1. EXTENSION OF DEADLINE(S). The Submission Deadline for this RFP is hereby extended to Tuesday, September 18, 2018 at 3:00 pm EDT. Both electronic and hard copy proposals must be received by the Contract Manager prior to the noted date and time stated herein. 2. CLARIFICATIONS. Below are responses to questions asked during the Q/A period of this RFP: After making a final decision on a vendor in October, what is the University s timeline for project kick-off? Once a contract is awarded and executed, the approximate timeline for kick-off is anticipated to be within 30 days Please outline the University s approval process, budgeting, and finalization of contracting. UTMC is a state of Ohio institution. Contracts>$50K for goods and >$75K for services must go out to vendor RFP. UTMC legal must review all contracts. Budgets are created annually. Will CDI and coding staff be requested to work onsite or remotely? Current CDI staff are on-site UTMC employees. Inpatient coding staff are remote UTMC employees. The expectation is the CDI resources through the selected vendor will be a combination of on-site and off-site depending on overall program needs and requirements. Please clarify if the University is seeking CDI services for all areas (IP, OP, Clinic, and Physician Office) or does this RFP pertain to a specific area? UTMC is seeking CDI services for inpatient services at this time Does the University currently have an existing CDI Program? If yes, what service areas are currently providing CDI (IP, OP, Clinic/Physician)? Yes, there is an existing inpatient CDI program. It is staffed by 4 UTMC DIS (Documentation Improvement Specialists) analysts focusing on inpatient services. How long has the CDI program been in place? List for all service areas. Current DIS (Documentation Improvement Specialists) program has been in place for a little over 3 years. Page 1 of 7
Who did initial program installation (vendor, vendor name, self-implemented)? UTMC does not have an electronic CDI application. The reviewed patient encounters, queries, query results and increased DRG reimbursement are captured in an Excel spreadsheet. Selfimplemented program. When is the last time formal-education was provided to UTMC staff? The last formal coder education provided was ICD-10 training. Occasional webinars are attended. HIM manager subscribes to AHIMA notifications, etc How many CDI staff do you currently have (total number of reviewers/total management staff)? List separately for all areas for CDI as it is performed today. 4 Documentation Improvement Specialists ; Inpatient DIS staff do not have CDI certification The UTMC coding manager manages the CDI analysts in additional to the OP & IP coding staff Does UTMC currently utilize any outsourced CDI team members? If yes, how many? UTMC does not utilize any outsourced CDI staff. What payors are currently reviewed? All payors are currently reviewed by the CDI team. Approximately 6 months ago only inpatient Medicare admissions were reviewed Focus was changed to >7 days inpatient length of stays which includes all payors Based on Vizient data, we have also recently added Vascular Surgery admissions to the review Does UTMC have any automated CDI tools? If yes, what products? UTMC does not have automated CDI tools. See 9a; without true electronic/template documentation it is difficult to implement an electronic CDI system. Page 2 of 7
How is performance measured today? Difficult to manually measure successes Does UTMC s CDI staff work with Quality today? If yes, please describe and provide the number of Quality staff FTEs. The CDI staff currently does not work quality today. The IP coders work with quality where if a PSI case is coded, quality is notified via an electronic queue in our One Content application. The Quality Department consists of 8 FTE s and our Infection Prevention Department is a division of the Quality Department consisting of 4 FTE s. Does UTMC have a current CDI Physician Advisor/Champion? The current CDI champion is our Chief Medical Officer How many residents/care extenders (NP, PAs) does UTMC have? Residents: o UTCOM in total: Residents 301.4, Fellows 41.3 FTE s o UTMC gets part of the total: Residents 117.3 and fellows 20.8. CNPs-4 NPs-51 PAs-19 When was last time physicians were educated on CDI content? The UTMC hospitalist group receives monthly education. Most recent education to the hospitalist group as follows: 5-13-18 DRG MCCs 6-21-18 Sepsis documentation 7-19-18 Acute Kidney Injury/Failure 7-19-18 Malnutrition Obesity Vascular Surgery presentation: 8-19-18 Vascular Surgery CDI Education Page 3 of 7
