Contents

SECTION C 3 1.0 Volunteer Electronic Health System Overview 3 1.1 Goals o VEHS 3 1.! "unctional Com#onents o the Volunteer Electronic Health System $VEHS% 3 1.!.1 &ractice 'ana(ement System $&'S% 3 1.!.! Electronic Health )ecor* $EH)% 3 1.!.3 Clinical +ecision Su##ort System $C+SS% 3 1.!., &re-Service 'o*ule 3 1.3 The VEHS On-.oar*in( Intersection 3 1., VEHS an* the Volunteer +elivery System 3 !.0 &E/CE CO)&S0 ./C1G)O2N+ 3 !.1 /(ency .ac3(roun* 3 !.1.1 O ice o Volunteer Su##ort .ac3(roun* 3 !.! +escri#tion o 2sers 3 !.3 Num4er o 2sers 3 !., System Ca#acity 3 !.5 Current &hysical Environment 3 !.5.1 +omestic O#erations 3 !.5.! International O#erations 3 !.6 Current IT In rastructure +evelo#ment Stan*ar*s 3 !.7 Current IT In rastructure 3 !.8 Current /rchitecture 3 !.9 O ice o Volunteer Su##ort0 Current O#erations 3 !.9.1 &re-Service $me*ical clearance% 3 !.9.! In-Service 3 !.9.3 &ost-Service 3 !.9., 'e*ical )ecor*s 3 !.9.5 &ro(ram /nalysis an* E#i*emiolo(y $)e#ort : /nalysis% 3 !.9.6 &ro(ram : Trainin( 3 !.9.7 ;uality Im#rovement $;I% 3 !.9.8 O ice o S#ecial Services $OSS% 3 !.9.9 Health In ormation Systems $HIS% 3 3.0 Current Volunteer Su##ort 'e*ical Challen(es 3 3.1 Customer Service Challen(es 3 3.! In ormation 'ana(ement Challen(es3 3.3 /*ministrative 2ser Challen(es 3 ,.0 VEHS O4<ectives 3 5.0 General )e=uirements3 5.1 .usiness "unctional )e=uirements 3 5.! Technical )e=uirements 3 5.!.1 Service Oriente* /rchitecture $SO/% 3 5.!.! &eace Cor#s S#eci ic SO/ To-.e Environment 3

5.!.3 5.!., 5.!.5 5.!.6 5.!.7 5.!.8 5.!.9 5.!.10

System Inter aces 3 &ortals 3 Security )e=uirements Health Care )e=uirements Hostin( Su##ort 3 Trainin( 3 Im#lementation &lan 3 Hel# +es3 Su##ort 3

3 3

SECTION C 1.0 Volunteer Electronic Health System Overview
The &eace Cor#s is issuin( an )"& see3in( a Contractor to #rovi*e in*ustrylea*in( commercial-o -the-shel $COTS% so tware to *evelo# an* u#(ra*e the core 4usiness systems an* #rocesses re=uire* to mana(e all as#ects o Volunteer health. The )"& ocuses on the *evelo#ment o a Volunteer Electronic Health System $VEHS% that inclu*es the ollowin( com#onents0 • • • &ractice 'ana(ement System $&'S% Electronic Health )ecor* $EH)% Clinical +ecision Su##ort System $C+SS% or me*ical sta

In a**ition> &eace Cor#s is see3in( a mo*ule to automate the me*ical clearance o a##licants or Volunteer service that &eace Cor#s calls the &re-Service mo*ule. &eace Cor#s will im#lement a VEHS that su##orts the se=uential sta(es o the Volunteer e?#erience> re erre* to as the li ecycle o the Volunteer. Inclu*e* are all the 4usiness #rocesses> recor*s> an* *ata that a**ress the com#rehensive activities associate* with all sta(es o the li ecycle o the Volunteer@ rom outreach to #otential a##licants to those who have inishe* their service an* returne* $)eturne* Volunteers%. &eace Cor#s is not see3in( to sim#ly retro it its current 4usiness #rocesses an* e?istin( systems. &eace Cor#s re=uires in*ustry lea*in( health care technolo(y an* 4usiness #rocess reen(ineerin( services. Current systems are neither a*a#ta4le nor com#rise in*ustry lea*in( wor3 low systems that en(a(e customer relationshi# mana(ement or in ormation technolo(y su##orte* healthcare stan*ar*s. The #ro#ose* system shall inclu*e a #rotecte* ;uality /ssurance $;/% unction throu(h which authoriAe* users will con*uct #eer reviews an* =uality im#rovement. The selecte* VEHS Contractor shall ena4le e icient mission *elivery utiliAin( commercial o -the-shel so tware> resh 4usiness #rocesses> an* wor3 low systems that re=uire minimum customiAation to meet &eace Cor#sB mission.

1.1

Goals of VEHS
The overall VEHS shall im#rove the o#eration an* customer service o the O ice o Volunteer Su##ort 4y achievin(0 1. The electronic recor*in( o all me*ical> mental health an* *ental *ata o #ro(ram #artici#ants throu(hout the li ecycle o the Volunteer.

2. Cin3a(e o me*ical units o the O ice o Volunteer Su##ort 4y #rovi*in( a thorou(h set o me*ical *ata to 4e use* or re#ortin(> research> *ata-*riven mana(ement *ecisions> an* in orme* #olicy ormulation. 3. /n im#rove* me*ical clearance system incor#oratin( a &re-Service mo*ule> with an a##licant #ortal or e?chan(in( in ormation an* a##lyin( 4ranch-lo(ic> *ecision-tree automate* #rocessin( in or*er to assess a##licants. 4. The *elivery o automate* remin*ers to a##licants> Volunteers an* )eturne* Volunteers on a##licant #rocessin(> healthcare *elivery> or health 4ene its in ormation res#ectively. 5. The im#lementation o a C+SS to ai*e me*ical sta on meetin( stan*ar*iAe* levels o health care. 6. &er ormance relia4ility in the &eace Cor#s environment inclu*in( security re=uirements> telecommunication constraints> 4an*wi*th issues> an* sta in( turnover. 7. Im#rove* a*ministrative mana(ement usin( stan*ar* #ractice mana(ement system tools. 8. &rotecte* =uality assurance activities with #rivate> recor*e* #eer review unctionality in or*er to *eliver on(oin( =uality im#rovement. 9. /ll /(ency an* "e*eral re=uirements such as> 4ut not limite* to> Health Insurance &orta4ility an* /ccounta4ility /ct $HI&//%> Health In ormation Technolo(y or Economical Clinical Health /ct $HITECH%> +e#artment o Health an* Human Services $HHS%> an* "e*eral In ormation Security 'ana(ement /ct $"IS'/% re(ulations. 10. Com#liance with &eace Cor#s recor* retention #olicies> which vary rom 1! months to !5 years 4ase* on li ecycle status. &eace Cor#s re=uires a Contractor to intro*uce a VEHS which meets mission out#ut re=uirements an* i*enti ies mo*ern 4usiness #rocesses> to(ether with *ocument han*lin( a4ility an* #ro#ose* in rastructure. The new system shall meet man*ate* (overnment stan*ar*s $i.e. HI&//> "IS'/> an* HITECH% an* "e*eral a(ency re=uirements $see section H%. The system shall also 4e *esi(ne* to e iciently an* com#rehensively co#e with chan(in( /(ency re=uirements> #articularly those *ealin( with #ro(ram (rowth> chan(es in countries o service> an* varyin( me*ical #rotocols. The /merican )ecovery an* )einvestment /ct $/))/%> si(ne* into law "e4ruary !009> motivate* the healthcare community to 4ecome meanin( ul users o an EH). Startin( in !015> all healthcare #rovi*ers are e?#ecte* to have a*o#te* an* 4e actively utiliAin( an EH) to im#rove =uality an* sa ety> en(a(e #atients> im#rove care coor*ination> im#rove #u4lic health> an* im#rove security. 'any o the =ualities associate* with

the /))/ will 4e a*o#te* 4y the &eace Cor#s as it im#lements a VEHS. /ccor*in( to a short sam#le o #u4lishe* stan*ar*s> 75 "e*. )e(. 18,,> 185,-58 $Dan. 13> !010%> the &eace Cor#sB (oals an* o4<ectives are consistent with in*ustry stan*ar*s. They re=uire that the a(ency0 • Im#lement *ru(> *ru(-aller(y> an* *ru( ormulary chec3s • 'aintain an u#-to-*ate #ro4lem list o current an* active *ia(nosis 4ase* current an* uture International Classi ication o +iseases $IC+% co*es • Incor#orate clinical la4-test results into an EH) as structure* *ata • Generate lists o #atients 4y s#eci ic con*itions to use or =uality im#rovement> re*uction o *is#arities> research> an* outreach • Sen* remin*ers to #atients #er #atient #re erence or #reventiveE ollow-u# care • Im#lement ive clinical *ecision su##ort rules relevant to s#ecialty or clinical #riority

1.2

Functional Components of the Volunteer Electronic Health System (VEHS
VEHS shall inclu*e the ollowin( unctional com#onents to a**ress me*ical> mental health an* *ental care $ or *etaile* re=uirements> #lease see /##en*i? /%0 1.2.1 !ractice "ana#ement System (!"S This system #rovi*es tools or #racticin( healthcare *elivery an* is ty#ically an um4rella system that inclu*es the com#onents o an EH) an* a C+SS. The &'S 4rin(s to(ether the in ormation o all com#onents inclu*in(0 • +ia(nosis> #roce*ures> an* clinical mana(ement #ractices • O iceEme*ical unit a*ministration> unction or a##ointments> an* customer service remin*ers to #atients • Inventory status> recor*e* me*ical resources> an* su##lies utiliAe* to #rovi*e care • Clinical outcomes resultin( rom health interventions • Se#arate =uality assurance #er ormance section re=uirin( *ocumentation o #rotecte* #eer review activities that can 4e isolate* rom the rest o the recor* an* use* or stan*ar* =uality im#rovement activities • Surveillance tool$s% or in ormation (atherin(

