultrasound

162.   Provide a prenatal flowsheet able to display data from multiple visits
       in one table. Header data should include:
            patient age
            and Ob history (G, P, Tab, Sab, Ectopic, LMP, EDC.)

       At every visit, the following data points should be entered by nursing



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                                                                                             Appendix I - Page 54


2. Electronic Health Records Requirements
ID     Requirement                                                        Vendor     Vendor Comments
                                                                          Response
       staff:
               Weight
               Blood pressure
               urine protein
               leukocytes

       The remaining physical examination data should be completed by a
       physician, including:
           fundal height
           fetal heart tones
           fetal lie
           vaginal exam
           return to clinic interval.

163.   Provide a template for the provider progress note geared toward
       prenatal history and physical, which would include appropriate
       prompts by gestational age.


L.5    Osteopathic
164.   Provide the ability to record Osteopathic examinations which
       encompass:
           Head and Face
           Neck and Cervical
           Thoracic
           Ribs
           Lumbar
           Sacrum/Pelvis
           Innominate
           Abdomen/Viscera



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2. Electronic Health Records Requirements
ID     Requirement                                                              Vendor     Vendor Comments
                                                                                Response
              Upper Extremity
              Lower Extremity
              Neurological

165.   Provide the ability to record osteopathic manipulation treatments.

166.   Provide the ability to record herbal medicine administered or applied.

167.   Provide the ability to record muscular/skeletal exams using relevant
       anatomical drawings.

168.   Provide the ability to record acupuncture prescriptions and
       treatments.

169.   Provide the ability to record tongue and pulse diagnosis.


L.6    Women’s Health
170.   Provide the ability to record emergency contraception visits.

171.   Provide support for pregnancy testing including the ability to print a
       verification of pregnancy.

172.   Provide the ability to record women‟s health history data, including:
           Last menstrual period
           Age of first live birth
           Age of menarche
           Age of menopause
           GxPx data
           Data of last Pap


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                                                                                                 Appendix I - Page 56


2. Electronic Health Records Requirements
ID     Requirement                                                            Vendor     Vendor Comments
                                                                              Response
              Pap normal or abnormal, and date of abnormal
              Date of last mammogram
              Current Birth Control Method
              Desired birth control method
              Gynecological Surgeries
              Abnormal vaginal bleeding, discharge or symptoms
              History of STDs
              Number of sexual partners in past 6 months AND ever
              Sexual History
              Personal and family history of breast cancer
              Current breast symptoms
              Breast reduction/augmentation
              History of breast biopsies
              Lifestyle (smoking, alcohol, diet, exercise)
              Domestic violence

173.   Provide the ability to record a women‟s physical exam, including the
       use of diagrams, for the following:
            Skin
            Head
            Eyes
            Ear, Nose, Throat
            Thyroid
            Breast
            Lungs
            Heart
            Abdomen
            Back
            Rectal
            Extremities



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                                                                                                Appendix I - Page 57


2. Electronic Health Records Requirements
ID     Requirement                                                           Vendor     Vendor Comments
                                                                             Response
              Vulva
              Vagina
              Cervical exams, including:
                  o Uterus Size, Position and Shape
                  o Inflammation
                  o Wet Mount
                  o lesions or IUD strings
              Right Adnexa
              Left Adnexa
              Discharge

174.   Provide support for recording breast exams, including the following
       observations:
           Nodularity
           Skin edema
           Tenderness
           Redness
           Ulceration
           Mass
           Nipple/areola change
           Surgically absent
           Lymph Nodes
           Implants
           No breast abnormality
           Benign breast condition

175.   Provide support for recording screening plans and assessment,
       including:
            Pap
            Mammogram



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2. Electronic Health Records Requirements
ID     Requirement                                                               Vendor     Vendor Comments
                                                                                 Response
              Family Planning
              STI/HIV Screening

176.   Provide support for completing California Department of health
       DETEC – Breast Cancer Screening Cycle Data.


L.7    Teen and Adolescent Care
177.   Provide the ability to flag a chart that is receiving “confidential”
       services for patients under the age of 18 using self-consent.

178.   Provide the ability to record if provided services have been discussed
       with parents during a patient encounter.

