request for information (rfi) · medical oversight (bemo) has determined the strategic need for a...

Request for Information (RFI) Florida Department of Health Last Saved: 6/23/2015 11:52:22 AM Page 1 of 15

Business Intelligence and Data Warehouse Solution

State of Florida – Department of Health

Health Information & Policy Analysis Section Bureau of Emergency Medical Oversight

Division of Emergency Preparedness & Community Support

Request for Information (RFI)


Table of Contents

TABLE OF CONTENTS ................................................................................................................................................ 2

SECTION I ..................................................................................................................................................................... 3

GENERAL INFORMATION ................................................................................................................................................. 3

Mission .................................................................................................................................................................... 3

Vision ...................................................................................................................................................................... 3

Values ..................................................................................................................................................................... 3

Priorities .................................................................................................................................................................. 3

Additional Information ............................................................................................................................................. 4

INTRODUCTION .............................................................................................................................................................. 4

History ..................................................................................................................................................................... 4

Future State Vision ................................................................................................................................................. 5

Approach................................................................................................................................................................. 5

Organization and Business Process Information .................................................................................................... 5

SECTION II .................................................................................................................................................................... 5

RFI PURPOSE ............................................................................................................................................................... 5

RFI SCOPE ................................................................................................................................................................... 6

Key Considerations ................................................................................................................................................. 6

RFI VENDOR NOTICES ................................................................................................................................................... 8

Proprietary Information ........................................................................................................................................... 8

Vendor Costs .......................................................................................................................................................... 8

RFI CONTACT(S) ........................................................................................................................................................... 8

RFI SCHEDULE ............................................................................................................................................................. 9

RFI QUESTIONS ............................................................................................................................................................ 9

RFI RESPONSES AND SUBMISSIONS ................................................................................................................................ 9

RFI LIST OF ATTACHMENTS ............................................................................................................................................ 9

RFI LIST OF VENDOR WORKSHEETS ............................................................................................................................. 10

SECTION III ................................................................................................................................................................. 10

VENDOR RESPONSES .................................................................................................................................................. 10

Part I - Executive Summary .................................................................................................................................. 10

Part II – Requirements Questionnaire ................................................................................................................... 10

Part III – Proposed Solution(s) and Implementation Approach ............................................................................. 11

Part IV – ROM Cost Estimates .............................................................................................................................. 14

Part V - Additional Vendor Commentary ............................................................................................................... 15


Section I

General Information The Department of Health (the Department) is Florida’s state agency dedicated to protecting, promoting and

improving the health of all people in Florida through integrated state, county, and community efforts.

Established by the Florida Legislature in 1996, the Department traces its roots to the creation of the Florida State

Board of Health in 1889. The Department of Health is an executive branch agency, established in section 20.43,

Florida Statutes. Led by a State Surgeon General who serves as the State Health Officer and is directly appointed by

Florida’s Governor and confirmed by Florida’s Senate, the Department also has three Deputy Secretaries who

oversee the business and programmatic operations.

The Department is comprised of a state health office (central office) in Tallahassee with statewide responsibilities,

Florida’s 67 county health departments, 22 Children’s Medical Services area offices, 12 Medical Quality Assurance

regional offices, nine Disability Determinations regional offices, and four public health laboratories. Facilities for the

67 county health departments (CHDs) are provided through partnerships with local county governments and provide

a variety of services. These 67 CHDs have a total of 255 sites throughout the state, providing a variety of services,

and ranging from small to large in location size.

The Department is accountable to the state legislature, the Executive Office of the Governor, all residents and visitors

in the state, and the federal government. The Department is responsive to priorities identified by the Governor and

the legislature in determining services, associated funding, and delivery mechanisms. Annually, the state legislature

passes a budget, approved by the Governor, and creates or amends laws that direct the Department’s actions.

The Department’s total budget for fiscal year (FY) 2012 – 2013 was $2,793,152,317. Additionally, the Department

has appropriated 16,550.25 Full Time Equivalents (FTEs).

Mission

To protect, promote & improve the health of all people in Florida through integrated state, county, and community

efforts.

Vision

To be the healthiest state in the nation.

Values

ICARE

Innovation We search for creative solutions and manage resources wisely.

Collaboration We use teamwork to achieve common goals & solve problems.

Accountability We perform with integrity & respect.

Responsiveness We achieve our mission by serving our customers & engaging our partners.

Excellence We promote quality outcomes through learning & continuous performance improvement.

Priorities

Priorities for improving public health in Florida are addressed through a variety of plans that address collaboration

with our partners as well as internal agency priorities that will help achieve a healthier Florida.

HEALTHIEST WEIGHT FLORIDA INITIATIVE

Healthiest Weight Florida is a public-private collaboration bringing together state agencies, not for profit

organizations, businesses, and entire communities to help Florida's children and adults make informed choices about

healthy eating and active living.

http://www.healthiestweightflorida.com/


STATE HEALTH IMPROVEMENT PLAN

The State Health Improvement Plan (SHIP) is a statewide plan for public health system partners and

stakeholders to improve the health of Floridians. Quarterly reports are collected to track progress on the goals and

objectives in this plan.

LONG RANGE PROGRAM PLAN (LRPP)

The Long-Range Program Plan (LRPP) provides the framework and justification for the agency budget. It is a

goal-based plan with a five-year planning horizon and focuses on agency priorities in achieving the goals and

objectives of the state.

AGENCY STRATEGIC PLAN IMPLEMENTATION PLAN

The Agency Strategic Plan Implementation Plan provides a unified vision and framework for action for the

Florida Department of Health.

Additional Information

Please refer to the following link for additional information on the Department: http://www.floridahealth.gov.

Introduction The Department’s Division of Emergency Preparedness & Community Support (DEPCS) - Bureau of Emergency

Medical Oversight (BEMO) has determined the strategic need for a Business Intelligence / Data Warehouse Solution

(BIDWS). In short, the business problem to be solved is one of efficiently and effectively addressing the need for

robust and enterprise-level data analysis, reporting, and decision support across the Bureau.

History

In 2010, the Health Information and Policy Analysis Section (HIPAS) – part of the DEPCS BEMO – implemented a

proof-of-concept (POC) Operational Data Store (ODS) to address data analysis, reporting, and decision support

needs of the statewide Emergency Medical Services (EMS) incident-level data collection program. From the initial

implementation, continued improvements to the ODS POC have been executed in an iterative process, which has

included identifying the required data elements and extracting them from the respective source systems.

The ODS POC is currently in its fourth iteration and it houses a repository of data from the EMS patient care reports.

Key sources of data are function-specific (e.g. EMS data, hospital data, licensing and enforcement data, etc.) and are

referred to as “operational data.” Operational data is housed in function-specific, transaction-based systems. The

ODS POC is refreshed (at scheduled, regular intervals – often nightly) with data from the operational data systems.

New data is transferred utilizing Extract, Transform, and Load (ETL) processes.

In addition, data linking has been established between the EMS patient care reports and the hospital data (in-patient

and emergency department), and between the EMS agency demographic data and the licensing and enforcement

data.

Frequently, the information requested by key decision makers within the organization requires the utilization of data

from several of these operational data systems. In response, the ODS POC has provided both immediate and

ongoing benefits to the data analysis, reporting, and decision support needs related to the EMS community.

It has enabled the retrieval of data faster and more efficiently than from the stand-alone operational data

systems.

It has enabled tracking of Key Performance Indicators (KPI’s) and associated attributes in various subject areas

of emergency medicine to establish benchmarks for improving the quality of patient care.

It has provided the capability to pull in external data from other bureaus and agencies to assess the effectiveness

of pre-hospital patient care and outcomes through the Continuum of Care, by linking critical data sources.