The ca#ture an* or(aniAation o such *ata will ena4le continuous ee*4ac3 to in orm mana(ement an* #olicy *ecisions. The a4ility to re#ort on these *ata> as note* in /##en*i? .> is critical to ma3in(

a(ency *ecisions as well as meetin( other e?ternal re#ortin( re=uirements. 'ore im#ortantly> this system shall> throu(h SO/ an* an ES.> allow or *ata to 4e =uerie* alon( with the *ata rom other SO/ #ro(rams lin3e* throu(h the ES.. The system shall i*enti y correlations 4etween actors such as0 • &re-service me*ical characteristics an* ollow-u# care *elivere* in the iel* • &re-service me*ical characteristics an* #ost-service "e*eral Em#loyee Com#ensation /ct $"EC/% claims • In-service me*ical care *elivere* in the iel* an* #ost-service "EC/ claims • 'e*ical accommo*ations an* assi(nments or other #ro(ram actors • )ecor*e* *uration o Volunteer illness an* lists o me*ical con*itions 1.2.2 Electronic Health $ecor% (EH$ This EH) shall recor* the com#rehensive me*ical in ormation rom the me*ical clearance #rocess inclu*in( history o *ia(nosis an* treatment> clinical *ia(nosis an* #roce*ures *elivere* *urin( Volunteer service> an* #ost-service me*ical status. The EH) must 4e an or(aniAe*> secure recor* o #ersonal me*ical in ormation inclu*in(> 4ut not limite* to> the ollowin(0 • Trac3in( o all sta(es o me*ical in ormation with International Classi ication o +ia(nosis $IC+%> Current &roce*ural Terminolo(y $C&T%> an* Current +ental Terminolo(y $C+T% co*es an* other relevant HI&// transaction stan*ar*s • &rescri#tion history 4oth #ast an* #resent • /ller(ies inclu*in(> 4ut not limite* to> oo*> *ru(> animal> an* insect • /n u#-to-*ate #ro4lem list o current an* active *ia(nosis • Clinical la4-test results> vaccine history> vaccine re=uirements • &atient-s#eci ic con*itions necessary or me*ically accommo*ate* #lacements> e#i*emiolo(ical surveillance> an* =uality im#rovement initiatives

1.2.3

Clinical &ecision Support System (C&SS The C+SS shall stan*ar*iAe clinical care ren*ere* 4y me*ical sta . The C+SS shall ena4le sta to0 • /ccess clinical (ui*elines an* e?#ert *ia(nostic *ecision #athways • &rovi*e real time i*enti ication o #otential errors an* #ossi4le *ru( interactions • 2tiliAe stan*ar*iAe* *ecision su##ort> an* allow in#ut to stan*ar*iAe* #rotocols • Con*uct tele#hone tria(e !re'Service "o%ule The &re-Service mo*ule shall con*uct a##licant me*ical screenin( an* automatically #ro*uce me*ical clearance =uali ications as *e ine* 4y &eace Cor#s 'e*ical Clearance Gui*elines> see /ttachment 1 or a co#y o the in*e? an* two sam#le (ui*elines. It shall0 • &rovi*e intero#era4ility with the )ecruitment an* inal on4oar*in( systems re=uire* or the VC'S throu(h the ES. • /ccommo*ate chan(es in the me*ical clearance (ui*elines an* inta3e #rocess • Issue access to &eace Cor#s sta #er various roles an* #rivile(es • Trans er *ata out#uts to the VC'S • "unction as #art o the &eace Cor#s on-4oar*in( #rocess an* house a##licant me*ical in ormation> screenin( (ui*elines> an* me*ical resources at &ost in or*er to *etermine i > when> an* where an a##licant can serve as a Volunteer • 2tiliAe me*ical in ormation as early in the #rocess as #ossi4le to i*enti y =uali ie* a##licants> or to *etermine current me*ical status must 4e resolve* 4e ore a##lication can #rocee* • +eliver e?cellent automate* customer service to those in the Ci ecycle #rocess • &rovi*e a wor3 low to su##ort an a##eals #rocess or those a##licants who are *etermine* to 4e me*ically not =uali ie* or service as a Volunteer • /utomate the me*ical clearance a##roval #rocess utiliAin( in*ustry lea*in( wor3 low incor#oratin( /(ency acce#te* stan*ar* o#eratin( #roce*ures • Gui*e &re-Service Nurses when a##ro#riate with e?ce#tional

1.2.4

a*ministrative *ecision su##ort )ecor* all me*ical in ormation into the EH)

1.3

The VEHS On'(oar%in# Intersection
/ #rimary unction o &eace Cor#s is to *eliver Volunteers to its o#erations a4roa*. This re=uires the coo#eration an* e?chan(e o *ata amon( three Hea*=uarters o#erational units an* the re(ional recruitment o ices@ it covers the recruitment o #ros#ects> me*ical screenin( o a##licants> an* the #lacement o Volunteers. This is illustrate* in Ta4le 1.

Ta)le *
Volunteer &elivery System Inte#ration

&eace Cor#s reviews the health status o a##licants 4e ore they 4ecome Volunteers in or*er to ensure that Volunteers will 4e li3ely to com#lete !7 months o service in challen(in( environments without unreasona4le *isru#tion *ue to health #ro4lems. Those *etermine* to 4e me*ically eli(i4le are (iven a me*ical clearance> an* their a##lication is sent orwar* or urther> non-me*ical review. The &eace Cor#s ollows the e*eral )eha4ilitation /ct o 1973> as amen*e*> which #rohi4its *iscrimination on the 4asis o *isa4ility in e*eral #ro(rams or activities. &eace Cor#s uses Screenin( Gui*elines in *eterminin( who may 4e me*ically cleare* an* whether a me*ical accommo*ation is necessary or a #articular a##licant. / me*ical clearance with a me*ical accommo*ation may 4e o two ty#es0 $1% in or*er to accommo*ate the a##licantBs me*ical con*itions> the a##licant may 4e #lace* only in a country that has the me*ical resources necessary to accommo*ate those con*itions@ or $!% in or*er to accommo*ate the a##licantBs me*ical con*itions> the a##licant must 4e #lace* only at a site with s#eci ic in*ivi*ually-re=uire* con*itions> an* only in a country with the me*ical resources necessary to accommo*ate the a##licantBs me*ical con*itions. In su##ort o the me*ical accommo*ation> the O ice o Volunteer Su##ort has *evelo#e* /ccommo*ation Cists with country #lacement $on-4oar*in(% o#tions or common me*ical con*itions. See Sam#le /ccommo*ation Cist> /ttachment !.

The &re-Service mo*ule shall im#rove the *elivery o Volunteers 4y ena4lin( a 4etter me*ical screenin( #rocess which shall also ca#ture a##ro#riate me*ical *ata an* #o#ulate an EH) that meets mo*ern healthcare technolo(y recommen*ations. In a**ition> the &re-Service mo*ule shall incor#orate a match 4etween mana(ea4le me*ical con*itions o an a##licant an* the corres#on*in( &osts that have the me*ical resources to accommo*ate the con*ition. The &re-Service 'o*ule shall also i*enti y the a##licants who may re=uire site-s#eci ic me*ical accommo*ation> an* throu(h system intero#era4ility> su##ort urther #ro(ram on-4oar*in( tas3s. The VEHS must a**ress the tas3 o on-4oar*in( the a##licant with a success ul me*ical clearance #rocess. It must also unction throu(hout the li ecycle o the Volunteer 4y #o#ulatin( the EH) with the *ata necessary or In-Service Nurses an* me*ical sta at &osts to *eliver healthcare services> an* or &ost-Service Nurses to coor*inate health 4ene its on an authoriAe* 4asis or )eturne* Volunteers. / hi(hly unctionin( &re-Service 'o*ule shall meet the (oals an* o4<ectives state* in or*er to create an EH) that0 • Fill 4e use* throu(hout the li ecycle o the Volunteer • Contri4ute to the *ata> ;uality /ssurance> an* re#ortin( ca#a4ility o the overall VEHS • 2tiliAe a wor3 low en(ine that con*ucts me*ical screenin( or &eace Cor#s Volunteer service.

1.4

VEHS an% the Volunteer &elivery System
The Volunteer +elivery System $V+S% is the overarchin( set o systems that ena4le &eace Cor#s to #rocess> trac3> an* 3ee# recor*s o a##licants> o those who 4ecome Volunteers> o Volunteers who serve> an* o Volunteers who inish their service an* 4ecome )eturne* Volunteers. The VEHS shall reco(niAe sta(es o Volunteer service such as 4ut not limite* to a##lication status> Volunteer status> an* )eturne* Volunteer status. The V+S system will 4e 4ran*e* 4y &eace Cor#s as the +OVE system $+ata4ase o Volunteer E?#erience%. The e?istin( V+S is a #atchwor3 o #a#er-4ase* an* electronic systems *evelo#e* over many years an* re=uires a com#rehensive revision in or*er to meet new (overnmental IT an* #rivacy re=uirements> an* to co#e with antici#ate* #ro(ram e?#ansion. The current systems that com#rise the many unctions o Volunteer *elivery #rocessin( an* su##ort evolve* without *evelo#in( overall system inte(ration (oals. It is re erre* to as the Volunteer +elivery System> even thou(h it has ew attri4utes o a sin(le hi(hly- unctionin(

system. The e?istin( systems #rovi*e various critical contri4utions to the mission o the a(ency> 4ut create #a#er or 4usiness #rocess 4ur*ens *ue to a lac3 o inte(ration> an* the evolution o systems an* #rocesses. Various systems e?ist to serve the ste#s o on-4oar*in(> me*ical an* non-me*ical #ro(ram su##ort> an* #ost-service activities. /s a result> the &eace Cor#s see3s to reinvent an* im#rove 4usiness #rocesses with in*ustry-lea*in( COTS systems to su##ort its mission. In a**ition to this )"&> the &eace Cor#s has issue* an )"& or a Volunteer Ci ecycle 'ana(ement System $VC'S%. "or more in ormation on the sta(es o the Volunteer li ecycle> #lease see &eace Cor#s Volunteer +elivery Ci ecycle> /ttachment 3. Selecte* Contractors shall wor3 to(ether in coo#eration with &eace Cor#s to inte(rate the VC'S an* the VEHS> utiliAin( Service Oriente* /rchitecture $SO/% an* the new ES.> which is un*er construction.

2.0

!E+CE CO$!S, (+C-G$O.N& 2.1 +#ency (ac/#roun%
&resi*ent 1enne*y orme* the &eace Cor#s with an e?ecutive or*er on 'arch 1> 1961 an* in 1979> it was ma*e a ully in*e#en*ent a(ency. Since its oun*in(> &eace Cor#s has serve* in 138 *evelo#in( countries> an* nearly !00>000 /merican citiAens have serve* as &eace Cor#s Volunteers $&CVs%. The &eace Cor#s has a##ro?imately !000G em#loyees> 800 o whom wor3 in the 2nite* States at hea*=uarters in Fashin(ton +C an* in 9 re(ional recruitin( o ices> an* 1!00 who wor3 in our &osts throu(hout the worl*. The &eace Cor#sH mission has three sim#le (oals0 1. Hel#in( the #eo#le o intereste* countries in meetin( their nee* or traine* men an* women. 2. Hel#in( #romote a 4etter un*erstan*in( o /mericans on the #art o the #eo#les serve*. 3. Hel#in( #romote a 4etter un*erstan*in( o other #eo#les on the #art o /mericans.

