1000 N. Lakeshore Drive Chicago, IL 60606 Oct.

30, 2011 To Whom It May Concern: Your organization has been selected to participate in a Request for Proposal (RFP) process for a Document Management System (DMS) for the University Medical Group (UMG). Attached you will find: A Letter of Intent to Respond to this RFP, which must be completed by your organization and received via e-mail by UMG no later than Nov. 8, 2011. A detailed RFP describing the requirements for the DMS, including questions and schedules to be completed by potential vendors. As you will see in Section 2.2, the timeline for vendor selection and enterprise-wide implementation of a DMS solution across all UMG locations is an aggressive one, with vendor selection to be complete by March 1, 2012, and full implementation complete by Dec. 31, 2012. Please keep this in mind when considering the Letter of Intent to Respond. All questions related to this RFP/RFP process should be directed to Charles Kesinger, UMGs Project Manager for the DMS Project: Charles Kesinger 1000 N. Lakeshore Drive Chicago, IL 60606 ckesinger@umg.com 312-555-1212 office 312-555-1313 cell 312-555-1414 fax We look forward to your participation in this process. Sincerely,

Matt Reid
Matt Reid Chief Information Officer University Medical Group

Letter of Intent to RespondDue Nov. 8, 2011

This letter shall act as confirmation that (Name of Organization) will participate in the University Medical Groups (UMGs) Request for Proposal process for a Document Management System (DMS). Furthermore we understand and accept UMGs evaluation process and timeline for vendor selection and system implementation. The key contact for (Name of Organization) for the purposes of this RFP is: (name) (address) (phone number) (mobile number) (fax number) (email) Sincerely,

(name and title)

Request For Proposal

For

A Document Management System for

Table of Contents

1.0 Introduction.............................................................................................................................5 1.1 Project Title........................................................................................................................5

1.2 Background............................................................................................................................5 1.3 Objectives..............................................................................................................................7 1.4 Reference to other applicable documents..............................................................................8 2.0 Staffing Roles and Responsibilities.......................................................................................9 2.1 Staffing..................................................................................................................................9 2.2 Roles and Responsibilities Matrix.......................................................................................10 3.0 Key Assumptions..................................................................................................................16 4.0 Risks.......................................................................................................................................20 5.0 Scope of Work.......................................................................................................................21 5.1 Inclusions.............................................................................................................................22 5.2 Exclusions............................................................................................................................23 5.3 Deliverables.........................................................................................................................23 5.4 Milestones............................................................................................................................24 6.0 Work Approach....................................................................................................................24 7.0 Completion Criteria and Final Acceptance........................................................................26 7.1 Completion Criteria.............................................................................................................26 7.2 Final Acceptance.................................................................................................................27 8.0 Schedule.................................................................................................................................27 9.0 Project Management............................................................................................................27 9.1 Enterprise PMO...................................................................................................................27

9.2 Project Status Reports..........................................................................................................28 10.0 Relevant Organizational Policies, Standards, Supported Software & Environment...29 11.0 Timeline and Period of Performance................................................................................31 12.0 Compensation and Payment Schedule..............................................................................31 13.0 Miscellaneous......................................................................................................................33 14.0 Appendices............................................................................................................................34

Statement of Work 1.0 Confidentiality This Request for Proposal (RFP) and all information contained within are the property of the University Medical Group (UMG). Responses to this RFP are the sole property of UMG. UMG has the right to use any or all information represented in responses unless the vendor designates the information as proprietary. Each response containing proprietary information must be clearly labeled PROPRIETARY. UMG will not release information identified as proprietary except as required by law. UMG will provide contractor a Mutual Non-Disclosure Agreement upon request.

Recipients agree to direct all communications regarding the RFP to UMGs Document Management System Project Manager, Charles Kesinger. No other UMG employees are to be contacted regarding this RFP without prior approval. Failure to comply with this and any other guidelines in the RFP may disqualify the contractor from the process. (HIMSS, 2011) 2.0 Introduction and Overview 2.1 Project Title This RFP is for a Document Management System, also referred to as the DMS, DM system or the Project, for the University Medical Group (UMG).

2.2 Background UMG is a physicians practice comprised of 150 physicians across 20 specialties. UMG physicians are on the staff of University Medical Hospital, serving patients across the greater Chicago area. Specifically, UMG maintains: One main facility (located on the campus of University Hospital), housing 80 physicians, including 68 specialists and 12 primary care physicians (PCPs). Ten other office locations across the Chicago area, each of which houses between five and eight physicians. There are 50 PCPs located across these clinics as well as 20 specialists. An offsite paper records storage facility managed by a 3rd party, Iron Mountain, for all paper records five years old. Iron Mountain provider shreds all records 10 years old.

At UMG our Mission is to deliver the highest quality of care to the communities in which we operate. We seek to improve both patient outcomes and patient satisfaction in a cost effective manner, and leverage our relationship with University Hospital to bring the latest advances in medical research to the patients we serve.

In 2010, UMG implemented Epic, an electronic medical records (EMR) system, and has successfully deployed computerized physicians order entry (CPOE), clinical documentation, and clinical decision support modules. Any system proposed to UMG must be compatible with and integrate into the currently installed Epic environment.

While successful in the implementation of its EMR system, UMG is still challenged with the ongoing presence of paper documents in its workflow. Since the implementation of the Epic system in 2010, standard practice has been to capture all patient information using the clinical

documentation features of the system. However, historical paper charts are still kept in each facility. Physicians perpetuate the paper form factor when they request that information from the EMR be printed out; they then update that information on paper to be included in the chart.