Would coders participate in the education process? Yes, the inpatient coders would participate in the education process. How many IP coders does UTMC currently have? UTMC has 3 FTE IP coders If performing OP/Prof CDI, please list number of coders? UTMC is not performing OP/professional CDI Does UTMC currently utilize any outsourced IP coders? If yes, how many? Outsourced coders are not utilized for IP or OP coding Which version of the EMR(s) are currently utilized at UTMC? List separately if different for different service areas? UTMC s inpatient EMR is Horizon Clinicals which was sunset by McKesson on 3-31-18, and is now under third party support by Leidos Horizon Clinicals does not include electronic note documentation templates. There is a hybrid of handwritten and vendor transcribed documentation. Recently we implemented a homegrown documentation app utilizing Dragon, but the documents aren t in hl7 format or DRG template based. When the physician/resident is complete with the homegrown note, it is printed and placed in the paper chart. At discharge the homegrown note is scanned into the legal medical record Is the EMR used in both the clinical and financial billing systems? Allscripts STAR is UTMC s patient access and revenue cycle application. Horizon Clinicals is our EMR. Both were McKesson applications at one time. Does DIS stand for documentation improvement specialist? If not, please indicate what it means. Yes, UTMC defines DIS as documentation improvement specialist Page 4 of 7
How many and what types of facilities make up the UT/UTMC health system? UTMC is comprised of one academic medical center. Included in the medical center is an alcohol/drug detox unit, a senior, geriatric, behavioral health unit, and a child adolescent psych unit. We also specialize in orthopedics, heart and vascular, and oncology care What are the monthly patient volumes per setting (IP Admissions, SDS, Obs, ED, Hospital OP, Ambulatory, Clinic, etc.)? UTMC Response- FY18 volumes (July 2017 to June 2018): Page 5 of 7 Acute Admissions 9,624 Detox Admissions 972 Child Adolescent Psych Admissions 606 Geriatric Psych Admissions 448 Patient Days 56,636 (surgical ICU 1,655 included and Medical ICU 5,108 included) Observation cases 2,650 Clinic visits 214,098 Inpatient Surgeries 3,993 Outpatient Surgeries 5,616 Emergency Visits 35,237 How many providers are affiliated with UT (per specialty, if possible)? Cardiology-14 Endocrine-4 Family med-14 Gastro-3 General surgery-9 Geriatric med-4 Hospitalist-8 Infectious disease-7 Internal med-20 Med oncology-4 Nephrology-6 Neuro Surg -2 Ortho-16 Psych-12 Pulmonary-8 Rad oncology-4 Rheumatology-4
Urology-4 Vascular-4 What is the organizational structure applicable to the CDI, HIM, Coding and associated departments? CFO Director of HIM & HIT HIM Coding Manager DIS, IP and OP Coders What systems are utilized by UT for: EHR (per setting), Encoder, CDI software (if any), HIS Abstracting/Billing? 3M EAPG 3M Encoder Optum CAC computer aided coding Allscripts STAR Revenue cycle Page 6 of 7
Is UT requesting the provision of coding services utilizing Contractor coding staff as a component of the Scope? If so, please provide the patient volumes per setting included (IP, Obs, SDS, ED, Ambulatory, Hospital OP, Clinic, etc...), as well as, the specific services to be included in the coding process (edit resolution, physician queries, data abstraction, etc...). No, not at this time What percentage of Risk Bearing contracts does UT have? And are these to be included within the Scope of services? We have minimal risk bearing contracts with non-governmental payers. What setting(s) is/are to be included in the CDI process for the Scope provided (Inpatient, Hospital OP, Obs, ED, SDS, Ambulatory, Clinic, etc...)? UTMC is seeking CDI services for inpatient services at this time Does UT have a preference or expectation of which payers are to be included in the proposed Scope? Does UT have a preference or expectation of the percentage of patient admissions/encounters are included in the CDI process (ex. 100% of Inpatient admissions; Medicare Only; DRG reimbursed cases; etc...)? Pursue looking at 100% of acute admissions excluding detox admissions. UTMC Leadership will also look at proposals based upon pay on performance based metrics. Are monthly meetings to be held onsite or remotely? Meetings requested to be on-site if at all possible; some remote may be necessary to be considerate of overall costs and schedules. Page 7 of 7