&eace Cor#s> throu(h the O ice o Volunteer Su##ort> is res#onsi4le or the coor*ination> mana(ement> an* oversi(ht o all me*ical> mental health an* *ental care o in*ivi*uals enrolle* as &eace Cor#s Trainees> Volunteers an* )eturne* Volunteers who are reci#ients o "EC/ health 4ene it claims throu(h either the &eace Cor#s or the +e#artment o Ca4or $+OC%. &eace Cor#s su##orts )eturne* Volunteers 4y coor*inatin( health 4ene its> on an authoriAe* 4asis> or some health issues that arise or are e?acer4ate* *urin( Volunteer service. &eace Cor#s Volunteers ty#ically serve at a I(rassrootsJ level an* the #ro(ram currently o#erates in over 75 countries. In or*er to 4ecome a Volunteer> each a##licant must meet s3ill> suita4ility> me*ical> an* le(al criteria 4e ore assi(nment to a &eace Cor#s o ice> or &ost> a4roa*. /##ro?imately 8>000 Volunteers are currently servin( aroun* the worl*.

See the &eace Cor#s we4site www.#eacecor#s.(ov or more in ormation. 2.1.1 Office of Volunteer Support (ac/#roun% The O ice o Volunteer Su##ort> with a##ro?imately 70 sta at hea*=uarters> has three core me*ical units0 • &re-Service0 a##licant me*ical clearance@ *elivers a*ministrative *ecisions • In-Service0 *irect healthcare *elivery> an* coor*inate* su##ort • &ost-Service0 mana(e )eturne* Volunteer health 4ene it claims /**itional units inclu*e the ollowin(0 • &ro(ram an* Trainin( 2nit $&T2%0 trains &eace Cor#s me*ical sta • O ice o S#ecial Services $OSS%0 mental health s#ecialists • Health In ormation Systems $HIS%0 su##ort o#erations • O ice o &ro(ram /nalysis an* E#i*emiolo(y0 health surveillance an* outreach • ;uality Im#rovement $;I%0 clinical an* technical monitorin( • 'e*ical )ecor*s0 mana(ement o #a#er iles> mail> movement o recor*s> security o recor*s> an* other relate* res#onsi4ilities Each &ost is sta e* 4y one or more me*ical #ro essionals. There are currently 130 me*ical #ro essionals at &eace Cor#s &osts. These me*ical #ro essionals are in char(e o uni=ue health units which #rovi*e healthcare to Volunteers. Some &osts are in resource-challen(e* environments where electricity an* 4an*wi*th are unrelia4le an* latency is varia4le. O ices at overseas &osts are locate* in ma<or cities> 4ut Volunteers are #lace* in 4oth ur4an an* rural environments. Communication 4etween an* amon( hea*=uarters> re(ional recruitment sta > inclu*in( iel*-4ase* an* contract recruiters> &osts> Volunteers> an* )eturne* Volunteers must unction within this conte?t.

2.2

&escription of .sers
2sers o this system will 4e 4oth internal an* e?ternal. Internal users are hea*=uarters an* iel* sta . E?ternal users are the a##licants> Volunteers> )eturne* Volunteers> an* healthcare #rovi*ers who may su##ly in ormation to the system. 2sers will inclu*e0

Hea%0uarters "e%ical Staff • !re'Service K collects an* assesses clinical in ormation rom

• •

• • • •

a##licants an* their #rovi*ers inclu*in( me*ical> mental> an* *ental to ma3e an a*ministrative *etermination on me*ical =uali ication an* me*ical #lacement *etermination> *e erre* me*ical clearance #rocessin(> or me*ically not =uali ie* &entist K *etermines *ental clearance or eli(i4ility to serve as Volunteers> receives ?-rays an* *ental charts rom a##licants or *ental #rovi*ers In'Service K Nurses su##ort me*ical sta in the iel* to coor*inate clinical an* a*ministrative *eterminations> mana(e me*ical evacuees in Fashin(ton> +.C. an* elsewhere an* #rovi*e su##ort to #re-*e#arture (atherin(s o (rou#s o enterin( Volunteers calle* Trainees OSS1mental health specialists K *eliver mental health services or case-s#eci ic review in &re-Service> an* or In-Service cases !ost'Service K mana(e healthcare 4ene its to )eturne* Volunteers with me*ical claims to the &eace Cor#s or the +OC. Office of !ro#ram +nalysis an% Epi%emiolo#y K con*uct ormal surveillance o clinical *ia(nosis an* relate* activities> an* *eliver various outreach initiatives on #u4lic health issues 2uality Improvement K monitor an* #u4lish on(oin( clinical re=uirements or healthcare *elivery> monitor an* *evelo# on(oin( me*ical clearance (ui*elines or me*ical an* mental health clearance> oversee =uality assurance an* im#rovement

Hea%0uarters +%ministrative Staff • /*ministrative tas3s inclu*e trainin(> contract mana(ement o
healthcare services> inter*e#artmental #ro<ects> me*ical recor*s mana(ement> customer service> #rovi*in( su##ort to clinical sta > an* accessin( recor*s

!ost "e%ical Staff • 'ana(e a stan*-alone me*ical unit re=uirin( #ractice mana(ement
• • a*ministere* 4y one or more me*ical sta Coor*inate healthcare services with In-Service sta in Fashin(ton> +.C. an* with local #rovi*ers 2sually locate* with the &ost /*ministrative 2nit an* are #art o the /*ministrative 2nit in rastructure

!ost +%ministrative Staff • Cocate* in the ca#ital city o the country where Volunteers live an*
• • wor3 Have a stan*-alone #hysical in rastructure that inclu*es telecommunication tools an* a networ3e* com#uter system Su##ort me*ical sta in the me*ical #ractice unit an* 4y

monitorin( a*ministrative activity

+pplicants • &rovi*e me*ical history> current me*ical in ormation> an* other
• me*ical clearance *ata as *etermine* to &re-Service sta Nee* to 3now0 the in*ivi*ually-re=uire* materials to su4mit as soon as #ossi4le or me*ical clearance> me*ical clearance #rocessin( status at all times> an* 4e mana(e* to meet #ro(ram *e#arture *ea*lines

Volunteers • Volunteers live an* wor3 at sites that are not locate* near the &ost
• • /*ministrative 2nits an* are not #art o the /*ministrative 2nit in rastructure /re not necessarily locate* near their me*ical sta who are usually in a ma<or or ca#ital city )e=uire communication with me*ical sta an* nee* to receive remin*ers> *irectives or other healthcare in ormation *urin( service in the iel*

$eturne% Volunteers • )e=uire e?chan(e o in ormation to su##ort health 4ene it claims
• with the &eace Cor#s or the +OC 'ay re=uire short-term> lon(-term or li elon( 4ene its

E3ternal !rovi%ers • +octors> *entists> an* counselors who are not &eace Cor#s sta
• /ny source that su##lies other me*ical in ormation> such as la4 results

2.3

Num)er of .sers
/##licants who coul* utiliAe a me*ical system #ortal or #rocessin( may ran(e 10>000 K !0>000 #er year. Volunteers in the iel* who coul* communicate an* access in ormation with me*ical sta may ran(e 8>00016>000 #er year. Our users are locate* in 75 &osts throu(hout the worl* an* at &eace Cor#s Hea*=uarters in Fashin(ton +.C.

Hea%0uarters clinical staff • 5 or more *octors
• • • • 5 nurse mana(ers 30 or more nurses 5 or more mental health counselors 1 *entist

Hea%0uarters a%ministrative staff • , a*ministrative mana(ers
• !0 or more a*ministrative sta

Fiel% )ase% clinical staff • 'ore than 130 &C'Os Fiel% )ase% a%ministrative staff • 'ore than !!5 a*ministrative> a##ro?imately 3 #er #ost +pplicants • /##ro?imately 10>000-!0>000 #er year Volunteers • /##ro?imately 8>000-16>000 #er year $!CVs • /##ro?imately !8>000 cases are currently o#en re#resentin( all
on(oin( claims since 1961> while a##ro?imately 600 are a**e* each year

2.4

System Capacity
Over 180>000 in*ivi*uals contact the &eace Cor#s each year e?#ressin( an interest in Volunteer Service. In iscal year !009> 15>386 in*ivi*uals com#lete* an a##lication to serve in the &eace Cor#s. This a##lication inclu*e* a me*ical history orm. See 'e*ical History "orm> /ttachment ,. )ecruitment #reliminarily assesse* an* then interviewe* a##ro?imately 63L $9>706% o these a##licants. "rom this (rou#> a su4set o 5!L $7>900% o the total num4er o a##licants were recommen*e* 4y recruiters or urther a##lication #rocessin(. The &re-Service 2nit con*ucts me*ical clearance on all recommen*e* recruits. O those who com#lete the me*ical clearance re=uirements0 • • • • • /##ro?imately 5L are me*ically not =uali ie*@ /##ro?imately 10L are me*ically *e erre* until a con*ition 4ecomes sta4le an* me*ical clearance resumes at a later *ate@ /##ro?imately ,5L are =uali ie* to 4e #lace* at any site in any country@ /##ro?imately 35L are =uali ie* or any site in a country that has resources which can su##ort their uni=ue me*ical history an* status@ /##ro?imately 5L are =uali ie* or an un3nown num4er o sites which may meet s#eci ic> in*ivi*ually re=uire* con*itions an*

within a country that has resources which can su##ort their uni=ue me*ical history an* status. Currently> 15-30L o all recommen*e* recruits *o not com#lete the a##lication #rocess. Some a##licants who receive a me*ical clearance *ro# out 4e ore on-4oar*in(@ an* some me*ically-cleare* a##licants are re<ecte* on the 4asis o s3ills or suita4ility issues *urin( later sta(es o on4oar*in(> currently mana(e* in the &lacement O ice. Ty#ically> our e?istin( #rocesses *emonstrate the ollowin( metrics0 • I the &eace Cor#s re=uires 1>000 Volunteers> then it must recommen* 1>800-!>000 a##licants or urther #rocessin( in or*er to me*ically clear 1>300.

The system must o#erate without re(ar* to the volume o a##licants> Volunteers> an* )eturne* Volunteers an* 4e scala4le to chan(es an* variations in the num4er o #ro(ram #artici#ants> #osts> re(ional o ices> an* me*ical #rotocols.

