SAM #36C24426Q0758

VA Pittsburgh Healthcare System Teleradiology Services Solicitation

The VA Pittsburgh Healthcare System is seeking a contractor to provide comprehensive teleradiology services to support its radiology department. - Government Buyer: - Department of Veterans Affairs - VA Pittsburgh Healthcare System - Network Contracting Office 4 - Services Requested: - 24/7 professional teleradiology interpretation for radiology exams (plain film, ultrasound, CT, CTA, MRI) - Preliminary and final interpretations, including STAT and routine cases - Report transcription and immediate communication of critical/emergent results - Installation and maintenance of secure, VA-compatible hardware/software for image transmission and reporting - Training for VA staff on systems provided - Compliance with HIPAA, VA, and Joint Commission standards - Quarterly quality assurance reporting and strict records management - Key Requirements: - Contractor must be a U.S.-based corporation - All radiologists must be board-certified - 24/7 coverage with minimum 99% system uptime - No subcontracting to locum tenens providers - Equipment/software must be compatible with VA imaging systems (VISTA Imaging, Powerscribe, Philips ISite Radiology) - Strict privacy, credentialing, and quality assurance protocols - No specific OEMs or vendors are named, but compatibility with VA imaging platforms is mandatory.

Description

Department of Veterans Affairs VA Pittsburgh Healthcare System. PERFORMANCE WORK STATEMENT (PWS) Teleradiology Services-Imaging GENERAL: The Pittsburgh Department of Veterans Affairs has a requirement to provide Veterans within the service area with Teleradiology Services. BACKGROUND: Physician personnel shortages in the Radiology Services of the Pittsburgh VAMC have created a significant need to provide preliminary and final radiology interpretation for exams performed on off tours and in some cases for exams performed during routine tours to cover leave and staff vacancies. The use of Radiology Services outsourcing should provide a highly cost-effective and expeditious alternative to meet an ongoing need within the VA Healthcare System. The Pittsburgh VAMC uses an electronic image management and distribution system called VISTA Imaging. In conjunction with Vista Imaging, the facility uses Powerscribe and ISite radiology to complete Imaging Dictations. WORK STATEMENT: Contractor shall provide professional teleradiology services for radiology examinations performed at the Pittsburgh VAMC. Contract services will include off-campus film interpretation via network connection to the VA informatics system. Interpretation will include immediate communication of results both when an interpretation is requested STAT or with a critical emergent test result. Contractor must be a U.S. based corporation capable of final interpretation and reporting services via the Contractor's secure Teleradiology network. Interpretation services will be conducted by board certified Radiologists. Contractors shall provide all professional personnel and technical support, medical and other equipment, telecommunication, supplies, and supervision necessary to perform, implement and administer these teleradiology services to meet the specific medical needs of the Pittsburgh VAMC. The Contractor is responsible for all Contractor personnel, Subcontractors, agents, and anyone acting for or on behalf of the Contractor. Records Management Language for Contracts When Federal agencies acquire goods or services, they need to determine what Federal records management requirements should be included in the contract. Federal contractors often create, send, or receive Federal records. Federal contracts should provide clear legal obligations describing how the contract employees must handle Federal records. Agency records officers, procurement counsel, and acquisitions officers must discuss how to integrate records management obligations into their existing procurement processes. NARA has developed the following language to be included as an agency-specific term and condition in Federal contracts for a variety of services and products. The majority of contracts should include language on records management obligations, but each contract should be evaluated individually. For example, the data-rights paragraph (Paragraph 10 below) may not be appropriate for all contracts. Instead, agencies may be better served by one of the established data-rights clauses in the Federal Acquisition Regulations. This language should not replace specific records management requirements included within Federal information system contracts. RECORDS MANAGEMENT OBLIGATIONS A. Applicability This clause applies to all Contractors whose employees create, work with, or otherwise handle Federal records, as defined in Section B, regardless of the medium in which the record exists. B. Definitions Federal record as defined in 44 U.S.C. § 3301, includes all recorded information, regardless of form or characteristics, made or received by a Federal agency under Federal law or in connection with the transaction of public business and preserved or appropriate for preservation by that agency or its legitimate successor as evidence of the organization, functions, policies, decisions, procedures, operations, or