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DHA - Global Service Center

Solicitation Number: HT0011-14-RFI-0031
Agency: Other Defense Agencies
Office: Defense Health Agency
Location: Contract Operations Division - Falls Church
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Sources Sought
Added: Mar 18, 2014 9:00 am

1.0 Purpose of this RFI
This Request for Information (RFI) is to obtain information regarding the availability and capability of all qualified sources to assume management of and further mature the Defense Health Agency Global Service Center (DHAGSC). The DHAGSC is the integrated service center supporting all centrally managed Military Health System (MHS) medical information systems and associated communications and computing infrastructure (C&CI). The purpose of this RFI is to determine various industry partners' ability to meet the requirements outlined below. Both small and large businesses are encouraged to respond. The information gathered as a result of this RFI will aid DHA in moving forward with a Request for Proposal (RFP) for DHAGSC support. DHA anticipates contract award for this requirement in spring, 2015.

2.0 Background
The DHA Health Information Technology (DHAHIT) delivers and manages health care operations through design, development, test, evaluation, and deployment of healthcare information systems worldwide. The Chief Information Officer (CIO) is responsible for Infrastructure and Operations (I&O) directorate who integrates C&CI requirements. DHAHIT captures and analyzes end-to-end performance data for C&CI components and MHS systems including Armed Forces Health Longitudinal Technology Application (AHLTA) and Composite Health Care System (CHCS), the military's electronic health record. DHAHIT uses the results of the analyses to optimize network and end-user system performance.
DHAHIT provides and manages the following C&CI products and services:
• Network Protection
• Wide Area Network (WAN) Connectivity
• Circuit Management
• Local Area Network (LAN)
• End User Devices (EUDs)
• Computing Center Operations
• Capacity Management
• End-to-End (E2E) Performance Measurement and Monitoring
• Hardware/Software Maintenance and Sparing (HSMS)
• DHA Global Service Center (DHAGSC) formerly the MHS Service Desk (MHSSD)
o MHS Application Support (Tier 1 and Tier 2)
o MHS Common Infrastructure Support (CIS)
o MHS Blades Systems Administration (BSA) formerly Enterprise Blade Server (EBS)
• Network Security Operations Center (NSOC)
The DHAGSC formerly called the Military Health System (MHS) Service Desk (MHSSD) serves as the entry point into the MHS information technology (IT) customer support structure. It provides toll-free, worldwide access to identify, log, asses, analyze, escalate, track, report and resolve incidents for centrally-managed MHS Applications and Systems, 24 x 7 x 365 for over 9 million worldwide customers, including Active Duty, Guard, Reserve, Dependents, Retirees and other beneficiaries of the Military Health System. Currently the DHAGSC averages 27,000 calls per month and logs 32,000 incidents. Analysts are collocated in government facilities primarily in San Antonio, Texas with a secondary site in Falls Church, Virginia.

The DHAGSC also provides comprehensive around-the-clock support and monitoring of the network infrastructure components and security suites deployed to Military Treatment Facilities (MTFs) and other MHS data centers. In addition to network and monitoring services, the DHAGSC manages all aspects of the current development and production Server Virtual Hosting Environment (SVHE) that runs MHS applications for the MTFs. This includes remotely maintaining all blade frames in a standard configuration, all aspects of the underlying blade architecture (SAN and SAN switch fabrics), monitoring and managing the blade environment, back-up, and the distributed applications hosted at the twenty MHS Application Access Gateway (MAAG) sites through a central operations center. Additionally, some staff with Secret clearance is required to access the Secret Internet Protocol Router Network (SIPRnet) and classified data.

DHA Global Service Center: Application Support
Tier 1 and Tier 2 Application Support Analysts support approximately 35 core MHS applications and facilitate incident resolution for over 190 other MHS applications. They assist MHS customers in resolving problems with applications such as AHLTA and CHCS, the military's electronic health record. Tier 1 Analysts support MHS customers by answering, triaging and ticketing all inbound calls and electronically submitted incidents. This level also assigns and escalates incidents whenever they cannot be managed at the Tier 1 level. Tier 2 Analysts are responsible for providing escalated (second level) service for MHS applications. The Tier 2 Analysts' primary responsibility is to provide advanced software/systems support and subject matter expertise to assist Tier 1 Analysts as necessary on supported MHS applications.