2.5

Current !hysical Environment 2.5.1 &omestic Operations
• Hea%0uarters Office The &eace Cor#s hea*=uarters o ice is locate* in Fashin(ton> +.C. an* coor*inates an* su##orts re(ional an* international iel* o#erations. /##ro?imately 800 em#loyees wor3 in this o ice. • $e#ional Offices There are nine )e(ional )ecruitin( O ices0 /tlanta> G/@ /rlin(ton> V/@ .oston> '/@ Chica(o> IC@ +allas> TM@ Cos /n(eles> C/@ New Nor3> NN@ San "rancisco> C/@ an* Seattle> F/ 2.5.2 International Operations &eace Cor#s &osts are s#rea* out worl*-wi*e amon(st three a*ministrative re(ions0 / rica@ E'/ $Euro#e> 'e*iterranean an* /sia% an* I/& $Inter /merica an* &aci ic.% Ty#ically> the central o ice at a &ost is locate* in the ca#ital city o each host country. Volunteers are o ten #lace* in remote> rural locations> without access to electricity. It is not unusual or them to 4e a lar(e *istance rom the central o ice> althou(h some Volunteers wor3 in towns or ur4an settin(s. &osts con*uct #ro(ram activities un*er *iverse #hysical an* technical con*itions. However> most &osts> inclu*in( their rural locations> thrive with te?tin( technolo(y which is wi*ely a*o#te* 4y Volunteers an* sta . See &ost In rastructure> /ttachment 5.

2.6

Current IT Infrastructure &evelopment Stan%ar%s
Current IT in rastructure is *e ine* in Current /rchitecture> #ara(ra#h !.7 4elow. "or &eace Cor#s system *evelo#ment stan*ar*s #lease re er to the &eace Cor#sB Systems &evelopment 4ifecycle (S&4C Han%)oo/ Version 5676 See S+CC Han*4oo3> /ttachment 6. The S+CC outlines the #olicies> stan*ar*s an* li ecycle that (overn in ormation technolo(y systems at &eace Cor#s. The S+CC re#resents the entire li ecycle o &eace Cor#sB system *evelo#ment an* is the framework that re=uires tailorin( or im#lementation. The contract will 4e ocuse* on the control #hase o the S+CC that inclu*es0 &ro<ect +e inition> System +esi(n> Construction> /cce#tance> an* O#erational )ea*iness. The control #hase may consist o multi#le iterations an* shoul* ollow either a s#iral or a(ile metho*olo(y o system *evelo#ment.

2.7

Current IT Infrastructure
Over the #ast !0-#lus years> &eace Cor#s in ormation systems an* technolo(y has incor#orate* a variety o #lat orms> system owners> an* unctions to su##ort various activities at overseas &osts an* all *omestic locations. )ecent initiatives have inclu*e* e?am#les such as the ollowin(0 a inancial system $O*yssey%> an overseas in rastructure system $GSS 3.0%> an* *ata4ases or in-service Volunteers $VI+/%. See Volunteer +elivery System 'o*els> /ttachment 7 an* Enter#rise /rchitecture Systems 'a#> /ttachment 8> which *e#ict current systems an* #lat orms. Some o these systems have 4een 4uilt in a #iecemeal ashion that re lecte* shi tin( #riorities> availa4le un*in(> an* current technolo(y. See Ta4le !. )ou(hly our eras o technolo(y can 4e i*enti ie*. Fhile the earliest #erio*> 'ain rame> ha* 4een success ully mi(rate* to other systems> &eace Cor#s maintains three se#arate #erio*s o so tware an* systems *evelo#ment. Even with the latest iterations o &eace Cor#s IT systems to su##ort the me*ical mission> the current system remains #rimarily a #a#er an* #rocess-4ase* system. /ssistiveEautomate* wor3 lows are not well im#lemente*> i at all> an* much in ormation resi*es outsi*e o any IT system in ile ol*ers an* ca4inets an* in locally *evelo#e* s#rea*sheets create* 4y in*ivi*ual o ices or &osts.

Ta)le 7
Era "ainframe 'ain rame Oracle !C+pps 2NIMEFin*ows Oracle (i8+pps 2NIMEFin*ows Oracle 6NET1+0uifer Fin*ows S;C Server Oracle

&ata Tier

+pplication Tier

Col*"usion

.NETE/=ui er

!resentation Tier Time

+um4 Terminal

Thic3 Client Oracle "orms

Fe4 "orms

Smart Client /S& .NET

2.8

Current +rchitecture
The &eace Cor#s Se(ment /rchitecture consists o ei(ht systems s#rea* amon(st three se(ment areas. The se(ments are illustrate* in Ta4le 3. • Core 'ission /rea Se(ments consist o the Volunteer +elivery an* Su##ort System $V+S%> 'e*ical Services> an* &ost Services. • The .usiness Services Se(ments consist o Human )esources> "inancial Systems an* Ins#ector General Systems. • Enter#rise Services consist o the Glo4al Networ3 an* Glo4al In rastructure which inclu*es +omestic> I/&> E'/ an* / rica. The &eace Cor#s Technical /rchitecture is #re*ominantly ma*e u# o Fintel systems. Fin*ows M& is the *es3to# o#eratin( system an* Fin*ows !000> !005 an* !008 #hysical an* virtual servers resi*e in the on-site *ata center. /**itionally> there are several H&-2M an* Cinu? systems in the on-site *ata center. &eace Cor#s maintains a *isaster recovery site outsi*e o Fashin(ton +C. +ata4ases inclu*e Oracle 10i an* 'icroso t S;C Server !000> !005 an* !008. 'any> i not all> 4usiness units an* overseas &osts maintain their own /ccess an* E?cel-4ase* *ata. "ile an* #rint services are mana(e* via Fin*ows !005 an* !008 servers. /ctive +irectory $/+% is in #lace an* a sin(le /+ structure is 4ein( im#lemente* at all overseas &osts connecte* to the &eace Cor#s (lo4al networ3. 'icroso t Share&oint is currently in the &eace Cor#s environment. /##ro?imately a thir* o all &osts $all o I/& an* a ew &osts in E'/ an* / rica% are inte(rate* into the &eace Cor#s (lo4al networ3 via V&N usin( CiscoBs Fi*e /rea /##lication Services $F//S%. The F//S #rovi*es 4oth security an* F/N acceleration. The remainin( &osts are *isconnecte* rom the &eace Cor#s (lo4al networ3 on their own un-truste* *omains. However> they are connecte* to the Internet via either local IS& an*Eor VS/T. VS/T is #re*ominantly use* in &osts in / rica. Overall> the architecture allows 4usiness-relate* communication 4y all &osts to H; via custom-4uilt a##lications. &eace Cor#s Systems have 4een *evelo#e* usin( Oracle "orms> Col*"usion> Dava> D!EE : .NET. 2sers in the 2S an* at &osts ty#ically

have multi#le lo(ins to access *i erent systems. Sin(le si(n-on has yet to 4e im#lemente*.

Ta)le 9

2.9

Office of Volunteer Support, Current Operations
The O ice o Volunteer Su##ort *elivers all me*ical as#ects o the &eace Cor#s mission inclu*in( *ental an* mental health. See 'e*ical Services IT Systems> /ttachment 9. 2.9.1 !re'Service (me%ical clearance /ll &eace Cor#s a##licants must (o throu(h a me*ical> mental health an* *ental review #rocess 4e ore 4ein( cleare* or service. The review #rocess is carrie* out 4y the &re-Service 2nit in Volunteer Su##ort. In'Service 2.9.2.1 Sta#in# Sta(in( is the irst #hysical (atherin( o acce#te* a##licants or *e#arture to an overseas #ro(ram> an* or healthcare to commence at the #ost me*ical unit. The irst *ay o Sta(in( is the irst o icial *ay o &eace Cor#s service. Oversi(ht o the health an* well-4ein( o Volunteers 4e(ins with the a##licantBs *e#arture rom home to re#ort or Sta(in(. 2.9.2.2 !ost "e%ical .nits &eace Cor#s su##orts the health o the Volunteer 4y #rovi*in( a 'e*ical 2nit at each &ost le* 4y at least one &eace Cor#s 'e*ical O icer. / &ost me*ical unit is analo(ous to a clinic> althou(h the &eace Cor#s health units vary in the services they can #rovi*e> or re er Volunteers to in their res#ective $local% me*ical communities. 'e*ical sta *uties inclu*e the ollowin(0 • &rovi*e healthcare services to Volunteers in-country • 'aintain the EH) 4y *ocumentin( relevant actions that ta3e #lace *urin( Volunteer service • /ssess local health resources to maintain a country health resource *ata4ase or the me*ical accommo*ation #lacement #rocess • &rint the scanne* me*ical recor* rom a C+ to create a #a#er me*ical recor* or each Volunteer arrivin( at &ost • 'aintain a small o ice #harmacy an* inventory system • Coor*inate care with local healthcare #rovi*ers • Communicate with Volunteers an* hea*=uarters sta

2.9.2

re(ar*in( health care issues via email> a? an* tele#hone> inclu*in( te?t messa(es an* re(ular mail Contri4ute to the monthly E#i*emiolo(ical Surveillance System 4y re#ortin( TraineeEVolunteer health *ata to the O ice o &ro(ram /nalysis an* E#i*emiolo(y 2nit. See 'onthly Surveillance SurveyETG,10 ESS )e#ort "orm> /ttachment 10.