As a result of this dual workflow, UMG has not realized the full benefits from its investment in an EMR, and must also maintain a large medical records department (both in terms of personnel and space) in several locations. Added to this cost is the contract in place (expiring at end of 2012) with Iron Mountain to store/shred records five years old in accordance with Illinois guidelines and UMGs policies. UMG staff is often required to travel back and forth to retrieve documents from Iron Mountains facility, located one hour from downtown Chicago.

UMG is seeking to eliminate the paper chart and reduce related costs through the electronic capture, storage, and viewing of longitudinal patient data in the EMR system. The ideal system will also integrate and coordinate overall records retention schedules (both paper and electronic, onsite and offsite), and provide document status (e.g. offsite, being scanned, in record). Timeframe for start of enterprise-wide deployment of a document management system is July 2012, with completion of roll-out and transition to new workflows/systems complete by December 2012.

The UMG Document Management Project Team reports to a Project Steering Committee comprised of UMGs CEO, CFO, CIO, CMIO, and COO. The Project Management Team is responsible for the RFP process as well as enterprise-wide project implementation. The structure of UMG Project Team is below:

The timeline for evaluation, selection, and final contract negotiation with the selected contractor is as follows: Action RFP document sent to contractors Contractor to provide Letter of Intent (LOI) to respond to RFP (see Appendix A for LOI template) Questions regarding RFP due back to UMG DMS Project Manager Conference call with all contractors to answer all questions submitted. RFP response deadline. Contractor presentations, including system demonstrations and site visits. Complete reference checks. Vendor selection, contract negotiations. 2.3 Objectives The key objective of the Project is to establish a common digital repository comprised of all patient data that will be shared, accessed, and updated across all UMG locations. This requires not only that historical paper-based documents be digitized, tagged, and included in individual patient records, but that a system and set of processes be put into place to enable on-going, real time capture of information during patient visits. Other objectives of the Project include: Improving patient care through enabling clinicians real time access to a patients longitudinal record during the patient visit. The EMR will contain adequate historical data for the clinicians to provide safe care for their patients, and patients will be satisfied that their physician has appropriate information in the EMR for their care. Leveraging the investment already made in our existing EMR to include the full patient record, including paper input provided from third party providers (e.g. lab results, physicians outside the UMG practice). Any proposed system or process must be fully compatible and integrated with the current Epic EMR system. Date 11/1/11 11/8/11 11/14/11 11/15/11 12/5/11 1/6/12 thru 2/1/12 1/6/12 thru 2/1/12 2/1/12 thru 3/1/12

Facilitating physician acceptance of a fully electronic environment through improvement of physician workflows/schedules. This should in turn increase the practice capacity for seeing additional patients.

Decreasing patient wait times and increasing patient satisfaction due to elimination of patient interview forms each time a visit is made.

Complying with Meaningful Use guidelines in order to be eligible for Federal and State subsidies for EMR implementation, as well as to continue to be eligible for full reimbursement rates for Medicare/Medicaid patients post-2014 (deadline for implementing an EMR system).

Reducing the amount of space being consumed by paper chart storage in each facility, which in turn should enable consolidation of physician practice offices.

Reducing the number of clerical staff currently focused on managing paper charts. Reducing and ultimately eliminating the cost for Iron Mountain, as well as eliminate time/delays spent/incurred by UMG staff retrieving records from that facility.

Better compliance with the State of Illinois record retention policies.

3.0 Key Assumptions UMG has an overall patient population of 332,800. Of that number, 280,000 are served by the primary care practices, and the balance of 52,800 patients are served by UMGs specialty practices. Within the total patient population: 50% of are current, meaning they have visited a UMG clinic > 1x in each of the past two years. 30% are active patients, meaning they have visited a UHG practice 1x/year over the past two years. 20% are inactive, meaning that they have not been to a UMG clinic in >2 years.

UMG requires that the paper records be digitized and tagged with specific metadata in a phased approach. Resultant image files must be attached to and travel along with the electronic patient record enabling a clinician to open and view those files at anytime within the existing Epic EMR interface. OCR scanning and population of all fields of the record within the EMR is not required. Prioritization for record digitization is as follows: Current patients who have visited a UMG clinic > 1x in each of the past two years. Active patients who visit a UMG clinic at least 1x/year over the past two years. New patients providing documents from other providers. Physician to approve and initial which documents within the supplied paper chart needs to be digitized. On an as-needed basis (one week turnaround time) for inactive patients who have not been to a UMG clinic in the past 2 years, but have an upcoming appointment. Inactive patient records will otherwise not be digitized. Each paper chart is comprised of an average of 10 pages/document. Documents include patient medication/allergy records and problem lists, immunization records, last available radiology reports, laboratory, and cardiac diagnostic test reports, hospital discharge summaries, annual physical exam progress notes and consultation reports. The paper charts all have a patient summary sheet. Based on all above, the following chart provides an estimate of required volume of paper to be scanned: Current Patient Documents 1,664,000 Active Patient Documents 998,400 Inactive Patient Documents 665,600

UMG will maintain a small scanning operation in a centralized location to accommodate any on-going digitization requirements for new information. Physicians will be required to initial any paper documents provided to them by new patients prior to being scanned at the central location.