Please refer to Attachment I for details on the current BEMO ODS POC.

http://www.floridahealth.gov/public-health-in-your-life/about-the-department/_documents/state-health-improvement-plan.pdfhttp://floridafiscalportal.state.fl.us/Document.aspx?ID=11029&DocType=PDFhttp://www.floridahealth.gov/public-health-in-your-life/about-the-department/_documents/agency-strategic-plan-implementation-plan-ver1-2.pdfhttp://www.floridahealth.gov/


However, limitations do exist in the current ODS POC solution, as it relates to its continued use and ability to expand

and scale to meet the growing needs of the BEMO. A more comprehensive, long-term business strategy is needed

to ensure that this capability is grown and built-out in the most appropriate and efficient manner. This strategy will

incorporate the full complement of the BEMO’s business requirements, in support of its information and decision

support needs. As well, this will set the stage to potentially incorporate the needs of other Department entities at

some point further in the future.

Future State Vision

Building upon the success of the ODS POC, the HIPAS has identified the need to strategically transition to a more

robust BIDWS. The initial deliverable in realizing the future state vision is to provide recommendations on the best-fit

solution options and recommendations on an initial implementation design / approach, based on the business

requirements of the BEMO. The recommended best-fit solution options and implementation design / approach must

have the capability to grow and scale, and potentially be used as a model and applied to other Department needs.

This future state vision supports the overall mission of the Department – to protect, promote, and improve the health

of all people in Florida through integrated state, county, and community efforts – by providing insight (not currently

available) into the data across BEMO’s Continuum of Care – Emergency Services – in order to drive greater and

more rapid improvement in the quality of patient care within the state of Florida via actionable information and

insights.

Please refer to Attachment II for details on the BEMO’s Emergency Services Continuum of Care.

Approach

In order to ensure the greatest opportunity for success, a phased project approach is being taken. Because of the

stated limitations that do exist in the current ODS POC solution – as it relates to its continued use and ability to

expand and scale to meet the growing needs of the BEMO – a more comprehensive, long-term business strategy is

needed to ensure that this capability is grown and built-out in the most appropriate and efficient manner. Recent

advancements in both the technology and service offerings in the BIDWS space further enhance this opportunity to

drive out a sustainable, long-term business strategy.

Phase I of the approach is focused on the activities required to develop and deliver a Business Case that will provide

the strategic direction to be taken, inclusive of best-fit solution options and an initial implementation design /

approach, in order to meet the business requirements of the BEMO and achieve the stated future state vision, in

support of the overall mission, goals, and objectives of the Department.

Organization and Business Process Information

To facilitate a greater understanding of this effort, it is helpful to have a working knowledge of how the Department as

a whole is structured organizationally and where the BEMO fits in, as well as the primary business and work

processes of the BEMO and its various programs / sections.

Please refer to Attachment III for details on the Department’s organizational structure; Attachment IV for details on

the BEMO’s business and work processes; Attachment V for supplemental notes on the BEMO’s business and work

processes; and Attachment VI for details on the BEMO’s current reports and performance measures.

Section II

RFI Purpose The Department – specifically the HIPAS – is seeking information from qualified vendors who are capable of and

interested in providing both the technology solutions and the consulting, professional, and integration services

required for the implementation of a more robust BIDWS. This Request for Information (RFI) is intended to:

Educate the HIPAS on the vendors – and their associated offerings – in the BIDWS space.


Obtain information about various BIDWS implementation options that meet business requirements.

Obtain Rough Order of Magnitude (ROM) cost estimates to assist the HIPAS in understanding what realistic,

budgets / funding levels for an implementation effort might look like.

These RFI deliverables will be used to develop the Business Case that will provide the strategic direction to be taken,

inclusive of recommendations on best-fit solution options and an initial implementation design / approach. The

Business Case will be presented to key management stakeholders in order to seek approval, develop budgets, and

identify funding to move forward with the subsequent, proposed project phases for an implementation. Further

consideration will be given to this effort, based on the Business Case decision / outcome.

RFI Scope The scope for this RFI, with respect to the technology solutions / capabilities and consulting, professional, and

integration services required for an implementation, is comprised of the following core components:

Migration of the existing POC ODS data and reporting functionality to a more robust and scalable enterprise data

warehouse solution.

Existing data sources

Existing staging area

Existing ETL’s

Existing data linkages

Existing static (canned) reports

Existing self-service (ad-hoc) reporting capabilities

Integration of additional data sources – based on identification and prioritization by the client – to the enterprise

data warehouse, inclusive of all required ETL’s and data linkage methodologies.

Transactional database sources (i.e. SQL, Access, etc.)

File sources (i.e. XML, XLS, CSV, etc.)

Reference sources (i.e. industry standard code sets, etc.)

External sources (i.e. U.S. Census Data, other Florida state agency data, etc.)

Unstructured sources (i.e. PDF [static & interactive], DOC, scanned files/images, etc.)

Assessment and determination of new, line-of-business specific, data mart functionality, and implementation.

Assessment and determination of new, data-set specific cube functionality for data retrieval, analysis and

exploration, and implementation.

Implementation of new business intelligence tool sets for reporting, analytics, and consumption services based

on business requirements.

Reporting

Static (canned) reports

Self-service (ad-hoc) reports

Data analysis (interactive)

Descriptive analytics

Predictive analytics

Prescriptive analytics

Data mining

Data visualization

Graphics

Scorecards

Dashboards

Please refer to Attachment VII for details on the BEMO’s business-oriented, future-state vision with respect to a

BIDWS.

Key Considerations

When assessing the above core components of the RFI scope, there are key considerations that the vendor must

keep in mind when developing a recommended solution and implementation approach, with respect to several items.


Resources, Support, and Hosting

There is minimal support capability available from the Department’s Office of IT, with respect to infrastructure

(server), database, and application support staff.

Current Development, Test/User Acceptance, and Production environments for the POC ODS are housed in

the State’s Data Centers, which are managed by the Florida Agency for State Technology (AST), a separate

departmental entity from the Florida Department of Health.

The HIPAS employees only three Contract personnel and one Full Time Equivalent (FTE) who currently support

the POC ODS:

One (1) Project Manager

Two (2) Business / Technical Analysts

One (1) Data Modeler / Business Intelligence Developer

Consideration must be given to types and numbers of resources that would be required from the Department and the

HIPAS for an initial implementation, as well as ongoing support / maintenance, enhancements, and growth. As well,

consideration must be given to the most appropriate hosting environment(s) for a recommended solution, in light of

resource / support constraints.

Data Sources and Data Linking

Current Data Sources

Consideration must be given to the variety and quantity of data sources that are currently being utilized to

support the BEMO’s business and work processes. A strategic approach must be taken to prioritize the

order in which each of the data sources is integrated into the proposed solution(s). Prioritization must take

into account the type, size, and complexity of the data source, as well as the access (permissions) to and

criticality (to the business) of the data source.

There are also several pockets of currently utilized data sources that reside in unstructured document

formats, such as Microsoft Word, Adobe PDF (static and interactive forms), etc. As well, there is also an

abundance of scanned document (image and other) formats. These unstructured sources contain data

components that are considered to be high-value and are often manually consulted in order to provide

answers to business questions and/or to provide input to business decisions. Consideration must be given

as to the most appropriate and efficient way to incorporate these data sources into a recommended solution,

in order to extract the greatest degree of value.

Desired Future Data Sources

Consideration must be given to the variety and quantity of data sources that are NOT currently being utilized

to support BEMO’s business and work processes, but that are desired to be utilized in the envisioned future-

state. Again, a strategic approach must be taken to prioritize the order in which each of the data sources is

integrated into the proposed solution(s). Prioritization must take into account the type, size, and complexity

of the data source, as well as the access (permissions) to and criticality (to the business) of the data source.

Data Linkages

Consideration must be given to the need to determine and develop the required data linkages between

identified, unstructured data sources such that they can be interlinked / connected and in order to generate a

greater degree of usefulness and value in the envisioned future state.

End-Users

Consideration must be given to the types of end-users that will be accessing the envisioned future-state solution. In

addition to “internal” users within the BEMO and the Department as a whole, there will also be “external” users that

are comprised of the following:

Employees of other State agencies and entities

Representatives of state-level partners and entities, such as EMS agencies, trauma centers, acute care

hospitals, etc.

Representatives of key national-level partners and entities


Etc.

A rough estimate of current, potential internal users is ~150 – 200, and a rough estimate of current, potential external

users is ~650 – 1,000.

