SeaPort-e is the Navy’s electronic platform for acquiring support services in 22 functional areas including Engineering, Financial Management, and Program Management. The Navy Systems Commands (NAVSEA, NAVAIR, SPAWAR, NAVFAC, and NAVSUP), the Office of Naval Research, Military Sealift Command, and the United States Marine Corps compete their service requirements amongst 2400+ SeaPort-e IDIQ multiple award contract holders. The SeaPort-e portal provides a standardized, efficient means of soliciting offers from amongst the diverse population of large and small businesses and their approved team members. All task orders are competitively solicited, awarded and managed using the SeaPort-e platform. Since nearly 85% of its contract–holders are small businesses,the SeaPort-e approach to acquiring services provides opportunity that fuels the Nation’s engine of job growth.
Cognitive Medical Systems, Inc. (Cognitive, Prime) was founded to help drive change in U.S. healthcare through innovative software solutions, platforms, and tools. We are a service-disabled veteran-owned small business (SDVOSB) and a small disadvantaged business (SDB) professional software services and products company. Our focus is on engineering solutions for organizations where real world experiences with healthcare standards, clinical workflow, decision support, and / or legacy system integration are needed for success. Cognitive provides a broad range of services and capabilities, including mobile applications development, consulting, program management, software development, database design, eHR / eMR systems analysis (e.g., VA VistA, IHS RPMS, DoD AHLTA), data modeling, metric reporting, standards development and business process reengineering. We specialize in standards-based, advanced concept software solutions for healthcare organizations. Our domain and field experience in designing, implementing, and integrating medical service oriented architectures for the Veterans Administration (VA), Department of Defense (DoD), and Health and Human Services (HHS) enables us to develop cost-effective, customized solutions to complex problems. We have extensive experience in healthcare interoperability and standards, particularly with healthcare semantics and the emerging Nationwide Health Information Network (NHIN), an initiative for the exchange of healthcare information under the Office of the National Coordinator (ONC) for Health Information Technology within HHS.
QSSI (dba Optum and a division of United Healthcare Group, Subcontractor) is a leading provider of health services, offering capabilities, products, and solutions touching every dimension of the health care system. With $72 billion in annual revenue, they bring the largest portfolio of products and services in the industry, enabling them to serve over 40 payers, providers, and consumers while driving improvements for the broader marketplace. They are a CMMI Maturity Level 3 rated healthcare information technology (IT) and services company, with primary competencies in software engineering with full system development lifecycle (SDLC), systems integration, cloud application engineering, data management, health IT analytics, software quality assurance, managed business services including business process outsourcing (BPO), security, and privacy services. Today they work with 17 Federal agencies and government offices across 36 states and the District of Columbia. They have hundreds of offices located globally.
Last 3 Years’ Services Experiences for All Team Members:
The Cognitive team has the capacity and experience to support and provide services in all seven (7) geographic regions (Zones) and in eighteen (18) functional areas.
Cognitive developed a flexible technology solution for point-of-care at the bedside that can be applied across multiple facilities to allow real-time data entry and decision making by healthcare providers. The core functionality of the system is Cognitive Medical Systems’ Decision Support Framework (DSF) that is delivered to neonatal caregivers via a series of applications on handheld wireless devices (Apple iOS or Google Android). The technology analyzes the data collected at the point-of-care to determine care recommendations, alerts and notifications as appropriate for a particular patient. For example, DSF will determine who should be notified, how they should be notified and when escalation to an alternative recipient is necessary. The mobile application was successfully piloted in 2014 with the nurses at the University of North Carolina. The pilot included entering of neonatal patient data, transmission to the cloud infrastructure and generation of real-time alerts. Integration of the data with UNC legacy data was also demonstrated. The pilot included delivery and configuration of 10 Apple iPad devices to the PQCNC for use during the training and has completed phase 1 of the project. Phase 2 of the project has been initiated with the rollout of the product to UNC Rex and transitioning the product to 50 Google Nexus Android devices. Cognitive continues to provide support and maintenance during the ongoing phases and anticipates rolling this solution out to the other 185+ neonatal facilities in 2016.