2.9.2.3 Fiel% Support Nursin# The #rimary role o the "iel* Su##ort Nurses> 4ase* in Fashin(ton> +C> is to maintain Volunteer health 4y su##ortin( me*ical sta at &ost an* mana(in( cases o Volunteers who are me*ically evacuate* to Fashin(ton> +C or other locations. /ctivities inclu*e coor*inatin( care> visitin( an* evaluatin( 'e*ical 2nits an* Volunteer sites> consultin( in-house or with #anel s#ecialists> reviewin( me*ical recor*s> an* ormulatin( health care (ui*ance an* *is#osition. Health care nee*s that e?cee* the ca#a4ility o in-country resources result in a me*ical evacuation $me*evac% o Volunteers rom their &osts. 'e*evac acilities are locate* in the 2nite* States an* other countries. 'e*ical sta e?chan(e critical in ormation an* u#*ate the status o me*evacs via secure email an* a? systems. In-Service Nurses #rovi*e !,-hour su##ort covera(e to me*ical sta via email an* #hone. 2.9.3 !ost'Service The #rimary 4usiness o the &ost-Service 2nit $&S2% is to assist )eturne* Volunteers with &ost-Service health 4ene its *ocumentation an* #rocessin(. The sco#e o services &eace Cor#s #rovi*es is lar(ely limite* to claims 4y )eturne* Volunteers un*er the +e#artment o Ca4orBs $+OC% "e*eral Em#loyment Com#ensation /ct $"EC/% #ro(ram. This re=uires communication amon( the )eturne* Volunteer> the +OC> the &S2 an* any e?ternal contractors. See 1!7-C "orm> /ttachment 11. The &S2 relies u#on the all *ocumentation rom the &re-Service an* In-Service 2nits to #rocess claims ma*e 4y )eturne* Volunteers. The current case mana(ement system o the &S2 incor#orates *ata u#loa*s rom the +OC. See +OC +ata Elements : +OC +ata Coa* SO&> /ttachments 1! an* 1!4. "e%ical $ecor%s The 'e*ical )ecor*s 2nit mana(es all health recor*s an* releases me*ical in ormation to authoriAe* #rovi*ers an* in*ivi*uals. The core unctions o the 'e*ical )ecor*s 2nit are the creation>

2.9.4

*istri4ution> trac3in(> an* archivin( o Volunteer health recor*s. The current system or creatin( me*ical recor*s re=uires manual collation o in ormation (athere* in &re-Service> scannin( all #a#er *ocuments an* then 4urnin( com#act *iscs that contain an /##licantBs entire me*ical recor* or each country. Other res#onsi4ilities inclu*e the maintenance an* monitorin( o health recor* #olicies an* #roce*ures. This inclu*es #rovi*in( co#ies o health in ormation u#on re=uest rom /##licants> Volunteers an* )eturne* Volunteers. The &eace Cor#s retains recor*s or 1! months to !5 years as re=uire* 4y &eace Cor#s #olicies. 2.9.5 !ro#ram +nalysis an% Epi%emiolo#y ($eport : +nalysis The &ro(ram /nalysis an* E#i*emiolo(y 2nit *evelo#s> maintains> an* analyAes health surveillance systems. The core unctions o the &ro(ram /nalysis an* E#i*emiolo(y 2nit are to #rovi*e oversi(ht o health surveillance o Volunteers throu(h the E#i*emiolo(ical Surveillance System an* other health surveillance systems> con*uct stu*ies to analyAe health con*itions an* i*enti y ris3 actors or certain con*itions amon( Volunteers> an* assist in the *esi(n o #revention strate(ies. +ue to the limite* an* stove-#i#e* nature o the systems currently in use in the O ice o Volunteer Su##ort> the &ro(ram /nalysis an* E#i*emiolo(y 2nit is currently limite* in its a4ility to analyAe *ata without si(ni icant manual la4or. See /ttachment 10 or a co#y o the 'onthly Surveillance Survey> which is com#lete* manually 4y me*ical sta worl*wi*e> an* #rocesse* manually 4y the sta o the &ro(ram /nalysis an* E#i*emiolo(y 2nit. 2.9.6 !ro#ram : Trainin# The &ro(ram an* Trainin( 2nit $&T2% #rovi*es oversi(ht o hea*=uarters-s#onsore* trainin( events or the me*ical sta worl*wi*e. This unit will 4e involve* in the trainin( o the me*ical sta on the new VEHS. The &T2 manually trac3s the cre*entials o all me*ical sta alon( with their annual trainin( atten*ance. 2uality Improvement (2I The ;uality Im#rovement 2nit *evelo#s health system #olicies> monitors the e ectiveness o health care to Volunteers> an* #rovi*es in ormation an* analysis on health con*itions an* #ro(rams. The core unctions o the ;uality Im#rovement 2nit are to *evelo#> *isseminate> an* monitor me*ical #olicies an* #roce*ures.

2.9.7

2.9.8

Office of Special Services (OSS The O ice o S#ecial Services $OSS% assists &osts in the mana(ement o Volunteer 4ehavioral an* a*<ustment challen(es throu(h tele#hone an* secure email consultations. The OSS also #rovi*es in#ut into the mental health me*ical clearance o a##licants> con*ucts *irect mental health me*evac su##ort> an* consults as necessary on mental health su##ort. Health Information Systems (HIS The Health In ormation Systems 2nit #rovi*es su##ort to the e?istin( health in ormation in rastructure o the O ice o Volunteer Su##ort. The HIS (athers an* re#orts in ormation an* *ata o #rivate health insurance contracts utiliAe* 4y returne* Volunteers. The HIS also en(a(es in trac3in(> usa(e an* u#*atin( o 4usiness an* me*ical orms. It acilitates receivin( )eturne* Volunteer case mana(ement in ormation rom the +OC> an* #rovi*in( *ata in a##ro#riate ormats to healthcare service #artners.

2.9.9

3.0

Current Volunteer Support "e%ical Challen#es 3.1 Customer Service Challen#es • 'any in ormation technolo(y tools have 4een *evelo#e* in a
#iecemeal an* stove-#i#e* environment resultin( in in*e#en*ent *ata4ases that s#an many technolo(ical #lat orms. Conse=uently> customers must su##ly the same in ormation to *i erent sta units an* the *ata is not systematically share*. • • The system *oes not allow or ca#turin( an* recor*in( customer satis action ee*4ac3 that will assist with im#rovin( #rocesses. The current systems *o not allow a##licants> Volunteers or )eturne* Volunteers to monitor the me*ical in ormation re=uests ma*e to them> the res#onses to those re=uests> the ollow-u# re=uire* o them> an* the overall status o their #rocessin( with &eace Cor#s. The various systems *o not have su4stantial customer relationshi# messa(in(. Conse=uently> the volume o tele#hone calls rom customers re(ar*in( the status o their #rocessin( in any wor3 unit is very hi(h. The current &re-Service technolo(y an* 4usiness #rocesses com#licate the a##lication e?#erience an* may contri4ute to a hi(h attrition rate amon( a##licants.

3.2

Information "ana#ement Challen#es • There is no electronic system in which to house or ena4le #eer review
;/ activities.

• • • • • • • • • • •

Clinical sta must access multi#le systems to access in ormation relate* to the same me*ical recor*. The &re-Service IT system is not #ro(ramme* to automatically a##rove or hi(hli(ht irre(ular an*Eor out-o -ran(e me*ical test results su4mitte* 4y the a##licant. The &re-Service IT system *oes not automatically a##ly the me*ical clearance (ui*elines to the evaluation o a##licant me*ical in ormation. The In-Service system *oes not ai* the In-Service Nurse with #ractice mana(ement technolo(y in or*er to monitor the a*herence to re=uire* healthcare *elivery stan*ar*s. The In-Service system *oes not have tools to mana(e me*ical a##ointments an* consultation sche*ulin(. The me*ical sta in the iel* has no electronic me*ical system. The *iverse systems within the me*ical units sometimes overla# in unction> 4ut *o not inter ace to #ro*uce an EH) or inte(rate* wor3 low with share* 4usiness #rocesses. The current systems *o not have #er ormance relate* stan*ar*s or *ecision su##ort 4uilt in to assist users in clinical *ecision ma3in(. The current system *oes not allow or mental health consultations to 4e recor*e*. The current o#eration *oes not have a me*ical inventory control or cost trac3in( system or &ost or sta #er ormin( central #rocurement services at hea*=uarters. The *ata in current systems is not easily electronically availa4le or e#i*emiolo(ical use or ;I.

3.3

+%ministrative .ser Challen#es • Numerous systems increase maintenance wor3 o a*ministrative an*
• • • • IT sta . The &re-Service IT system *oes not have the a4ility to assess the com#leteness o a ile> thus re=uirin( re#eate* manual han*lin( an* I#re-screenin(J to *etermine material com#leteness. .ecause the system has no a4ility to *etermine i all the materials have 4een su4mitte*> the unit cannot #re*ict #ro*uctivity or res#on* to alternative #lans to su##ort #ro(ram inta3e (oals. In ormation rom me*ical sta is collecte* only via #a#er #rocesses> a?> an* e-mail. The sharin( o in ormation 4etween various me*ical *elivery an* su##ort units is not #ossi4le 4ecause the systems are not *irectly lin3e* an* *o not constitute a sin(le connecte*> wor3 low system with *ata ee*4ac3. 2n*er the &eace Cor#s /ct> e*eral em#loyees o the /(ency are termlimite* to ive years. The I ive-year ruleJ results in si(ni icant sta

• •

• • •

turnover an* re*uces institutional 3nowle*(e an* memory. Conse=uently> the current environment is saturate* with uni=ue le(acy systems. /s health con*itions chan(e in a##licant #o#ulations> the current system is not a4le to ca#ture those chan(es in a timely an* systematic manner to a*<ust mission *elivera4les such as0 me*ical clearance (ui*eline chan(es@ me*ical sta trainin(@ e?#ense calculations@ #lacement accommo*ations@ ;I #olicy *iscussions@ an*Eor mana(ement *ecisions. &eace Cor#s has over 75 overseas &osts interconnecte* throu(h a *istri4ute* wi*e area networ3 $F/N%@ many su er rom low4an*wi*th> hi(h-latency connections an* inconsistent electrical su##ly. The me*ical actors o #lacement eli(i4ility are not currently availa4le to recruiters *urin( the recruitment an* a##lication #hase when a##licants 4e(in to *evelo# #ro(ram e?#ectations> inclu*in( #ossi4le (eo(ra#hic #lacement. /##ro?imately ,0-50L o those who com#lete the me*ical clearance #rocess have a #lacement-relate* accommo*ation contri4utin( to a chan(e in #lacement o#tions. This contri4utes to a##licant *ro#-out an* e?#en*iture o a(ency resources *urin( the recruitment> me*ical an* #lacement #rocesses. Fithout automation tools or reasona4le customer messa(in(> the re=uirements o the current #rocess are o ten un*erestimate* 4y a##licants> who may 4e cleare* later than *esire*. The current system *oes not ca#ture 3ey #er ormance metrics. The current system *oes not trac3 or re#ort me*ical su##ly usa(e an* relate* costs.