The requirement to ensure the appropriate level of access (only what an individual has been authorized and

approved for) for each and every end-user, in a secure manner, is absolute. The requirement to support access for

“external” end-users must be reflected in all proposed solutions.

Please refer to Attachment VIII for details on the BEMO’s current and desired future data sources, data linkage

needs, data source types / quantities, and user / size details for key data sources (to help provide a baseline for what

a future state user-base may look like).

RFI Vendor Notices This RFI is not a method of procurement.

Responses to this RFI are not offers and may not be accepted by the Department to form a binding contract.

This RFI shall not directly result in the execution of a contract with the Department.

The Department is not obligated to any course of action as the result of this RFI.

The Department reserves the right to utilize the information gathered through the RFI process to develop a scope

of services, which may be incorporated into a contract using a statutorily approved method of procurement.

Vendors submitting responses to the RFI are not prohibited from responding to any subsequent, related

solicitation.

The Department reserves the right to modify this RFI at any time.

Information submitted in response to this RFI will become the property of the Department.

Responses to this RFI will be reviewed by the Department for informational purposes only and will not result in

the award of a contract.

The HIPAS will review and utilize the responses received from this RFI process to develop the Business

Case that will provide the strategic direction to be taken, inclusive of recommendations on best-fit solution

options and an initial implementation design / approach.

The Business Case will be presented to key management stakeholders in order to seek approval, develop

budgets, and identify funding to move forward with the subsequent, proposed project phases for an

implementation.

Further consideration will be given to this effort, based on the Business Case decision / outcome.

All requests for cost information are for budgetary purposes only.

By submitting a response, the vendor consents that the Department may copy the response information for

purposes of facilitating a review, and warrants that such copying will not violate the rights of any third party.

Proprietary Information

Vendors must indicate which portions, if any of the information being provided, are proprietary and confidential

by marking each page upon which such information appears.

Failure to do so will result in all information submitted being subject to public disclosure in accordance with

Florida Statute Chapter 119, Public Records.

The information requested may be used to develop specifications for a solicitation.

Vendor Costs

Vendors are responsible for all costs associated with the preparation, submission, and any potential meeting(s)

to discuss this RFI.

The State of Florida, the Department, the DEPCS, the BEMO, or the HIPAS will not be responsible for any

vendor related costs associated with responding to this request.

RFI Contact(s) All vendor communications regarding this RFI shall be directed to the following contact(s):

Name Contact Information

Connie L. Clark IT Business Consultant


Health Information & Policy Analysis Section Bureau of Emergency Medical Oversight Division of Emergency Preparedness & Community Support Florida Department of Health 4052 Bald Cypress Way, Bin A-22 Tallahassee, FL 32399-1722 Phone: (850) 245-4440 Ext. 2482 E-Mail: [email protected]

RFI Schedule Activity Month – Date – Year Time

RFI Released to Vendors June 24, 2015 By or before 5:00 p.m. EDT

Submission of Vendor Questions July 1, 2015 By or before 5:00 p.m. EDT

Delivery of Responses to Vendor Questions July 9, 2015 By or before 5:00 p.m. EDT

Submission of Vendor RFI Responses July 24, 2015 By or before 5:00 p.m. EDT

RFI Questions Vendor questions regarding this RFI should be submitted to the named contract(s), as referenced in Section II, RFI

Contact(s). All responses to vendor questions will be provided in electronic format. Please refer to Section II, RFI

Schedule for the deadline for all vendor questions to be submitted, and the deadline for all responses to vendor

questions by the Department to be delivered.

RFI Responses and Submissions The responses shall be submitted in the following format (refer to Section III – Vendor Responses): Part I – Executive Summary Part II – Requirements Questionnaire Part III – Proposed Solution(s) and Implementation Approach Part IV – ROM Cost Estimates Part V – Additional Vendor Commentary Vendor RFI response submissions should be directed to the named contract(s), as referenced in Section II, RFI

Contact(s), and submitted in an electronic format. Please refer to Section II, RFI Schedule for the deadline for all

vendor responses to be submitted. Please also refer to Section II, RFI Vendor Notices for important information on

Proprietary Information and Vendor Costs.

RFI List of Attachments

Attachment Name Attachment

[Click Icon to Access] Attachment Description

Attachment I X BEMO – Proof of Concept – Operational Data Store Details

Attachment II X BEMO – Emergency Services Continuum of Care

Attachment III X Department of Health Organizational Structure

Attachment IV X BEMO – Business & Work Processes

Attachment V X BEMO – Business & Work Processes – Supplemental Notes

Attachment VI X BEMO – Reports and Performance Measures List
mailto:[email protected]

Attachment I

Bureau of Emergency Medical Oversight Proof-of-Concept (POC) || Operational Data Store (ODS) Details

Florida Department of Health Division of Emergency Preparedness and Community Support Page 1 of 3

Data Sources & Data Linking The following data sources are currently integrated to the POC ODS:

EMS Detail Data (EMSTARS-CDX)

Includes EMS agency demographic data

Hospital In-Patient & Emergency Department Data (AHCA)

Licensing and Enforcement Data (LEIDS)

The following data sources are currently linked in the POC ODS:

EMS Detail Data || Hospital In-Patient & Emergency Department Data (AHCA)

EMS Agency Demographic Data || Licensing and Enforcement Data (LEIDS)

Extract, Transform, Load (ETL) List EMSTARS CDX To EMS-ODS

In-Patient (AHCA) to EMS-ODS

Emergency Department (AHCA) to EMS-ODS

Match EMS to AHCA Data

LEIDS to EMS-ODS

Cubes There is one cube that was developed for the EMS detailed data; however it has not been maintained

and is not up-to-date. It was created primarily as a test, to illustrate what could be done and accomplished with cube

environments.

Reports (Canned / Static) This is the minimal list of canned / static reports, as the majority of reporting that is performed out of

the POC ODS is ad-hoc (self-service) in nature.

National Submission Count

Submission Timeliness

Missing Critical Elements

Number of Users Internal – 12

External – 0

Estimated Concurrent – 12

Database Details Size = 433 GB

Attachment I



Record Count = 13,317,595

Estimated Annual Growth (in terms of records added) = 2.5 million records

Attachment I



Architecture Diagram

Development Environment Test Environment Production Environment

Microsoft BI Stack 2008

Database Services

Integration Services

Analysis Services

Reporting Services

Database Engine

SQL Server 2008

Proof-of-Concept || Operational Data Store (Data Warehouse)



Database Services


Analysis Services

Reporting Services

Database Engine

SQL Server 2008


Database Services


Analysis Services

Reporting Services

Database Engine

SQL Server 2008

Data Source

EMS Detail Data

(EMSTARS-CDX)

ETLs

Data Source

Hospital In-Patient & Emergency

Department Data (AHCA)

Data Source

Licensing & Enforcement Data

(LEIDS)

Data Sources & Data Linking

Extract, Transform, Load (ETL) List

Cubes

Reports (Canned / Static)

Number of Users

Database Details


Connie L. ClarkFile AttachmentAttachment I - BEMO - Proof of Concept - Operational Data Store

Pre-Hospital Self-Admit Referral

Medical Care Facility ServicesPatient Outcome

Systems Support || Data Collection || Compliance || Reporting || Analysis[HIPAS Section]

Case Planning & Management[BSCIP Program]

Health & Safety[BSCIP Program]

Service Provider Management[BSCIP Program]

Resources & Services Management[BSCIP Program]

Research[IP Program]

Outreach & Prevention Programs[IP Program]

Patient Care Services

Case-Based Financial Management

[Trauma & BSCIP Programs]

Regulation[EMS & Trauma Programs]

Licensing / Certification[EMS & Trauma Programs]

Attachment II - Emergency Services Continuum of Care – Public Health View

Patient Emergency Medical Event

Wellness, Outreach, &

Prevention ServicesEMS Care Services

Grants & Financial Support[All]

Compliance, Monitoring, & Quality Assurance[EMS, Trauma, & BSCIP Programs]

Training & Continuing Education[EMS Program]

BEMO Support Programs & Integrating Mechanisms

Attachment II - Emergency Services Continuum of Care – Services View

Wellness, Outreach, &

Prevention Services

EMS Care Services

Medical Care Facility

Services

Extended Care Services

Home Care Services

Housing Services

Patient ServicesBEMO Integrating Mechanisms

Research

Outreach & Prevention

Programs

Grants & Financial Support

Regulation

Licensing & Certification

Training & Continuing

Education

Compliance, Monitoring, &

Quality Assurance


Regulation

Certification (Verification)


Quality Assurance

Case Based Financial

Management


Case Planning &

Management

Resources & Services

Management

Service Provider

Management


Quality Assurance

Health & Safety

Case-Based Financial

Management


Systems Support || Data Collection || Compliance || Reporting || Analysis

BEMO Support Programs

Injury Prevention Program

Emergency Medical Services

Program

Trauma Program

Brain & Spinal Cord Injury

Program

Attachment II - Emergency Services Continuum of Care – Process View

Yes

Patient Emergency Medical Event

Pre-HospitalEmergency Medical Services

(EMS Program)Medical Care Facility

Does Patient Meet Trauma criteria?