With respect to document scanning: If providing document scanning services, either on- or offsite, contractor (as a covered entity) certifies that processes and procedures are in place to protect personal health information (PHI) based on HIPAA requirements. Contractor indemnifies UMG from any liability that results from a breach related to PHI. All document handling/scanning work will be done in the United States. Some document scanning capabilities will be required in all clinics initially, with volumes decreasing until only new patient-supplied documents will need to be scanned at individual sites. The project team will provide contractor samples of documents that are representative of the quality of the input. Contractor will provide scans at various resolutions, and project team and CMIO will approve standard resolution requirement. As the largest provider of physician services to University Hospital, UMG has arranged with University administration to have a scanner in the hospital HIM department set up for scanning of hospital discharge summaries and other appropriate documents for upload into the UMG EMR. Once scanned, documents will be stored at UMGs 3rd party storage facility, and shredded in accordance with mandated guidelines.

IT Infrastructure requirements and network diagram can be found in Section 5.0 and Appendix C.

Billing and coding departments may be required to deploy the new document management system if needed.

Contractor will be responsible for training all staff members at UMG in the processes for scanning, storing, and retrieving documents from the Document Management System.

Contractor will be paid based on acceptance criteria for each project deliverable. UMG reserves the right to stop/start/discontinue the project based on contractor performance against deliverables/schedule as detailed in Section XXX.

4.0 Scope of Work The contractor will deliver a document management system that will act as a shared repository for patient information across the UMG enterprise. The system must be compatible and integrated into the current Epic EMR system. In addition to the system, the contractor should propose a process for digitizing the documents identified by UMG at each location, as well as a process for on-going ingestion of paper-based documents. 4.1 Inclusions Tasks Process map of the current as is workflow for paper documents in each location, including number of FTEs required to maintain paper charts. Estimate of cost (both staff and space) for existing workflow Confirm volume of paper to be digitized, by # of pages. Estimate of space available after elimination of paper chart storage Options for digitizing current records either on-site or off-site, including recommendations for prioritization. Options for ingestion of documents on an on-going basis, either on-site or off-site. Recommended new workflow, including an estimate of potential staff reductions in each location. Cost to digitize paper charts, per page, in on-site or off-site scenario. Timing for digitizing records based on prioritization levels in Section 3. Recommended scanning resolution for document digitization. Estimates on productivity in terms of increasing number of patients seen, decreasing patient wait time with fully digitized records. Cost of system, both one-time and recurring charges, including reps/warranties, maintenance charges. Training plan for staff. Transition plan for document management/shredding activities currently being provided by Iron Mountain. Coordination of workflow/best practices with University Hospital Resources Contractor UMG Contractor UMG Contractor Contractor Contractor Contractor Contractor UMG Contractor Contractor Contractor Contractor UMG Contractor Contractor Contractor UMG Iron Mountain Contractor

for document scanning and upload. Project Status Updates Project Management

UMG University Hospital UMG Contractor Contractor UMG

4.2 Exclusions This project is strictly limited to document management, and does not include replacement of any of the functionality that currently exists in the Epic EMR system (ex: CPOE, ePrescribe, etc). Document storage, either prior to or post- scanning, is not a contractor responsibility.

5.0 Key Deliverables and Schedule Contractor will be held accountable to the following tasks and schedule. Tasks that are shaded represent project gates. The UMG Steering Committee reserves the right to stop or cancel the project if key deliverables, dates, or assumptions change. Key Tasks Analysis of current workflow, and proposal for future workflow. Includes validation of UMG assumptions regarding: document volume current space requirements staffing potential productivity (capacity) or cost benefits Review by Steering Committee for go/no go decision Document conversion complete for 50% of Current patients System development, integration complete. Document conversion complete for 50% of Current patients, and 100% of Active patients Pilot implementation in one site Review of pilot site results by Steering Committee; go/no go decision based on results. Phased enterprise-wide roll-out of system complete System testing and acceptance complete. Review of key project metrics, including but not limited to: cost savings productivity (capacity) gains user satisfaction/acceptance patient satisfaction Date 3/15/12

3/16/12 5/1/12 5/1/12 6/1/12 6/1/12 7/1/12 12/31/12 12/31/12 1/30/13

6.0 Functional Requirements for the DMS System will allow single point of information for clinicians to view imaged information as well as electronic documentation within the EMR system. Vendor must demonstrate capability for historical paper documents to be digitized, tagged, and included in individual patient records. Integration with EMR will be transparent to users with a transparent user interface. Users will not be required to switch between systems nor will they need separate training or user access. Single sign-on capability to the EMR will allow access to scanned images. Synchronization with EMR will be real-time. Document management system will have automatic indexing capability to decrease labor cost and safety risk of manual entry -indicating ability to natively inherit context from EMR. The EDM will function with all components of the Epic EMR system including billing, enterprise registration, inpatient and ambulatory patient access, and provider access software. EDM will allow electronic import of paper EOBs via 835 processing and index with Epic billing software. Document management system will have the capability to allow scanning of facility records, blueprints, and relevant CAD drawings to allow facilities management team the ability to reduce paper. System will allow intake of multiple document types and sources to maintain complete record for longitudinal care of medical home patients. EDM will allow integrated release of information with Epic EMR system. System is capable of batch scanning as well as integrated scanning capabilities.

System or process must be fully compatible and integrated with the current Epic EMR system and will utilize true API level integration versus screen scraping.

The system will meet federal regulatory guidelines including HIPAA standards for privacy and security as well as certification standards to meet Meaningful Use criteria.