179.   Provide the ability to print a doctor‟s note for school administration.

180.   Provide support for Simple Message Service (SMS aka texting)
       communications.

181.   Provide support for the following physical examinations:
           General Appearance
           Head
           Eyes
           Ears
           Nose and Throat
           Teeth
           Neck
           Breast
           Lungs
           Heart


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2. Electronic Health Records Requirements
ID     Requirement                                                              Vendor     Vendor Comments
                                                                                Response
              Abdomen
              Femoral Pulses
              Genitalia
              Extremities
              Lymph Nodes
              Back
              Skin
              Neurologic

182.   Provide the ability to record delivery of the following patient
       education:
           Contraception
           Accident Prevention/Vehicle Safety
           Testicular Exam
           Exercise
           Family Involvement
           Nutrition
           Sexuality/ Birth Control & Abstinence
           Substance Abuse

183.   Provide the ability to record patient history on the following topics:
           Psychosocial History
           Home
           Education
           Activity
           Diet
           Drug Use
           Tobacco Use
           Alcohol Use
           Sexual Activity, including:



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                                                                                                   Appendix I - Page 60


2. Electronic Health Records Requirements
ID     Requirement                                                              Vendor     Vendor Comments
                                                                                Response
                   o Age of coitarche
                   o Number and gender of partners
                   o Consensual vs coerced
              Partner Violence
              Birth Control
              Suicide/Depression
              Dating Violence

184.   Provide the ability to record the school that is being attended by the
       patient.


L.8    HIV
185.   Provide the ability to record HIV clinic specific intake information,
       as follows:
            Consent to receive mail
            Consent to receive voicemail
            Previous HIV Tests
            Partner‟s awareness of HIV status
            Interest in “Buddy Program”
            Alternate contact
            Alternate contact‟s awareness of HIV status

186.   Provide the ability to print a “Medical Information Form” detailing
       an HIV diagnosis and providing the following information:
           Patient Name
           Date of Birth
           Social Security Number
           Basis for Diagnosis
           CD4 Count


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                                                                                                      Appendix I - Page 61


2. Electronic Health Records Requirements
ID     Requirement                                                                 Vendor     Vendor Comments
                                                                                   Response
              CD4 Percentage
              Viral Load
              Viral Load Test Type
              Last TB Test
              Last CXR Test
              Karnofsky Scale Assessment
              Nursing Facility Care Required
              Clearance for Dental Care and Oral Procedures
              Physician‟s Name
              Physician‟s License #
              Date Printed

187.   Provide a flow chart containing:
           CD4 Count
           CD4 Percentage
           Viral Load
           Weight

188.   Provide the ability to record e-mails sent by a patient.

189.   Provide the ability for a provider to sign-off e-mails sent by a patient.

190.   Provide support for AIDS Drug Assistance Program.


L.9    Homeless
191.   Provide support for homeless outreach by recording information
       relating to:
            Living situation
            Length of Time Homeless


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                                                                                                  Appendix I - Page 62


2. Electronic Health Records Requirements
ID     Requirement                                                             Vendor     Vendor Comments
                                                                               Response
              Family
              Meals (Help Needed?)
              Transport (Help Needed?)
              Smoking
              Alcohol/Drug Use
              Psychiatric History
              Sexual Activity, including:
                  o Number of partners
                  o Condom use
                  o HIV status
              Domestic Violence

192.   Provide the ability to include one or more photographs as a form of
       identification in a patient chart.

193.   Provide support for triage by the nursing staff.

194.   Provide a report of homeless population by:
           Age
           Gender
           Homeless status
           Diagnosis
           CPT codes
           Case management


L.10   Pharmacy
195.   Provide integration with the dispensary system such that orders
       placed for the dispensary are not re-keyed into the dispensary system
       for labeling of medications.


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2. Electronic Health Records Requirements
ID     Requirement                                                           Vendor     Vendor Comments
                                                                             Response

196.   Record the pharmacist‟s comparison of medications dispensed with
       prescription for dispensary ordered medications.

197.   Record the delivery of medications to the patient.


L.11   Mental Health
198.   Provide the ability to recording mental health encounters.

L.12   Optometry
199.   Provide the ability to have a separate view of only
       Optometry/Ophthalmology information in a patient‟s chart.