Patient Outcome

Does Patient Have a Brain or Spinal Cord

Injury?

Specialty Care Facility

**If Trauma Criteria Met Trauma Center /

Acute Care Hospital**

(Trauma Program)

Brain & Spinal Cord Injury(BSCIP Program)

Pre-Hospital

Yes

Yes(Referral by Medical Care Facility)

Yes

No

No

Does Patient Require Transport to Medical

Care Facility?

No

Does Patient Meet Specialty Care Facility Criteria

(i.e. STEMI, Stroke, Trauma, etc.)

No

Self-Admit

Patient Self-ReferralInternal Referral

(BSCIP)

Systems Support || Data Collection || Compliance || Reporting || Analysis

Wellness || Outreach || Prevention Services

DATA

DATA

Transfer Required if Initial Medical Care

Facility is not a Trauma Center / Acute Care

Hospital

Attachment II - BEMO - Emergency Services Continuum of Care.vsd

Public Health View

Services View

Process View

Connie L. ClarkFile AttachmentAttachment II - BEMO - Emergency Services Continuum of Care

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Vital Statistics / Records

Community Health Assessment

Clinical Informatics

Florida SHOTS

Health Clinic Management

Support

Health Clinic Management

Training

Community Health

Improvement

FloridaCHARTS.com

Development / Support

Health Resources & Access

Public Health Reporting

Volunteer Health Services

County Health Departments(67)

Alachua, Baker, Bay,

Bradford, Brevard,

Broward, Calhoun,

Charlotte, Citrus, Clay,

Collier, Columbia, Dade,

Desoto, Dixie, Duval,

Escambia, Flagler,

Franklin, Gadsden,

Gilchrist, Glades, Gulf,

Hamilton, Hardee, Hendry,

Hernando, Highlands,

Hillsborough, Holmes,

Indian River, Jackson,

Jefferson, Lafayette, Lake,

Lee, Leon, Levy, Liberty,

Madison, Manatee, Marion,

Mart in, Monroe, Nassau,

Okaloosa, Okeechobee,

Orange, Osceola, Palm

Beach, Pasco, Pinellas,

Polk, Putnam, Santa Rosa,

Sarasota, Seminole, St.

Johns, St. Lucie, Sumter,

Suwannee, Taylor, Union,

Volusia, Wakulla, Walton,

Washington

Deputy Secretary for Administration

Office of Budget & Revenue Management

Office of Information Technology

Disability Determinations

Administration & Financial

Management

Business Automation &

Information Management

Data Administration

Administrat ive Services

Information Systems

Program Operat ions

Program Services

Quality Assurance

Administration

Strategic Process Management

General Services

Administrative & Financial

Application Management

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Compliance Management

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Acupuncture

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Workers

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Nursing

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Electrolysis

EMTs

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Marriage / Family Therapy &

Mental Health Counseling

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Occupational Therapy

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Orthotists / Prosthetists

Osteopathic Medicine

Pain Management Clinic

Registration / Physician

Assistants

Paramedics

Pharmacies

Physical Therapy

Podiatric Medicine

Psychology

Radiologic Technologists

Respiratory Care

School Psychology

Speech-Language Pathology /

Audiology

Business Operations

Web Support Services

Systems Support Services

Licensure Support Services

Practitioner Reporting /

Examination Services

Central Records

Execut ive Boards

(22)

Attachment III – Department of Health Organizational Structure

Attachment III - Department of Health Organizational Structure.vsdx

Page-1

Connie L. ClarkFile AttachmentAttachment III - Department of Health Organizational Structure

Glossary

Attachment IVBureau of Emergency Medical OversightBusiness and Work Processes - Glossary

Key AcronymsDefinition

FS or F.S.Florida Statutes

FAC or F.A.C.Florida Administrative Code

DEPCSDivision of Emergency Preparedness and Community Support

BEMOBureau of Emergency Medical Oversight

EMSEmergency Medical Services Program

TraumaTrauma Program

BSCIPBrain and Spinal Cord Injury Program

IPInjury Prevention Program

HIPASHealth Information and Policy Analysis Section

Data Source AcronymsRefer to the Attachments for "BEMO - Business and Work Processes - Supplemental Notes" and "BEMO - Data Source Details"

&8Florida Department of Health&8Division of Emergency Preparedness and Community Support&8Page &P of &N

EMS

Attachment IVBureau of Emergency Medical OversightBusiness and Work Processes - EMS

Global Input1Florida Statutes and Florida Administrative Code

Key Inputs1DEPCS Strategic PlansEMS Federal GrantEMSC Federal Partnership GrantEMS Statutes and Rules [401, 120, and 64J-1]DOE Curriculum FrameworkF.S. and Administrative Code [401, 64J-1, 64J-1.017, 401.345 EMS Trust Fund, 401.414 Collection of Fines]

2EMS Statutes [401]EMSC National Performance MeasuresEMSC National Performance MeasuresEMS National Education Standards

3EMSTARS DataNational Pediatric Readiness ProjectF.S. and Administrative Code [401, 120, 64J-1]EMS Statutes and Rules [401, 120, and 64J-1]

F.S. [Section 401]NHTSA EMS Re-Assessment RecommendationsNational Standards and GridlinesFDLE 40-Hour LEO Training Program

4National, state, local recommendations / standardsTraffic Fines / Collections [EMS Trust Fund]

Data Inputs1N/AN/AEMS Rural and Matching Grants ApplicationEMS - Ground Ambulance Service Provider Application911 PST Exam ApplicationEMS Investigation Unit Complaint Form

2EMS Grant Management Application Reviewer Scoring Spreadsheet(s)EMS - Air Ambulance Service Provider Application911 PST Exam Registration Form911 PST / 911 PST Training Programs Complaint Tracking Database

3EMS Grant Management Tracking DatabaseEMS - Application for Vehicle PermitPrometrics Computer Based Testing (CBT)LEIDS

4EMSC Grant Management National Performance Measure SpreadsheetsEMS - Application for Air Ambulance Permit911 PST Testing Database

5LEIDSPST 911 Initial / Original Certification Form

6EMS Provider Inspection FormsPST 911 Renewal / Change Certification Form

7EMS Provider Inspection Grid spreadsheet911 PST Certification System (aka "Dispatch System")

8EMS Provider Service Compliance spreadsheet.911 PST Training Program Application

9911 PST Training Programs Tracking Spreadsheet

10EMS Training Programs - Initial Training Program Application

11EMS Training Programs - Continuing Education (CE) Program Application

12EMS Training Programs - CPR / ACLS Course Equivalent Application

13EMS Training Programs - Initial Training Program Site Visit Worksheets

14EMS Training Programs - Initial Training Programs Tracking Spreadsheet

15EMS Training Programs - Continuing Education (CE) Courses Tracking Spreadsheet

16EMS Training Programs - CPR / ACLS Course Equivalent Tracking Spreadsheet

17EMS Training Programs - Training Center (School) Status Log

18EMS Training Programs - Training Program Contact Hours Tracking Spreadsheet

19LEIDS

Connie L. Clark: Connie L. Clark:Used by EMS Training Programs Group

Used for running reports only; they provide information to MQA and MQA personnel perform the data entry.

