NNG15SD34B-104.pdf

DSS Live PeriOp Manager with Planner and Control Number TAC-19-51747 Installation, Implementation, Configuration, Maintenance and Training

JUSTIFICATION FOR AN EXCEPTION TO FAIR OPPORTUNITY

1. Contracting Activity: Department of Veterans Affairs (VA)

Office of Procurement Acquisition and Logistics Technology Acquisition Center 23 Christopher Way Eatontown, NJ 07724

2. Description of Action: The proposed action is for firm-fixed-price order to be issued under the National Aeronautics and Space Administration (NASA) Solutions for Enterprise-Wide Procurement (SEWP) V Government Wide Acquisition Contract (GWAC) for brand name Document Storage System (DSS) PeriOperative (PeriOp) Manager with Planner solution which includes software, hardware, associated installation, implementation, configuration, maintenance and training.

3. Description of the Supplies or Services: VA, Veterans Health Association (VHA), Richard L. Roudebush, Indianapolis (Roudebush) VA Medical Center (VAMC) has a requirement for a DSS PeriOp Manager with Planner solution to support 10 or more Operating Rooms (OR) which includes software, installation, implementation, configuration services; training; maintenance; and brand name or equal hardware. VHA requires a DSS PeriOp Manager with Planner solution that integrates to the maximum extent with Veterans Health Information Systems and Technology Architecture (VistA) and Computerized Patient Record System (CPRS), which will interconnect all of the Roudebush VACM ORs and decrease dual data entry, and reduce work-arounds such as using phone calls and Lync messages for notifications such as patient ready, room ready, case going over allotted time and using Excel spreadsheets, Outlook calendars, white boards for the surgical schedule sharing that have been created due to lack of current resources. The DSS PeriOp Manager with Planner software solution is a VistA-integrated, graphical user interface designed to provide a constant integrated view of patient status in real-time, manage perioperative complexity, improve team communication, enhance patient safety, and improve operational efficiency by streamlining documentation and updating VistA. The DSS PeriOp Manager with Planer software solution shall support the Roudebush VAMC to better manage, track, and improve surgical performance regarding patient safety, surgical throughput, utilization and efficiency, and surgical quality of care. The solution will pull lab test and other pre-operative test results such as electro-cardiogram and pulmonary function testis, which in turn, assists in patient scheduling and updating patient status. The solution integrates real-time data with bi-directional workflow automation that coordinates and manages patient care. The solution converts data from inside VistA to real-time, usable information that will streamline and enhance the quality of service VHA provides its patients. Additionally, the solution synchronizes patients preoperative progress against available resources, enables clinical staff to plan surgical cases and coordinating patient progress from first surgical referral to their scheduled procedure.

The DSS PeriOp Manager with Planner software solution includes the following modules that support these key dimensions:

▪ PreOp Board: Large screen wall and workstation displays that provide situational awareness of the surgical preparation process

▪ OR-Dashboard with Active Time Out: Comprehensive, continuously updated view of the surgical case from setup to closing

▪ OR-Schedule Board: Current days surgical caseload on one large screen showing an aggregated view in real-time

▪ Family Waiting Board: Display to allow families to track family member progress

▪ An analytics package that enhances reporting capabilities

Following initial installation and configuration, the Contractor shall provide onsite implementation, configuration, and training services to include remote and on-site user training, management and workflow assessments, and mentoring. Following successful implementation, the Contractor shall provide maintenance and technical support on the solution to include Monday – Friday 8-7 EST technical support, bug fixes, minor release upgrades, and telephone support. The Contractor shall deliver all hardware and software to the Roudebush VAMC no later than four months after award. The Contractor shall complete all installation, implementation, and configuration no later than six months after award. The period of performance for all software with licensing and maintenance support shall be for 12 months. All training services shall occur within one week of upon mutually agreed-to go-live date and shall be completed within 90 days.

4. Statutory Authority: Pursuant to Federal Acquisition Regulation (FAR) Subpart 16.505(a)(4), the following brand name requirement is being justified and approved as an exception to fair opportunity under the statutory authority of Section 41 U.S.C.

4106(c)(2) as implemented by FAR Subpart 16.505(b)(2)(i)(B), entitled “Only one awardee is capable of providing the supplies or services required at the level of quality required because the supplies or services ordered are unique or highly specialized”.

5. Rationale Supporting Use of Authority Cited Above: Based upon market research, as described in section 8 or this justification, it was determined that limited competition is viable among resellers of the DSS PeriOp Manager with Planner solution and associated installation, implementation, configuration, maintenance and training. Only DSS PeriOp Manager with Planner solution can meet all of VA’s requirements.

Specifically, the DSS PeriOp Manager with Planner solution is the only OR Manager software that can integrate and work in the existing VistA/CPRS system. VistA/CPRS is VA’s Health Information Technology system that provides an integrated inpatient and outpatient electronic health record for VA patients. Additionally, the DSS PeriOp Manager software was developed by VistA programmers to integrate an automated solution with the VA VistA environment through bidirectional communications using Health Level 7 code and Application Programming Interfaces. No other OR Manager software is capable of integrating with the current VistA infrastructure and has the bidirectional dataflow functionality. If another brand name OR software was used, VA would have to implement it into the current VA infrastructure which would require a complete redesign and redevelopment of the existing infrastructure and interfaces.