200.   Provide the ability to record Optometry/Ophthalmology
       examinations.

201.   Provide the ability to store retinal photographs.

202.   For optometry visits record results from examinations or procedures
       using the following equipment:
            Refractometer
            Lenometer
            Feropter
            Tenometer
            Slit lamp
            Opthalmascope
            Phenactor

203.   Provide the ability to record visual acuity tests.


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2. Electronic Health Records Requirements
ID     Requirement                                                              Vendor     Vendor Comments
                                                                                Response

204.   Provide the ability to record and print optical prescriptions.

205.   Provide the ability to record orders for glasses including frame type.

206.   Provide the ability to record dispensing of glasses to a patient.


L.13   Dental
207.   Provide a separate component of the patient chart to record dental
       examinations and encounters such that dental staff can be presented
       with only the dental related component of the patient chart.

208.   Provide the ability to record digital x-rays.

209.   Provide the ability to record periodontal exams.

210.   Provide support for dental and oral hygiene visits.

211.   Provide the ability to record and report on completion of dental
       treatment.

212.   Record the delivery of oral hygiene instructions.


L.14   Specialty
213.   Allow referral to be made to “in-house” specialties, including:
           Asthma/Allergy
           Acupuncture
           Cardiology


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                                                                                                    Appendix I - Page 65


2. Electronic Health Records Requirements
ID     Requirement                                                               Vendor     Vendor Comments
                                                                                 Response
              Dental
              Dermatology
              Development Evaluations
              Endocrinology
              ENT
              GI
              Mobile Echoes
              Musculoskeletal
              Nephrology
              Neurology
              Optometry
              Ophthalmology
              Plastic Surgery
              Rheumatology

214.   Allow referrals to be made to “outside” specialists.

215.   Allow specialty services to be identified as not currently available
       from “in-house” resources.

216.   Allow referrals to specialty clinics to be approved by a specialty
       coordinator.

217.   Allow the number of specialty referrals to a given clinic to be tracked
       on a monthly basis.

218.   Record the name, address, phone number and e-mail address for
       specialty providers along with the ability to add notes that will be
       visible to referring providers.




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                                                                                                    Appendix I - Page 66


2. Electronic Health Records Requirements
ID     Requirement                                                               Vendor     Vendor Comments
                                                                                 Response
219.   Provide facilities to record a specialist‟s report in a patient‟s chart
       either in electronic format or via scanning of paper reports.


M      Case Management
220.   Highlight missed appointments for referrals and provide the ability to
       notify the referring provider.

221.   Generate confirmation letters for mammograms, pap smears and
       other lab reports that return normal results. Confirmation letters
       should be available in English and Spanish.

222.   Provide the ability to record care coordination activities performed at
       the end of a patient visit including:
            Future Appointments
            Referrals
            Psychosocial Support
            Transportation Support

223.   Automatically conduct appointment reminder phone calls.

224.   Provide a Discharge Summary Sheet for each visit with details of
       referrals, future appointments, labs ordered, etc.


N      Population Health Management
225.   Provide public health reporting for:
           Reportable diseases
           Immunization
           Abuse and negligence (child, elderly, adult)


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                                                                                                Appendix I - Page 67


2. Electronic Health Records Requirements
ID     Requirement                                                           Vendor     Vendor Comments
                                                                             Response
              Rape and domestic violence
              Elderly assistance

226.   Provide facilities for outcome reporting on the following outcomes:
           General
                  o Gastro Intestinal Cancer
                  o Prostate Cancer
                  o Breast Cancer
                  o Melanoma
                  o Body Mass Index
                  o Hyperthyroidism
                  o Hypothyroidism
                  o Deep Vein Thrombosis
                  o Pneumonia
                  o Influenza
           Asthma
                  o Classification Severity
                  o Average Symptom Free Days
                  o Urgent Care Visits and Hospitalizations
                  o Lost Work or School Days
           Diabetes
                  o A1C
                  o Blood Pressure
                  o Fasting Lipid Panel
                  o Micro Albumin
                  o Retinopathy
                  o Foot Ulcers
                  o Onychomycosis
                  o Depression
                  o Gingivitis



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                                                                                           Appendix I - Page 68


2. Electronic Health Records Requirements
ID     Requirement                                                      Vendor     Vendor Comments
                                                                        Response
                  o Myocardial Infarction
                  o Neuropathy
                  o Chronic Renal Insufficiency
              Hypertension
                  o Stroke
                  o Blood Pressure
                  o Fasting Lipid Panel
                  o LDL
                  o HDL
                  o MI – EKG
                  o Congestive Heart Failure
                  o Atrial Fibrillation
              Depression
                  o PHQ9 Score