1EMS Statewide PlanningEMS System AssessmentsEMS / EMSC Grant ManagementEMS Provider Licensure and InspectionEMS and 911 PST Training / Certification / Continuing Education Program and Provider ManagementEMS Investigation and Compliance Management

Key Outputs1Short-term tactical and long-term strategic plansAnalyzed NHSTA recommendations (EMS system)EMS county, matching, and rural grantsALS, BLS, and Air Licenses -- New and RenewalsEMS training program approval / denial

EMS continuing education (CE) provider and course approvals / denialsEMT paramedic, EMS provider, EMT training schools, 911 PST, 911 training programs

2Advice and technical support for FDOHEMS provider and hospital surveys (pediatrics)EMSC Federal Partnership GrantVehicle Permits -- New911 PST testing

911 PST certification / re-certification

911 PST training program approval / denialFelony referrals and exemptions

3Provider inspectionsCompliance and monitoring of final order

Connie L. Clark: Connie L. Clark:There is an online, externally facing tool (owned by MQA) to be able to see final orders:

https://appsmqa.doh.state.fl.us/finalordernet

Work Processes1Coordinate ongoing input mechanisms from key constituencies and EMSACAnalyze recommendations and collected survey dataPerform state-level grant management activities: advertise availability, solicit applications, review applications, award grantsExecute the license and permit process: receive and process applications (fees), determine level of completeness, issue license and/or vehicle permit upon completionManage the application process: receive applications (fees), review and determine completeness of applicationExecute the investigation and compliance process for guidelines, felony referrals/exemptions, and fine collection, in collaboration with key agency partners

2Develop action plans and obtain necessary approvalsDevelop and implement associated action plansPerform national-level grant management activities: complete and submit application, implement goals/objectives upon award, submit progress reportsExecute the provider inspection process: Conduct inspections biennially of each provider, track deficiencies and trendsEMS: Conduct site visit within 30-days upon acceptance of application [initial training programs only]Receive and review complaints, conduct investigations, and prosecute investigations with legal sufficiency

3Implement action plansEMS: Approval or denial of training program or CE provider / courseReceive and review felony referrals and exception requests, perform necessary documentation research, approve / deny requests

4911 PST: Schedule testing, if application is completePerform monitoring to ensure compliance with Final Order and imposed discipline, transfer fines to EMS trust fund, maintain log for reporting

5911 PST: Issue certification / re-certification

6911 PST: Approve / deny training program

Report / Performance Measure Outputs1EMS compliance reports

2EMS Grant Management ad-hoc reports (situational, as needed)

3EMSC Federal Grant Performance Measures - Prepared Data Sets

Connie L. Clark: Connie L. Clark:Raw data must be "prepared," based on the NEDARC methodologies, to calculate Florida’s performance against the measures. This information is then used by the EMSC to identify patterns, gaps, deficiencies and to develop subsequent strategic action plans to address these items, with the goal being to improve results from year-to-year.

4EMSC Federal Grant Performance Measures - Annual Progress Report

Connie L. Clark: Connie L. Clark:Developed annually to “tell the story” of the strategic action plans that have been implemented, and the progress being made.

5EMS Investigation & Compliance performance measures (multiple, see comment for list)

Connie L. Clark: Connie L. Clark:1) Receive, review, and enter complaint into LEIDS (formerly COMPASS/Case Log Management System) within 8 days of receipt.

2) Ensure that all LEIDS activities are indicated during the input of new case and throughout the complaint process.

3) Process, review, and approve/deny EMT and/or Paramedic certification/recertification application with indicated felony convictions within 15 days of receipt from MQA.

4) Prepare, review case file, and submit investigative report to Section Administrator for prosecutorial review within 15 days of response from Subject.

5) Maintain case activity in LEIDS (formerly COMPASS) by entering the correct codes that reflect the status and activity of the complaint (case file) and/or document.

6) Track and resolve all complaints received from external stakeholders. These are other complaints and do not include complaints filed against EMT Paramedics, EMS Providers, EMS Training Centers, 911 PST’s, and 911 PST Training Programs.

Connie L. Clark: Connie L. Clark:Used by EMS Training Programs Group

Used for running reports only; they provide information to MQA and MQA personnel perform the data entry.6EMS Provider Inspection EMSAC quarterly report (see comment for measures)

Connie L. Clark: Connie L. Clark:EMSAC Quarterly Reporting:

Number of Investigations CompletedNumber of Announced InvestigationsNumber of Un-Announced InvestigationsNumber of Provider First-Time InspectionsListing of what the majority of deficiencies documented were; what were the major deficiencies documented.

7EMS Training Program EMSAC monthly & quarterly reports (approved courses)

8EMS Training Program ad-hoc reports (situational, as needed)

Connie L. Clark: Connie L. Clark:Ad-hoc school reportsAd-hoc program contact hour reports (for schools and DOE)

9LEIDS reports (canned, see comment for list)

Connie L. Clark: Connie L. Clark:EMS Provider Licensure and Inspection ReportsProvider listProvider profileVehicle / Aircraft listProvider expiration date listMedical director list

EMS Training Programs Reports (EMSAC -- monthly & quarterly)Schools accredited / not accredited (number)

School exam statistics reports (by EMT / Paramedic Tracts)- Summary (aggregate level data)- Detail (student-level detail data)- Exam Module Statistics Report (Paramedics)

Connie L. Clark: Connie L. Clark:There is an online, externally facing tool (owned by MQA) to be able to see final orders:

https://appsmqa.doh.state.fl.us/finalordernet

Connie L. Clark: Connie L. Clark:Raw data must be "prepared," based on the NEDARC methodologies, to calculate Florida’s performance against the measures. This information is then used by the EMSC to identify patterns, gaps, deficiencies and to develop subsequent strategic action plans to address these items, with the goal being to improve results from year-to-year.

Connie L. Clark: Connie L. Clark:Developed annually to “tell the story” of the strategic action plans that have been implemented, and the progress being made.Key Outcomes1Assure a comprehensive statewide plan for a stable EMS workforceFlorida EMS systems meet NHTS guidelines and standards for EMS careFlorida EMS systems meet NHTS guidelines and standards for EMS careFlorida EMS systems meet NHTS guidelines and standards for EMS careFlorida EMS systems meet NHTS guidelines and standards for EMS careFlorida EMS systems meet NHTS guidelines and standards for EMS care

2Percent of EMS providers found to be in compliance


Trauma

Attachment IVBureau of Emergency Medical OversightBusiness and Work Processes - Trauma


Key Inputs1ACS reportF.S. and FACF.S. and FACF.S. and FACF.S. and FAC

2Analysis of trauma researchACS resource manualACS reportTraffic fines collectionACS report

3Annual trauma system reportScientific researchDOH Pamphlet 150-9Trauma center reportsSystem performance

4F.S. and FACSystem performanceTrauma care outcomesTrauma registry dataTrauma care outcomes

5Hospital system emergency operations plansTrauma care outcomesTrauma registry data [trauma center and acute care]Trauma registry data

6National standards for healthcare system preparedness and response

7Regional trauma services plans

8Scientific research

9Trauma center standards

Data Inputs1N/AN/ANGTR DataNGTR DataNGTR Data

2Site Survey and Assessment FormsEMSTARS Data

Business Process / Program1Trauma System Assessment and State PlanningTrauma Center VerificationTrauma Center Monitoring and Quality AssuranceTrauma Revenue Collection and DistributionTrauma Registry Management and Reporting

Outputs1Annual trauma system assessmentApproved transport protocolAnnual status reportTrauma center report analysisData collection execution

2Trauma system strategic planApplication managementQuality assurance / evaluationPayment allocationCompliance reporting

3Regional trauma agency plansVerified trauma centersSite surveysFund verification

