Health Care Delivery IT Solutions (MHS GENESIS) Documentation

DHA Contracting, on behalf of PEO DHMS, is seeking industry feedback on the below request.

MHS GENESIS was implemented as the first all-in-one record electronic health record (EHR) system for the entire Department of Defense. The MHS GENESIS solution is also used by the U.S. Coast Guard (USCG), the Reserve Components (RCs), the United States Military Entrance Processing Command (US MEPCOM), and National Oceanic and Atmospheric Agency (NOAA) with deployment to the National Security Agency (NSA) in progress. 

MHS GENESIS plays a vital role in ensuring health, increasing readiness, and improving the safety of care.  By standardizing clinical and business processes, MHS GENESIS enables beneficiaries to fully engage in their health care, and focuses on quality, safety, and patient outcomes that will ensure the Military Health System (MHS) can provide high-quality and reliable care globally. 

MHS GENESIS is comprised of inpatient and outpatient software solutions from Oracle Health (formerly Cerner), a dental solution from Henry Schein, an enterprise service bus, a suite of revenue cycle management capabilities, and interfaces to external systems that enhance capability delivery.  MHS GENESIS is supported by uniquely configured and integrated third-party clinical content, functional baseline content (such as workflows, roles, training, and reports), local site “builds” (including formularies, device locations, and clinic information), solution-unique hardware, infrastructure, clinical application services, and turn-key operational management services in a contractor-provided “enclave.”  The core of MHS GENESIS is interfaced with additional commercial off-the-shelf (COTS) solutions, including virtual and behavioral health capabilities from Converge, Conversa, and Silvercloud, virtual health delivery from Phillips eCare, and population health management and analytics from HealtheIntent.

MHS GENESIS provides patients with a single record of care. It integrates inpatient, outpatient, and dental records, and improves communication between patients, military hospitals and clinics, the Department of Veterans Affairs (VA), and civilian health providers.  Patients utilize a portal for seamless, secure messaging with providers and access to their medical history.

MHS GENESIS is a system of systems, meaning that it contains interfaced EHR COTS product components from multiple different sources (e.g., Oracle Health, Henry Schein, etc.).

MHS GENESIS has an enormous scale and level of complexity.  The solution is comprised of 12 major subsystems, utilizes 81 DOD, joint, or commercial interfaces across more than 1,000 end points, and processes at least 20 million messages daily.  MHS GENESIS has more than 975 workflows and more than 200 user roles, and it serves 194,000 users and 9.6 million beneficiaries across 137 commands globally.  MHS GENESIS contains 255 TB of Millenium data growing at 100 TB annually.  The DOD spent 7 years, 2017-2024, migrating data from legacy sites into MHS GENESIS.  Additional data is stored across MHS GENESIS’s 12 major subsystem footprints.

MHS GENESIS is comprised of ~26,000 hardware and software assets to deliver capabilities which need to be scanned every 48 hours for cyber vulnerabilities (and remediated as necessary). During deployment, each of the 26 waves averaged more than 7,500 end points.

The MHS GENESIS system documentation is lacking with respect to the sustainment processes and procedures and internal interface configurations.  Other technical documentation, such as architecture artifacts and system/sub-system design documents, are understandable to the current prime contractor and Government team but need to be revised so they are understandable to a third party.  This would include documenting how the system is configured, and how the system is maintained and operated, and who is responsible for various functions.  Because MHS GENESIS is in the process of migrating to the cloud, the documentation would need to be developed during the migration, completed within approximately six months after the cloud migration is complete, and the process would require cooperation with the current prime contractor.  The final documentation deliverables should provide offerors with sufficient information to competitively respond to a full and open competition to support MHS GENESIS, including systems integration, hosting, and software licensing.  

The Government is seeking industry feedback to address the following:

1. What is the best approach to creating and maintaining consistent and comprehensive documentation in an environment such as that of MHS GENESIS where there are multiple vendors (for example, multiple COTS product component vendors)?
2. What, if any, risks or lessons learned should be taken into account when creating and maintaining system documentation in an environment such as MHS GENESIS?
3. Where should lines of responsibility by drawn between software component vendors responsible for delivery as opposed to software component vendors responsible for documentation? With respect to coordinating the drafting of documentation?  With respect to consolidating documentation?
4. Any recommended incentive(s) or disincentive(s) to promote a cohesive and cooperative working relationship between and among a contractor engaged to develop documentation, the MHS GENESIS prime contractor, and the COTS product component vendors? 
5. What are important Service Level Agreement (SLA) measurements and key outcomes the Government should consider for the documentation services? How would you recommend measuring success for each recommended SLA and key outcome?
6. How can innovation be used to support the creation and maintenance of  technical documentation to support MHS GENESIS?

Small Business Set Aside

1. Is this a capability that Small Business or 8(a) could support as a set aside? Provide a reasoning for your response.
2. Please advise what NAICS code and reasoning in accordance with FAR 52.219-14 Limitations on Subcontracting.  Please also identify whether you qualify under such NAICS code as a small business or 8(a).

Instructions for Submission

Submit responses no later than December 12, 2024 at 12:00 PM eastern to:

Dha.ncr.peo-ipo.mbx.dhms-enablers@health.mil

In the submission please include:

• Cover page:  Company name, Cage Code, Sam Unique Entity ID (UEI), point of contact, small business concern (if applicable), document names of any additional documents as part of this submission, and permission/ rejection of release or proprietary information to identified subcontractors (see below)
• RFI Response:  For questions 1 through 6, limit response to no more than five (5) pages in word or 15 slides in power point.  Font should be no smaller than 12 point.  For questions 7 and 8 one (1) page in word or 2 slides in power point with font no smaller than 12 point may be submitted.  Submissions should clearly articulate the question being addressed.  For ease of navigation a one (1) page table of contents may be added and will not count towards the page limitation.  Submissions may be converted into a *.pdf but the same restrictions apply. 
• Capability Statement:  A one page capability statement may be submitted as part of the supporting documentation.

Responses and comments may be utilized to develop a contracting strategy, including the scope of competition, and in the preparation of the description of services for a possible future solicitation. 

Proprietary information may be submitted; however, RFI respondents are responsible for adequately marking proprietary, restricted or competition sensitive information contained in their response.  If a submission is marked, it will be protected from disclosure outside of Government personnel, unless permission is granted for Government support contractors to view the material.

The following companies and individual employees are bound contractually by Organizational Conflict of Interest and disclosure clauses with respect to proprietary information, and they will take all reasonable action necessary to preclude unauthorized use or disclosure of an RFI respondent’s proprietary data.  RFI responses MUST clearly state whether permission is granted allowing the support contractors identified below access to any proprietary information.

•Boston Consulting Group (BCG)

•Swing Tide

•Andrew Morgan Consulting, LLC 

•Greenlight Analytic, LLC

•Itero Group, LLC

This RFI is not a solicitation.  This RFI is for planning purposes only.  It does not constitute an RFP or a promise to issue an RFP in the future.  This RFI does not commit the Government to contract for any supply or service whatsoever.  Further, the Government is not seeking proposals at this time, and will not accept unsolicited proposals. Respondents are advised that the Government will not pay for any information or administrative costs incurred in response to this RFI.  All costs associated with responding to this RFI will be solely at the responding party’s expense.  Participation is not mandatory or required; participation or response to this RFI is not a prerequisite for any future procurement activities.