Single Source Procurement: SHIN-NY Regional Health Information Organizations (RHIO)

Pursuant to New York State Finance Law § 163.10(b), The New York State Department of Health is presenting the following summary of relevant circumstances, and material and substantial reasons why a competitive procurement was not feasible.

The Statewide Health Information Network for New York (SHIN-NY) is a "network of networks" that will exist across New York State. The SHIN-NY is the mechanism within New York State that is used to facilitate the sharing of patient-specific health information via the health information exchange (HIE) among hospitals, providers, health plans and public health officials in a secure and confidential manner. As such, it is the critical underpinning to a number of New York State Department of Health (NYSDOH) initiatives aimed at improving the quality of patient care, patient care experience and cost of delivering that care. The SHIN-NY is overseen by the New York State Department of Health (NYSDOH) and facilitated by NYeC. It is a network comprised of 10 RHIOs across the state that connect health care providers on a local level. The network will serve hundreds of hospitals, thousands of medical providers and millions of people who live in or receive care in New York State. The network will be governed by federal HIPAA and State privacy and security policies and standards. The Delivery System Reform Incentive Payment (DSRIP) Program is the main mechanism by which New York State will implement the Medicaid Redesign Team (MRT) Waiver Amendment. DSRIP's purpose is to fundamentally restructure the health care delivery system by reinvesting in the Medicaid program. The sharing of health information via connection to a RHIO/Qualified Entity (QE) is required in the DSRIP Program. The Health Home program also requires providers to share information via the SHIN-NY to facilitate the care of the targeted patient population. The NYSDOH Patient Centered Medical Home incentive program also requires, in order to receive the full incentive payment, connection to the SHIN-NY and to share patient information electronically to improve the quality of patient care delivered.

Established to facilitate an interconnected, statewide network of electronic health records, the SHIN-NY is designed to improve health care for all New Yorkers by ensuring that doctors have instant and accessible information about their patients, anywhere and anytime. For example, the network would allow a doctor treating an unconscious emergency room patient in Buffalo to instantly receive their full medical history including past procedures and relevant allergies from their primary care physician in Brooklyn.

The delivery of health care in New York State occurs in settings from individual physician offices and community health centers to large academic medical centers, nursing homes and multi-specialty physician practices, from Manhattan to rural upstate towns with vastly differing market conditions and health care needs. There is a critical need for a coordinated statewide health information technology (IT) framework which supports common policies, technical standards and protocols as well as regional "bottom up" implementation approaches and care coordination to allow local communities and regions to structure their efforts based on clinical and patient priorities. The RHIOs play a unique and critical role in enabling the secure, confidential exchange of information on a statewide basis to help address the health care data needs experienced by providers.

Established through the Healthcare Efficiency and Affordability Law for New York (HEAL-NY), the State has invested significant dollars in the RHIOs over the past several years. The HEAL procurements were a competitive process and vendors were selected based on responses to the HEAL applications and the competitive procurement process. Throughout the multiple HEAL-NY phases, the RHIOs were significant partners. These HEAL awards help to support the RHIOs in the initial phases of their development. The investment in the health IT phase of the HEAL program was extensive with an equal contribution coming from the award recipients and local stakeholders. NYS has invested significant funding to foster the early development of the RHIOs and this investment needs to continue to realize the full benefits across the State.

In addition, the 10 RHIOs are the only entities that have applied for, and received, certification from NYS to provide the required services to communities across NYS. The RHIOs are, therefore, the Qualified Entities (QEs). The RHIOs were the only organizations that stepped forth for certification and are the only organizations that have the infrastructure, both from a technology and administrative services perspective that could meet the criteria. The RHIO certification process (to become QEs) was completed by an independent third party (via a contract with KPMG) by conducting a detailed review, using 38 criteria and associated test procedures, of the current status of the RHIOs relative to the minimum technical and administrative standards they would need to achieve to be QEs and eligible for state funding. All 10 of the RHIOs have completed the process and become provisionally certified and therefore eligible to receive this funding.

The RHIOs are uniquely positioned in their local communities and they are the only entities capable of fulfilling the requirements associated with New York's Health Information Strategy. No other organizations possess the technical or administrative skill set needed to fulfil this critical role.

Procurement / Program Name SHIN-NY Regional Health Information Organizations (RHIO)
Contractor Name(s) Multiple – Please see attached
Contract Period Period 4/1/2014 – 3/31/2017
Contract Number(s) Multiple – Please see attached