4.0

VEHS O);ectives
&eace Cor#s re=uires an electronic system an* new 4usiness #rocesses to constitute a VEHS that inclu*es a &re-Service mo*ule. The &eace Cor#s can not interru#t the on-4oar*in( o Volunteers or the *elivery o me*ical su##ort or care. &eace Cor#s re=uires an automate* system with *ocument han*lin( a4ility> as *escri4e* throu(hout this solicitation> an* antici#ates new 4usiness #rocesses to accommo*ate COTS #ro*ucts> with minimum customiAation. &eace Cor#s re=uires sim#ler #rocesses an* in*ustry-lea*in( a##roaches such as IOHIOJ $Only Han*le It Once %> which can 4e a##lie* to the &re-Service mo*ule or &ostService case mana(ement *uties in or*er to 3now when the &eace Cor#s customer has su4mitte* all o the in ormation necessary or a*ministrative *eterminations to #rocee*. Fhen com#lete> the new system shall 4e an in*ustry-lea*in( system that creates #ositive> clear> well-communicate* #rocesses or a##licants> Volunteers> an* )eturne* Volunteers. "or e?am#le> the new &re-Service mo*ule shall i*enti y eli(i4le a##licants as early as #ossi4le 4y #rovi*in( the a##licant with a #rocess that trans#arently *elivers results without un*ue e?#ense> e?#ectations> or

investment 4y the a##licant or the /(ency. The new system shall allow &eace Cor#s to monitor me*ical sta #er ormance> an* recor* com#liance an* e?ce#tions to com#liance. It shall have an isolate* ;uality /ssurance #er ormance section to con*uct #rotecte* #eer review activities lea*in( to on(oin( ;uality Im#rovement. The uni ie* system shall collect *ata once an* use it many times without un*ue 4ur*en o re#eate* re=uests to all users. This *ata inclu*es me*ical> mental health an* *ental in ormation. 1ey #er ormance metrics or 4oth clinical *elivery an* 4usiness #rocesses will 4e unctionin( in or*er to #ro*uce mana(ement-oriente* an* in*ivi*ual-nee*s *ash4oar*s. The lin3a(e o relevant #olicies to #roce*ures shall create measura4le =uality assurance. Fhen health con*itions or #olicies chan(e> the connecte* system shall ena4le systemic a*ministration o u#*ates. The system shall ta3e into consi*eration uni=ue &eace Cor#s =ualities such as0 a current sta in( mo*el with hi(h turnover@ a wi*e variety o user technical a4ilities 4oth in clinical an* a*ministrative #ositions@ an* &eace Cor#sB (lo4al environment that inclu*es *iverse telecommunication in rastructures an* irre(ular outa(es. Irre(ular outa(es inclu*e situations where internet connections are not wor3in( 4ut #ower at the site is wor3in(> or where 4oth #ower an* internet connectivity are not wor3in(. These con*itions are usually 4rie > not lastin( lon(er than !, hours. &eace Cor#s re=uires a system that wor3s un*er all these challen(in( con*itions. The new system shall have an inventory control system. It shall also monitor an* re#ort a*ministrative #ractice mana(ement *ata. )e#orts may inclu*e> 4ut are not limite* to0 costs #er Volunteer@ costs o con*itions@ me*ical costs 4y #ost@ an* similar #arameters.

O);ectives, 1. 'aintain an Electronic Health )ecor* $EH)% that0
• • • • Ca#tures an* recor*s all relevant health> *ental an* mental health in ormation usin( a stan*ar*iAe* ormat rom the a##lication #rocess throu(h to the en* o service or close o "EC/ claims Is #o#ulate* with *ata rom an electronic health in ormation inta3e orm that will collect me*ical history an* current me*ical status )ecor*s me*ical> *ental> an* mental health in ormation rom numerous internal an* e?ternal sources which utiliAe various #a#er #rocesses an* various electronic inter aces Inclu*es voice reco(nition so tware in En(lish that accommo*ates a wi*e ran(e o international accents

2. The C+SS shall #rovi*e com#rehensive> #recon i(ure* clinical care tem#lates or utiliAation 4y me*ical sta . The C+SS com#onent shall0 • &rovi*e the O ice o Volunteer Su##ort with increase* clinical *ecision-ma3in( ca#a4ilities

• • • •

Cover all ma<or anatomical systems an* their *iseases> inclu*in( tro#ical *iseases /llow stan*ar*iAe* care throu(hout the li ecycle o the Volunteer Incor#orate &eace Cor#s me*ical treatment (ui*elines an* #rotocols &rovi*e care #lans that corres#on* to treatment (ui*elines an* #rotocols

3. &rovi*e a &re-Service mo*ule to con*uct me*ical clearance that0 • Collects all necessary me*ical> *ental> an* mental health in ormation rom a##licants • Inter aces with the EH) an* &'S as necessary or healthcare *elivery an* re#ortin( *ata • Con*ucts the me*ical clearance #rocess with a 4ranch-lo(ic> *ecisiontree =uestionin( orm that i*enti ies #otentially *is=uali yin( me*ical history early in the #rocess> me*ical history or current status that re=uires a**itional in ormation> an* current status that re=uires treatment an* su4se=uent sta4ility 4e ore me*ical clearance #rocessin( can continue • )eceives in#ut rom the Volunteer Ci ecycle 'ana(ement System> such as the #rocessin( *ea*line o an a##licant who is nee*e* or a #articular #ro(ram • 2ses im#rove* 4usiness #rocesses to ensure e icient #rocessin( $See /##en*i? /3.9% • /utomatically #rovi*es> to eli(i4le users> the current &eace Cor#s +ental E?am> Eye E?am an* &hysical E?amination orms $/ttachments 17> 18 an* 19% in accor*ance with the 'e*ical Clearance Gui*elines. See /ttachment 1 or 'e*ical Clearance Gui*eline Sam#les an* In*e?. • /utomatically #rovi*es any s#ecialist e?am re=uests in accor*ance with me*ical clearance (ui*elines • 2tiliAes a secure a##licant #ortal or users to access the mo*ule> an* or the mo*ule to *eliver secure messa(in( an* status in ormation. See Section C 5.!., o this )"&. • Stores an* maintains me*ical clearance (ui*elines that *etermine service eli(i4ility • Gui*es the &re-Service Nurse as necessary with a*ministrative *ecision su##ort • +elivers re(ular> clear> rien*ly communication to a##licants> a**ressin( in ormation re=uire* to continue the me*ical clearance #rocess • Stores an* maintains a *ata4ase o in-country me*ical resources that i*enti y which me*ical con*itions each country can accommo*ate. See Sam#le /ccommo*ation Cist> /ttachment !. • Su##orts #ro*uction o a three-#art a*ministrative *ecision0

• •

1. 'e*ically cleare* or service> inclu*in( a listin( o where the a##licant is eli(i4le to serve 2. 'e*ical clearance #rocessin( is *e erre* *ue to an active con*ition that must 4e treate* an* sta4iliAe* or a *e ine* #erio* o time 4e ore #rocessin( can continue 3. The a##licant is me*ically not =uali ie* to serve in the &eace Cor#s )e-en(ineers 4usiness #rocesses to *eliver a##licants ontime to #ro(rams )e*uces a##licant attrition 4y #rocessin( me*ical clearances more =uic3ly an* in accor*ance with tar(ete* #ro(ram *e#arture *ates

4. &rovi*e a &ractice 'ana(ement System $&'S% that0 • /ccesses me*ical an* a*ministrative in ormation *urin( initial evaluation@ *urin( service@ an* any e?ten*e* su##ort re=uire* a ter service • &rovi*es a #er ormance monitorin( system that *ocuments me*ical sta a*herence to> or variance rom> treatment #rotocols • &rovi*es ;uality /ssurance ca#a4ility re=uirin( *ocumente*> #rotecte* #eer review activities that must 4e se#arate rom the rest o the me*ical recor* • Im#lements in*ustry lea*in( ;uality Im#rovement stan*ar*s an* #ractices to ensure the health o > an* sa e healthcare *elivery to> Volunteers • Coor*inates o ice communication> sche*ulin(> an* other o ice a*ministrationEmana(ement unctions • )ecor*s #harmaceutical> (eneral su##ly> an* all inventory in each *istinct location • +ocuments usa(e #atterns such as those 4y user> (eo(ra#hic location> a iliate* use such as #atient *ia(nosis $IC+%> clinical #roce*ure $C&T%> *ental con*ition $C+T% or #atient su##ly re=uest • )ecor*s *uration o Volunteer illness • Su##orts &ost-Service case mana(ement or en*-o -service an* +OC "EC/ claims • 2ses HHS Electronic Transaction Stan*ar*s #er ,5 C") O 16! 5. Collects> trac3s> share in ormation an* (enerates re#orts on *ata or all com#onents o the VEHS. This unctionality shall #rovi*e0 • 1ey #er ormance metrics an* tools to ena4le stan*ar* an* a* hoc re#ortin( to su##ort *ata-*riven *ecisions • Enhance* communication throu(h wor3 low mana(ement within the VEHS • Enhance* communication throu(h wor3 low mana(ement outsi*e o the VEHS

6. Con orms to Service Oriente* /rchitecture $SO/% stan*ar*s. SO/ shall0 • Ena4le the e?chan(e o *ata 4etween VEHS an* other &eace Cor#s In ormation Systems throu(h the &eace Cor#s ES. • /##ear as one seamless system to e?ternal users • &rovi*e the a4ility to a** or su4tract su4systems without mo*i ication to the system 7. &rovi*es an in*ustry-lea*in(> secure system o architecture that meets an* can a*a#t to (overnment stan*ar*s an* /(ency re=uirements or in ormation mana(ement an* wor3s within &eace Cor#sB technical environment. The system shall0 • 'eet *ata trans er re=uirements o &eace Cor#s &ostsB limite* 4an*wi*th ca#acities • Scale to increases or *ecreases in #rocessin( volume without a ectin( sta in( levels • Have a common loo3> set o *ata values> 4ran*in(> access> an* #rocessin( metho*s • Contain *iscrete mo*ules to allow minimum interru#tion to the system when 4usiness #rocesses chan(e • &rovi*e sustaina4le a*ministration not a ecte* 4y the rami ications o re=uent sta turnover $the /(encyBs 5-year rule% • &rovi*e necessary security an* #rivacy #rovisions> #olicies> #roce*ures an* oversi(ht to meet e*erally-man*ate* IT securityEHI&//EHITECHEHHS re(ulationsE&rivacy /ctE&eace Cor#s #olicies or 4oth the internal an* e?ternal users. See Security )e=uirements> #ara(ra#h 5.!.5 an* Health Care )e=uirements> #ara(ra#h 5.!.6

5.0

General $e0uirements
The Contractor shall #rovi*e a we4-4ase* VEHS. The Contractor shall #rovi*e a system an* services that a**ress the .usiness "unctional an* .usiness Technical )e=uirements s#eci ie* in /##en*ices / an* ..

