eDoc4U Services

Fully Automated and Integrated Health Screening & Preventative Care

The eDoc4U services can be private labeled and integrates the fully automated health screening technology and preventive care web services to providers, health plans and employers.  The intuitive “smart browser interface” creates a unique and comprehensive medical profile for personnel in a matter of minutes.  Personalized, culturally sensitive and easy-to-understand preventive care plans are delivered to members for interactive participation with “trusted physician” video counseling for disease prevention, healthy lifestyles, self-care and injury prevention.

The eDoc4U currently supports hundreds of client sites with millions of members. Broadband Technology Corporation is headquartered Lubbock, TX with offices in the Nashville, TN Area, Kentucky and the Knoxville, TN Area.  

These products are listed below:

  • Health Risk Assessments (HRA)
  • Disease Risk Index (DRI)
  • Preventive Care Plan (PCP)
  • Personal Health Record (PHR)
  • On-Line Health Coach
  • Reporting and Management
  • ASP Platform
  • Security
  • SP Platform
  • eDoc4U Integrating
  • Reporting and Access Management

Delivery:  As negotiated between the ordering agency and Broadband Technology Corp.

1.0     Introduction

Broadband Technology Corp is pleased to offer the development and delivery of a common and standardized Health Risk Assessment (HRA) instrument that can each customize to meet the needs of each respective population. The eDoc4U HRA can be integrated with the clients Online Web Portals, and Computerized Patient Record System for real-time bi-directional patient data transfer and consistent patient experience. Components of this offering are provided by our Broadband Services Division, and its eDoc4u online web delivery system further described below.

2.0       Executive Summary

eDoc4u provides an integrated and fully-automated health screening technology and preventive care platform to providers, health plans and employers. The eDoc4u platform is a comprehensive, easy to use, medical web service that presents patients with: personalized risks for diseases, specific prevention recommendations, culturally competent ‘trusted physician’ video counseling, integrated personal health record and on-line health coaching. eDoc4u impacts population health by empowering, educating and motivating patients to take action and improve their health and safety. 

eDoc4u delivers its web services as a flexible, scalable and integrated ASP platform. The eDoc4u platform is private labeled within client portals using specific style guides, content and language, in either pop-up or I-frame configurations for consistent user experience.eDoc4u’s enterprise architecture, with distributed caching and load balanced server farms, is fully scalable to support millions of patients. Our current client base has a population of over 7 million eligible members (see 2.3.5 for details). Data access, storage and transmission are all designed to stringent HIPAA compliance requirements for security and protection of patient information.

eDoc4u integration services include Single-Sign-On for patient authentication and data sharing, web services for data import and export, module pre-population from client data warehouses, and full customization to client specifications.eDoc4u’s platform supports the Continuity of Care Record format for compatibility and is totally integrated with health risk assessment, preventive care plan and personal health record modules.  The platform can be pre-populated with other data sources such as provider sources of prescriptions, biometric and lab data.

  • Health Risk Assessment

An intuitive Health Risk Assessment (HRA), utilizing “branching logic” resembling a clinician’s diagnostic tree, creates a unique clinical pathway for each patient. Self-reported information is captured by our “smart browser interface” during a 10-15 minute on-line patient session. Clinician updates and real-time client data transfer are also facilitated. eDoc4u’s HRA interactively integrates patient medical risks and biometrics with lifestyle, mental health and injury prevention.  Our HRA can also be customized for specific client requirements. Current HRA variables include; age, gender, ethnicity, personal and family health history, medications, allergies, biometric, screening test history, nutrition, physical activity, readiness to change, substance use, mental health and injury risks. Biometric and clinical laboratory values are evaluated in conjunction with screenings. 

  • Preventive Care Plan

Highly personalized, ethnic specific, culturally sensitive and easy-to-understand Preventive Care Plans are delivered to patients for interactive participation. Evidence-based Best Practice guidelines and ethnicity-based predictive modeling are used for accuracy and culturally appropriate presentations. Patients receive recommendations for disease prevention, healthy lifestyles, self-care and injury prevention, along with their risk evaluations for: coronary artery disease, diabetes, high blood pressure, stroke, obesity, depression, asthma, colon cancer, breast cancer, cervical cancer, prostate cancer and testicular cancer. Prioritized recommendations and disease risks include “trusted physician” video counseling, action lists, educational information, and ability to manage in ‘real time’, enforcing on-going behavioral change for better health.

