20200814 JA Cerner New CLINs Medtronic FINAL - Signed - Redacted.pdf

FOR OFFICIAL USE ONLY

DEPARTMENT OF VETERANS AFFAIRS

NATIONAL ACQUISITION CENTER

COMMODITIES AND SERVICES ACQUISITION

SERVICE 555 CORPORATE CIRCLE

GOLDEN, CO 80401

Justification & Approval for Other than Full & Open Competition Home Telehealth Contract

VA791-17-D-0004 – Medtronic Care Management Services, LLC August 14, 2020

1. Contracting Agency & Activity

The Department of Veterans Affairs (VA), Commodities & Services Acquisition Service (CSAS) a division of the National Acquisition Center (NAC), 555 Corporate Circle, Golden, Colorado, 80401 is submitting a Justification and Approval for Other than Full and Open Competition to issue a modification to add scope and two CLINs to Home Telehealth Contract: VA791-17-D-0004, Medtronic Care Management Services (MCMS) for integration and sustainment of the electronic health record system under the Cerner Government Services, Inc. (Cerner) contract initiative.

These modifications are being funded by the VA’s Office of Electronic Health Record Management (OEHRM).

2. Nature & Description of the Action Being Processed:

CSAS is requesting approval to issue a modification to contract VA791-17-D-0004, Medtronic Care Management Services (MCMS), to add scope and CLINS to accommodate for the mandatory direction of VA transitioning electronic health care record management system provided by Cerner away from the current electronic health care record management system (VistA/CPRS).

3. Description of Supplies/Services Required to Meet Agency Needs:

Program Background: The VA supports the ongoing and emerging business needs of the Veterans Health Administration (VHA) National Home Telehealth (HT) Program.

VHA’s HT Program relies upon home telehealth platforms from commercial contractors that the VA classifies as Medical Device Data Systems (MDDS). These systems are purchased by VHA and used in the patient’s home to maintain their independent living capability, throughout the U.S. The HT program is considered a mission essential program within the VHA.

Veterans use the home technologies to upload vital signs, clinical question responses, and other measurements that can help them self-manage their medical condition(s) and alert to the need for active care/case management, including referral for clinic and/or hospital care. This data includes, but is not limited to blood glucose, blood pressure, pulse, temperature, weight, pain, and pulse oximetry. All these measurements are obtained from peripheral devices (except pain which is subjective and manually entered using a Likert Scale). Peripheral devices are provided with the HT platform and transmit the data by wired or wireless connection, or self-reported via manual entry. The data that is collected on the HT platform is sent to a Clinician Web Viewer on the contractor website. The monitoring information is then available for the purposes of managing the health conditions of the Veterans. The vital signs and other data captured would be implemented into the Cerner Millennium dashboard, and ultimately to the Veteran’s health records, if this Justification and Approval is approved.

Current: The Department of Veterans Affairs is currently undertaking migration to a new Electronic Medical Record System from VistA to Cerner Millennium. According to GAO-20-447R1, A “Determination and Findings” was signed on June 1, 2017 by former Secretary David Shulkin that provided approval to issue a solicitation directly to Cerner.

Of note, Cerner is also under contract with Department of Defense to upgrade their electronic healthcare system. The VA’s contract with Cerner was announced May 17, 2018 for $10 billion over 10 years.

According to the VA’s electronic health records management website2, the VA plans to deploy the initial sites starting October 2020 and is anticipated to continue until 2028.

The Cerner rollout schedule within the VA anticipates 48 deployment waves between 2020 through 2028. The current HT contracts use the Health Level 7 (HL7) to exchange all clinical data between contractor systems and VA patient records systems using VistA Integration processes. With the transition to Cerner, the VA is requesting the vendor direct the information through a different avenue (Cerner). There is a cost-impact to this effort which has determined to be out of scope as they are re-routing the Veteran’s vital signs.

The VA has selected two sites in Veterans Integrated Service Network (VISN) 20 to be the initial operating capability (IOC) sites. The VISN 20 IOC sites include: Mann- Grandstaff VA Medical Center in Spokane, Washington and VA Puget Sound Health Care System - American Lake and Seattle Divisions, designated as Capability Set 1 (CS1) and Capability Set 2 (CS2). Based on the Department of VA moving forward with the modernization of the Electronic Health Record (EHR) provided by the Cerner Millennium, there is a need to modify the current HT contracts to accommodate for the cost increase to set up the additional servers and labor for this effort. The goal is to bring the HT contracts into alignment of updating the HT patient records in the Cerner Millennium in line with the go-live of the CS2 site at IOC.