In summary, • The Contractor shall su4mit an im#lementation #lan *escri4in( how it will
• • meet the re=uirements s#eci ie* in this solicitation The VEHS> services> an* inter aces ac=uire* un*er this contract shall 4e *e#loye* in #hases throu(hout the #erio* o #er ormance in or*er to re*uce ris3s to the /(ency The Contractor shall *escri4e the hostin( solution 4oth internationally an* *omestically ta3in( into consi*eration &eace Cor#sB entire technical environment. The hostin( solution shall meet all re=uirements or all testin(> #ilot an* #ro*uction systems. /n e?ternal hostin( acility must meet all &eace Cor#sB #hysical an* cy4er security re=uirements or hostin(

• •

Sensitive 4ut 2nclassi ie* $S.2% *ata. See "I&S-1990 /ttachment 13 an* Section C> 5.!.50 Security )e=uirements /ccommo*ate a se#arate #hysical environment to 4e use* 4y &eace Cor#s sta or trainin( an* &eace Cor#sB own testin( an* ;uality /ssurance activities. /**itionally> the Contractor shall 4e re=uire* to #ro*uce monthly status re#orts> con*uct trainin(> con*uct assessments o #ilot system im#lementations> an* #rovi*e Hel# +es3 services on an on(oin( an* asre=uire* 4asis. See Section C> 5.!.100 Hel# +es3 Once the VEHS is im#lemente* an* enters #ro*uction mo*e> the #rovi*er will 4e re=uire* to ensure that the VEHS is continuously availa4le on a I!,E7J 4asis as *e ine* an* a(ree* to in the Service Cevel /(reements. See /##en*i? . 3.8.1

5.1

(usiness Functional $e0uirements
The system must meet the o4<ectives oun* in section 5.0 with urther ela4oration oun* in /##en*i? /> .usiness "unctional )e=uirements.

5.2

Technical $e0uirements
The system shall con orm to the technical environment as *escri4e* within this section an* the *etaile* re=uirements as s#eci ie* within /##en*i? .6

5.2.1 Service Oriente% +rchitecture (SO+ &eace Cor#sB uture IT architectural *irection will em4race the use o SO/. )e er to / !ractical Gui%e to Fe%eral Service Oriente% +rchitecture version *6* <une 9=> 7==? $htt#0EEwww.whitehouse.(ovEom4Ee-(ovE#( soa.as#?% or more *etails on the *e inition an* recommen*e* a##roach in im#lementin( a Service Oriente* /rchitecture within the e*eral (overnment. 5.2.2 !eace Corps Specific SO+ To'(e Environment The uture SO/ architectural *irection or &eace Cor#s will ma3e use o an Enter#rise Service .us $ES.%> as *e#icte* in Ta4le ,. /n ES. will ena4le communications an* in ormation sharin( 4etween ma<or a##lications. System Interfaces The ContractorBs #ro#osal must #rovi*e system inter aces that will automate *ata e?chan(es 4etween the VEHS o this solicitation> an* other &eace Cor#s systems connecte* to an Enter#rise Service .us $ES.%. /n ES. to su##ort SO/-4ase* systems is currently un*er *evelo#ment. 'icroso t .iATal3 was chosen as the ES. #lat orm. Ta4le , illustrates the ma<or systems that will 4e inte(rate* into the ES.. Those systems an* a**itional systems are

5.2.3

liste* 4elow0 • Volunteer Electronic Health System • E?istin( So tware relate* to Volunteer Ci ecycle 'ana(ement an* Su##ort $&CV+.'S an* 'E++.'S% • O*yssey $E-.usiness "inancials an* H)'SE&ayroll% • "or&ostE"orH; $&ostEH; #ortions o O*yssey% • 'icroso t O ice Share&oint Server $'OSS% • CI)S $Crime Inci*ent )e#ortin( System> use* to re#ort crimes a(ainst Volunteers to H;% • VI+/ $Volunteer In ormation +ata4ase /##lication> use* to mana(e Volunteer an* 4asic #ro(ram in ormation at &ost% • &CV)T $&eace Cor#s Volunteer )e#ortin( Tool> use* to mana(e Volunteer activities an* their im#act% • Ce(acy &eace Cor#s a##lications $Inclu*es many o the a##lications 4uilt usin( Oracle "orms an* Col*"usion to su##ort the current V+S system% /**itionally> the Contractor shall *e ine re=uirements or im#lementin( a##ro#riate inter aces to allow *ata e?chan(es or #ur#oses o eliminatin( manual #roce*ures an* or trac3in( the status o new a##licants> current volunteers an* )eturne* Volunteers.

Ta)le 5

5.2.4

!ortals &ortals #ro#ose* 4y the Contractor shall inte(rate with Volunteer Ci ecycle 'ana(ement System #ortals. /ll #ortals must su##ort sin(le si(n-on ca#a4ility.

5.2.5 Security $e0uirements The VEHS is a 'a<or /##lication $'/% in the &eace Cor#s System Inventory as 4ase* u#on the O ice o 'ana(ement an* .u*(et $O'.% Circular /- 130 /##en*i? III htt#0EEwww.whitehouse.(ovEom4EcircularsPa130Pa130a##en*i?Piii. "urthermore> 4ase* on the in ormation to 4e #rocesse*> transmitte* an* store* 4y the VEHS an* the im#act to the /(encyBs mission o a loss in the availa4ility> inte(rity or con i*entiality o the in ormation> this '/ has 4een cate(oriAe* as a hi#h im#act system #er the criteria #rovi*e* in the "e*eral In ormation &rocessin( Stan*ar*s $"I&S% 199- Standards for Security Categorization of Federal Information and Information Systems htt#0EEcsrc.nist.(ovE#u4licationsE i#sE i#s199E"I&S-&2.-199- inal.#* an* NIST 800-60> )evision 1> Guide for Mapping Types of Information and Information Systems to Security Categories htt#0EEcsrc.nist.(ovE#u4licationsEnist#u4sE800-60-rev1ES&800-60PVol1)ev1.#* an* htt#0EEcsrc.nist.(ovE#u4licationsEnist#u4sE800-60-rev1ES&800-60PVol!)ev1.#* . The analysis an* evaluation is inclu*e* in /ttachment 13> "I&S-199. The VEHS must meet current an* uture re=uirements o all relevant O ice o

'ana(ement an* .u*(et $O'.% 'emoran*a> "e*eral In ormation &rocessin( Stan*ar*s $"I&S%> an* National Institute o Stan*ar*s an* Technolo(y S#ecial &u4lications $NIST% htt#0EEcsrc.nist.(ovE#u4licationsE&u4sS&s.html> inclu*in( the re=uirements o O'. 'emoran*a> "I&S> other NIST S&s an* other note* re erences> Recommended Security Controls for Federal Information Systems un*er all security controls in*icate* as #art o the mo*erate-im#act system 4aseline. This list inclu*es 4ut is not limite* to0 § § O'. 'emoran*um '-06-16> &rotection o Sensitive In ormation> Dune !006. O'. 'emoran*um '-07-16> Sa e(uar*in( /(ainst an* )es#on*in( to the .reach o &ersonally I*enti ia4le In ormation> 'ay !007. "I&S-199 Stan*ar*s or Security Cate(oriAation o "e*eral In ormation an* In ormation Systems "I&S-!00 'inimum Security )e=uirements or "e*eral In ormation an* In ormation Systems. NIST S& 800-18> Gui*e or +evelo#in( Security &lans or "e*eral In ormation Systems@ NIST S& 800-30> )is3 'ana(ement Gui*e or In ormation Technolo(y Systems@ NIST S& 800-3,> Contin(ency &lannin( Gui*e or In ormation Technolo(y Systems@ NIST 800-37> rev 1> Gui*e or /##lyin( the )is3 'ana(ement "ramewor3 to "e*eral In ormation System@ NIST S& 800-53> )ecommen*e* Security Controls or "e*eral In ormation Systems.

§ § § § § § §

The Contractor shall com#ly with the *elivery *ates or system a##lications to 4e su4mitte* or in*e#en*ent vali*ation an* veri ication to com#lete 4oth #reliminary an* inal authoriAations to o#erate. &eace Cor#s will wor3 in con<unction with the Contractor to meet the re=uirements o #reliminary an* inal /uthoriAations to O#erate. It is &eace Cor#s res#onsi4ility to #rovi*e resources or inal a##roval authority in accor*ance with NIST 800-37. 5.2.6 Health Care $e0uirements The Contractor VEHS must meet all current an* uture re=uirements or electronic health recor*s> as re=uire* 4y the Health Insurance an* &orta4ility /ccounta4ility /ct o 1996 $HI&//% an* the Health In ormation Technolo(y or Economic an* Clinical Health $HITECH% #rovisions inclu*e* in the /merican )ecovery an* )einvestment /ct o !009 $/))/%> an*

re(ulations issue* thereun*er> to sa e(uar* 4oth #ersonally i*enti ia4le in ormation $&II% an* electronic #rotecte* health in ormation $e&HI%. /**itionally> the Contractor must ensure that all uture so tware or system u#*ates an*Eor u#(ra*es o the VEHS remain com#liant with any uture statutory or re(ulatory re=uirements. The VEHS shall allow &eace Cor#s to create electronic health recor*s that meet all the current re=uirements o HI&// an* HITECH that are 4ein( im#lemente* 4y the 2.S. +e#artment o Health an* Human Services $+HHS% Office of t e !ational Coordinator or Health In ormation Technolo(y $ONC% an* other +HHS o ices. In #articular> the Contractor shall ensure that all current an* uture relevant initial stan*ar*s> im#lementation s#eci ications> an* certi ication criteria or electronic health recor*s or am4ulatory health care services are inclu*e* in the VEHS as set out in the +HHS interim inal re(ulations. The Contractor must *eliver a certi ie* VEHS #ac3a(e 4ase* on the certi ications re=uire* in the +HHS interim inal re(ulations> or su4se=uent certi ication stan*ar*s that may 4e issue* in the uture> an* maintain certi ications or the entire #er ormance #erio* o this contract inclu*in( any o#tions that &eace Cor#s may e?ercise. See 75 "e*. )e(. !01, et se". $Dan. 13> !010%@ 75 "e*. )e(. 113!8 et se". $'ar. 10> !010%. The Contractor shall ensure that the VEHS meets all current an* uture man*atory HI&// #rivacy re=uirements inclu*in( 4ut not limite* to authoriAe* an* restricte* use an* accessi4ility to recor*s> stora(e an* #rotection o recor*s> an* #ro#er #roce*ures or the *is#osal o electronic recor*s. The Contractor shall 4e res#onsi4le or meetin( all current an* uture man*atory HI&// an* HITECH security re=uirements a##lica4le to electronic health recor*s an* electronic #rotecte* health in ormation> inclu*in( authoriAe* an* restricte* accessi4ility> an* stora(e an* #rotection o electronic health recor*s. The VEHS must meet current an* uture re=uirements o all relevant "e*eral In ormation &rocessin( Stan*ar*s $"I&S%> an* National Institute o Stan*ar*s an* Technolo(y S#ecial &u4lications $NIST% htt#0EEcsrc.nist.(ovE#u4licationsE&u4sS&s.html re=uire* un*er HI&// or HITECH or security o e&HI as *ata at rest> *ata in motion> *ata in use an* *ata *is#ose* usin( encry#tion metho*s. This list inclu*es 4ut is not limite* to0 • NIST S& 800-111> Gui*e to Stora(e Encry#tion Technolo(ies or

• • • • • "I&S 5.2.7

En* 2ser +evices "I&S 1,0-! NIST S& 800-88> Gui*elines or 'e*ia SanitiAation NIST S& 800-5!> Gui*elines or the Selection an* 2se o Trans#ort Cayer Security $TCS% K Im#lementations O) NIST S& 800-77 Gui*e to I&Sec V&Ns O) NIST S& 800-113> Gui*e to SSC V&Ns or others which are 1,0-! vali*ate*.