  • Personal Health Record

An interactive Personal Health Record (PHR) provides patients with a single location for access, updates, storage and security of their healthcare information. The patient’s PHR is automatically generated upon registration and completion of the HRA.  Additional information can be directly entered in appropriate fields. Any changes made by the patient to their medical profile automatically update both their recommendations and PHR.  For convenience, patients can create printer-friendly versions of their PHR and Preventive Care Plan and/or email both. The Personal Health Record is compatible with the Continuity of Care Record format standard. PHR management categories includes; demographic information, screening tests, medical conditions and procedures, family disease history, medications and allergies, immunizations, emergency contacts, providers and caregivers, health plans and insurance, care facilities and hospitals.

  • On-line Health Coaching

A personalized lesson plan is generated based upon the member’s disease risk indices. Lessons are organized around health education, stress management, nutrition, exercise & fitness and personal development. Each lesson is a 10-15 minute multi-media educational experience, and includes a quiz to measure comprehension. The lesson plan also tracks open and completed lessons with date of completion.

  • Medical Team Portal & Patient Reporting

Health care providers are provided with patient access of Protected Health Information on a patient-by-patient and group-by-group basis.  Approved members of a group’s health care team have the ability to review patient recommendations, disease risks and personal health records.

Patient aggregate data and reporting tools are provided via secured Internet access.  On-line reporting tools deliver aggregate group reports including; personal and family diseases, medications, performed screenings, lifestyle and behavior, personal injuries, recommendation, demographics, enrollment activity, participation, member age groups, gender and ethnicity.

2.1       Current Health Plans          

Health Plans are currently utilizing eDoc4u to impact the health management of members and also assist employers with escalating health care costs. Employers look to eDoc4u for a high tech, high touch solution that makes a significant impact on at-risk populations to improve their health. Members are presented with their disease risk indicators and comprehensive medical recommendations, motivating them with culturally competent preventive care advice and encouraging them to take action with on-line coaching. eDoc4u’s medical web services also enhance clinician/patient communications and their relationship. Office visits are better utilized and more efficient with clinicians spending more of their time consulting with patients. Providers are given on-line permission-based access to patient personal health information for review, counseling and updating. Group reports, accessed on-line or thru web services, provide real time proactive health management of client groups.  Reports include; demographics, enrollment activity, member participation, recommendations, personal and family diseases, medications, demographics and history of completion.           

2.2       Services

  • eDoc4u currently provides medical web service implementation, integration and support for member portal access according to customer-specific requirements. Services provided to these customers involve the five (5) eDoc4u modules described in 2.1, with various workflow and integration configurations. Modules are customized to customer specifications including; style guide, data integration and specific content.
  • Web services for these customers are provided in a SAS 70 Level 2 ASP environment.  Annual license fees, workflow development, customization, integration web services and support are typically several million dollars per year.   
  • eDoc4u customers are typically health plans and providers that support employer preventive health care requirements for their employees and plan eligible members.
  • Current on-line portal reference customers for this RFI include; CVS Caremark, Blue Cross Blue Shield and United Healthcare. These customers support a client base with over 7 million eligible members.
    • Technical and Administrative Response

2.3.1       General Approach  eDoc4u follows a typical SDLC (Software Development Lifecycle) methodology for the identification and capturing of all project related requirements.  Requirements analysis includes three types of activities:

Requirements gathering: eDoc4u communicates with customers and users via JAD sessions or other agreed to meetings to determine what their requirements are.  These are collected and described in high level use cases.  Usually 6-12 use cases are identified.

Analyzing requirements: eDoc4u determines whether the stated requirements are clear\unclear, incomplete, ambiguous, or contradictory, and then resolves these issues with the client during iterative discussions.

Recording requirements: eDoc4u works with the client to determine what form the requirements may be documented in.  Because audiences vary and requirements take differing forms (listed below) eDoc4u recognizes that differing recording strategies must be employed.  For example business & functional requirements (BRs & FRs) may be documented as business rules consumed by stakeholders and analysts, while technical requirements will be consumed by technical staff and reference BRs and FRs directly.  Forms may include use cases, user stories, process specifications, workflow\swim lane diagrams, etc.

eDoc4u identifies and collects information related to some or all of the following requirement categories.  This list may vary from project to project based on need:

  • Customer
  • Business
  • Functional
  • Technical
  • Performance
  • Design

At its very core eDoc4u is a decision based system designed to deliver Disease Prevention Recommendations and Disease Risk Index details to an individual.  This output is based on the individual’s unique Protected Health Information profile.  This profile data is filtered through eDoc4u’s patent-pending set of algorithms established on evidence based best practices.

eDoc4u’s core technology adheres to and supports industry established protocols like XML, Continuity of Care Record (CCR), secured web services, etc.  These standards allow eDoc4u to quickly adapt to and scale its offerings to meet the needs of external decision support systems. 