Cognitive helped establish VA mobile computing environment by developing and deploying an open source, scalable, standards based, framework for mobile healthcare computing and multitasking linking VistA and secure Apple devices. We assisted in establishing the programmatic, technical, and security foundation for the use and growth of mobile devices in VA. Included in the project was the development of the integration solution between VistA and the iPad / iPhone for demographics, laboratory data, medications, allergies, problem lists and appointments. Additionally, we developed a function that integrates the VistA clinical schedules and the provider’s administrative Outlook calendar. This project did not simply replicate VistA on a laptop but it provides the engineering and software development work to present the information in a new and relevant way using modern high-resolution graphics on iPhones and iPads. Cognitive supported the iHealth data architecture and its implementation. We were responsible for clinical data extraction from VistA using OVID, a RPC resource-messaging interface, including clinical schedules as standard iCAL objects consumable in iCal clients. We supported iPhone / iPad development for a patient’s clinical summary viewer and lab / medication graphing. We supported the program pilot at VA Medical Center in Washington DC to demonstrate iHealth. Cognitive was able to demonstrate the successful development and deployment of secure mobile applications within VA while maintaining VA’s high standards for security. We also demonstrated the use of open source, standards based framework for integration of VistA with demographics, laboratory data, medications, allergies, problem lists and appointments.
QSSI uses the simulation tools LoadRunner and SourceForge to generate loads on a mission critical system that would mirror what a production environment is expected to support. Extensive traffic modeling is done to make sure they capture the use cases that the system is expected to encounter in production. 3rd party as well as custom tools are then used to sift through volumes of performance data and generate graphical displays of system performance. Their current stress testing efforts were focused on loads that simulate up to one million users.
QSSI builds, fabricates, tests, evaluates, operating scale models, mock-ups, prototypes, pre-production units, and research and development (R&D) test tools of electronic and electro-mechanical systems and system elements.
Cognitive developed a transition analysis plan (TAP) document to define a rational plan, financial profile, and schedule that addresses transition of existing electronic healthcare records (HER) and related military healthcare systems (MHS) programs / projects / initiatives. We recommend an optimized sequencing and timeline based on financial, technical, and functional considerations including legacy code business rules identification and potential for reuse in the new architecture. Utilize previous studies from the 2003 and 2004 composite health care system (CHCS) legacy analysis to complete documentation, analysis, and recommendations for approach to the Government to overtake key transactional files. We evaluated and produced an opportunities analysis document with associated costs / return on investment that enterprise service bus (ESB) architecture provides for semantic interoperability and terminology management. Cognitive proved the concept of applying AHLTA structured data set in a local clinical data repository. We conducted a technical feasibility analysis with a working prototype to provide a recommendation to the Government identifying projected costs and potential ROI of moving select AHLTA / computerized patient record system (CPRS) client functionality onto MHS / VA selected ESB. We further proved the ability to aggregate distributed corporate data at the point of care (inpatient and outpatient) and or preserve enterprise reporting. Cognitive provided the Government with a tested approach to the use of open source code to develop and integrate with new or established ESBs to enable the department to migrate from legacy system dependence to a service oriented architecture (SOA) approach that will allow the acquisition and integration of COTS software. We provided the SOA service repository and service registry of the system. We catalogued and reported all known and supported CHCS internal and external interfaces using the existing Defense Health Information Management System (DHIMS) provided. Cognitive developed and reported a detailed workflow analysis for selected pilot programs.
Cognitive consolidated Veteran health records into a single view, consolidating data from multiple systems (include VLER, other instances of VistA and DoD records) to allow a healthcare provider, or Veteran, to view their complete patient record providing a holistic view of patient care and history. This project consisted of two elements:
- Clinical Decision Support (CDS) Service: Cognitive built CDS into VistA and the clinical Web application with computerized patient record systems (CPRS) functionality, known as the Enterprise Health Management Platform (eHMP). We adapted and modified the OpenCDS open source product to work within eHMP and incorporate robust population health management features, leveraging the vast data repository VA has developed over nearly three decades. Cognitive developed clinical applications that are Clinical Context Object Workgroup (CCOW) compliant for backwards interoperability with other existing or future applications that depend on CCOW connections with CPRS. We created a loosely coupled bi-directional access layer for use of this application such that additional future applications can reuse. We supported the definition and management of clinical criteria or quality measures resulting in a particular clinical intervention or recommendation. Cognitive supported the definition and management of a rules-based set of clinical interventions and recommendations that result from the presence of clinical criteria or quality measures for any patient. We supported the definition and maintenance of patient cohorts or panels. We established criteria which detects whether patients, either individually or based on a specific cohort / panel, meet a clinical criteria or quality measure, and whether an intervention or recommendation is warranted. We supported auditing and tracking of the use of rules, clinical criteria, quality measures, interventions and recommendations.