The privacy protection must include document encryption/decryption. Documents transported off-site for storage or destruction must be maintained in HIPAA compliant manner.

Vendor must be able to provide suggested best-practice processes to put into place to enable on-going, real time capture of information during patient visits when paper forms or documents are presented.

Functionality must be demonstrated through onsite vendor proof of concept presentations utilizing comparable network and server technology.

Functionality will be tested for a minimum of 30 users during a 10-day pilot before transitioning to full implementation.

7.0 Technical Requirements 7.1 UMG IT infrastructure: All locations have 10/100/1000 network capabilities. There will be a minimum 100 MB of free bandwidth on the LAN There will be a minimum of 1.5 MB of free bandwidth on the WAN Each of the 10 satellite clinics is connected back to the data center, housed in the main office, via a 10Mb/s metroE connection. 7.2 Server Hardware Availability / Aspects (Current) Documents will be stored locally in UMGs Data Center. Servers will be maintained in a virtual environment. One or more virtual machine servers can be used to run the document management system application and MS SQL databases.

The virtual environment will be run on VMware Websphere. The virtual environment will run on Dell servers and SAN. The virtual environment will be maintained by UMGs IT department. VMware hosts (6 hosts in total) are currently configured in: Quad core Intel processors 4 GB of RAM for Windows 2003 Standard 32 bit. 8 to 16 GB of RAM available for Windows 2008 Enterprise servers. 6 NICs per host RAID 5+ Hard drive configuration for fault tolerance per host.

7.3 Desktop Hardware Availability / Aspects (Current) UMGs current workstation environment includes a mixture of Windows XP Pro and Windows 7 PCs. All are members of UMGs domain. 4 GB of RAM Core Duo & Dual core processors Dedicated video cards (512 MB) on computers acting as scanning stations 17 to 19 LCD monitors CA Antivirus Threat Manager v8.1

UMG's computing environment is operated and managed from an enterprise perspective. The following provides an overview of the technical architectures environment specific to the DMS project. UMG maintains a data center connected to the LAN via TCP/IP over Cat6 Ethernet. UMG currently uses 500 computers, Windows virtual servers and a disk backup storage system. Supported operating systems include Windows XP Pro, 7 and Windows Server 200X. UMG IT staff provides technical support for the hardware and software in these standards. The desktop software standard is Microsoft Office 2003 or 2010. The network connects all UMG clinics through Metro Ethernet. The clinic maintains print and file servers based on Windows Server 200X. The enterprise directory is managed through Microsoft Active Directory.

The UMG IT staff provides help desks from 8am - 5pm, Monday - Friday. On-call service is available 24hrs/day. The Internet portal passes through our corrupt firewall allowing only HTTPS traffic. Oracle will be used as the enterprise database standard.

A complete list of software products and standards used by UMG is available at UMG.com/policy/software/default. UMG uses cryptographic keys for security measures, and requires all users to authenticate and receive authorization for use. UMG audits, monitors, and tracks system usage. UMG supports intrusion detection and containment controls. UMG supports security awareness and provides technical training for users to ensure the awareness of rules, behavior, and their responsibilities in accordance with HIPAA and UMG IS policy. UMG supports and requires physical security (24/hour recorded video surveillance and access key cards). 8.0 Completion Criteria and Final Acceptance Criteria 8.1 Completion Criteria It is the policy of UMG to obtain system acceptance from the client administrator prior to the Go-Live. The system acceptance consists of two parts, clinical and technical as outlined below. As each portion of the system acceptance test is completed, both the UMG Account Manager and the contractor must acknowledge acceptance. Procedures: 1. System Test Criteria The system test is completed on the latest release/version of UMG Document Management System project. 2. Clinical System Acceptance Test This test covers all options and features within UMG Document Management System project to verify that they are functioning correctly. Each subsystem is submitted to a

functional test prior to the integrated system test. 3. Technical System Acceptance Test The technical system acceptance is an integrated test to verify the network, workstation, printer and scanner configurations. 4. UMG Document Management System Test Procedure An integrated system test is a trial run before the actual implementation begins. This consists of a pre-established testing protocol of all system functions. Testing includes, but is not limited to: a. User types/access b. User Pathways c. Manual Printing d. Final system configuration review 5. Integrated System Test On-Site The integrated system test is the final verification that the system has been configured properly. The test lasts approximately two day and covers scanning, chart production, retrieval and quality assurance. Any and all discrepancies are documented and a copy given to both the UMG Account Manager and the contractors Project Administrator.

8.2 Final Acceptance It is the policy of UMG to obtain system acceptance from the client administrator prior to the Go Live. The system acceptance consists of two parts, clinical and technical. As each portion of the system acceptance test is completed, both the UMG Account Manager and the Contractor must acknowledge acceptance. Objectives: To ensure that the application functions are performing as intended. To ensure that the network and hardware is functioning/performing correctly. To validate the system functionality and related workflow procedures.

Procedures: 1. System Test Criteria The system test is completed on the latest release/version of UMG Document Management System project. This test will be performed by UMG staff and will be guided by the guidelines in the Document Management System project documentation. The testing must follow the guideline documentation and must achieve 98% accuracy in correlation with the steps and outcomes defined. 2. Clinical System Acceptance Test This test covers all options and features within UMG Document Management System project to verify that they are functioning correctly. Each subsystem is submitted to a functional test prior to the integrated system test. This test will be performed by UMG staff and will be guided by the guidelines in the Document Management System project documentation. The testing must follow the guideline documentation and must achieve 100% accuracy in correlation with the steps and outcomes defined for providing clinical information. 3. Technical System Acceptance Test The technical system acceptance is an integrated test to verify the network, workstation, printer and scanner configurations. This test will be performed by UMG staff and will be guided by the guidelines in the Document Management System project documentation. The testing must follow the guideline documentation and must achieve 98% accuracy in correlation with the steps and outcomes defined.