2.3.2       eDoc4u provides several unique aspects that distinguish our services from other vendors. Our HRA is ethnic specific, our preventive care plans include culturally competent ‘trusted physician’ video counseling, the disease risk indexes cover the big 12 diseases, and there is platform customization flexibility to ensure a uniform patient experience.

2.3.3       eDoc4u offers the following customized modules with associated development, integration and support services:

Health Risk Assessment:

An intuitive HRA, utilizing “branching logic”, creates a unique clinical pathway for each member. Self-reported information is captured during a 10-15 minute on-line member session as well as physician updates and real-time client data transfer. Our HRA variables include; age, gender, ethnicity, personal and family health history, medications, allergies, biometric, screening test history, nutrition, physical activity, readiness to change, substance use, mental health, injury risks and much more. eDoc4u’s HRA interactively integrates member medical risks and biometrics with lifestyle, mental health, substance use and injury prevention. Our HRA can be customized for specific client requirements.

Disease Risk Index:

Comprehensive risk evaluation for: coronary artery disease, diabetes, high blood pressure, stroke, obesity, depression, asthma, colon cancer, breast cancer, cervical cancer, prostate cancer and testicular cancer.  Each of our 12 DRI’s is based on age, gender, ethnicity and peer comparison of over 400 unique data points. Trusted Physician video “Call to Action” are provided for each disease risk index, with action lists and percent reductions that directly connect the actions to reduced disease risk scores in their profile. Dynamic updates take place during member sessions, making the experience of reducing an individual’s risk for a disease happen in “real time”.

Preventive Care Plan (PCP):

Evidence-based Best Practice guidelines, including ethnic-specific health risks, determine preventive recommendations with culturally competent ‘trusted physician’ video counseling, “Why Me” educational information, “Schedule Me” links and reminder email features. Preventative Care Plan (PCP) self management enforces the on-going process of behavioral change across medical, lifestyle, self care and injury prevention.  Members may receive medical advice for; lab tests, examinations, medical procedures, screening results and biometrics, self-care, mental health, nutritional needs, weight management, physical activity, substance use and injury prevention from our library of over 150 comprehensive recommendations. Interactive updates occur as personal profiles change in real-time and over time.

Personal Health Record (PHR):

eDoc4u’s PHR puts members in charge of their health data. When you help members gather, manage and share their personal health data you empower them and their providers to make better heath care decisions. eDoc4u’s PHR supports the Continuity of Care Record (CCR) format for compatibility and is totally integrated with HRA and PCP.  The PHR can be pre-populated with other data sources such as provider sources of prescriptions, biometric and lab data. Patient-granted physician access, email communications and download options places PHR ownership and control in the member’s hands.

Online Health Coaching:

eDoc4u’s online health coaching features a new and innovative approach to personal health promotion and wellness programs developed by experts at Duke University’s Center for Living. Personalized lesson plan is based upon the member’s disease risk indexes. It’s organized around health education, stress management, nutrition, exercise & fitness and personal development. Each lesson is a 10-15 minute multi-media educational experience, and includes a quiz to measure comprehension. “My Lesson Plan” tracks open and completed lessons with date of completion.

Medical Team Portal & Patient Reporting:

Health care providers are provided with patient access of Protected Health Information on a patient-by-patient and group-by-group basis. Approved members of a group’s health care team have the ability to review patient recommendations, disease risks and personal health records. Patient aggregate data and reporting tools are provided via secured Internet access. On-line reporting tools deliver aggregate group reports including; personal and family diseases, medications, performed screenings, lifestyle and behavior, personal injuries, recommendation, demographics, enrollment activity, participation, member age groups, gender and ethnicity.

2.3.4    The eDoc4U applications continue to be developed under a combination of software development methodologies; however these approaches may change based on whether internal vs. external integrations are being pursued.  Typically iterative in nature, eDoc4u generally adheres to methodologies most appropriate to the project at hand.  Examples include Agile, XP, Rapid, Rational Unified Process, etc.  Data models or sequence diagrams are often used to map out iterations, keep track of what has been tried, approved, or discarded, and eventually serve as a kind of blueprint for the final project deliverables.

eDoc4u delivers its core offerings via an ASP (Application Service Provider) model; however onsite client installations may be explored.  For its ASP implementation eDoc4u is able to support client iFramed, as well as eDoc4u managed (stand-alone) installations.  eDoc4u’s core clinical applications are built on the Microsoft .Net platform (v2.0, 3.0 & v3.5) in C# and SQL 2005, WSE, WCF.  More details are available upon request.