other activities of the United States Government or because of the informational value of data in them. The term Federal record: includes [Agency] records. does not include personal materials. applies to records created, received, or maintained by Contractors pursuant to their [Agency] contract. may include deliverables and documentation associated with deliverables. C. Requirements Contractor shall comply with all applicable records management laws and regulations, as well as National Archives and Records Administration (NARA) records policies, including but not limited to the Federal Records Act (44 U.S.C. chs. 21, 29, 31, 33), NARA regulations at 36 CFR Chapter XII Subchapter B, and those policies associated with the safeguarding of records covered by the Privacy Act of 1974 (5 U.S.C. 552a). These policies include the preservation of all records, regardless of form or characteristics, mode of transmission, or state of completion. In accordance with 36 CFR 1222.32, all data created for Government use and delivered to, or falling under the legal control of, the Government are Federal records subject to the provisions of 44 U.S.C. chapters 21, 29, 31, and 33, the Freedom of Information Act (FOIA) (5 U.S.C. 552), as amended, and the Privacy Act of 1974 (5 U.S.C. 552a), as amended and must be managed and scheduled for disposition only as permitted by statute or regulation. In accordance with 36 CFR 1222.32, Contractor shall maintain all records created for Government use or created in the course of performing the contract and/or delivered to, or under the legal control of the Government and must be managed in accordance with Federal law. Electronic records and associated metadata must be accompanied by sufficient technical documentation to permit understanding and use of the records and data. [Agency] and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Records may not be removed from the legal custody of [Agency] or destroyed except for in accordance with the provisions of the agency records schedules and with the written concurrence of the Head of the Contracting Activity. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. In the event of any unlawful or accidental removal, defacing, alteration, or destruction of records, Contractor must report to [Agency]. The agency must report promptly to NARA in accordance with 36 CFR 1230. The Contractor shall immediately notify the appropriate Contracting Officer upon discovery of any inadvertent or unauthorized disclosures of information, data, documentary materials, records or equipment. Disclosure of non-public information is limited to authorized personnel with a need-to-know as described in the [contract vehicle]. The Contractor shall ensure that the appropriate personnel, administrative, technical, and physical safeguards are established to ensure the security and confidentiality of this information, data, documentary material, records and/or equipment is properly protected. The Contractor shall not remove material from Government facilities or systems, or facilities or systems operated or maintained on the Government's behalf, without the express written permission of the Head of the Contracting Activity. When information, data, documentary material, records and/or equipment is no longer required, it shall be returned to [Agency] control or the Contractor must hold it until otherwise directed. Items returned to the Government shall be hand carried, mailed, emailed, or securely electronically transmitted to the Contracting Officer or address prescribed in the [contract vehicle]. Destruction of records is EXPRESSLY PROHIBITED unless in accordance with Paragraph (4). The Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, contracts. The Contractor (and any sub-contractor) is required to abide by Government and [Agency] guidance for protecting sensitive, proprietary information, classified, and controlled unclassified information. The Contractor shall only use Government IT equipment for purposes specifically tied to or authorized by the contract and in accordance with [Agency] policy. The Contractor shall not create or maintain any records containing any non-public [Agency] information that are not specifically tied to or authorized by the contract. The Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected from public disclosure by an exemption to the Freedom of Information Act. The [Agency] owns the rights to all data and records produced as part of this contract. All deliverables under the contract are the property of the U.S. Government for which [Agency] shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest. Any Contractor rights in the data or deliverables must be identified as required by FAR 52.227-11 through FAR 52.227-20. Training. All Contractor employees assigned to this contract who create, work with, or otherwise handle records are required to take [Agency]-provided records management training. The Contractor is responsible for confirming training has been completed according to agency policies, including initial training and any annual or refresher training. [Note: To the extent an agency requires contractors to complete records management training, the agency must provide the training to the contractor.] D. Flowdown of