4. UMG Document Management System Test Procedure An integrated system test is a trial run before the actual implementation begins. This

consists of a pre-established testing protocol of all system functions. Testing includes, but is not limited to: a. User types/access b. User Pathways c. Manual Printing d. Final system configuration review This testing will be performed by UMG staff and will be guided by the guidelines in the Document Management System project documentation. The testing must follow the guideline documentation and must achieve 98% accuracy in correlation with the steps and outcomes defined for providing clinical information. 5. Integrated System Test On-Site The integrated system test is the final verification that the system has been configured properly. The test lasts approximately two day and covers scanning, chart production, retrieval and quality assurance. Any and all discrepancies are documented and a copy given to both the UMG Account Manager and the contractors Project Administrator. a. All documented problems are reviewed jointly by the UMG Account Manager and the contractors project manager to determine if the problem can and should be resolved prior to final system acceptance. b. Problems that can or need to be corrected prior to final system acceptance are evaluated by the UMG Account Manager to determine the resources needed to correct the problems. c. If the problems are numerous or large enough to warrant additional assistance, the UMG Account Manager discusses the problems with the UMG PMOT managers to determine the approach to take in correcting the situation

d. Depending on the effort and types of problems, the PMOT managers decides whether to have additional support onsite-at the facility for problem resolution or to have the problem reports forwarded to UMG and corrected at the UMG Corporate Office. e. After problem resolution, another integrated system test is performed at UMG testing site. This test may not cover all aspects of the system, but focuses on all the areas in which problems occurred.

8.3 Future Modification/Enhancement Policy Acceptance System modification and design by UMG after acceptance will be as requested by the contractor in writing, as agreed to by UMG, and in accordance with the then current UMG policies. Future system modification and enhancement requests, and, if accepted, the delivery date of the modifications and enhancements, will be at the sole discretion of UMG. 8.4 Training Acceptance The contractor has fulfilled all of the UMG project training as specified in the UMG Document Management System contract. Training or training assistance for UMG after acceptance will be billable to the hospital at the then current rates, and in accordance with the UMG training guidelines.

9.0 Contractor Overview and Business Practices 9.1 Overview of Contractor Please provide answers to the following questions regarding your company: 1. What is the full legal name of your company? 2. What is the address of your company? 3. Is your company a publicly or privately held?

4. When was your company founded? 5. Please provide an organizational chart that reflects both your overall corporate structure as well as your lines of business (including locations). 6. Please describe each of your major lines of business. 7. Please provide details on your financials for current and prior three years, including income statements, statements of cash flow, and balance sheet data. In addition, please provide detail on any credit facilities in place, as well as a reference we can speak to within those financial institutions. 8. How large (as a percentage of overall sales and in absolute dollars) is your DMS business relative to the other products/services your company provides? 9. What vertical markets does your company provide DMS services to? 10. What is your size and market position in the healthcare application space? How long have you been providing services focused specifically on the healthcare vertical? 11. Please provide a detailed breakdown of types of healthcare organizations currently utilizing your DMS. Include in your breakdown the number of installs in physicians offices, hospitals, and extended care facilities. For physician offices, please provide a further breakdown in terms of size of office in terms of both number of physicians/employees and number of locations. 12. How many employees do you currently have focused in the DMS area? How many are specific to healthcare? 13. Please describe your experience in integrating your DMS into an Epic EMR system. Please include detail on number of customers, size of install base, length of implementation timeframe (from contract to enterprise-wide implementation), and any key learnings. 14. Please provide three references for organizations of similar size and complexity as UMG who are currently using and have used your DMS application integrated into an Epic environment for at least two years. Please indicate which ones would be available for site visits. 15. What healthcare industry organizations does the contractor participate in? What healthcare-specific accreditations does the contractor have? Are you an Epic-certified integrator? 16. Who are your major competitors?

17. Please provide the number of applications that have been de-installed by the vendor in the last 12 months, and the reasons for the de-installation. 18. Will you use a third-party vendor as part of your solution? If so, please confirm that a Business Associate Agreement will be put in place in accordance with HIPAA regulations. 19. Will resources/locations outside the U.S. be involved in this project? If so, where? 20. List of all previous, pending litigation, or other proceedings the contractor is involved in, including for any subsidiary or affiliate. 21. Provide a list and description of all previous or pending investigations the vendor is involved in, including any subsidiary or affiliate. 22. Provide a list of any compliance or regulatory issues previous or pending by the vendor. Indicate whether there were any notices of known or alleged violation of Federal, state or local laws, regulations, and/or agreements. 9.2 Business Practices Please provide answers to the following questions regarding your companys business practices: 1. Based on your past experience implementing DMS in an Epic EMR environment, what Best Practices would you implement in approaching this project? 2. Who in Senior Management will be responsible for the success of this project? 3. Please provide an overview of the work plan and work schedule for the proposed DMS project. 4. Describe your companys approval, project prioritization, and project change management procedures. 5. Provide the chain of command for decision making for implementation of the EDMS project. 6. Indicate the level of involvement and participation of end-users in decision making. 7. UMG has identified potential project risks in the table below. Please provide a mitigation strategy for each, as well as provide your own list of possible risks and a mitigation strategy for each. Risk Scanner resolution of the handwritten records does not permit adequate legibility of the information. Contractor is unable to find adequate internal Risk Mitigation

resources to staff project in required timeframe. UMG resources are unavailable during the testing/implementation phases.

