09.SAP-Justification for Other than Full and Open Competition for FAR 13.1.pdf

Last Updated 11/01/24

U.S. COAST GUARD JUSTIFICATION FOR OTHER THAN FULL AND OPEN COMPETITION

SIMPLIFIED ACQUISITION PROCEDURES (SAP) FOR FAR 13.106-1(b)

PURCHASE REQUEST OR REQUISITION NUMBER: PR 47930PR250000421

ESTIMATED TOTAL VALUE, INCLUDING OPTIONS:

$221,017.99

AUTHORITY JUSTIFICATION TYPE

☒ 13.106-1(b)(1) ONLY ONE SOURCE REASONABLY AVAILABLE (e.g., urgency, exclusive licensing agreements, or industrial mobilization).

☐ FAR 5.102(a)(6), FAR

11.105, FAR 13.106-1

(b) (1)

BRAND NAME – Items peculiar to one manufacturer: The particular brand name, product, or feature is essential to the Government’s requirements, and market research indicates other companies’ similar products, or products lacking the particular feature, do not meet, or cannot be modified to meet, the agency’s needs.

BRIEF DESCRIPTION OF SUPPLIES OR SERVICES REQUIRED AND THE INTENDED USE:

This requirement for this contract is to provide 218 privileged Coast Guard healthcare providers and ~750 non-privileged health personnel with quick-access, concise, reliable, evidence-based, peer-reviewed online Medical Resource Database (MRD), anytime and anywhere to support clinical decisions. Access to the database shall be furnished through either personal or government furnished desktop, laptop, or mobile devices.

SUGGESTED SOURCE NAME, ADDRESS, & UNIQUE ENTITY IDENTIFIER (UEI):

UPTODATE, INC. 230 3RD AVE STE 1000, Waltham, Massachusetts 02451-7560

UEI: ZULJK3FWSPJ8

RATIONALE FOR JUSTIFICATION TYPE SELECTED ABOVE TO INCLUDE RELEVANT INFORMATION GAINED

THROUGH YOUR MARKET RESEARCH TO SUPPORT THE JUSTIFICATION TYPE:

In accordance with Federal Acquisition Regulation (FAR) 6.302-1(a)(2), this justification supports a sole-source award to Wolters Kluwer for the UpToDate clinical decision support tool. For the Department of Defense (DoD) and Coast Guard (CG), this authority permits procurement from a single source when no other solution meets agency requirements. UpToDate is uniquely capable of satisfying the government’s operational and clinical needs for the reasons outlined below.

The Defense Health Agency (DHA) has a long-standing history of relying on UpToDate to ensure continuity of care and consistent clinical standards across the Military Health System (MHS). UpToDate is fully integrated into DHA systems, including MHS Genesis, and is used by other federal and contracted healthcare agencies such as the Navy, Army, Air Force, VA, State Department, and TRICARE. This alignment ensures seamless coordination of care for Coast Guard personnel who transition between MHS facilities and Coast Guard clinics, reducing variability in treatment protocols and enhancing interagency collaboration during joint missions.

UpToDate has been linked to improved patient outcomes, including reduced hospital stays and fewer medical errors, making it a critical tool for Coast Guard healthcare providers. Its MobileComplete feature ensures uninterrupted access to evidence-based clinical decision support in remote or austere environments, such as aboard cutters or during disaster response missions. This capability is essential for maintaining mission readiness and delivering high-quality care in challenging operational settings.

Coast Guard healthcare providers, including doctors, dentists, physician assistants, nurse practitioners, behavioral health providers, optometrists, physical therapists, and pharmacists, require access to a reliable, evidence-based Medical Reference Database (MRD) to ensure safe, effective, and efficient patient care. This database must provide the latest peer-reviewed, physician-authored clinical knowledge to assist in point-of-care diagnosis, confirm the most recent medical treatment guidelines, and enhance professional development.

The MRD must also furnish comprehensive drug information, including indications, dosing, contraindications, side effects, safety/monitoring, pregnancy/lactation considerations, pharmacology, and a drug interaction checker. Access to such a resource is critical for reducing errors, improving care consistency, and achieving better patient outcomes. Additionally, the database must enable healthcare professionals to earn continuing education credits required to maintain active state licenses and board certifications.

Market alternatives, such as DynaMed, BMJ Best Practice, and general search engines like PubMed, fail to meet the government’s specific requirements. These tools lack the unified platform of expert-authored, peer-reviewed content, comprehensive drug information, and widespread adoption within the MHS that make UpToDate a powerful sole-source solution. Using multiple reference systems would https://www.acquisition.gov/far/13.106-1 https://www.acquisition.gov/far/5.102 https://www.acquisition.gov/far/11.105 https://www.acquisition.gov/far/11.105 https://www.acquisition.gov/far/13.106-1 https://www.acquisition.gov/far/13.106-1

Last Updated 11/01/24 introduce inefficiencies and compromise the quality of care. Transitioning to a new MRD would require retraining healthcare personnel, rewriting policies and procedures, and reworking training manuals, resulting in unacceptable delays and inefficiencies.

Access to synthesized medical information follows a tiered cost structure, with pricing estimates based on publicly available information and generalized due to adjustments for large institutions. PubMed is free but offers only citations without summaries, limiting its utility for point-of-care decision-making. DynaMed provides concise, evidence-based content for an estimated $399 annually per physician.

UpToDate offers comprehensive reviews at an estimated $559 per year, with a government discount reducing the cost to approximately $350 per person. BMJ Best Practice is typically institution-based in the U.S., with individual subscription pricing varying by region.

UpToDate’s combination of comprehensive content and cost-effectiveness makes it the most suitable option for Coast Guard healthcare providers.

UpToDate is the MRD that Coast Guard health professionals have used in the past and is utilized by many other federal agencies offering healthcare services. Its widespread adoption ensures continuity of care and alignment with standards of care provided by other agencies.

Learning to use another MRD would require additional training, duplicating government efforts and wasting the time of high-value resources. Furthermore, UpToDate is integrated into the training curriculum at Uniformed Services University of Health Sciences and the Interservice Physician Assistant Program, ensuring familiarity among military healthcare providers from the start of their careers.

A search was conducted of the strategic sourcing vehicles (SSVs) for DHS and the Coast Guard, but none were in scope or provided this type of service. A deeper review was conducted of the Defense Logistics Service (DLS), General Services Administration (GSA), Veterans Affairs (VA), and SAM.gov, none of which identified an existing government vehicle capable of meeting this requirement.

UpToDate is the only responsible source capable of meeting the government’s operational and clinical requirements. Awarding this sole-source contract is essential to ensure military clinicians have access to reliable, expert-guided information, thereby enhancing the quality and consistency of patient care across the Coast Guard enterprise.

CONTRACTING OFFICER - FAIR AND REASONABLE PRICE DETERMINATION METHODS:

☒ MARKET RESEARCH

☐ COMPARISON OF PROPOSED PRICE WITH PRICES FOUND REASONABLE ON PREVIOUS PURCHASES

☐ CURRENT PRICE LIST

☒ COMPARISON WITH SIMILAR ITEMS IN A RELATED INDUSTRY

☐ COMPARISON TO IGCE

☐ CONTRACTING OFFICER’S PERSONAL KNOWLEDGE (EXPLAIN)

☐ OTHER (EXPLAIN)

SIGNATURE AND TITLE OF TECHNICAL AND REQUIREMENTS POC DATE

SIGNATURE OF CONTRACTING OFFICER DATE

29 August 2025Clarissa E. Ernest, RN HcSC Nurse Consultant