4Disaster preparedness / response plan

5Analysis of trauma research / trauma service areas

6Promulgated rule

Work Processes1Execute all necessaries tasks to conduct annual assessment activitiesExecute renewals of air / ground licensing; review and assurance of proper transport protocols for trauma centersPerform trauma center assessments via multiple data inputs (data collection / analysis), customer request tracking / assessment, and site surveysAssess various data inputs for each trauma center to ensure alignment with data requirements and system strategies; document findingsEstablish schedule for routine and systematic collection / analysis of injury related information; execute as defined

2Receive and evaluate assessment input for state 5-year strategic plan; implement recommendations and updates as appropriate Execute the necessary activities of the trauma center application process: receive, preliminary review, determination of deficiencies, grant/deny provisional status, in-depth review, conduct on-site survey / audit, grant/deny verified statusEvaluate system components, resources, organization, and processes to help ensure provision of necessary servicesMonitor and assess different fund sources; determine funding allocations; communicate and disperse fundingDocument findings for input to strategic planning

3Receive and evaluate assessment input for agency-level plans; implement recommendations and updates as appropriate Issue 7-year trauma center certificates; manage application renewal processIdentify opportunities for intervention and/or performance improvement; make recommendationsMonitor and ensure funding is received appropriately by trauma centersMonitor research compliance requirement for in-scope facilities via site surveys / audits

4Collaborate with regionally agencies to develop and maintain necessary and appropriate disaster preparedness and response plans, inclusive of educational and communication componentsMonitor research compliance requirement for in-scope facilities via site surveys / audits

5Execute level-1 trauma center research / communication activitiesAssess any policy impacts

6Execute trauma service area research / decision making activities

7Execute all necessary legislative process activities (bills and rules)

Report / Performance Measure Outputs1Trauma compliance reports

2Trauma pay-out reports

3Annual status report (monitoring / quality assurance)

4Medical records review (deficiency) reports

5Site survey reports (to centers / hospitals)

Key Outcomes1Florida Trauma System Meets National NTDB StandardsFlorida Trauma System Meets National NTDB StandardsTrauma care to reduce preventable mortality rate of the severely injuredFlorida Trauma System Meets National NTDB StandardsFlorida Trauma System Meets National NTDB Standards


BSCIP

Attachment IVBureau of Emergency Medical OversightBusiness and Work Processes - BSCIP


Key Inputs1Hospital or other facility referrals / submissionsFS and FACFS and FACFS and FACCenters for Medicare and Medicaid Services Waiver Performance MeasuresFS and FACFS and FACCenters for Medicare and Medicaid Services Waiver Performance Measures

2Self-referrals by individualsBSCIP Central RegistryHCBS Waiver ApplicationsHCBS Waiver ApplicationsHCBS Waiver ApplicationsHCBS Waiver Applications

3Internal BSCIP referrals / submissionsHCBS Waiver ApplicationsMedicaid HandbooksMedicaid HandbooksMedicaid HandbooksMedicaid Handbooks

4Medicaid Handbooks

Data Inputs1Central Registry (manual referral / submission process)

Connie L. Clark: Connie L. Clark:Three Central Registry inputs:

1) Hospital or other facility (i.e. rehab or other ) identifies client for referral and submits via Central Registry.

2) Client reaches out to BSCIP directly with a self-referral (manual contact).

3) BSCIP may learn of a client create an internal referral - happens the least.

These referrals get manually entered into RIMS to establish an applicant / client case file.Client data (manual data gathering; manual input into RIMS)RIMSRIMSRIMS (reports)Provider applications (manual input into RIMS)RIMS (reports)RIMS (reports)

2

3

4

Business Process / Program1BSCIP Client (Applicant) ReferralsBSCIP Client Eligibility DeterminationBSCIP Client Care Plan DevelopmentBSCIP Client Case Management / Resources and Services FacilitationBSCIP Client Services Monitoring and Quality AssuranceBSCIP Service Provider Applicant Recruitment / Qualification DeterminationBSCIP Service Provider Gaps IdentificationBSCIP Service Provider Monitoring and Quality Assurance

Key Outputs1Client (applicant) statusPrioritization Screening InstrumentClient Care Plan of Services and SupportsPurchased Client ServicesQuarterly Performance Measure ReportsProvider Qualification ChecklistMISSINGQuarterly Performance Measure Reports

2701B AssessmentProvision of Community-Based Services and SupportsQualification Letter

32515 Level of CareProvider Agreement

4In-Service Status

5Closed Status

Work Processes1Receive client (applicant) referralsPerform data collection activities to build the case file (for determining eligibility)Develop client care planPerform authorizations for purchased client servicesRun reports and audit associated data to ensure clients are receiving the proper resources and servicesManage provider application processIdentify where the program has a need for additional providers in certain resource / service areas where there are not enough providersRun reports and audit associated data to ensure providers are supplying the proper resources and services

2Create client (applicant) case fileMake a final determination of eligibilityMove client to an "in-service" statusPerform client contacts / conduct client interactionsEnter provider into RIMS (if application is approved) for utilization as a program resource / service providerIdentify where the program has a need for additional providers in certain resource / service areas where there is a need to create more competition (i.e. create more client choice)

3Enter notes into client case file

4Scan documents into client case file

Report / Performance Measures Outputs1Ad-hoc reports (variety, routinely requested)

2Canned reports (variety)

3Compliance / performance measure reports (multiple; waiver side only)

4Legislative reports (ad-hoc -- financial, client counts / wait lists, etc.)

5Impact analyses -- How various factors (such as program funding) affect the success rates of re-introduction to work & society following rehabilitation

Key Outcomes1Assure access to careAssure access to careAssure access to careAssure access to careImprove efficiency and effectivenessAssure access to careAssure access to careImprove efficiency and effectiveness


IP

Attachment IVBureau of Emergency Medical OversightBusiness and Work Processes - IP


Key Inputs1F.S [401.243]CDC grant guidance / required data reportsCDC grant guidance

2Data: Vital Stats, HDD, EDData analysisData analysis

3Injury Surveillance RecommendationsData fact sheetsStakeholders

4Priority areasNational Highway Traffic Safety Administration (NHTSA)

5State and county profilesNational Council on Aging (NCOA)

6Top 10 chartsF.S. [515.31]

7StakeholdersFAC [64E-21.001]

8Previous SOPAT

9Safe Kids Agreement

Data Inputs

Connie L. Clark: Connie L. Clark:There is a list of data sources on the externally facing web site -- http://www.floridahealth.gov/statistics-and-data/florida-injury-surveillance-system/index.html

- Emergency Department Discharge Data*- Hospital Discharge Data*- Vital Statistics / Records (Death Certificates)*------------------------------------------------------------------ Behavioral Risk Factor Surveillance System- Child Death Review- Emergency Medical Services (EMS)- Motor Vehicle Crash Records- Uniform Crime Reporting System- Youth Risk Behavior Surveillance System

*BOLDED = These are the current, primary sources that are utilized to develop all reporting, etc.

All others are secondary, state-level data sources utilized as-needed for additional data and/or to perform comparison activities.

There are also several national-level data sources that are utilized as-needed for additional data and/or to perform comparison activities.

- NHTSA's Fatality Analysis Reporting System (FARS)- CDC's Web-Based Injury Statistics Query and Reporting System (WISQARS)1Emergency Department Data (AHCA)*

Connie L. Clark: Connie L. Clark:* = Primary data sources for reporting & performance measures

2In-Patient Data (AHCA)*

3Vital Statistics / Records (Death Certificates)*

4Behavioral Risk Factor Surveillance System

5Child Death Review

6Emergency Medical Services (EMS)

7Motor Vehicle Crash Records

8Uniform Crime Reporting System

9Youth Risk Behavior Surveillance System

10NHTSA's Fatality Analysis Reporting System (FARS)

11CDC's Web-Based Injury Statistics Query and Reporting System (WISQARS)

Business Process / Program1Injury Surveillance Data System

Connie L. Clark: Connie L. Clark:Not a true application, rather a systematic process to collect data from key sources for the purposes of reporting and monitoring of key performance measures.IP Statewide PlanningIP Program Management

Key Outputs1Reports and analysis of leading causes of injuryShort-term tactical and long-term strategic plansEstablished prevention programs for: bicycle/pedestrian safety, older adult falls, drowning, distracted driving, children

2Priority AreasData Fact SheetsState and County ProfilesTop 10 ChartsCoordination and leadership for Florida Injury Prevention Advisory Council (FIPAC) and Florida’s injury prevention networkInjury prevention education, training, and public awareness activities for each program.