10.0 Technical Solution Please provide answers to the following questions related the technical, workflow, and infrastructure aspects of your proposed solution: 10.1 Workflow 1. Does the system provide the ability to backup to tape entire database and ability to customize backup? In comments, please specify other options of backup capability (aside from tape). 2. Will the system support document file check-in and check-out controls to flag databases showing who is working on files and prevent simultaneous updates by other users? 3. Does the system support document exporting into PCX, TIFF, BMP, and JPEG file formats? In comments, please list any other export formats. 10.2 Scanning Any scanning solution must support the scanning of both color and monochrome one-and two-sided documents. Minimum scanner speed is 15 pages per minute (ppm), and they must be equipped with double feed detection. Given the above: 1. Can the proposed scanner accommodate multiple paper colors, inks, and paperweights from 8 to 36 pounds using the automatic document feeder? 2. Can the proposed scanner handle mixed-thickness documents? 3. Can the proposed scanner allow batch scanning of diverse documents without resetting scanner (e.g. documents on dark blue paper, pencil notations, highlighted text, faint carbon copies, documents with up to 45 degree skew, highly speckled documents, photographs, drivers licenses, insurance cards, etc.)? 4. Can the proposed scanner provide the ability to compress scanned images using a compression algorithm that complies with CCITT Group 4 or LZW compression scheme standards?

10.3 Import of External Files 1. Does the system provide the ability to import image and text files generated externally? (i.e. by vendors scanning backlog documents). 2. Does the system provide the ability to import image and text files generated by word processing, spreadsheet, graphics and other software applications. 3. Does the system support the import of .doc and .xls files? In comments, please list other file types that can be imported. 10.4 Indexing and Storage 1. Will the system allow users to customize database and indexing parameters (e.g. users can create index fields)? 2. Will the system allow documents to be moved from one folder (or tab) to another and re-indexed without re-scanning. 3. Will the system support storage of TIFF files and PC generated files (word processing documents, JPEG, voice files, and video clips) in one file cabinet? 4. Will the system allow index processing to be performed while other stations are actively searching, viewing, scanning and editing? 10.5 Database Search 1. Does the system support searching of text documents based on user-input character strings, keywords, etc? 2. Will the system support search queries using Boolean operators (e.g. AND, OR and NOT, wildcard)? 3. Upon completion of search, will the system immediately display all selected images and support quick navigation through documents? 10.6 General 1. Briefly describe the ability to archive soft copy documents such as e-mails, attachments, faxes, mainframe reports, etc. directly to the imaging system. 2. State the maximum number of images capable of indexing, storage, and retrieval. If limited, state by number of pages, documents, folders, records or other description. 3. Specify the maximum image size (in megabytes) capable of being imported or scanned into database.

4. List the image formats that are supported by the proposed system. 5. Describe image enhancement capabilities available with proposed scanners or software. 10.7 Security 1. Does the system provide comprehensive security down to the page level, for every action (including print, fax, and e-mail)? 2. Does the system use secure sockets layer (SSL) protocol to encrypt data transfer? 3. Will the system provide an audit trail that includes date, time, user and operation? 4. Does the system support security audit reporting on document access that includes document type, user ID, date and time range, access by workstation / location? 10.8 Technical 1. Does the system provide the ability to backup to tape entire database and ability to customize backup? In comments, please specify other options of backup capability (aside from tape). 2. Will the system support document file check-in and check-out controls to flag databases showing who is working on files and prevent simultaneous updates by other users? 3. Does the system support document exporting into PCX, TIFF, BMP, and JPEG file formats? In comments, please list any other export formats. 10.9 Editing 1. Does the system support document versioning? 2. Does the system provide the ability to apply sticky notes or text notes to all document types and retain the relationship of the notes to the page? 10.10 Workflow 1. Will the system provide a visual, graphical (GUI) workflow tool to design workflow processes by "dragging and dropping" icons that represent workflow steps? 2. Does the system support point-and-click configuration enabling customization of workflow processes and user interface without programming?

3. Does the system provide the ability to monitor which task the user is performing and automatically open documents (e.g. for reference) appropriate for that task? 11.0 Service Delivery 11.1 Pilot and Implementation (HIMSS, 2011) 1. Describe the general plan and strategies for implementing the DMS proposal. 2. Provide the length of time needed for completion of the implementation. 3. Describe some of the resources the vendor requires for successful implementation. 4. Describe some of the resources the vendor requires from the customer for successful implementation. 5. Indicate any third parties involved in the implementation process. 6. Describe the third party services and products used. 7. Describe the DMS management tools and methods used. 8. Indicate whether support is available for process redesign. Indicate whether this is available as part of the implementation or is it a separate agreement. 9. Describe the skills level of the project managers and consultants. 10. Describe the procedure for acceptance testing. 11. Describe the types of services available after successful implementation. 12. Describe some of the methods for measuring project performance and progress. 12.0 Training (HIMSS, 2011) 1. Describe the training plan for the implementation team and users during the implementation phase. 2. Describe the length, days and hours, and location of the training for the implementation team and end-users. 3. Describe the on-going training services available after the implementation phase. 4. Indicate whether documents, how to guides, and other training materials will be provided during training. 5. Indicate how often training documents are revised or updated, and how they will be delivered to the customer. 6. Indicate the types of media that are available for training such as classrooms and web sessions. 7. Indicate any training software that is available.