Specifically, this would require hundreds of hours of development by VistA programmers over a five-year period which would involve testing, validation, and reconfiguration resulting in extensive duplicated costs in the amount of $31,750,000.00 that would not be recovered through competition. This estimate is based on similar software development and installation efforts. In addition, the DSS PerioOp Manager with Planner solution is the only OR software that can meet all of VA’s functional requirements. Specifically, only the DSS PerioOp Manager with Planner solution PreOp Board maps VistA/CPRS data elements to PreOp milestones and documents milestone completion criteria. The OR Dashboard verifies the mapping of VistA/CPRS data elements to OR-Dashboard visuals. The OR-Schedule Board allows the user to view the current days surgical caseload as an aggregated view in real-time. The display shows the current status of all surgical cases and operating rooms, thus enabling VHA perioperative managers the ability to focus on the progress of cases while proactively canceling or rescheduling cases to allow for best operating room utilization. With bi-directional flow of data from and to Vista, this case canceling/rescheduling functionality is automatically reflected in VistA, thereby streamlining documentation practices and preventing perioperative bottlenecks. The use of another brand name DSS PeriOp data system with a platform this is incompatible with VistA/CPRS platform would also result in doubling VHA medical personnel workload to input of necessary data entries as every piece of data would require to be manually entered first into the DSS PeriOp data system and then separately entered into the VistA/CPRS system. This makes it impossible for the disparate systems to bidirectionally share information in real time, increases the risks of data entry errors, omissions, and contraindications, and creates inefficiencies in use of available operating room resources. This also increases risk to the patients due to poorly coordinated patient data and the inability to optimize in real time the use of that data.

Finally, DSS PeriOp Manager with Planner software is a proprietary software product.

Therefore, only DSS or its authorized resellers can provide maintenance on its software product. The proprietary code is required to ensure all DSS PeriOp software updates and patches are properly pushed through the fielded software and to ensure the software is properly configured. Access to this code is also required to ensure all services provided on the DSS PeriOp Manager with Planner software is properly configured. Access to DSS proprietary data and source code is required to provide the required software maintenance on DSS PeriOp Manager with Planner software. Only DSS and its authorized resellers can provide the associated knowledge base specific installation/implementation/configuration and training services for the DSS PeriOp Manager with Planner software as both require access to required proprietary code and technical data. If DSS PeriOp Manager is not procured, the Roudebush VAMC will lack in maximum VistA/CRPS integration with its perioperative activities. Roudebush VAMC would be required to continue to use manual processes without the benefit of improved OR utilization such as increased patient safety and more efficient communications.

6. Efforts to Obtain Competition: Market research was conducted, details of which are in the market research section of this document. This effort did not yield any additional sources that can meet the Government’s requirements. It was determined, however, that limited competition is viable among resellers for DSS PeriOp Manager with Planner software solution and associated services. In accordance with FAR 16.505(a)(4)(iii)(A)(2), this justification will be provided with the solicitation to all interested NASA SEWP V GWAC holders. In accordance with FAR 5.301 and FAR 16.505(b)(2)(ii)(D), notice of award of the resulting order will be synopsized and this justification will be made publicly available within 14 days after award on the Federal Business Opportunity website.

7. Actions to Increase Competition: The Government will continue to conduct market research to ascertain if there are changes in the market place that would enable future actions to be competed.

8. Market Research: VA technical experts conducted market research to ascertain the ability of any other source other than DSS or its resellers to provide a perioperative solution that would meet the Government requirements. VA technical experts conducted market research in June through September 2018 to find an alternate solution. Specifically, PICIS and WRSHealth were reviewed through website and direct communications. It was determined that there are no other perioperative solutions that are capable of integrating with existing VistA/CPRS and that provide real-time bi-directional data as outlined in Section 5 of this Justification. Direct communications with WRSHealth confirmed that its solution is unable to integrate and provide bi-directional data with VistA/CPRS. WRSHealth did not object to the Government’s assessment. Direct communications with PICIS determined that is solution is unable to integrate as a stand-alone software with the existing VistA/CPRS infrastructure. PICIS would need to purchase a licensing agreement with another manufacturer and initially conduct research and development for creation of a custom VistA/CPRS integrated database and software solution for perioperative integration. Alternatively, PICIS perioperative OR Manager software cannot be implemented as a stand-alone software at Roudebush VAMC without additionally procuring the PICIS Anesthesia Recordkeeping (ARK) software solution. This would require a complete replacement of the current MetaVision iMDsoft ARK solution with the PICIS ARK Anesthesia Manager software, of which the Roudebush VAMC has no need for. This would also additionally require the Roudebush VAMC to ensure all validations of the PICIS ARK Anesthesia Manager is communicating properly and staff would need to be trained on the new system beyond the original need of the PeriOp manager. PICIS did not object to the Government’s assessment.

Additional market research was conducted during August 2018 by utilizing the NASA SEWP V GWAC Provider Lookup Tool. The Provider Lookup Tool yielded four contract holders, of which one is a Group B(2) Service Disabled Veteran-Owned Small Businesses (SDVOSB) offering DSS brand name products. Direct communications with DSS indicated that requests from additional NASA SEWP SDVOSB contract holders would be considered. Furthermore, the NASA SEWP V GWAC has a dynamic catalog where line items can be added based on customer requests; therefore, as long as the required item or service is within scope of the NASA SEWP V GWAC, items and services can be added to the catalog on a daily basis.

9. Other Facts: N/A

P03 JA TAC-19-51747 FINAL

TAC08112018