VIBERT: One Person One Record process clouded by questions

They didn’t check references.

A contract with an estimated value of half-a-billion-dollars hangs in the balance. Yet, the government’s selection committee didn’t bother to check references before cutting the field from four bidders to just two left competing for the One Person One Record (OPOR) health IT contract.

Twenty-per-cent of the score that determined which IT groups survived to bid on OPOR was based on experience and, you guessed it, references. Nevertheless, in qualifying bidders to supply the digital wizardry behind OPOR, references were evaluated only as provided by bidders, not checked with the customers.

The head of Nova Scotia’s purchasing agency, Chris Mitchell said, “Contacting of references was not required by the evaluation team.”

The Internal Services Department confirmed this week that all bidders were asked to provide up to three references to highlight their qualifications through examples of past work. But reference checks, such as they were, waited until the field was reduced to two.

“Reference sites were visited as part of the subsequent formal RFP process,” a government spokesperson wrote. Two bidders — Allscripts and Cerner — made it to the formal RFP process.

Why references wouldn’t be checked as part of the process to select the most qualified bidders remains unanswered. In fact, the entire process seems to have been conducted devoid of intelligence, other than that provided by the proponents themselves.

Late to purchasing

OPOR is a big deal. When and if it gets done, every Nova Scotian should have an individual health record that can be accessed electronically by health-care providers — wherever and whenever needed.

The province received submissions from six health IT companies in the initial stage, called the request for supplier qualifications (RFSQ). Four were evaluated, and Allscripts and Cerner made it to the final round and got to bid on the contract, which could be awarded any time.

One smaller company didn’t advance past initial screening, and Epic, an industry leader, was disqualified after its submission was delivered to the wrong government office, where it languished for a couple of days while employees, realizing the mistake, tried to connect with purchasing.

When no one in government purchasing returned their calls, folks in the wrong office delivered Epic’s package to the correct office, but it was too late. The deadline for submissions had passed, and when Epic made noises like it intended to challenge its disqualification, it — along with all other proponents — got a letter from a government lawyer threatening to refer the matter to the courts. Epic apparently decided the litigiously-inclined little province on Canada’s East Coast wasn’t worth the hassle.

Meditech and Evident were eliminated during evaluation of the RFSQ submissions. Evident cried foul, raising a number of issues, including conflict of interest.

Evident had been told by a senior IT official with the Nova Scotia Health Authority in March of 2016 that, “Although we are not in a formal RFP, we are not meeting with vendors at this time.”

Except throughout that spring, summer and fall, the NSHA met with officials from the Allscripts and Cerner groups, both of which made presentations in an NSHA series called Let’s Talk Health Informatics.

The NSHA has removed those presentations from its online archives and refuses to shed any light on why it covered its tracks leading to the doorstep of the two finalists in the OPOR competition.

The province hasn’t addressed any of the concerns raised about the process that culminates when it awards the largest IT contract in Nova Scotia’s history. Provincial and NSHA officials merely cite a “fairness” monitor from Ottawa and an internal review committee, both of whom said the RFSQ evaluation process was conducted appropriately.

References weren’t all the selection committee overlooked. By its own admission, it picked the finalists out of a virtual information vacuum where only the proponents’ words were heard.

“Proposals are evaluated on the content provided therein; outside information is not traditionally gathered or obtained through other sources (i.e., internet),” Mitchell wrote.

The province’s don’t-ask, don’t-check purchasing policy isn’t terribly comforting given the shifting landscape in Health IT, cost overruns and other issues that plague similar projects elsewhere and the emergent preference among Canadian customers for products from the U.S.-based company Nova Scotia disqualified — Epic.

So far, this vital contract is clouded by the NSHA’s ongoing relationship with the two eventual finalists after it had rebuffed communication from another bidder; the apparent disinterest of the province in the experience of other jurisdictions; and a selection process that seems a tad indolent considering Nova Scotians are going to be on the hook for a nine-figure deal.