O      Reporting
227.   Provide daily and monthly reports of patient totals by:
           Site
           Clinic
           Specialty
           Provider
           Visit type
                  o New Patient
                  o Follow Up
                  o History and Physical
                  o Protocol Patient (asthma, diabetes, hypertension)
           Services provided (CPT codes)
           Patient demographic
           Last Visit (range)



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                                                                                                   Appendix I - Page 69


2. Electronic Health Records Requirements
ID     Requirement                                                              Vendor     Vendor Comments
                                                                                Response

228.   Provide daily and monthly reports by provider of:
           hours worked (seeing patients and other)
           patients seen
           labs orders
           medications ordered
           referrals ordered

229.   Provide daily and monthly reports by provider that are weighted
       according to visit type.

230.   Provide support for concurrent and retrospective provider peer
       review. Peer review is conducted monthly and annually.

231.   Report on the cost of a given intervention.
232.   Provide a report on “no-show” data by provider and visit type.

233.   Provide a monthly report on continuity of care by provider, as well as
       panel size.


P      Billing Support
234.   Ensure that all lab orders include one or more diagnoses.

235.   Provide alerts to the ordering provider when a diagnosis does meet a
       payor‟s requirements for a given laboratory test.

236.   Ensure that all services provided during a patient visit are recorded,
       coded and passed to the practice management systems for billing.



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2. Electronic Health Records Requirements
ID     Requirement                                                               Vendor     Vendor Comments
                                                                                 Response

Q      System Interfaces
237.   Provide connectivity with disease registries:
           PECS
           LINK

238.   Provide connectivity or integration with external expert systems for
       diagnosis support for specific chronic diseases or drug interaction
       information (this would be in addition to any in-built expert
       functionality).

239.   Provide the facility to fax all patient data or selected items to other
       providers.

240.   Provide a means for generating and receiving patient data in HL7
       format.

241.   Provide a bidirectional interface with the practice management
       system (PMS).

242.   Exchange data about a current pregnancy with a hospital system.


R      Audit, Monitoring and Quality Assurance
243.   Provide support for random chart reviews.

244.   Provide support for provider evaluation.

245.   Provide support for clinic staff evaluation, including the following
       reports:


 Electronic Medical Records and Practice Management System                                             Venice Family Clinic
                                                                                                    Appendix I - Page 71


2. Electronic Health Records Requirements
ID     Requirement                                                               Vendor     Vendor Comments
                                                                                 Response
              Referrals authorized per day
              PAP applications processed per day
              Patients processed

246.   Record the time that data for a patient visit was entered in order to
       provide monitoring of patient flow for the following events:
            Front Desk
            Back Office
                   o Patient Intake
                   o Provider
                   o Medical Assistant
                   o Lab
                   o Dispensary
                   o Patient Education

247.   Provide the ability to generate a random sample of charts.


S      Security and Confidentiality
248.   Provide the ability to prevent specified user(s) from accessing a
       designated patient's chart.

249.   Provide the ability to identify certain information as confidential and
       only make that accessible by appropriately authorized users.

250.   Provide the ability to identify all users who have accessed an
       individual's chart over a given time period, including date and time of
       access.

251.   Provide the ability to review any data that is being exported from the


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                                                                                                   Appendix I - Page 72


2. Electronic Health Records Requirements
ID     Requirement                                                              Vendor     Vendor Comments
                                                                                Response
       system for the purposes of being supplied to other medical facilities.

252.   Record any data that has been transmitted, exported or supplied to
       other medical facilities.




 Electronic Medical Records and Practice Management System                                            Venice Family Clinic
                                                                        Appendix II - Page 1


APPENDIX II - SAMPLE LETTER OF TRANSMITTAL


To the Venice Family Clinic:

   Re: RFP for an Electronic Health Records and Practice Management System

Having examined the Request for Proposal (RFP), including the appendices, the receipt of
which is hereby duly acknowledged, we, the undersigned, offer to deliver, install, configure,
support, maintain, and provide training for document management, records management,
document imaging, and workflow application software (the "Electronic Health Records and
Practice Management System") in full conformity with the said RFP.

We undertake, if invited by you to do so, to attend a clarification meeting, at our own
expense and at a place of your choosing, for the purposes of reviewing our proposal.