1 https://www.gao.gov/assets/710/706639.pdf 2 https://www.ehrm.va.gov/

The VA is requesting approval to add the following two CLINs to clarify the work needed to migrate EHR systems:

0703 – General Services Fee- Cerner Development 0704 – General Services Fee- Cerner Operations

The modernization of the electronic healthcare record management system is vital because both Department of Defense and VA will both be utilizing the system from Cerner. The implementation of Cerner Millennium EHR will allow an active duty service member’s records to transfer from the DoD to the Department of VA upon separation.

4. Statutory Authority Permitting Action:

The statutory authority that permits this action is 41 U.S.C. 3304 (a)(2) as implemented by FAR 6.302 Only one responsible source and no other supplies or services will satisfy agency requirements per FAR 6.302-1.

5. Demonstrate that the proposed contractor’s unique qualifications or the nature of the acquisition requires of the authority cited:

This contract is in Option Year 3, currently set to end January 31, 2021, with an additional option year to exercise. Given the Department of VA’s schedule to deploy and implement the new Cerner electronic health record system in 2020 and beyond, it is necessary to modify this contract to align with Department of VA’s Cerner deployment schedule. Therefore, in accordance with FAR 6.302-1, there is only one responsible source for HT and no other supplies or services will satisfy Agency requirements.

6. Description of Efforts Made to Ensure Offers are Solicited from as Many Potential Sources as practicable:

Due to the fact MCMS is currently on contract for providing Remote Patient Monitoring via the HT contract and is providing supplies and services which ultimately need to be recorded in the Veteran’s electronic health records, no additional sources were solicited on this action.

7. Determination by the Contracting Officer that the Anticipated Cost to the Government will be Fair and Reasonable:

Adequate price competition was utilized for the original contract in accordance with FAR 15.403-3(b), Adequate Price Competition. The current contract utilized full and open competition, and eighteen (18) proposals were received for consideration.

As this is new scope to support an additional electronic record management system, this work was not originally anticipated; and this was not previously negotiated. The Contracting Officer (CO) has requested proposals from the vendor for this modification.

The CO will analyze the proposed cost to ensure it’s fair and reasonable prior to executing the contract modification.

The CO has requested proposals from both vendors to support the transition to the Cerner EHR.

These aforementioned documents will be analyzed and shall provide the basis to negotiate fair and reasonable pricing to support this action.

The CO has determined none of the exceptions apply under FAR Subpart 15.403-1(b) are applicable.

8. Description of the Market Research Conducted and the Results or a Statement of the Reasons Market Research was not Conducted:

Market research was not performed, as the VA is transitioning to a new EHR provided by Cerner. Given the mission of modernizing the EHR, there is only one source (per contract) who can meet the requirements of the implementation schedule for the EHR Modernization efforts at IOC at CS2 with the data their HT devices and peripherals capture.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition:

No additional information.

10. Listing of Sources that Expressed in Writing, an Interest in the Acquisition:

Not applicable to this action.

11. A Statement of the Action, if any, the Agency May Take to Remove or Overcome any Barriers to Competition Before Making Subsequent Acquisitions for the Supplies or Services Required:

The VA will continue to conduct market research, including interacting with vendors at professional conferences, exhibitions, and trade shows, to identify alternative sources that could be considered for future acquisitions.

Requirements Certification:

I certify that the requirement outlined in this Justification & Approval is a Bona Fide need of the Department of Veterans Affairs and that the supporting data under my cognizance, which are included in the justification, are accurate and complete to the best of my knowledge and belief.

Cathy Buck Program Manager

Office of Connected Care

Contracting Officer’s Certification (required): I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

Alyssa Urquhart

Contracting Officer

NAC HCA Review and Approval: I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and recommend approval for other than full and open competition.

Craig Robinson Date Associate Executive Director Head of Contracting Activity (HCA) National Acquisition Center

Alyssa S. Urquhart 1633605

Digitally signed by Alyssa S. Urquhart 1633605 Date: 2020.08.20 15:44:10 -06'00'

Ronald R Sandreth 126281

Digitally signed by Ronald R Sandreth 126281 Date: 2020.08.21 11:19:59 -04'00'

CRAIG ROBINSON

254508

Digitally signed by CRAIG

ROBINSON 254508

Date: 2020.08.26 13:07:33 -05'00'