DHA Global Service Center: Network Common Infrastructure Support
The Network Common Infrastructure Support (CIS) team goal is to maximize network availability to over 148 MTFs worldwide in support of all MHS applications and the Defense Health Headquarters (DHHQ) network. Highly skilled network engineers and analysts are specifically trained to address the complexities of resolving problems on military networks across all DoD Services. Network support also provides proactive troubleshooting through network event, incident and problem analysis, by responding to detected events and triaging for impact, resolving network related incidents and gathering and reviewing performance data for threshold conditions. The CIS Tier 2/3 support provided includes:
• Network event analysis and diagnosis (both proactive and reactive)
• System performance measurement
• Network protection monitoring
• Network Management System ( NMS) system administration

DHA Global Service Center: Blade System Administration
The Blade System Administration (BSA) team delivers centralized system administration for more than 530 virtual machines hosted globally at twenty MAAG sites and DHHQ ensuring 99.9% system availability. The Server Virtual Hosting Environment (SVHE) formerly Enterprise Blade Servers (EBS) provides a common hosting environment for applications, computing infrastructure, and common storage array for both SVHE and the Application Virtualization Hosting Environment (AVHE). The EBS Tier 2/3 support provided includes:
• Blade enclosure management - remotely manage the MAAG blade enclosures supporting the unified enterprise virtualization architecture
• SAN management - remotely manage the MAAG SAN, system backups, and SAN switch fabrics supporting the unified enterprise virtualization architecture
• Virtualization management - remotely manage MAAG ESXi hosts and vCenter with root admin level access supporting the unified enterprise virtualization architecture
• Database management - database administration for the SAN and virtualization layer supporting the unified enterprise virtualization architecture
• Application management - management for the SVHE applications, IAVM remediation, system maintenance, audit log review, and deployment support
• Remote monitoring - remotely monitor MAAG blade enclosures, SAN, SAN switch fabrics, and networking supporting the unified enterprise virtualization architecture

MHS applications running on SVHE vary by MAAG site. Below is a partial list of applications approved to run on the SVHE platform: Third Party Outpatient Collection System (TPOCS), TRICARE Online (TOL), Coding & Compliance Editor (CCE), Shared Application Server (SAS), Special Needs Program Management Information System (SNPMIS), and Nutrition Management Information System (NMIS), Bidirectional Health Information Exchange (BHIE), and Janus Enterprise (JLV).

Information Technology Service Management
In order to streamline operations, the DHA began an IT Service Management (ITSM) transformation in 2009 using the Information Technology Infrastructure Library (ITILv3) framework developing and implementing integrated processes. Using an iterative approach, the DHAGSC rolled out incident, problem, event, and knowledge management processes and procedures. In addition, they play key roles in change and IT service and asset management, as well as supporting information assurance for managed systems.

The current trouble ticket system is Remedy ITSM 7.6.4. The Remedy ITSM suite is hosted by DHA; the Remedy software, licenses and hardware are government owned, contractor operated (GOCO). The Remedy ITSM tool is supporting our ITIL methodology implementation using the following modules: Incident Management, Problem Management, Change Management, Knowledge Management, Asset Management, Service Level Management, and Service Request Management. This contract excludes the management of the Remedy tool.

3.0 The overarching Service Desk objectives are:
• Central point of contact for advice, guidance, and rapid restoration of normal service operations to users using the ITSM model, including the following customers:
o Military Services
o MTFs
o DHA Program Offices
o Managed Care Support Contractors (MCSC)
o MHS Beneficiaries
o Other partner agencies (Defense Information Systems Agency (DISA), Application Developers, VA, commercial partners, etc.)
• Agility to adapt to changing requirements which may add or remove support for applications
• Leverage efficiencies and simplify ITIL process implementation in an enterprise level Service Center
• Dedicated and consistent, high quality support for customers or authorized users world-wide
• Increase efficiencies in daily operations and incorporate automation and self service
• Continuous quality improvement of IT services for all users and stakeholders
• Leverage automated workflows mapped to structured processes within Remedy
• Enhance business processes based on maturity and efficiencies of IT processes and systems
• Streamline and further mature Blade System Administration using automation tools to enforce standard configurations, patch, monitor, and manage the unified virtualization environment
• Awareness and integration of Release Management activities for supported information systems in order to accurately conduct Event, Incident, and Problem Management
• Accessible, high quality, support for MHS supported applications to resolve user requests at the lowest support tier
• Further mature Event, Incident, Change, Problem, Configuration, and Service Level Management capabilities already in place
• Increase efficiencies to integrate, leverage, and synthesize information from various sources and analyze data to allow for proactive management and action
• End-user self-service access to ticket information, ticket status, and reports up-to-date and pertinent Remedy self-service customer portal including fully functional, 100% web-based access for both customers and service desk agents/analysts
• Service Desk staff with Remedy and ITIL knowledge and experience

