Purchasing Department
Addendum #2
Date: October 30, 2017
Title: RFB/RFP #LH-0476 – Telemedicine
Subject: Questions and Answers
- Does the term “telemedicine vendor” as used in the Purpose Statement (p.8) refer to an organization providing telemedicine technology and implementation services so that the Hospital District can use its own providers to deliver services, or an organization bringing its own credentialed providers in to provide services to patients?
Answer:Vendors are welcome to present both possible scenarios (hospital providers and vendor organization’s telemedicine providers). However, keep in mind we are a self-funded plan and encourage our employees through cost savings to use the hospital’s providers. Long term there is a strategic value proposition discussion. The long term preference is for Tarrant County Hospital District resident and providers to deliver services for a full telemedicine rollout.
- Is it envisioned that “telemedicine, remote clinical services” also stated in the Purpose Statement refers to services where patients are serviced at Hospital District clinics or sites as opposed to in their homes or places of work?
Answer: Employee- patients should be able to access from Employee Clinic initially. The desire is to have employees access remote and @ place of work within the boundaries of telemedicine federal and state law. Additionally, consideration for privacy will need to be in design, development, and implementation.
Phase 1- Focus is to have 24/7 employee clinical services. Telemedicine should be accessible to augment the on-site face to face Employee Clinic experience. This could be accomplished by having room(s) in the clinic for employees to meet with a telemedicine practitioner or dial in remotely from home to have an appointment.
- Is it intended that these “telemedicine, remote clinical services” are to be delivered in accord with CMS reimbursement guidelines - i.e. Live two way video and audio, with patients located at medical sites?
Answer: Telemedicine services and remote clinical services will be delivered in compliancewith Texas State lawswith patients primarily located at sites remote to the clinic.
The Telemedicine visit will be scheduled with a provider and medical assistant scheduled exclusively for Telemedicine in a focused clinic as an adjunct to the regular office visits and may include asynchronous telehealth digital imaging , and /or live two way video and/or audio .
The Telemedicine visit will be documented in EPIC and billing for a non-face to face encounter and will be reimbursed using appropriate CPT codes that are mutually acceptable between JPS and its 3rd party claims administrator.CMS reimbursement level should not constrain strategic fee structures, but reasonable, quality and value based pricing should be of concern and delivered.
Remote visits will need to be established within the Texas Telemedicine law rules. No remote prescribing, if prohibited by law.
- Is there an estimated number of service sites for Phases 1, 2, and 3 as designated on p. 10?
Answer: Phase 1 will comprise the Employee Clinic as the on-site location to augment in person staff for 5000-6000 employees. The successful roll-out of Phase 1 would justify increasing site location. Expansion to other clinics is desirable. Phase 2 could include expansion into JPS 20 key health centers. Right now, the focus is Phase 1.
- Is there an estimated number of consulting practitioners for Phases 1, 2, and 3 as designated on p. 10?
Answer: Consider Phase 1 is to augment the Employee Clinic,which currently has about 2 MDs and a Nurse Practitioner for about 5700 employees plus their dependents. The number of staff needed is to ensure wait times are reduced and service. Assume a minimum of 2 and a maximum of 5 for the Employee Clinic in Phase 1. Breakout the price differential for 1, 2, 3, 4, and 5 telemedicine providers/practitioners. Less providers/practitioners are needed after hours. The hours of operation for the employee clinic are 7AM to 3PM (Monday – Thursday); Friday 7AM to 12 noon.
- On p.13, under Tab3. Price – what is meant by “Pricing should be for an annual period.”?
Answer: Exactly what’s stated for phase 1 of this what is overall total cost for year 1-6
Answer: Provide cost estimate for Phase 1 – Employee Health Clinic Solution (Jan 18 – Dec 18). This could include any consulting fees for design, development, and implementation. Billable hours or time and materials. If there are no fees and cost is passed to the carrier, please state what Phase 1 pricing is passed through.