Hostin# Support The &eace Cor#s hea*=uarters so tware must 4e e?ternally hoste*. However> hostin( status o so tware at &ost is un*etermine* an* the contractor shall #ro#ose the 4est solution> ta3in( the ollowin( into account0 nee* or hi(h accessi4ility 4y me*ical sta @ latency@ 4an*wi*th@ #ower su##ly issues@ an* the architecture at &osts. I Contractor #ro#oses an international solution or installe* so tware at each &ost> it must 4e in a turn3ey con i(uration or installation 4y &eace Cor#s sta . The Contractor is re=uire* to #rovi*e a hostin( solution that #rovi*es ull service su##ort> inclu*in( the *evelo#ment> testin(> trainin(> #ilots> #hase* im#lementation an* #ro*uction o#eration o the Volunteer Electronic Health System ta3in( into consi*eration all o &eace Cor#s technical environment. The Contractor must #rovi*e at least one #hysical environment se#arate rom #ro*uction. The hoste* solution is re=uire* to meet the technical re=uirements as s#eci ie* in /##en*i? . an* meet Service Cevel /(reements as s#eci ie* therein.

5.2.8

Trainin# The Contractor is re=uire* to #ro#ose 4est #ractice an* user *ocumentation or the VEHS System. Trainin( shall 4e #rovi*e* at the &eace Cor#s Fashin(ton> +.C. Hea*=uarters site. Trainin( an* *ocumentation shall 4e *evelo#e* an* *elivere* or testin(> acce#tance> an* or each #ro*uction #hase. The ollowin( ty#es o trainin( are re=uire*0 • Trainin#'of'Trainers (TOT (!eace Corps in'house staff Trainin( is or overall system use an* navi(ation as well as s#eci ic su4- unctions. TOT Trainin( shall cover all levels o use. • !eace Corps System +%ministrators

Trainin( an* trainin( materials shall 4e #rovi*e* *irectly to &eace Cor#s *esi(nate* System /*ministrators. !eace Corps Technical &evelopment Staff Trainin( an* trainin( materials shall 4e #rovi*e* *irectly to &eace Cor#s technical *evelo#ment an* su##ort sta or the #ur#ose o *ata re#ortin( an* inter ace #rocessin( across the Enter#rise Service .us. On'#oin# Trainin# "o%ules Interactive trainin( mo*ules shall 4e incor#orate* into the VEHS or in*ivi*ual instruction. &eace Cor#s will use this mo*ule or sel -*irecte*> in*e#en*ent learnin(.

&eace Cor#s will #rovi*e en*-user trainin( to the me*ical sta . 5.2.9 Implementation !lan The Contractor shall #rovi*e a *etaile* im#lementation #lan in its technical #ro#osal. The Im#lementation &lan shall ta3e into consi*eration the re=uirement that the on-4oar*in( unction an* the *elivery o health care to Volunteers cannot 4e interru#te*. &eace Cor#s has i*enti ie* 'e*ical 2nits at our &osts to im#lement the #ilot or the VEHS> with the e?ce#tion o the &reService mo*ule> 4e(innin( in /u(ust !010. "ee*4ac3 rom the #ilot will contri4ute to urther *evelo#ment o the VEHS. &eace Cor#s #lans to im#lement the #ilot or the new &re-Service mo*ule 4e(innin( Octo4er 1> !010. "ee*4ac3 rom the #ilot will contri4ute to urther *evelo#ment o the VEHS. &eace Cor#s #lans ull #ro*uction o the VEHS inclu*in( the &reService mo*ule> 4e(innin( Danuary 1> !011. )e(ional rollouts o the entire VEHS will coinci*e with Sta Trainin( events to acilitate en* user trainin(0 • &eace Cor#s Hea*=uarters K a##ro?imately Danuary 15> !011 • Euro#e> 'e*iterranean> an* /sia $E'/% K a##ro?imately Danuary 15> !011 • Inter-/merica an* the &aci ic $I/&% K a##ro?imately 'arch 15> !011 • / rica K a##ro?imately 'ay 15> !011 The Contractor shall mo*i y the im#lementation #lan 4ase* on *iscoveries ma*e *urin( the Ga# /nalysis #hase. This shall 4e calle* the I"inal Im#lementation &lan.J

The Contractor shall su##ort #lannin( e orts that inclu*e> 4ut are not limite* to0 analyAin( or(aniAational nee*s@ *e inin( (oals@ o4<ectives an* metrics@ #lannin( im#lementation to *etermine which com#onents will 4e rolle* out@ i*enti yin( an* ma##in( re=uirements to system com#onents@ sche*ulin( an* assi(nin( resources or a success ul im#lementation 4ase* on or(aniAational re=uirements@ an* 4ac3u# an* *isaster recovery #lannin(. The &ro#ose* Im#lementation &lan shall a**ress> at a minimum> the areas outline* 4elow0 1. Gap +nalysis The #ro#osal shall *escri4e the contractorBs metho*olo(y an* sche*ule or *eterminin( how mission out#ut an* 4usiness #rocesses will 4e a ecte* 4y the trans ormation rom current systems to COTS #ro*ucts. 2. Confi#uration It is antici#ate* that the VEHS shall consist o one or more 4est-o -4ree* commercially availa4le #ro*ucts with limite* custom *evelo#ment. The Contractor will i*enti y an* *escri4e mission out#uts that0 • Shall 4e achieve* without con i(uration • Shall re=uire con i(uration to 4e met 3. &ata "i#ration The Contractor shall wor3 in con<unction with &eace Cor#s in the mi(ration o *ata rom e?istin( le(acy systems to the VEHS. The Contractor shall 4e res#onsi4le or the (eneration o s#eci ications an* *evelo#ment o re=uire* loa* routines. &eace Cor#s will #rovi*e *ata or mi(ration rom le(acy systems in the loa* ormat. 4. Testin# The Contractor shall con*uct testin( at various sta(es throu(hout the li e cycle o the VEHS System. The Contractor shall #rovi*e technical su##ort to assist with error *etection #rior to rollout an* to #re#are the system or the #ro*uction environment. 5. !ro%uct Support Technical Su##ort shall consist o &ro*uct Su##ort an* So tware u#*ates as s#eci ie* in /##en*i? .> Technical )e=uirements. The Contractor shall #rovi*e such technical su##ort services in accor*ance with the ContractorBs so tware technical su##ort #olicies in e ect at the time the services are #rovi*e*. +urin( the #erio* o #er ormance o this contract> the Contractor shall not materially re*uce the level o service

#rovi*e* in its technical su##ort #olicies in e ect as o the e ective *ate o the contract. The ContractorBs &ro*uct Su##ort shall inclu*e> 4ut not 4e limite* to> the ollowin(0 • !,E7 #ro4lem *ia(nosis an* resolution> as *e ine* within the Service Cevel /(reements will #rovi*e technical users with in ormation an* assistance@ • Near real-time solutions throu(h !,E7 we4 an* tele#hone access to technical e?#ertise as *e ine* within the Service Cevel /(reements@ • )ich> we4-4ase* technical resources> inclu*in( technical re#ositories@ ra#i* in ormation access@ an* the a4ility to lo( an* trac3 service@ • Contractor Su##ort Services or VEHS *evelo#ment or all system releases an* #atches@ • Solutions 4ase* on current in*ustry stan*ar*s an* 4est #ractices to ensure consistent> accurate su##ort suita4le or worl*-wi*e a##lication@ • Hi(h-=uality #ro4lem analysis an* res#onsiveness on su4mitte* service re=uests throu(h Service Cevel /(reements $SC/%@ an* • &rioritiAation o service re=uests 4ase* on #ro4lem severity 6. Software .p#ra%es Contractor so tware assistance an* #ro4lem resolution shall inclu*e> 4ut not 4e limite* to> the ollowin(0 • &ro(ram u#*ates an* u#(ra*es> inclu*in( (eneral maintenance releases an* selecte* unctionality releases • +ocumentation u#*ates • .u( in ormation an* #atches as they are ma*e availa4le • I2#(ra*eJ means a su4se=uent release o the #ro(ram that the Contractor (enerally ma3es availa4le or #ro(ram licenses to its su##orte* customers> #rovi*e* that &eace Cor#s has or*ere* so tware u#(ra*es or such #ro(ram licenses or the relevant time #erio*. 2#(ra*e *oes not inclu*e any release> o#tion> or uture #ro(ram that the Contractor licenses se#arately The Contractor shall noti y the COT) o any new u#(ra*es to enhance the system. The &eace Cor#s reserves the ri(ht to acce#t or *ecline #ro#ose* so tware u#(ra*es. There shall 4e no a**itional cost or u#(ra*es an* enhancements that are #art o the core #ro*uct or or technical su##ort to im#lement such u#(ra*es or enhancements.

5.2.10 Help &es/ Support The Contractor shall #rovi*e Hel# +es3 technical su##ort as tier-! throu(h the &eace Cor#s Hel# +es3. The &eace Cor#s Hel# +es3 will #rovi*e all *irect user su##ort $inclu*in(> 4ut not limite* to> har*ware> so tware> an* networ3% to the users as the tier-1 Hel# +es3. The Contractor will only 4e contacte* 4y the &eace Cor#s Hel# +es3 to resolve issues relatin( to the VEHS System a##lication itsel . No users will *irectly contact the Contractor an* the Contractor will not have to a**ress any issues relatin( to user access to &eace Cor#s systems. The cost or this service shall 4e inclu*e* in the #ro#osal. The Contractor shall #rovi*e su##ort on a !,E7 4asis as mutually a(ree* in Service Cevel /(reements. "or *escri#tion o the re=uirement> #lease see /##en*i? . 3.8.1. The Contractor shall #rovi*e status re#orts 4ase* on the a(ree* u#on Service Cevel /(reements

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