8. Describe the method for training customers and users for enhancements, updates, major and minor software releases, and patches. 13.0 Services and Support (HIMSS, 2011) 1. Provide a plan and turn-key solution for software and hardware training for the implementation team and all end-users. 2. Describe the consulting services and follow-up support services available during the implementation phase. 3. Provide the support levels and hours available. 4. Provide the process for providing enhancements, updates, major and minor software releases, and patches to software. 5. Indicate whether the vendor responds to, develops and implements both federal and state regulatory changes and mandates. 6. Describe the vendor's frequency of providing enhancements, updates, major and minor software releases, and patches to software. 7. Describe what is covered in the software warranty period and length of the warranty. 8. Describe the support services that will be available during and after the implementation phase. 9. Indicate whether there are procedures for end users to follow to report problems. Indicate how to contact support services, the locations of the support services, days and hours of availability. 10. Describe some of the methods for measuring customer and user satisfaction, methods for creating and receiving feedback. 11. Describe the involvement of customers and users in development of the vendors products and software. 12. Describe how customers and users can become involved, and submit product and software suggestion requests. 13. Indicate if other methods of support are available for customers and users, for example a website, documents, how to guidelines. 14. Indicate if support, guidelines, and protocols are available for users for self-use and self-answered questions. 15. If a third vendor is used, describe the support and maintenance services provided by outsourced company.

14.0 Contractor Staffing, Roles, & Responsibilities The Contractor will provide the following support to the UMG Document Management Project Team: Contractor Role Executive Sponsor Function Responsibilities This individual will be a high level Overall relationship management member of the Contractors Senior between Contractor and UMG Leadership Teamnot a Sales resource. He/she will represent the Contractor at all read-outs to the Project Steering Committee. This individual will be dedicated 100% Primary responsibility will to the Project, and will interface directly be to ensure contractor with the UMG Document Management delivers against plan on time Project Leader. The Contractor Project and on budget. The Leader will be tasked with reporting out contractor Project Leader to the Steering Committee on an agreed will function in close upon schedule. association with the UMGs Project Manager to ensure successful implementation of the project. These resources will interface with their The contractor will provide respective counterparts on the UMG technical support for the analysis, team, and will ensure solution meets build, and implementation of the UMGs application and infrastructure project. The technical team leaders standards. will work closely with the CIO to ensure installation of the software and optimal technical performance of the system. Represent the Contractor in all contract discussions. Will act as the primary contact for all contract discussions and negotiations, with input from the Contractors and UMGs broader team. The trainer is responsible for ensuring transfer of knowledge in use and minor troubleshooting of the system to the HIM director and the clerical/EDM analysts. The training sessions are expected to occur one-one and last two hours to ensure individualized attention to the steps in the process and using the system. The testing support person will work with the trainer, CIO, PMs

Project Leader

Technical Leaders, both Application and Infrastructure

Legal/Procurement resource

Training

Transfer knowledge for the new system and processes to UMG users, including physicians, nurses, clerical staff, and others in the organization.

Testing

Ensure the system meets the acceptance criteria as outlined in Section 7.

and technical lead regarding testing of the interface, scenarios testing to ensure all functionality is assessed and optimized. Project Analyst Ensure communications both with the contractor team as well as between contractor and UMG. The analyst will assist in scheduling meetings for the project team, ensure meeting rooms are selected, send meeting reminders, provide communications with the corporate office and provide minutes of meetings as well as documentation of testing logs. The analyst will also assist EDM team members in other duties as required.

The contractor will provide a project manager (PM), training team, and project analysts. Support for the technical build will be provided by the contractor, in close collaboration with the organizations CIO, with respect to infrastructure, hardware and interfaces.

The Steering Committee will meet with the Project Team and the Contractors Executive Sponsor and Project Leader on a monthly basis. After implementation, the Project Team will meet with the contractor regarding verification of contract deliverables.

14.1 Contractor Staffing Questions Please answer the following questions regarding staffing: 1. Provide an organizational list for the DMS proposal, including all management and staff involved in the planning, development, and implementation of DMS. 2. Provide the resumes for all staff who are part of the on-site implementation team. Resume will include education, experience and background, accomplishments, and other qualifications. 3. Provide some methods used to access employee performance level. 4. Provide some methods used for hiring employees, promotions, termination, and other relevant human resource policies.

15.0 Relevant Organizational Policies Standards, Supported Software and Computing Contactor must comply with UMG's most current and up to date Policies, Standards, and Computing Environment. All enterprise information systems must comply with the policies of the UMG. UMG publishes policies, standards, and guidelines documents. UMG maintains and implements policies in Administration and Planning, Finance, Acquisition/Procurement, Staff Management, Research and Development, Networking and Communications, Risk Management, and Public Relations. The organizational document policies are available online at UMG.org/policies/default or may send a copy request to: PMO Consultants, Matt Reid, 2020 Enforcer Way, Pluto, 75309, Phone: (111) 222- 3434, Email:mreid01@PMOway.org. 16.0 Timeline and Period of Performance The period of performance for this project will start on March. 1, 2012 and all work tasks are to be completed by Dec. 31, 2012. Detail on specific Deliverables and Milestones can be found in sections Sections 5.3 and 5.4. On-going support beyond the system implementation date will be addressed in a separate agreement by the Contractor and UMG, and covered in a separate contract. The Organization has the right to extend or terminate this SOW at its sole discretion.