4.0 How to Respond
a) THIS IS A REQUEST FOR INFORMATION (RFI) ONLY. This RFI is issued solely for information and planning purposes - it does not constitute a solicitation nor does it restrict the Government as to the ultimate acquisition approach. In accordance with FAR 15.201(e), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract. Any contract that might be awarded based on information received or derived from this market research will be the outcome of a competitive process. Responders are advised that the U.S. Government will not pay for any information or administrative costs incurred in response to this RFI. All costs associated with responding to this RFI will be solely at the interested vendor's expense. Not responding to this RFI does not preclude participation in any future RFP, if any is issued.
b) The formal closing date for this RFI and for the submission of responses is 12:00PM EST 1 APRIL, 2014. All responses should be submitted electronically using PDF, HTML, MS Word or PowerPoint formats with subject "HT0011-14-RFI-0031 - DHAGSC - [VENDOR NAME]" to the following Email addresses:
c) Responses are limited to 10 single sided pages and shall be no smaller than Times New Roman font 12 pitch.
d) The following sections are not subject to page limits:
• Title Page
• Table of Contents
• Glossary of Acronyms
• Project Narrative described in Appendix A (separately limited to 3 pages for each narrative)
*Total e-mail file limit size is restricted to 5MB. Files exceeding this threshold shall be submitted over multiple messages, and be identified as "Message #x of #x".

Appendix A - Questions to be addressed for this RFI
1. Discuss your approach for transitioning, operating, and maintaining, the consolidated global Service Center described in the RFI.

2. Discuss your approach for improving the consolidated global Service Center as described in the RFI.

3. Discuss your ability to staff and provide support for the core DHA applications described in Appendix B.

4. Provide the labor categories that would possess the required expertise/technical skills as described in the RFI.

5. Discuss your ability to adapt to changing requirements which may add or remove support for applications.

6. Describe three completed or on-going project(s) in the past three years of similar size and complexity supporting a global Service Center
• Within a three page limitation for each project narrative, respondents shall outline the following:
o Provide background information on the project or projects presented to demonstrate expertise.
o Outline how the project or projects are related to the work described in the RFI.
o Submit summary of the final deliverables for the noted project or projects.
o Respondents shall demonstrate that the tasks performed are of a similar complexity to the work described in the RFI.
• Provide the following information for each project submitted:
o Project/Contract Name;
o Project Description;
o Dollar Amount of Contract;
o Project Duration; and
o Point of Contact and Telephone Number
Appendix B - MHS Supported Applications/Systems