requirements to subcontractors The Contractor shall incorporate the substance of this clause, its terms and requirements including this paragraph, in all subcontracts under this [contract vehicle], and require written subcontractor acknowledgment of same. Violation by a subcontractor of any provision set forth in this clause will be attributed to the Contractor. All services SHALL be performed within the territorial borders of the United States. I. Teleradiology Services: The Contractor shall be responsible for management of all aspects of the contract, and this includes the following: Electronically distribute appropriate studies to board certified Radiologists for primary diagnosis. Provide professional radiology services, offsite from Pittsburgh VAMC. The most frequent regular usage of teleradiology services will be Monday-Thursday 8pm-8:00 am, and Friday 8pm through Monday 8:00 am, but 24-hour coverage is expected. Some interpretations will be requested STAT and other interpretations will be requested routine. Imaging procedures will include plain film cases, US cases, CT cases, CTA cases, and MRI cases. Provide configuration of the physical, operational, and procedural environment within the Pittsburgh VA Medical Center facilities radiology department and installation for the system to include broadband connectivity and assist VA Pittsburgh Healthcare System (VAPHS) facility in site preparation and support during transition. The images will be sent by VA's Teleradiology System (ISite Radiology) to the Business Partner through a VA approved Business Partner Gateway (BPG). Radiologists shall be available for telephone consultation regarding examinations and provide recommendations for appropriate procedures to referring clinicians. VA Technologists performing procedures to be interpreted may consult the Radiologist/contractor with questions regarding protocol of exams, possible contrast allergy questions or for direction regarding abnormal laboratory values, or questions regarding premedication. Relevant prior studies will be made available to the teleradiologist. Interpretations must compare current and prior studies. Radiologists will have access to CPRS, or to a health summary or be able to contact the ordering physician to obtain clinical information such as history, progress notes, medications, and laboratory values, as well as reports of prior radiologic examinations. The Radiologist providing the preliminary interpretation shall also perform the final interpretation and communicate any change in that interpretation to the referring or treating clinician and the practitioner contacted, date and time of this communication must be documented in the final report. If the study is technically limited or incomplete, and cannot be interpreted with certainty, the teleradiologist shall notify the referring clinician so that the study may be repeated. If this is not feasible, cannot be done immediately, or is not likely to be productive, the study must be reported, and the technical limitations of the interpretation described in the report. Documentation. All film interpretations will either meet or exceed established standards of timeliness, accuracy, content, and signature. Only VAPHS approved abbreviations will be used for documentation of the patient health record. (1) Routine interpretations: Completed and verified reports for routine studies are available in CPRS/Vista Imaging Information System within 48 hours of exam registration. (2) STAT interpretations: Provide preliminary report by fax to referring clinicians within 45 minutes of the teleradiologist receiving the request for interpretation. If the exam is a critical/emergent rest result, results also must be communicated by telephone to the referring physician. Final report will be verified within 48 hours of exam registration and available in CPRS/VISTA Imaging Information System. Each report (routine and stat interpretations) shall identify the films reviewed, objective findings, the Radiologist's impression of the patient's condition, and recommendation for treatment. Any incomplete report will be dedicated, transcribed, and verified within 24 hours of notification at no additional cost to Pittsburgh VAMC. Additional requirements apply if any exam demonstrates a critical/emergent test result, as defined in a Medical Center Memorandum, as excerpted, and listed as diagnoses #1 - #8 re-listed in this PWS under 1(a) (4).) Reporting Imaging Test Results/Critical Results. In the case of a critical finding, results must also be communicated by telephone to the referring physician or a licensed clinician who can address the critical finding. This communication must be documented in the report and includes the name of the clinician receiving the report, date, and time communicated. (3) All reports are to be in accordance with American College of Radiology (ACR) standards. Interpretations must include the following information: patient's full name, SSN, date of birth, reason for study, exam case number (accession number), date of study, date of interpretation, requesting physician, description of the exam, (body of the report), impression, name of interpreter and signature of Radiologist providing interpretation. The report shall list pertinent positive and