The contact person at our organization for this solicitation is:

               Name:           ____________________________
               Title:          ____________________________
               Telephone:      ____________________________
               E-mail:         ____________________________

We agree to abide by this proposal for a period of one hundred and twenty (120) days from
the proposal due date and it shall remain binding upon us until the expiration of that period.

We confirm to the best of our knowledge that neither our organization nor any person
connected with our organization, or sub-consultants to our organization, has any conflict of
interest arising from this RFP. We understand that you are not bound to accept the lowest
or any bid you may receive.


Dated this ___________________ day of ______________, 20_____.


__________________________________                   ____________________________
(signature)                                          (title)

Duly authorized to sign this proposal for and on behalf of:


____________________________________________________________________
(organization)




Electronic Medical Records and Practice Management System                   Venice Family Clinic
                                                                       Appendix III - Page 1


APPENDIX III - TECHNICAL PROPOSAL EVALUATION FORMS

This appendix provides the forms that are required for inclusion in the technical proposal, as
follows:

      Proposer Information Form
      References




Electronic Medical Records and Practice Management System                   Venice Family Clinic
                                                                     Appendix III - Page 2


 Proposer Information Form

 Name of Proposer:     _________________________________________________________

What is the date and State of formation,
registration or incorporation of your
organization?

If outside of California, are you authorized
to do business in California?

For how many years has the company
actively participated in the business of
information technology, software
development and/or systems integration?

How many locations does your
organization operate?

 Please provide a breakdown of these locations by function:

Function                                                      Locations

Management & Executive Offices

Marketing and Sales

Software Development

Product Support

Implementation & Consultancy


How many staff are employed by your
organization?




 Electronic Medical Records and Practice Management System                Venice Family Clinic
                                                                        Appendix III - Page 3




 Please provide a breakdown of staff numbers by function:

Function                                                     Number of Staff

Management & Executive Offices

Marketing and Sales

Software Development

Product Support

Implementation & Consultancy



 Please provide the following details on the location of your technical support offices and
 staff:

Location                                            Number of           Number of Staff
                                                    Locations
Los Angeles County Area

California (Outside LA County Area)

US (Outside of California)


What were the total gross sales during the
last financial year for your organization? $

In the case where your organization has
multiple departments, what were the total
gross sales during the last financial year
for system integration services relating to
information technology?                        $




 Electronic Medical Records and Practice Management System                    Venice Family Clinic
                                                                        Appendix III - Page 4


 References Form

 Proposers should provide at least four (4) references for similar installations. Please use one
 form per reference.

Customer Name:


Address:




Contact Name:


Contact Title:


Telephone Number:


E-Mail:


Date System Installed:


Description of Work:




 Electronic Medical Records and Practice Management System                    Venice Family Clinic
                                                                       Appendix IV - Page 1

APPENDIX IV - COST PROPOSAL EVALUATION FORMS

This appendix provides the forms that are required for inclusion in the cost proposal, as
follows:

      Software Cost Schedule
      Service Cost Schedule, identifying:
       -      Service costs prior to the maintenance period (initial costs)
       -      Service costs during the maintenance period (annual recurring costs)
      Estimated Hardware Cost Schedule
      Cost Summary Schedule

The prime contract and all sub-consultant (if any) costs should be submitted in the required
format.




Electronic Medical Records and Practice Management System                   Venice Family Clinic
                                                                        Appendix IV - Page 2

Software Cost Schedule


Name of Proposer:     ____________                     __________________


Software                                                           Extended Price ($s)


Practice Management Software
Electronic Health Records Software
Other Software

Total Costs


Notes on the Software Cost Schedule

Proposers should complete only the unshaded boxes providing costs for each category of
software as identified in the RFP. Where the means of pricing for software does not fit
exactly into the identified categories, Proposers should provide their best estimate of the
cost in each category while ensuring the accuracy of the total.

Notes should be provided to clarify the costs, as necessary. For example, to explain license
breakpoints if any, whether the software license is for the site, by user or concurrent users,
and the warranty period.