AHLTA AHLTA, formerly CHCS II, is the Department of Defense (DoD) Electronic Health Record. AHLTA is an enterprise-wide medical and dental clinical information system that provides secure online access to longitudinal health records. AHLTA enables Military Health System (MHS) providers to document the patient's health information and history, which is consolidated in a single clinical database known as the Clinical Data Repository (CDR) and is made accessible to authorized users worldwide, 24 hours a day. The CDR facilitates trend analyses and medical surveillance at the patient or population level. Providers can access executive-level reports on common diagnoses and procedures to identify trends of concern.
AHLTA Web Print AHLTA Print gives users the ability to print all or specific sections of the medical record for one or more patients with a single command.
Application Virtualization and Hosting Environment (AVHE) Application Virtualization and Hosting Environment (AVHE) provides a platform for the deployment of standardized virtualized applications that provides end users with reliable and secure access to Armed Forces Health Longitudinal Technology Application (AHLTA), Composite Health Care System (CHCS), and associated clinical applications and tools.
Bidirectional Health Information Exchange (BHIE) BHIE is a series of communications protocols developed by the Department of Veterans Affairs. It is used to exchange healthcare information between Department of Veterans Affairs healthcare facilities nationwide and between VA health-care facilities and Department of Defense healthcare facilities. It is one of the most widely used healthcare data exchange systems in routine healthcare use, and is used to facilitate health-care data exchange associated with a patient's medical record.
Blood Management Blood Bank/Transfusion Services (BMBB/TS) Is an enterprise-wide automated information system (AIS) used to organize the management of blood bank and transfusion services at facilities across the TMA/MHS.
Business to Business (B2B) The Business to Business gateway provides external medical business support partners access to the DoD NIPRNET.
Centralized Credentials Quality Assurance System (CCQAS) CCQAS is an automated Tri-Service, web-based database containing credentialing, privileging, risk management and adverse actions information on direct healthcare providers in the MHS. CCQAS has an automated self-service application that allows providers to apply for privileges online. Supporting medical personnel readiness, CCQAS contains comprehensive data on licensure, education and training certifications.
Coding and Compliance Editor (CCE) CCE is a suite of 3M Health Information Systems commercial-off-the-shelf (COTS) products integrated into a single MHS application focused on coding, compliance, and data management.
Composite Health Care System (CHCS) CHCS - one of the most broadly used Computer-based Provider Order Entry (CPOE) systems in the nation and the backbone of AHLTA - enables DoD providers to electronically perform patient appointment processes and scheduling, order laboratory tests, retrieve test results, authorize radiology procedures and prescribe medications. CHCS supports multiple healthcare administration activities, including patient administration, medical service accounting, medical billing and workload assignments.
Defense Enrollment Eligibility Reporting System (DEERS) Defense Enrollment Eligibility Reporting System
A worldwide, computerized database of uniformed services members (spouses), their family members, and others who are eligible for military benefits.
Defense Financial Accounting System (DFAS) DFAS leads the Department of Defense (DoD) in finance and accounting by ensuring the delivery of efficient, exceptional quality pay and financial information. DFAS is headquartered in Indianapolis, Indiana and consists of 11 sites located in seven states and two overseas locations. DFAS fulfills important fiscal responsibilities entrusted to it by the American taxpayers.
Defense Medical Human Resource System internet (DMHRSi) DMHRSi is a web based Tri-Service system designed to simplify and standardize human resource visibility. It tracks essential human resource information to support manpower, personnel, readiness, labor cost assignment, education and training.
Defense Medical Logistics Standard System (DMLSS) DMLSS is an automated information system that provides automation support of reengineered medical logistics business practices and delivers a comprehensive range of materials, equipment, and facilities management information systems.
Defense Occupational & Environmental Health Readiness System - Hearing Conservation (DOEHRS-HC) DOEHRS is an integrated Environmental, Safety and Occupational Health (ESOH) application; this application captures, stores and analyzes the exposure history of all military -related personal throughout their life. This RAM system provides functionality without immediate Internet connectivity. DOEHRS-HC provides noise exposure surveillance, diagnostic evaluation and management of auditory pathology, hearing loss and injury referrals auditory readiness documentation.
Defense Occupational & Environmental Health Readiness System - Industrial Hygiene (DOEHRS-IH) DOEHRS-IH provides the ability to capture workplace and environmental exposure information, support industrial hygiene decisions, directly view environmental laboratory results and actively track air, water, and soil environmental hazards in garrison and theater operations.
Development and Testing Center The MHS Common Development Environment (CDE) is housed in a brick and mortar facility called the Military Health System Development and Testing Center (MHS DTC). The CDE consists of C&CI components that mirror those components found in the enterprise production environment, including components of the wide area network (WAN), local area network (LAN), enclave demilitarized zones (DMZ).
Enterprise Service Bus/ Service Oriented Architecture Suite (ESB/SOA) The Department of Veterans Affairs (VA) and the Department of Defense (DoD) conducted analysis to conclude that a Commercial Off The Shelf (COTS) Service Oriented Architecture (SOA) Suite with supporting services and sustainment will provide the necessary capability to manage the critical Enterprise Service Bus (ESB) functionality of the integrated Electronic Health Record (iEHR) architecture. The purpose of the SOA Suite is to facilitate the data sharing and application communication for the implementation of iEHR and provide the base capability from which the departments can proceed to leverage the capability to support broader exchange of information between the departments in support of, but not limited to, the following: iEHR clinical applications (laboratory, pharmacy, and immunization), iEHR User Interface, and iEHR Virtual Patient Record.
Enterprise Wide Scheduling-Registration (EWS-R)
EWS-R is a web based system that provides appointing, scheduling, registration, and calendar based scheduling management to MTF's. This application, fielded in the existing CHCS Cache host site's LAN on the Enterprise Blade Server (EBS) infrastructure, provides graphical workflow, as well as admissions, discharging transactions and operating room scheduling.
Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Essence is a web-based syndromic surveillance application that examines DoD healthcare data for rapid or unusual increases in the frequency of certain outcomes. An increase in frequency may be a sign of diseases occurring during possible outbreaks of communicable illnesses or from the possible use of biological warfare agents.
Essentris (formerly Clinical Information System - CIS) Essentris is a commercial off-the-shelf (COTS) product that supports health care providers in the delivery of inpatient clinical care. The core of Essentris is point -of-care data capture at the patient's bedside for physiological monitors, fetal/ uterine monitors, ventilators and other patient care machines. All clinical documentation is created and stored in Essentris. This clinical data can be aggregated, trended and analyzed to manage care for a single patient or for an entire patient population. Essentris supports all facets of Military Health System (MHS) inpatient care including critical care; labor and maternal childcare; operating room; acute care units; fetal central stations and selected outpatient areas (e.g., same day surgery).