negative findings. (i) Preliminary reports are to be provided by fax to referring clinicians within 45 minutes of receipt of exam. If the exam is a critical/emergency test result, the report also must be communicated by phone to the referring physician. Preliminary written reports must be kept until the final report is verified and until they are no longer needed for quality assurance and peer review purposes. Preliminary reports need not be entered in the medical record, however, any significant discrepancies between the preliminary and final report must be documented in the final report and the treating team notified with date and time of notification in the final report. (ii) Final written reports shall be transcribed and verified by the teleradiologist (electronically signed) within 48 hours of exam registration. (iii) The facility or Contractor providing teleradiology interpretation may temporarily store copies of reports and images but must delete or destroy all copies after the contract has expired, excepting records required for billing and reimbursement purposes. Reporting Imaging Test Results/Critical Results. Critical Test results in Imaging are defined as those interpretation findings which, if left untreated, could be life threatening or place the patient at serious risk. These results will require urgent intervention or change in patient management. Emergent Test results are findings that are associated with a high likelihood of short-term poor outcome and require immediate intervention or close monitoring. The Radiologist will communicate results of critical/emergent exams to the ordering practitioner or surrogate practitioner immediately upon interpretation as outlined below. Critical/Emergent Test results for Imaging Service will include, but not be limited to: Ectopic Pregnancy Testicular or Ovarian Torsion Pneumoperitoneum-not postoperative Acute Intracranial Hemorrhage Unstable Cervical Spine Fracture Thoracic or Lumbar Spine Fracture with cord compression Aortic Dissection Mediastinal or Retroperitoneal Hematoma Intracranial Mass with New Herniation Acute Pulmonary Embolism or Acute above the Knee DVT Hemoperitoneum Acute laceration of the Liver, Spleen or Kidney Acute cord compression Appendicitis Abscess requiring medical/surgical attention or intervention Bowel Necrosis Portal Venous Gas Acute Arterial Embolism/Occlusion Tension Pneumothorax Significantly Mal-positioned line or tube or unexpected foreign body Communication of critical/emergent imaging results will be direct. Direct Communication is defined as non-electronic dialogue between the diagnostic practitioner and ordering practitioner or another appropriate licensed provider by telephone. Documentation of communication of critical/emergency results will be included in the imaging report. This will include the name of the practitioner contacted, as well as date and time of communication. Electronic Communication (view alerts) may be used to communicate important/abnormal study findings that require attention by the ordering practitioner, but not necessarily in an immediate time frame. (ii) In addition, all reports (normal and abnormal) must have a diagnostic code which is dictated and transcribed along with the report or inserted at the time of report verification. Inline below are the diagnostic codes which must be used as they are used by the VHA. Some of the diagnostic codes will generate view alerts which can convey important study findings that may require a change in patient management, but not necessarily within an immediate timeframe. The list of diagnostic codes used will be provided at time of contract award. Value LabelCode 12001200 No AAA 12011201 AAA Present 1202Unsat for AAA Screen 1000No Alert Required 1001Significant Abnormality 1002Critical Abnormality 1003Possible Malignancy iii) A method has been established to relay the results of abnormal exams performed off routine business hours. The AOD will be contacted by the contractor and the AOD will facilitate communication with either the ER attending or responsible clinician on call. In all cases, should there be difficulty in reaching the clinician responsible, the ER attending Medical Officer of the Day will serve as point of contact. All Radiologists providing preliminary or final reports will be required to read the abnormal reporting policy, sign that the policy was reviewed and is understood, prior to providing interpretations. The contractors shall distribute the policies, obtain signed policies, and ensure that the process outlined in MCP TX-144 is followed by Radiologists reading for Pittsburgh VAMC. The contractor will distribute these to all Radiologists and obtain signed receipt and acknowledgement of understanding for Radiologists providing interpretation. Signed acknowledgement must be submitted prior to contract implementation. A schedule for teleradiology service days will be submitted monthly and approval is required by Radiology Manager or Imaging Chief. The names of the VETPRO credentialed Radiologists and dates of their scheduled coverage must be received by the VA in advance from the contractor no later than the 20th workday of the month prior to the work schedule. Contractor must all at least 3 months after receipt/completion of all required