Cognitive managed the project using Agile development methodology, and to maximize collaboration with VA. We prioritized work, facilitated data gathering, served as a subject matter expert and ensured the project met time and functional objectives. Cognitive’s work enabled VA to receive certification from Office of the National Coordinator for Health Information Technology (ONC) and demonstrate the software meets all requirements to add, edit and remove problems within a Veteran’s patient record. The quality and accuracy of Veteran health data enables VA providers to protect patient safety and save system dollars by leveraging previously delivered patient care (i.e., avoiding duplicate tests).
QSSI provides services for requirements, design, development, enhancement and maintenance for multiple system interfaces. They provide application systems design, development, documentation, testing, and implementation for the successful migration of the client / server applications to a secure, role-based web system. QSSI has provided software migration support for conversion of the systems to a new hardware platform as well as transitioning the current production data center to a new physical location and setting up a new continuity of operations planning (COOP) site.
QSSI ensures data is not exposed to unnecessary risk by unauthorized software modifications and that only authorized modifications are implemented. System administrators, trainers, and testers are held accountable through enforcement of SEI-CMMI Level 3 procedures: change management, governance, project management, and process development and procedures.
QSSI develops a quality assurance strategy to provide assurance and evidence that the required product or service quality is achieved and that the CMMI Level 3 quality management system has been implemented correctly within every project. They perform a gap analysis to assess state of the current processes and developed a quality assurance plan that detailed clear standards, metrics and a surveillance plan. They identify quality areas associated with accuracy and consistency of work and define metrics to measure our compliance with these areas over the life of the project. QSSI established quality activities and metrics to track progress. They monitor all problem reports and validates all defects are tracked to closure.
Cognitive provide specialized IT expertise to redesign, develop and deploy the public facing internet site as well as a new intranet site accessible only to Naval Health Research Center (NHRC) staff. Engineering and design support included all planning, execution, implementation, and training for a new public-facing Internet site for NHRC, as well as advising NHRC on enterprise integration and development of administrative tools to help manage the content and functionality within the site. Intranet redesign focused on planning and design work as well as configuring and implementing intranet pages approved by NHRC. Provided Agile software design and development support prioritizing development work at the beginning of each phase in cooperation with the NHRC. Provided a product demonstration at the end of each phase as well as regularly scheduled progress reports.
Cognitive created a secure technology laboratory to enable Department of Veterans Affairs (VA) to test new tools and technologies in an autonomous environment that replicates, but is not tied to, the production environments. Built and configured a realistic lab environment that mimics existing VA systems which allows them to deploy and demonstrate how best-of-breed new technologies and solutions can better the provision of patient care across the VA healthcare system. We analyzed and configured the Amazon Web Service (AWS) Elastic Computing Cloud (EC2) evaluation lab environment. Cognitive created a portal that consolidated and normalized patient data and information into a readable format and created an inbox, alerts and messages that directly impact patient care. We exposed the interconnected data sources, data marshaling tools, CDS authoring and execution environments and interfaces. We supported the development of three service oriented architecture (SOA) service specifications through the HL7 object management group (OMG) standardization processes and approved as draft standards for trial use (DSTU). Cognitive developed the open-source reference implementation of the three service interface specifications (unified communication, order processing and event publication and subscription) that can be used by VA and third parties to integrate the draft services in any SOA-based system. We integrated the three SOA services reference implementations in the open source electronic health record agent (OSEHRA) VistA / CPRS application hosted within the CDS evaluation lab. We verified and validated CDS user interface (UI) design guidelines by using the guidelines to develop five (5) CDS UI interventions complete with formative and summative usability testing for meaningful use stage II.
QSSI is well versed in applying the business, financial management, and technical disciplines required to support planning, organizing, staffing, controlling, and lead team efforts in managing acquisition programs. Specifically, QSSI supports SPAWAR by providing business and financial services for its Daytona operations.
QSSI provides clerical and administrative support required for seamless operations of offices and support functions, to include support of personal property management functions. Specifically, they provide functional and administrative support for various clients to include: The Executive Office of the President and US Department of State. QSSI personnel are responsible to general office functions: mail room operations, receptionists, financial administration, and executive administrative support.