Expense Assignment System IV (EAS IV)
EAS IV is a quality cost allocation tool providing standardized workload, expense, and manpower data reporting at Medical/Dental Treatment Facilities. This tool improves data validation and assists in auditing capabilities, with providing total cost of care data as well as supporting ad hoc reporting.
Force Health Protection and Readiness (FHP&R) Force Health Protection and Readiness' home page
Public website for Force Health Protection and Readiness' home page URL: Staging site URL:
Global Expeditionary Medical System (GEMS) GEMS is a paperless data linked tool made up of four components: the Patient Encounter Module (PEM); the Theater Epidemiological Module (TEM), the Theater Occupational Module (TOM) and the Public Health Deployed Module (PHDM). GEMS provides comprehensive medical data collection at deployed locations and daily data analysis for Disease Non Battle Injuries, enabling identification of like symptoms that could indicate enemy use of biological weapons. GEMS is an interim Air Force legacy system.
Healthcare Artifact Image Management System (HAIMS) The Health Artifact and Image Management Solution (HAIMS) manages healthcare artifacts and images (A&I) for the Military Health System (MHS). HAIMS provides access to A&I where needed, leverages standards for interoperability with existing and future systems, based on extensive real world understanding and experience supporting the MHS mission.
Joint Legacy Viewer (JLV)/ Janus Enterprise The Joint Legacy Viewer (JLV)/Janus Enterprise application displays medical records and images from Department of Veterans Affairs and Department of Defense sources in a single Graphic User Interface (GUI), using JLV 4.0 Presentation Layer. Janus Enterprise will expand capacity of the existing JLV infrastructure hosted on the Enterprise Blade System (EBS) in San Antonio.
Joint Medical Asset Repository (JMAR) JMAR provides users with total visibility of DoD wide medical asset data, serving as the single integrated, authoritative source for joint medical logistical information provided to the Joint Total Asset Visibility system. This web-based application provides access to integrated joint-service medical asset information for any user, any time, on any machine.
Manage Care Forecasting and Analysis System (MCFAS) MCFAS is the officially sanctioned source of population forecasts for MHS planning and budgeting. This is used to manage care analysts, health care planners, and financial analysts to forecast health beneficiary populations worldwide.
MHS Learn MHS Learn is an enterprise wide e-Learning and collaborative portal for training activities, which also includes traditional classroom, virtual webinars, and discussion forums that connect training communities worldwide. MHS Learn provides a single unified learning delivery system to employees, patients, and partners. MHS Learn promotes content sharing with Uniformed Services University Veterans Health Administration, and other government and commercial organizations.
MHS Management Analysis and Reporting Tool (M2) M2 is a powerful ad hoc query tool for detailed trend analysis such as a patient and provider profiling. M2 provides summary and detailed views of population, clinical, and financial data from all MHS regions worldwide. Conducts trend analyses, patient and provider profiling studies.
MHS Management Care Forecasting and Analysis System Tool (MCFAS) MCFAS is the officially sanctioned source of population forecasts for MHS planning and budgeting. MCFAS is used by managed care analysts, health care planners, and financial analysts to forecast military health beneficiary populations from worldwide down to individual zip codes.
Medical Situational Awareness in Theater (MSAT) Medical Situational Awareness in Theater is a web-based application that combines information from multiple communities to provide a common operating picture as well as decision support. MSAT links together information that encompasses disease and non-battle related injuries; physical and psychological trauma; patient tracking; chemical and biological threats; environmental and occupational health; intelligence; Command and Control data; personnel; unit locations and weather. This provides theater and headquarters level staff with visibility of medical requirements and resources to plan for and support operations. It also provides the analytical tools and decision support mechanisms to provide a broad view of medical information. MSAT will provide a common operating picture and decision support capability for assisting staff in assessing risks, mitigating operational vulnerabilities and allocating scarce combat resources during the planning and conduct of operations.