documentation for any new Radiologist to be credentialed and privileged prior to scheduling. Contractors will be responsible for transcription services, report corrections, and sign reports electronically. Again, ALL reports must be signed by the interpreting Radiologist within 48 hours of exam registration. Contractor will install, secure, and maintain external communication systems required for image study delivery to remote Radiologists. Configure, install, and maintain Virtual Private Network all remote workstation software on the remote reading Radiologist workstation. These connections must comply with specifications in VA Handbook 6500. The remote Connection to the VA will be through a VA approved Business Partner Gateway (BPG). Teleradiologists performing work under this contract may also connect remotely to the VA using the Citrix Access Gateway VPN. Contractors must ensure that their own specific computers are capable of diagnostic interpretation and at the same time adhere to all VA security requirements. The extension of the network is fully functional, and Radiologists must have clinical privileges at the Pittsburgh VA Medical Center. Contractors will access current and prior comparison studies (if comparison studies exist) utilizing a secure VA Business Partner Gateway or similarly functional, rapid, and secure technology. Contractors shall provide and maintain the means for enabling this access. Contractor should install and maintain external communication systems required for secure, VA-compliant image and data delivery to its teleradiologists and will configure, install, and maintain all remote workstation software at its teleradiologists reading stations and will ensure security to VA Data. Contractor will expeditiously provide all requested information to VAPHS Information Security Officer (ISO) and Information Resources Management (IRM). Implement a Vista Rad/Vista Imaging/Philips ISite compatible DICOM appliance for transfer of images from Philips ISite Radiology to the DICOM server. Contractor Proposal shall include the specific hardware and software to be utilized by the contractor. Provide training on the new workflow for location activated. This training course will be no more than four hours. Provide maintenance on all contractor-provisioned equipment and installed systems. The contractor shall make provisions for the proper maintenance and functioning of all imaging, teleradiology and associated equipment, facilities and fixtures as may reasonably be required by Physicians to perform services hereunder. Provide security as required by Health Insurance Portability and Accountability Act of 1996 (HIPAA) and maintain the security and integrity of patient information in accordance with applicable VA regulations and HIPAA. Contractor will be required to follow all U.S. Laws and VA regulations regarding sensitive information, patient confidentiality, and information security, as set forth in; Privacy Act of 1974, Computer Security Act of 1987, Clinger Cohen Act of 1996, OMB A-130 Appendix IIIk and VA, VHA Directives 6500, and all other applicable regulations. See FAR clauses 52.224-1 and 52.224-2 included herein. Develop a project implementation strategy with the Pittsburgh VAMC to include preparing building, establishing telecommunications VISTA interface, policies and procedures transfer, credentialing, privileging and training staff, reporting procedures, operational readiness, and phase in schedule. The Contractor shall provide a system that maintains a minimum of 99% up time performance rate (excludes downtime related to VA's network problems, Internet traffic or ISP provider problems used by Contractor). Failure to provide this will result in contract termination. Contractor shall provide hardware and selected software to be utilized at contractor site to include: Facsimile, telephone, networking and other telecommunications equipment to be utilized at contractor facility. all supplies, services, maintenance, repairs and upgrades required at contractor facility to provide services as described above. equipment hardware, software and supplies must be compatible with the VA's software (Vista Imaging, Powerscribe, Philips ISite Radiology) and hardware used during performance of this contract including critical patches and antivirus updates. Contractor shall provide proof of installation of critical patches and/or antivirus updates to the VA upon request. network and security system must be compatible with the VA's network and security system. Contractor's system must be able to receive DICOM images to the Contractor server via secure VA facility-initiated VPN connection over the Internet. q. Contractor shall provide peer review data (quality assurance cross reads) on a quarterly basis for each Radiologist providing interpretations to Pittsburgh VA Medical Center. A copy will be provided to VAPHS for review. r. Contractor shall be responsible for ensuring that all providers/subcontractors complete training required by Pittsburgh VA Medical Center (Ethics, Cybersecurity, Privacy, etc.). The VAPHS will require documentation of completion. s. Contractor shall appoint one Radiologist to serve as a trainer for other Radiologists assigned to VAPHS. The Pittsburgh VAMC will be responsible for: The Pittsburgh VA Medical Center will be responsible for credentialing doctors to work in a timely fashion. An application package will be provided by the VA to be completed by the candidate. This includes Curriculum vitae, current references, signed release of information from candidate, and statement that candidate does not have any physical or mental health condition that would adversely affect his/her ability to carry out assigned duties, and additional credentialing and privileging forms. Candidate will also be required to make application through the VET-PRO Internet process. Candidates will need to be enrolled in VET-PRO by the Credentialing and Privileging Coordinators. The website address is: http://fcp.vetpro.org/ Prepare site for installation of the system. Obtain VA Authorization for installation of a separate network connection, located inside the hospital but outside the firewall, and a network connection of the DICOM store and Forward device that will be installed inside the Pittsburgh VAMC. The VA will establish accounts and authorize radiology module privileges for the use by contractors. Floor space, workspace, and power adequate for a PC tower computer, monitor and keyboard at customer site. 19" Rack space equivalent to 6u in computer room (to accommodate the server and IPS) and an outlet. Physical space in computer/Telco room for installation of Contractor-provided router and any remoter connectivity devices typically used by communications provider. Physical security for computer systems. Access to server and object forge devices for the installation of Category 5 cabling, if required. Availability of technician for two hours of assistance. IRM designated staff for testing and approval of installed remote connectivity solution. Provide pertinent historical and demographic information on each patient sufficient for Contractor to perform its services. PROCEDURE FOR TRANSMISSION OF IMAGES: Patient images along with exam Request forms for each patient will be transmitted via the VA's PAC System (VISTA IMAGING) through a data line provided by the Contractor. The request forms will include patient information, along with CPT codes. The Contractor shall interpret an exam and provide the Radiologist's final report and transmit using hardware/software provided by Contractor. Contractors shall use the same transcription services used at the Pittsburgh VAMC (CPRS/VISTA/Powerscribe Imaging Information System). Request(s) for stat interpretation or routine interpretation will be noted on the request form. CONTRACTOR REQUIREMENTS The Contractor shall provide all services specified in this contract for any person determined eligible by the Chief Medical Director, or Designee, regardless of the race, color, religion, sex, or national origin of the person for whom such services are ordered. The Contractor shall not subcontract as a means of circumventing this provision. Contractor must have a minimum of three years of experience providing off routine teleradiology interpretations for VA Medical Centers. The Contractor must be able to demonstrate consistent coverage (> 99% uptime for 3-year period). MEDICAL RECORDS STANDARDS: The Contractor shall maintain up-to-date medical records based on the Medical Record Compliance Standard as stated above. Utilization of CPRS is required. Medical center staff will provide technical training on the use and operation of CPRS during the start-up early operation stage and as updates become available. Medical center staff will provide at least annual Privacy Act training to appropriate contractor staff. The contractor, contractor employees, and subcontractors shall be subject to the Privacy Act of 1974 and HIPAA of 1996. The Contractor is not authorized to release any medical record information. The VAPHS is the sole entity authorized to release this information upon written request submitted via facsimile or mail from the patient. The VAPHS will provide the Contractor with access to pertinent patient medical information, within the existing privacy rules and regulations for the purpose of providing coordinated comprehensive primary care. Contractors shall ensure the confidentiality of all patient information and shall be held liable in the event of the breach of confidentiality. GUIDELINES: The Contractor will perform the functions required under this contract in accordance with the rules of medical ethics, Federal, State and local laws, rules and regulations, Joint Commission, and American College of Radiology (ACR.) for communication and teleradiology. The Contractor shall not participate nor be a party to any activities which are in conflict with Federal and/or State guidelines. In the event the Contractor encounters said conflicting situations, the Contractor shall notify the COTR or the Contracting Officer to resolve such issues. Neither the VA nor the Contractor will be responsible for any delays or failures to perform due to causes beyond each party's control. The VA and the Contractor may, upon mutual consent, modify the timing and schedule of services. The Contractor shall be following Joint Commission standards and shall submit a copy of either their Joint Commission accreditation OR comparable statement with their proposal. Complications review, double reading, and other appropriate monitors must be conducted and report forwarded to Pittsburgh VAMC quarterly. Failure to provide required documentation would be a breach of the contract and subject to the contract being revoked. Any occurrence of a sentinel event or potential sentinel event involving a VA patient will be reported to the facility as soon as the event is detected. Comprehensive review of the case will be provided to the appropriate VA facility. 