Point(s) of Contact to provide information on customer satisfaction with the services performed:
Description of the Contractor’s quality assurance program:
Our quality monitoring functions assess overall contract performance, the performance of individual employees, and compliance with documented processes, procedures, and standards. We use evidence-based quality metrics to provide insight into our operational effectiveness and delivery of requirements. These same metrics are used to ensure we continually meet performance objectives to maintain our trusted partnership with clients. For every project, the quality manager (QM) develops an audit plan with consideration to risk and past performance of the processes. In advance of each assessment, the QM reviews the scope of work, processes and procedures, applicable performance standards, and previous assessment reports. During the assessment, the QM interviews and observes employees at all levels of operations and then gathers evidence of compliance and non-conformity. When gaps in compliance or performance are identified, corrective action requests (CARs) are formally documented and assigned to the process owner to eliminate detected non-conformities and their causes. The quality department will track each issue until closed. Following each assessment, the QM meets with the program manager (PM) to provide an overview of the assessment, deficiencies, observed best practices, and improvement opportunities. The PM then receives standardized electronic reports detailing the same information within 5 days of the assessment. The executive management team (EMT) reviews the results of the quality assessments monthly. The results of quality monitoring are used to improve system processes and control tools such as policies, procedures and work instructions, inform and enhance training activities, and to coach employees on how to improve individual performance.
The QM is responsible for development, implementation, and oversight of the QAS. To maintain the independence and integrity of the QAS, the QM reports directly to the chief operations officer (COO), but is responsible to the PM for measuring and reporting quality. The QM ensures quality plans are effectively implemented and that all employees and subcontractors are adequately trained to support those plans. The QM conducts quality assurance inspections, participate in risk identification and mitigation discussions, identify quality deficiencies, report audit findings, recommend corrective actions, and ensure corrective actions have been implemented and are effective. A team of two quality specialists supports the QM.
Each subcontractor’s management team is contractually responsible for their company’s performance as part of our QAS. At contract kickoff, we confirm subcontract requirements; establish budgets, performance metrics, and deliverables. We contractually require all subcontractors adopt and incorporate, as a minimum, the same strict quality, safety, and operating procedures that Cognitive has established. The QM monitors performance on all projects by reviewing weekly reports and conducting scheduled and unscheduled audits. When subcontractor performance issues are identified, the QM works with the subcontractor to determine a corrective action plan, implementation of that plan, and subsequent monitoring of performance to ensure the corrective action was effective. Because we are careful in our team selection process, it has never been necessary to replace a subcontractor. But should it be necessary, we have a process ready for implementation.
The corrective action process can initiated through a variety of sources, including internal oversight of compliance with contract requirements and performance standards, business owner referrals, internal quality assessments, third party audits, and customer feedback. Corrective actions are initiated to prevent the recurrence of a problem after it has impacted a process or service. The formal corrective action process utilizes the same progressive approach to root cause identification and action planning as our preventive action process. Once a corrective action plan is in place, we monitor, track, and complete actions that eliminate or control the root cause of the problem. Each corrective action is verified twice after all tasks are complete to ensure it addresses the cause of the problem and to assure its long-term success. The status of corrective actions is reported in monthly management review activities, allowing senior management to track significant operational and compliance issues through to resolution.
Our intensive focus on performance metrics and other process feedback data enables proactive identification of potential issues to avoid problems. Preventive actions are initiated to prevent the occurrence of a problem before it affects a process or service. The formal preventive action process takes a progressive approach to potential problem root-cause identification and action planning, resulting in effective measures to avoid problems before it impacts operations and / or customers. The status of preventive actions is reported to the EMT weekly until the potential problem is appropriately resolved.
We ensure our services meet contractual requirements and customer expectations through: leadership, accountability for performance, and oversight by an independent quality department. We have supportive systems and data that enable measurement, monitoring, and reporting of performance of multiple, concurrent programs. We have defined processes for the development, calculation, production, and quality review of deliverables and reports. The EMT, including representatives from each subcontractor, will conduct monthly management meetings to ensure business processes defined in every quality plan are meeting or exceeding customer requirements and expectations. These meetings are data driven to enable fact-based assessment and decisions. The PM and QM produce performance, quality, and project analytics to support these reviews using analytic tools and programs. Besides performance standards, other topics discussed include: quality monitoring results, customer satisfaction results, productivity reviews, and process reviews.
Points of contact for information related to the SeaPort program:
Chief Operations Officer