3Establishment of program-specific work teamsMini grant oversight

4CDC Grant oversight

5Awareness and communications

Work Processes1Evaluate the completeness, timeliness, and quality of data sourcesDevelop, execute, and monitor progress of plansFacilitate program specific meetings, conference calls, etc.; monitor action plan progress; report status

2Monitor frequency of injuries and determine associated risk factorsFacilitate focus area specific meetings, conference calls, etc.Facilitate programs-specific education, training, and awareness activities

3Provide information to Florida's injury prevention community for program planning and evaluationFacilitate and manage grant processes: applications, reviews, scoring, selection, awards, progress reportsFacilitate and manage grant processes: applications, reviews, scoring, selection, awards, progress reports

4Provide a foundation for injury prevention strategies within the Florida Injury Prevention Strategic PlanFacilitate communications and awareness activities

Report / Performance Measure Outputs1Priority Areas -- CDC Reporting

Connie L. Clark: Connie L. Clark:- Drug poisoning / overdose- Traumatic brain injuries- Senior falls

2Data (Injury) Fact Sheets

Connie L. Clark: Connie L. Clark:Individual, six-page fact sheets describing select injury mechanisms and intents in great detail. Each fact sheet characterizes the topic using text, tables, graphs, and GIS maps to provide knowledge and focus for prevention activities.

All InjuryDrowningFirearmHip Fractures, Ages 65+Homicide and AssaultMotor Vehicle TrafficPoisoningSuicide and Self-HarmTraumatic Brain InjuryUnintentional FallsUnintentional FiresUnintentional InjuryUnintentional Older Adult Falls

3State / County Profiles

Connie L. Clark: Connie L. Clark:Detailed tables providing a picture of injuries within the state of Florida and each of Florida’s 67 counties. Each table has 68 tabs. Each tab contains a two-page profile of injury data by intent, mechanism, and age group; one for the state of Florida plus each of Florida’s 67 counties.

Fatal InjuriesNon-Fatal HospitalizationsNon-Fatal Injury Emergency Department Visits

4Top 10 Charts (Leading Statewide Injuries)

Connie L. Clark: Connie L. Clark:Color-coded tables showing the 10 leading injury mechanisms across 11 different age groups for each year of data.


5State Injury Indicators -- CDC Reporting

6Planning Data (ad-hoc)

7CDC Grant Data (ad-hoc)

8Trend Analysis Reporting (Excel-based)

Connie L. Clark: Connie L. Clark:Injury-based reports over the span of several years

Performance Measure Reporting (State / Agency Plans)

Connie L. Clark: Connie L. Clark:There are six (?) total IP-related measures in several different agency plans that are reported on as required by the specific plan (i.e. quarterly, annually, etc.):

- The State Health Improvement Plan (SHIP)- Long-Range Program Plan (LRPP)- Agency Strategic Plan

CDC Mini Grant Roll-Up Reporting

Connie L. Clark: Connie L. Clark:Widget counting roll-up reports for the following three areas that count number of education presentations, number of people reached with public awareness efforts, number of people trained, etc.:

- Child Drowning Prevention- Distracted Driving Prevention- Older Adult Falls Prevention

Connie L. Clark: Connie L. Clark:- Drug poisoning / overdose- Traumatic brain injuries- Senior falls

Connie L. Clark: Connie L. Clark:Individual, six-page fact sheets describing select injury mechanisms and intents in great detail. Each fact sheet characterizes the topic using text, tables, graphs, and GIS maps to provide knowledge and focus for prevention activities.

All InjuryDrowningFirearmHip Fractures, Ages 65+Homicide and AssaultMotor Vehicle TrafficPoisoningSuicide and Self-HarmTraumatic Brain InjuryUnintentional FallsUnintentional FiresUnintentional InjuryUnintentional Older Adult Falls

Connie L. Clark: Connie L. Clark:Detailed tables providing a picture of injuries within the state of Florida and each of Florida’s 67 counties. Each table has 68 tabs. Each tab contains a two-page profile of injury data by intent, mechanism, and age group; one for the state of Florida plus each of Florida’s 67 counties.


Connie L. Clark: Connie L. Clark:Not a true application, rather a systematic process to collect data from key sources for the purposes of reporting and monitoring of key performance measures.

Connie L. Clark: Connie L. Clark:Color-coded tables showing the 10 leading injury mechanisms across 11 different age groups for each year of data.


Connie L. Clark: Connie L. Clark:There is a list of data sources on the externally facing web site -- http://www.floridahealth.gov/statistics-and-data/florida-injury-surveillance-system/index.html

- Emergency Department Discharge Data*- Hospital Discharge Data*- Vital Statistics / Records (Death Certificates)*------------------------------------------------------------------ Behavioral Risk Factor Surveillance System- Child Death Review- Emergency Medical Services (EMS)- Motor Vehicle Crash Records- Uniform Crime Reporting System- Youth Risk Behavior Surveillance System

*BOLDED = These are the current, primary sources that are utilized to develop all reporting, etc.

All others are secondary, state-level data sources utilized as-needed for additional data and/or to perform comparison activities.

There are also several national-level data sources that are utilized as-needed for additional data and/or to perform comparison activities.

- NHTSA's Fatality Analysis Reporting System (FARS)- CDC's Web-Based Injury Statistics Query and Reporting System (WISQARS)

Connie L. Clark: Connie L. Clark:* = Primary data sources for reporting & performance measures

Connie L. Clark: Connie L. Clark:Injury-based reports over the span of several yearsKey Outcomes1Reduce intentional and unintentional injuryReduce intentional and unintentional injuryReduce intentional and unintentional injury

2Well supported policy efforts and public awarenessWell established and maintained Florida Injury Prevention Advisory Council (FIPAC) and Florida injury prevention networkReduce the number of pedestrian and bicycle fatalities and serious injuries

3Decrease the rate of death from falls among persons aged 65 and over in Florida

4Reduce the rate of deaths from all causes of external injury among Florida resident children ages 0–14

5Reduce the number of driving fatalities and serious injuries

6Reduce the number of unintentional injuries to children in Safe Kids Florida counties


HIPAS

Attachment IVBureau of Emergency Medical OversightBusiness and Work Processes - HIPAS


Key Inputs1ACSACS #9Management directive / prioritiesACS / ACS Resource ManualACSACSF.S.

2EMSAC Data CommitteeACS #10NHTSA performance measuresEMS / NEMSIS standardsF.S.CDCACS

3F.S. [401]ACS recommendationsNTDBEMS performance measuresNHTSAF.S.CDC

4NEMSISNHTSAF.S. [401.30]NTDBEMS strategic management

5NTHSAProgram goalF.S. and FACNTHSAF.S.