4. QUALITY MONITORING PROGRAM: The Contractor shall have a quality monitoring program and shall agree to comply with the requirements for meeting the JCAHO program as outlined by the VA radiology programs. Quarterly data will be provided to the VAPHS Pittsburgh Manager/Supervisor for each Radiologist credentialed at Pittsburgh VA Medical Center. Contractor must perform quality assurance cross reads and monitor appropriate communication of critical/emergency results as per MCM TX-144. Both sets of data will be provided to VAPHS quarterly. QUALITY CONTROL: The Contractor's facilities, methodologies, and quality control procedures may be examined by the VA Contracting Officer or his (her) designee at any time during the life of the contract. Quality Assurance Surveillance Plan (QASP): This QASP shall be changed at the sole discretion of the Government throughout the life of the contract via a unilaterally awarded modification. Performance Objectives Performance ObjectivePerformance Measure Prompt delivery of interpretations and return of films.Zero tolerance for late reports Availability of Radiologist.Zero tolerance for non-availability Maintains patient privacy/confidentiality.Standard is zero breaches of privacy Maintains appropriate Federal, state licensure/ certification requirementsMandatory prior to performance of duties All documentation will meet or exceed standards, to include but not limited to accuracy, content and signature.Zero tolerance for violations Timeliness of Patient Records. Reports are to be completed and verified within 48 hours of exam registration. Stat reports must be faxed to requesting clinician within 45 minutes of when the contractor receives request. All critical/emergent exam results must be called to requesting clinician and this is documented in the final report (clinician name, date, and time).95% Compliance Acceptable Quality Level. Zero tolerance for violations. Adheres to all HIPAA requirements.Standard is zero breaches of HIPAA requirements. Adequate Coverage100% Acceptable Quality Level. Zero tolerance for violations. (a) The Government will periodically evaluate the Contractor's performance by appointing a representative(s) to monitor performance to ensure services are received. The Government may inspect each task as completed or increase the number of quality assurance inspections if deemed appropriate because of repeated failures or because of repeated customer complaints. Likewise, the Government may decrease the number of quality assurance inspections if performance dictates. VAPHS Quality Assurance Personnel will validate any complaints and report to the Government Contracting Officer who will then take necessary action to enforce contract compliance. (b) If any of the services do not conform to contract requirements, the Government may require the Contractor to perform the services again in conformity with contract requirements, at no increase in contract amount. When the defects in services cannot be corrected by re-performance, the Government may result in contract termination. CONTRACTOR STANDARDS: Contractor is responsible for developing and maintaining written policies and procedures for licensure and certifications, competency evaluations, orientation, and continuing education, that are appropriate for the scope of care and services provided by employees and subcontractors under this contract. SPECIAL CONTRACTOR RESPONSIBILITIES: The Contractor must possess all licenses, permits, accreditation and certificates as required by law. The Contractor must perform the required work in accordance with Joint Commission, VHA and other regulatory standards. Joint Commission standards may be obtained from the Joint Commission on Accreditation of Healthcare Organizations, One Renaissance Blvd, Oakbrook Terrace, IL 60181. Requirement Timeline Peer Review (FPPE/OPPE): Quarterly Invoices: Monthly VA Cyber Security Awareness and Rules of Behavior: Yearly at beginning of Option Year Contractor Rules of Behavior: Yearly at beginning of Option Year VA privacy training: Yearly at beginning of Option year SUBCONTRACTOR PROVIDED SERVICES: All personnel that provide services under this contract and are not employees of the Contractor will be regarded as Subcontractors. The Contractor shall be responsible and accountable for the quality of care delivered by all of its Subcontractors. The Contractor shall hold the Subcontractor accountable for the requirements for availability and accessibility of services as outlined in this contract. The Contractor shall use a systematic approach to monitoring the availability and accessibility of services of the Subcontractor as they relate to the quality-of-care monitoring. CONTRACTOR EQUIPMENT/SOFTWARE: Upon completion or termination of the contract VPN software will be removed from contractor's