- Is information available regarding the devices and components that comprise the Polycom video platform mentioned in “Key Assumptions” on p. 9? Elements, model numbers, and quantities would be helpful. Answer: Not at this time
- Can the name of the consulting services firm noted on p.9 be disclosed?Answer: Not at this time.
- The RFP mentions that in August 2016 a consulting firm was hired to evaluate the hospital’s telehealth opportunities and priorities. Are you able to share the name of the vendor who conducted this study and is their report available online? Answer: Not at this time.
- Regarding Phase 1 (Page 8 - Section 1), it states that approximately 5,700 employees on the JPS Health Network Plan will potentially utilize telemedicine services. Approximately how many total physicians, nurses, and support staff will need access to the platform to provide that volume of consult services?
Answer: Assume 400 providers, 2000 nurses, 3780 professionals and staff.
- Regarding Phase 2 (Page 11), total patient population. Approximately how many patients does JPS Health Network serve on an annual basis? Will JPS Health make the telemedicine service available to all new and existing patients?
Answer: For 2017, assume 724.2K clinic visits, 61.4K urgent care visits, 1.217M outpatient visits. Annually, the trend is increases in visits justifying a long term strategy like telemedicine. The long term consideration is to make available to new and existing patients. For Phase 1, the focus is the employee and employee family population.
- Will there be any need now or in the future to integrate specialty telemedicine devices such as otoscopes and stethoscopes? Or will this strictly be synchronous communication via video consults?
Answer: JPS is interested in hearing how would the integration of specialty telemedicine devices be integrated into the offering. Please highlight in the RFP both synchronous and asynchronous offerings you have to clients. It will be important to consider in Phase 1 designing and developing a long term solution that can be built to address supporting an infrastructure that is broad to allow for otoscopes and stethoscopes and more.
- Will JPS Health Network require the need for outside specialty physician services or will the organization solely utilize their employed and affiliated physicians?
Answer: The preference is for the hospital to use our own providers, especially for a long term strategy. If a vendor organization bringing its own credentialed providers, please explain value proposition for Phase 1. The self-funded plan provides incentives to our employees to use our own providers. Consideration of both models is reasonable, based on the state of the industry today. Phase 1 may only entail an organization brining in its on credential providers for an interimperiod. The best short term and long term approach needs to be thought through as this is an innovative proposition for the industry.
- Regarding Epic integration (Page 9), is JPS Health seeking a full integration that will allow the clinicians to access a patient record in real time, and document and send information back to Epic in a true read/write fashion?
Answer: Yes. This supports having an internal provider strategy to offer telemedicine. Adherence to privacy and compliance regulation standards for the Employee Clinic and Health Plan will need to be solid.
The Telemedicine visitwill be documented in EPIC and billing for a non-face to face encounter
- Is there a number of providers in mind? If so, if this number is increased, can we assess fees for each additional provider added to the platform?
Answer: The right size to augment the current Employee Clinic staffing that will enable employee-patients to have shorter wait times and faster appointment. Phase 1 is to augment the Employee Clinic which currently has about 2 MDs and a Nurse Practitioner for about 5700 employees plus their dependents. The number of staff needed is to ensure wait times are reduced and service. Assume a minimum of 2 and a maximum of 5. Less practitioners are needed after hours. The hours of operation for the employee clinic are 7AM to 3PM (Monday – Thursday); Friday 7AM to 12 noon.
All corrections, changes, additions, revisions, and/or clarifications in this Addendum #1to the
RFP are hereby made a part of the RFB/RFP for #LH-0476 Telemedicine.
All Respondents to the RFB/RFP shall acknowledge receipt and acceptance of this Addendum #1 by
signing in the space provided and submitting the signed Addendum #2 with the RFB/RFP.
Proposals submitted without an executed copy of this Addendum #2 attached may be considered
informal and may be rejected.
Received, acknowledged, and conditions agreed to on this ______day of ______, 2017, by:
Respondent: ______
Company Name: ______
If there are questions pertaining to this addendum please contact Lizzie Harris at