17.0 Compensation Payment Schedule and Pricing 17.1 Compensation Payment Schedule Contractor invoices must include detailed breakdown of hours worked, by whom, including role and tasks performed associated to specific deliverables. The organization will pay upon receipt in accordance with standard practice after review and signed authorization by the organization project manager. UMG will hold back 20% of payment for each phase of the implementation, and upon final acceptance, the project manager will authorize the payouts be made to the contractor.

Phase Initial Phase: Analysis of current workflow, and proposal for future workflow.

Document conversion System development complete

Document conversion complete Pilot implementation in one site Training

Upon Completion Includes validation of UMG assumptions regarding: document volume current space requirements staffing potential productivity (capacity) or cost benefits Complete for 50% of Current patients UMG document management system meets business and technical requirements, and is ready for pilot implementation. 50% of Current patients, and 100% of Active patients 30 day pilot for at least 10 users Targeted training delivered to: Physicians Nurses Support/clerical staff All current and active patient documents are digitized and linked to the EMR. All documents are tagged for access through the Epic EMR. All UMG practice locations are linked to document management system. Final system acceptance for all UMG sites.

Payment 10%

10% 20%

10% 20% 10%

Phased enterprise-wide roll-out of system complete

20%

System testing and acceptance complete.

Release of all holdbacks.

Payment terms are net 60 days. Penalties will be assessed for work not completed per the approved Schedule. If a delay is anticipated due to failure to meet obligations on the part of the organization, contractor must be able to provide proof the issue was escalated to UMG Project Leader in a timely manner, as well as raised the UMG Monthly Steering Committee.

Hours worked beyond contracted estimates must be approved in advance by the UMG DMS Project Manager.

The contractor will provide for additional support services on an ongoing basis, with a plan for decrementing the support hours beyond the go-live for each site. After each site is successfully implemented, support is expected to convert to ongoing support as outlined in a separate maintenance agreement. Terms of the maintenance agreement should be provided to UMG as part of this RFP. After the first six months, the support contract will change to the maintenance agreement as outlined in separate documentation. Support will be charged to the physician organization on an hourly basis.

Organization shall reimburse Contractor for travel and other expenses as identified in this SOW, or as authorized in writing, in advance by Organization. No payment of travel expenses will be made to Contractor for routine travel to and from Organizations location. Contractor shall provide a detailed itemization of expenses as requested by Organization. The amount reimbursed to Contractor is included in calculating the not to exceed amount per final negotiated contract.

Please complete following pricing schedule based on the following phased activities: 17.2 Pricing Initial Phase Analysis of current workflow, and proposal for future workflow. Includes validation of UMG assumptions regarding: document volume current space requirements staffing potential productivity (capacity) or cost benefits # of Units Cost/Unit Total

Description Hours required to complete Staffing and cost by type (ex: analyst,

programmer) TOTAL Document Conversion, Tagging, and Uploading Conversion of documents identified by UMG in Section 3.0. into a digital format ready for tagging and uploading into system. Description Number of pages to be scanned Cost/page for scanning, including quality control check Cost/field for metadata tagging Cost/page for uploading TOTAL # of Units Cost/Unit Total

System Development Development of vendor system to meet UMG functional and technical requirements, including integration into Epic environment. Note that solution will be hosted on UMGs servers and supported within UMGs network environment. Description # of Units Software licensing, per seat, on an annual basis Staffing and cost (per hour) by type (ex: analyst, programmer, manager) required for UMG-specific development Staffing and cost (per hour), by type (ex: analyst, programmer, manager) required for Epic integration. TOTAL Cost/Unit Total

Pilot Implementation UMG document management system meets functional and technical requirements, and is ready for pilot implementation in one site for a minimum of 10 users.

Description Staff required for training--system Staff required for training scanning/tagging/uploading On-site support staff for pilot phase TOTAL

# of Units

Cost/Unit

Total

Enterprise-wide Implementation Roll-out of DMS to all locations and users across UMG as described in Section 2.2. Description Staff required for training, per site (per details in Section 2.2) Installation of hardware/software in UMG environment TOTAL # of Units Cost/Unit Total

On-Going Support and Maintenance Six months of support post-implementation is included in initial system acquisition cost (continuing through June of 2013). Description Maintenance costs, per year Software licenses, per seat Trainingon-site Trainingwebinar TOTAL 18.0 Miscellaneous Contractor agrees to resolve any contractual issues through a mediation process, and in accordance with the laws of the State of Illinois. Service Level Agreements (SLAs), Acceptance Testing, and Performance Standards are addressed in section 7.0 # of Units Cost/Unit Total

19.0 Appendices Appendix A: Letter of Intent to Respond Appendix B: Map of UMG Current Network Infrastructure

Execution/Signature Blocks In Witness Whereof, the parties hereto, having read this SOW for a Document Management System for UMG LLC in its entirety, do agree thereto in each and every particular.

SO AGREED. UMG LLC

SO AGREED. [Contractor]

Signature

Signature

Print or Type Name Title: Date:

Print or Type Name Title: Date:

[Use this space for other applicable Organization signatures]

Appendix A Letter of Intent to Respond

Appendix XXX UMG Network Infrastructure