equipment. Any network accounts will be disabled. All VA data gathered, created, received, or processed during the performance of the contract will be returned to the VA or certificate of destruction provided. No data will be retained by the contractor or its subcontractors. CONTRACTOR NETWORK ACCESS: The VA network is protected from unauthorized access by assigning a distinct Access and Verify code to each user of the network. Each Contractor staff person, hereinafter referred to as "user", must agree to the VA standard user application. Violation of the agreement as a whole or in part may result in permanent revocation of access for the user. REGULATORY INFORMATION: The Food and Drug Administration classifies VistARad as a medical device. As such, it may not be changed except as directed by the Vista Imaging SD&D group. Modifications to this software may result in an adulterated medical device under 21CFR820, the use of which is a violation of US Federal Statutes. To ensure compliance the VA will implement measures, including but not limited to, security policies, anti-virus devices, anti-intrusion devices, and periodically monitor the equipment. Any attempt to defeat or circumvent any of these measures may constitute a breach of this contract and result in revocation. II. SPECIAL CONTRACT REQUIREMENTS SERVICES: The services specified herein of this Work Statement may be changed by written modification to this contract. The modification will be prepared by the VA Contracting Officer. The services to be performed by the contractor will be performed in accordance with VA policies. (already mentioned) RESPONSIBILITY OF THE CONTRACTOR: The Contractor must obtain authorization from the Contracting Officer for any services required outside the scope of work provided herein. TERM OF CONTRACT AND PRICING: Pricing will be based on a flat fee for type of procedure. One invoice will be submitted to Pittsburgh VAMC for interpretations performed for radiology monthly, listing all studies interpreted, time and date of receipt by the contractor and time and date of final interpretation provided by the contractor for each. HOURS OF WORK: The Contractor as defined herein shall furnish the services covered by this contract. The Contractor is required to furnish teleradiology services 24 hours a day / 7 days a week. QUALIFICATIONS: The Contractor shall be responsible to ensure that Contractor personnel providing work under this contract are fully trained and completely competent to perform the required work. Prospective providers must present appropriate credentialing information including, but not limited to, the following: Possess the M.D. (medical doctor) or O.D. (Doctor of Osteopathic Medicine) degree Board certification in Diagnostic Radiology by the American Board of Radiology licensure in state of practice Clinical practice experience of at least two years General Liability and Malpractice insurance Barrier free office environment, equipment, and space to meet JCAHO, Federal and State standards The contractor must be a U.S. based corporation capable of final interpretation and reporting services via the Contractor's secure Teleradiology network. Interpretation services will be conducted by board certified. The contractor shall provide all professional personnel and technical support, medical and other equipment, telecommunications, supplies, and supervision necessary to perform, implement and administer these teleradiology services to meet the specific medical needs of the VA Pittsburgh Medical Center. The Contractor is responsible for all Contractor personnel, Subcontractors, agents, and anyone acting for or on behalf of the Contractor. Services provided under the contract are not to be performed outside of the United States. Contracting to Radiologists outside of the territories of the USA is prohibited. No subcontracting to locum tenens is allowed. The qualifications of such personnel shall also be subject to review by the VA Chief of Staff and/or Chief, Imaging Service and approved by the VA Facility Director at Pittsburgh VA Medical Center. Credentials will be updated annually during the term of the contract to ensure there has been no lapse in licensure, insurance coverage, etc. No changes of employee will be allowed without prior authorization by the Contracting Officer in WRITING, 15 days in advance. VA reserves the right to approve the assignment of individual personnel furnished by the Contractor to perform the functions specified in the contract. Residents are not permitted to provide preliminary or final interpretations. The Contractor is required to maintain records that document competence/performance levels of Contractor personnel working on this contract in accordance with JCAHO, and other regulatory body requirements. The Contractor will provide a current copy of the competence assessment checklist and semi-annual performance evaluation to the COTR for each Contractor's personnel working on this contract. VA may request the personnel records of any employee providing services under this contract for competency review. The VA reserves the right to request copies of current certifications and/or licenses at any time during the duration of the contract.

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