2.3.5       Requirements and Systems Analysis

·       To insure development success, eDoc4u recognizes the importance of identifying and working with key internal and, where necessary, external stakeholders and SMEs (Subject Matter Experts). As eDoc4u undertakes a new project it goes through an internal exercise to determine stakeholder need and acts accordingly. Stakeholders are typically internal eDoc4u leaders (CTO, Account management, VP Sales, etc.), as well as leaders from integration partners, 3rd party solution providers, etc. Stakeholder interviews are undertaken to offer perspective and possibly reveal requirements not previously identified as in scope. These stakeholders offer key direction on primary use case priority and scope.  All eDoc4u Statement of Work (SOW) deliverables, timeline and success criteria are derived from this prioritized list of Stakeholder use cases.

·       As stated in 2.3.1, eDoc4u utilizes use cases to describe high level and detailed functional requirements.  Functional requirements drive the development lifecycle. Use cases describe typical interactions between the users of the eDoc4u or 3rd party system and the system itself. They provide a narrative of how the system is used and each use case focuses on a common user goal. The functional requirements describe the system’s functionality like: The system should grant access to the user after he provides username and password; The system should provide access to the following pre-defined eDoc4u data…. Followed by the data itself; etc. Often functional requirements are listed under different project specific groups like user access, data access, user interface, etc.

·       eDoc4u recognizes that non-functional requirements describe a requirements capability.  For example, it is a non-functional requirement of the eDoc4u system that it adhere to certain transport security guidelines for web services transactions.  Other examples include data center certifications, system interoperability, response time, scalability, accessibility, clinical guidelines, etc.

2.3.6       Solution Identification and Evaluation

2.3.6.1  As previously described eDoc4u pursues and implements best practices to determine whatever suitable solution(s) is/are required to address internal and external project requirements. eDoc4u’s internal and outsourced teams are proven professionals with years of experience implementing clinical solutions. Through its experience and implementation of iterative practices, eDoc4u is able to deliver accurately against requirements, while remaining on timeline and budget. 

2.3.6.2  Please review 2.3.6.1 for details related to eDoc4u’s methodology to support standard solution identification and evaluation processes, such as Requests for Information and Evaluation.

  • Project ManagementeDoc4u implements an iterative SDLC model for the development of its software solutions. To support that development methodology, eDoc4u implements related project management techniques such as project scope planning, level of effort (LOE) estimation, project schedule creation, etc. Project plan development takes place to describe the tasks that will lead to project completion. Iterative risk identification, assessment and mitigation are also key steps performed by eDoc4u PMs during a project’s lifecycle. eDoc4u implements risk management strategies that include transferring the risk to another party, avoiding the risk, reducing the negative effect of the risk, and accepting some or all of the consequences of a particular risk.

eDoc4u recognizes the importance of prompt project monitoring. The purpose of project monitoring and control is to keep the team and management up to date on the project’s progress. If the project deviates from the plan, then the project manager can take action to correct the problem. Project monitoring and control involves status meetings to gather status from the team. When changes need to be made, change control is used to keep the products up to date.

  • Please review 2.4.4.1 for details related to eDoc4u’s management of its engagements adhere to project management industry best practices and tools.
    • eDoc4u’s development team has undergone CMM Level 2 and CMM Level 3 certification by the Carnegie Mellon University (CMU) Software Engineering Institute (SEI).  CMM is for Software Engineering where CMMI is for Systems Integration. eDoc4u would make use of these project management and process standardization techniques in this engagement.

2.5       Financial Response

2.5.1    Typical pricing for the eDoc4u web services include custom workflow and integration development for each module (see 2.4.1.3), platform integration and testing, implementation of on-going services and support.  Pricing estimates for the services provided are at the following rates;

  • Workflow development, product integration and testing:     $135 per hour
  • Web service implementation and ASP support services:  $0.06 per eligible per month
  • Supplemental BTC Support will be provided as required and pricing in accordance with GSA Schedule SIN 132.51 for the BTC Schedule 70 GS35F0813M.

2.5.2    A example of costs Based on a typical requirement and information generated from other requests and very large population’s eDoc4u would expect the approximate costs for our proposed solution to be:

Description Quantity Unit Price Extended Price
Requirements gathering, analysis, design (use cases/workflow development), product integration & testing 4,500 hours $135 per hour $607,500 
ASP Web services implementation for data integration; patient & clinician ASP access and support services to web portal 14,700,000 $0.06 per month $882,000 per month

The above information is only for information and will be negotiated with the client to fully meet the requirement of the users.

2.5.3    eDoc4u’s pricing methodology assumes fixed internal development and support costs, and variable software, hardware and ASP costs with industry standard utilization rates.

2.5.4 Broadband Technology Corp. will provide the necessary