Nutritional Management Information System (NMIS) NMIS supports nutrition management operations at Department of Defense military treatment facilities (MTFs) worldwide. NMIS is a clinical and production information system that enables dietetics personnel in the MHS to provide preventive and therapeutic Medical Nutrition Therapy and Medical Food Management.
Patient Encounter Processing and Reporting (PEPR) PEPR is a web-based application which assists in analysis of global MHS purchased care claims data. Its applications include Purchase Care Utilization, Reporting & Evaluation System (PCURES), Purchased Care Detail Information Systems ( PCDIS) and Purchased Care
Standard Insurance Table - Other Heath Insurance (SIT/OHI) The Standard Insurance Table (SIT) is a centralized DEERS database that contains information on Health Insurance Carriers (HICs) and the types of coverage (comprehensive, medical, pharmacy, dental, vision, etc.) that each HIC offers. The primary purpose of the SIT is to provide billing address and other contact information for each carrier based on the coverages they offer. HIC data are entered into the SIT by MTF and purchased care staff, and their input is verified by the TMA Verification Point of Contact (VPOC). Other Health Insurance (OHI) refers to other health insurance policies that a TRICARE beneficiary may carry. OHI data refers to information about a patient's policy, such as the policy name and number, coverage type, patient relationship to insured, and effective dates. This information is used to properly route a health care claim sent to the OHI carrier. Currently, OHI is locally stored on CHCS host servers and shared with TPOCS.
Prospective Payment System (PPS) PPS directs a performance-based budgeting system to provide incentives and financial rewards for efficient management. PPS provides MTF's with budgets, based on direct workload (hospital admission, prescriptions, filled, and clinic visits)
Special Needs Program Management Information System (SNPMIS) SNPMIS is the MHS automated information system designed to ensure the DoD meets the unique information requirements associated with implementation of the Individuals with Disabilities Education Act (IDEA). SNPMIS provides access to a comprehensive program of therapy, medical support, and social services for young MHS beneficiaries with special needs.
Theater Enterprise-Wide Logistics System (TEWLS) TEWLS supports the intermediate medical logistics functions for distribution and materiel management and ties together the national, regional, and deployed units into a single business environment. Creating necessary links for planners, commercial partners, and Army Medical Department (AMEDD) logisticians to accomplish essential care in the theater through a single customer facing portal.
Theater Medical Data Store (TMDA) The Theater Medical Data Store (TMDS) gives health care providers an unclassified Web-based means of accessing the same theater medical information collected by JMeWS. But because TMDS uses the same baseline code as JMeWS, medical surveillance and medical command and control features can be activated so that it may support unclassified operations during a disaster or mass casualty event in the Continental United States or elsewhere.
Theater Medical Information Program (TMIP) TMIP is a Tri-Service system that is designed to provide information to deployed medical forces to support all medical functional areas, including command and control, medical logistics, blood management, patient regulation and evacuation, medical threat/intelligence, health care delivery, manpower and training, and medical capability assessment and sustainment analysis. TMIP performs this service by integrating information from other medical systems, including the CHCS, CHCS II, Defense Blood Standard System and DMLSS.
Third Party Outpatient Collection System (TPOCS) TPOCS enables the collection, tracking, and reporting of data required for the outpatient billing process. Revenue collected from TPOCS is sent directly from the insurance company to the MTF. TPOCS maintains automated interfaces with CHCS and the Ambulatory Data Module (ADM).
TRICARE Online (TOL) TOL is the internet point of entry for the DOD providing beneficiaries, providers, external Support Contractors and Managers access to available healthcare services, benefits, and authenticated health care information with secure access.

Workload Management System for Nursing (WMSN)

WMSN is a management tool used to assess nursing personnel staffing based on patients' nursing care needs. Nurses classify patients according to an assessment of their nursing care needs for the next 24 hour period and determine the total number of nursing care hours (NCH) a unit's patients will require.


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