Electronic Medical Records and Practice Management System                    Venice Family Clinic
                                                                            Appendix IV - Page 3

 Services Cost Schedule


 Name of Proposer:      ____________                      __________________


Services                                 Unit Rate           Initial Cost        Annual
                                        ($ per unit)              ($)        Recurring Costs
                                                                                   ($)
                                     please state units
                                      e.g. $ per hour
Design Services

Delivery, Installation and
Configuration
Software Modification,
Development and Integration
Data Migration

Training

Software Maintenance

Support

Other Services


Total Costs


 Notes on the Services Cost Schedule

 Proposers should complete only the unshaded boxes providing costs for each category of
 services as identified in the RFP. Notes should be provided to clarify the costs, as
 necessary. For example, warranty periods for which there is no maintenance cost should be
 specified.

 It is expected that:

 Design Services will be required to determine the modifications that will need to be made
 to the software to meet VFC’s requirements, to design any interfaces to VFC’s existing
 applications, and to determine the best means of migrating existing data to the proposed
 system.



 Electronic Medical Records and Practice Management System                      Venice Family Clinic
                                                                         Appendix IV - Page 4

Delivery, Installation and Configuration of an integrated system for Electronic Health
records and practice management will be provided by the successful Proposer. The system
will be demonstrated to work satisfactorily with acceptable response times.

Software Modification, Development and Integration: The successful Proposer will
be expected to deliver an integrated system for Electronic Health records and practice
management. If the application software proposed is not already integrated, it is expected
that it will be integrated when delivered and demonstrated.

It may be that the software proposed does not fully meet the requirements of VFC. In this
case VFC will work with the successful Proposer to define the additional or modified
functionality required. Proposers should review the functional requirements set out in
Appendix I carefully and identify the functionality that the software proposed does not
provide. Missing functionality is a potential modification to the software. These potential
modifications should be listed in notes related to the cost table and the costs estimated
either individually or in logical groups. The total initial cost and any recurring annual costs
should be entered in the cost table. Short-listed Proposers will be given the opportunity to
refine their cost proposals based on discussions during the evaluation process.

Note that VFC may or may not accept the proposals for any or all modifications.

Data Migration services should include migration of the existing QSI database index of
patient records to the new system. Migration services will not be required for imaging of
patient charts.

Training will be required for the primary users of the software (estimated to be 185).

Software Maintenance: Software maintenance should include the costs of all mandatory
and optional upgrades to packaged software for the next three years, together with the
costs of applying the upgrades to the software installed. Notes should clearly distinguish
the costs of the upgrades from the costs of applying them to the installed software.

Support: Notes should clearly differentiate the support that you propose to provide, for
example, on-site, telephone, dial-in, hours of availability, guaranteed response and problem
resolution times.




Electronic Medical Records and Practice Management System                     Venice Family Clinic
                                                                      Appendix IV - Page 5

 ESTIMATED HARDWARE COST SCHEDULE


 Name of Proposer:     ____________                     __________________


Hardware                                  Extended Price
                                               ($s)

Scanners

Servers

Other Hardware


Total Costs


 Notes on the Hardware Cost Schedule

 The hardware cost schedule is provided for budgeting purposes only and should not be
 included in the total proposal price. Proposers should complete only the unshaded boxes
 providing costs for each category of hardware as identified in the RFP. Notes should be
 provided to clarify the costs, as necessary.




 Electronic Medical Records and Practice Management System                   Venice Family Clinic
                                                                        Appendix IV - Page 6

 Cost Summary Schedule


 Name of Proposer:     ____________                     __________________


                         Initial Cost                  Annual Recurring Costs
                             ($s)                               ($s)
                                                Year 1          Year 2        Year 3
Software Cost

Service Cost


Total Initial Cost

Total 3 Year Cost


 Notes on the Cost Summary Schedule

 Proposers should complete only the unshaded boxes by extracting the initial and annual
 recurring cost totals from the relevant schedules. In attached notes, proposers should also
 specify the dates at which the initial costs are incurred and the dates on which the annual
 recurring costs will start, taking account of the acceptance and implementation dates for
 each of the modules proposed.

 Confirmation of Proposal Price

 The total proposal price should be reflected in the total three year cost in this schedule.
 Proposers are asked to confirm that the cost reflected on this schedule is the total price as
 proposed. Short-listed proposers may be given the opportunity to refine their cost proposal
 based on discussions during the evaluation process.


 The total proposal price is $_________________


 Signature of Proposer         ______________________________




 Electronic Medical Records and Practice Management System                   Venice Family Clinic

				
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