6NHTSAProgram goalNTDB

7Program goalNTHSA

8Scientific researchNTHSA

9System performanceProgram goal

10Trauma care outcomes

11Trauma registry data

Data Inputs1N/AN/AN/AN/AEMS Pre-Hospital Aggregate Data [Collection Form & Database]EMS Pre-Hospital Aggregate Data [Collection Form & Database]N/A

2EMSTARS DataEMSTARS Data

3EMSTARS Data Dictionaries [National / State]EMSTARS Data Dictionaries [National / State]

4NGTR DataNGTR Data

5NGTR Data Dictionaries [National / State]NGTR Data Dictionaries [National / State]

6LEIDSRIMS

7LEIDS

8Emergency Department Data (AHCA)

9In-Patient Data (AHCA)

10Healthcare Facilities Data (AHCA)

11Vital Statistics / Records - Death Certificates

12Motor Vehicle Crash Records (DOT)

13GIS Base Map / Layer Data

14ZIP Code Data

15U.S. Census Data

16Industry Standard Code Sets [GNIS, ICD 9 & 10, Snomed, RxNorm]

Business Process / Program1HIPAS Strategic PlanningHIPAS Rule DevelopmentHIPAS Project ManagementHIPAS Technology Solution Assessment, Delivery, Support, and TrainingHIPAS Data Collection and ComplianceHIPAS Data Analysis and ReportingHIPAS Constituency Group Support

Key Outputs1EMS strategic objectives / action plansEMS participation rule changeFederal 405 grant awardManagement directives / prioritiesProgram-area specific reports: EMS and Trauma compliance reports; Trauma pay-out reportsProgram-specific data analysis reports (EMS, Trauma, BSCIP, IP)

General ad-hoc data reportsEMSAC data committee workshops and work products

2BSCIP strategic objectives / action plansTrauma ruleProgram area-specific project managementProgram-area specific technology solutions: EMS, Trauma, & BSCIPAnalysis and reporting protocols / standardsEMRC committee workshops and work products

3Program-area specific technology solution training: EMS, Trauma, & InjuryResearch / publications

4Database linkage methodologies

Work Processes1Provide coordination and facilitative support to applicable advisory councils / committees -- meetings, workshops, strategic planningProvide input into proposed participation-specific rules: language and specifications, estimated regulatory costs, and legal supportFacilitate and manage grant processes: develop proposal/application, prepare and present briefs, produce required reportsAssess inputs from management and strategic plan; assess current state technology environmentEnable compliance work processes for program area-specific data collectionDevelop program-specific and ad-hoc reports, as requestedProvide coordination and facilitative support to applicable advisory councils / committees -- meetings, workshops, strategic planning

2Plan and prepare input to program-specific strategic plansFacilitate and manage all program-area specific solution implementations: schedule, tasks, risks, issues, documentation / artifacts, implementation partners and SLAsIdentify gaps and set prioritiesMonitor and provide support for data submissionsResearch, develop, and publish protocols / standards for analysis and reportingDevelop / deliver briefings, presentations, agendas, workshops, work products, etc.

3Facilitate and manage all aspects of solution delivery and support: requirements (business, data, functional, technical), development, testing, migrations, implementation, reporting, monitoring, issue resolution, enhancements/upgrades, vendor management/SLAs, ongoing support Develop data submission compliance reportsResearch and develop topics for publication

4Design and develop training materials; conduct training sessions / workshopsProvide compliance issue resolutionDevelop and implement linkage methodologies for the different program-specific data sets

Report / Performance Measure Outputs1Program-area specific reports: EMS and Trauma compliance reports; Trauma pay-out reports

2Program-specific data analysis reports (EMS, Trauma, BSCIP, IP)

3General ad-hoc data reports

4EMSTARS-CDX Reports

Connie L. Clark: Connie L. Clark:Aggregate Level Benchmarking ReportsSolution utilizes Business Objects (aka "Universe") to provision; performance measures report card feeder.

Patient Care ReportsShows what the written EMS report would have looked like with all the various data fields; can be used easier than the XML file for troubleshooting upload file accuracy issues.

No Data Reporting (NDR)Enables the agencies to communicate with the Department if they have no data to report in a given month or if they are seeking some sort of reporting exception.

5EMS Agencies -- Performance Measures Report Card

Connie L. Clark: Connie L. Clark:32 measures / metrics

Two views: DOH View; Agency View

6Pre-Hospital Aggregate Reports (STARIS)

Connie L. Clark: Connie L. Clark:Agency StatusAgency TestingDeactivate EMSTARSDeactivate AggregatePast Due AggregateNew Agencies

7NGTR Reports

Connie L. Clark: Connie L. Clark:DrillerAllows hospitals and Department staff to quickly drill into the data to discover trends and review key data points.

Report WriterGeneration of custom report needsSome canned reports as wellWeb report runner (web-enabled Report Writer access) -- Cannot design reports, users can only run a pre-designed report that has been enabled for web report runner.

Charting / DashboardsAbility to upload .CSV files and have "dashboards" created on the fly.Currently limited to pre-defined reports.

SASUtilized exclusively by the HIPAS Reporting & Analysis team

Trauma MetricsPerformance measures "report card" feeder

8Trauma Centers / Acute Care Hospitals -- Performance Measures Report Card

Connie L. Clark: Connie L. Clark:~52 measures / metrics [under development]

Two views: DOH View; Agency View

Key Outcomes1Defined business prioritiesIncreased participation in data collectionFederal funding received and planned, and managed solution deliveryTechnology solutions and support to meet program area business / operational needsCompliance with Florida StatutesImproved quality assurance and decision supportStakeholder involvement and buy-in

2Improved decision supportImproved EMS service deliveryImproved quality assurance and decision support

3Florida EMS systems meet NEMSIS standardsImproved EMS service delivery

4Florida Trauma systems meet NTDB standards

4Trained workforce and stakeholders


Connie L. ClarkFile AttachmentAttachment IV - BEMO - Business & Work Processes

Attachment V

Bureau of Emergency Medical Oversight

Business and Work Process – Supplemental Notes

Emergency Medical Services (EMS)

Emergency Medical Services (EMS) is responsible for the statewide regulation of:

· Grants

· Education, Licensure and Compliance

· EMS for Children (EMSC)

· Emergency medical technicians (EMTs) and paramedics

· EMT and paramedic training programs

· 911 public safety telecommunicators (PSTs)

· Ground vehicles and aircraft

· The investigation, prosecution and discipline of legally sufficient complaints against EMTs, paramedics, licensed EMS providers, EMS training centers, and 911 PSTs

911 PST Process

· This is the form used to submit an application to be approved to take the PST 911 exam:

· http://www.floridahealth.gov/licensing-and-regulation/911-public-safety-telecommunicator-program/_documents/%20911pst-examapp2014.pdf

· The preferred submission process is for the application (and accompanying payment) to be mailed in.

· Occasionally some will e-mail the application, and then mail in the accompanying payment.

· Certain data components from these applications are used to populate the Master Database (aka “Testing Database;” see the blank record screenshot below).

· The received application is scanned to PDF and stored on the J: Drive (file share).

· The original hard-copy is then shipped to secure off-site storage and is retained per the period that is defined in statute for applications (~5-7 years).

· This is the online form that is used by approved applicants to register for a date / time / location for taking the exam.

· Online form – http://survey.doh.state.fl.us/survey/entry.jsp?id=1388703200737.

· This is homegrown, web-based survey tool solution; the form is created and published with the solution and the form data dumps into a back-end database (http://survey.doh.state.fl.us).

· Once received, the data is exported into a file (type unverified; believe to be RTF), which is then subsequently imported into the Master Database.

· A quick-view scheduling tool (Microsoft Excel spreadsheet) is developed using a sub-set of data from the Master Database to give EMS Program employees a quick view of the upcoming testing schedule (who, when, where, etc.) for each month.

· The current 911 PST testing process is manual and paper-based; Scantrons are used to capture test answers and then graded; scores are stored in the Master Database.

· There is a planned transition to a new Computer Based Testing (CBT) solution by mid/late summer 2015 (July/August).

· The new solution is hosted by Prometrics, and will piggy-back on the existing Prometrics implementations for EMT and Paramedic testing.

· Prometrics – https://www.prometric.com/en-us/Pages/home.aspx

· Current Department testing – https://www.prometric.com/en-us/clients/Florida/pages/FLDOH.aspx.

· The contract and solution are owned by the Division of Medical Quality Assurance (MQA).

· This solution will combine testing registration, scheduling, and administration processes.

· These are the forms used to submit applications for PST 911 certification:

· Initial/Original – http://www.floridahealth.gov/licensing-and-regulation/911-public-safety-telecommunicator-program/_documents/dh5066-911pstinitialcertificateapp1-9-131.pdf

· Renewal/Change – http://www.floridahealth.gov/licensing-and-regulation/911-public-safety-telecommunicator-program/_documents/dh5068renewalchangestatus911pstcert1-9-131.pdf

· The preferred submission process is for the application (and accompanying payment) to be mailed in.

· Certain data components f

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