JA VISN 2 Redacted.pdf

Medicom Imagex Software Subscriptions and Support CONTROL NUMBER VA-26-00038750

JUSTIFICATION

FOR OTHER THAN FULL AND OPEN COMPETITION

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: This proposed action is for issuance of a sole source firm-fixed price contract for renewal of brand name Medicom Technologies Inc.’s (Medicom) Imagex with Assistant Edition software and supporting services, maintenance, and training with the original equipment manufacturer Medicom located at 555 Fayetteville Street, Suite 300, Raleigh, NC 27601.

3. Description of Supplies or Services: VA, Veterans Health Administration (VHA), Veterans Integrated Service Network (VISN) 2 has a requirement for renewal of brand name Medicom Imagex with Assistant Edition software subscriptions per site (quantity of 10), associated support services, maintenance and training. VA requires a system that will satisfy the functional capability to save diagnostic images to the current VA systems and pathways, and both authenticate and validate bi-directional, electronic exchange of Digital Imaging and Communications in Medicine (DICOM) images, radiology reports, and radiology images with commercial healthcare facilities providing services to VA patients. Specifically, this solution will provide a peer-to-peer network which enables the seamless and secure sharing of radiology information, including reports and images, through encrypted conduits between providers on a fully federated health information network. The associated maintenance support includes timely provision of patches and updates to ensure the software remains operational, and virtual training will be provided to ensure seamless coordination with product updates. The Contractor shall furnish all necessary training materials and provide training to the VA as required.

The period of performance shall be one 12-month base period with two subsequent 12-month option periods for continued access to the Medicom Imagex subscription, associated maintenance and support, if exercised. The total estimated value of the proposed action is s.

4. Statutory Authority: The statutory authority permitting other than full and open competition is 41 U.S.C. 3304(a)(1) as implemented by the Revolutionary Federal Acquisition Regulation (FAR) Overhaul (RFO) 6.103-1 entitled, “Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements.”

5. Rationale Supporting Use of Authority Cited: Based on market research, as described in Section 8 of this justification, it was determined that no competition is available for this procurement. Brand name Medicom Imagex is already in place across 91 Veterans Administration Health Care Systems and VA Medical Centers across 46 states for clinical image data exchange, including 10 sites within VISN 2.

VA requires renewal of the existing software solution that meets all the technical and functional requirements and continues to seamlessly integrate with this existing network.

Brand Name Medicom Imagex’s remains the only solution that satisfies VA technical requirement of being able to search commercial imaging providers to locate and retrieve prior medical images and reports for storage within VA systems.

Further, the brand name Medicom Imagex solution deploys a proprietary peer-to-peer network which communicates via a propriety software code and enables the seamless and secure sharing of radiology information, including reports and images through encrypted conduits between providers on the fully federated health information network. No other like solution has access to, nor can seamlessly interoperate with the brand name Medicom Imagex software solution.

The absence of this capability to seamlessly communicate internally and externally to VA impacts VA’s ability to support congressionally mandated requirements, such as the Mission Act, which has enabled Veterans to seek diagnostic imaging services outside of VA. If VA is unable to renew its access to this solution, digital image transmission and sharing would not be possible. VA would have to use compact disks (CDs) and digital video disks (DVDs) that are hand-carried or mailed to and from VA facilities at the completion of a diagnostic test, ultimately creating bottlenecks and delays in the continuity of Veteran care. Additionally, delays in archiving images can also cause misplaced CDs or DVDs, repeated examinations, and “unreadable” images that are incompatible with some software in VA. All adverse factors add to unnecessary health risks of Veterans and additional costs to

VA.

Even if VA were able to identify a software solution that could meet all the unique functional and technical requirements, there would be a significant impact and duplicative cost to VA to accomplish this. Specifically, if VA were to switch vendors from brand name Medicom Imagex, VA facilities would have to remove the imaging solution from existing sites and engage with service providers and their unique/varied brand imaging solution to create a capability to share images seamlessly. As part of its commercial offering, Medicom coordinates these activities with the service providers to ensure compliance with VA security and privacy requirements, as outlined in its Business Associate Agreements (BAAs). The BAAs specify procedures for the secure handling of Personally Identifiable Information (PII), outline security requirements, and set expectations for reporting any violations related to HIPAA, the Privacy Act, or other concerns that may arise concerning the transmission of images or other patient medical data. If VA were to transition to a different source, VA would have to validate and ensure that each connection meets all privacy and security requirements. VA estimates that there are currently 443 unique connections across the current installations of Medicom Imagex in VISN 2.

The estimate to validate and ensure this compliance would take more than four years with an estimated cost over $5 million. These are additional costs that would not be recovered through competition. These estimates are based on previous acquisition history.

Failure to renew the brand name Medicom Imagex software and support services as proposed will have significant impact of VA’s ability to execute its mission and ensure patient healthcare and PII is protected and secure.

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. There is no competition anticipated for this acquisition. Additionally, the proposed action will be synopsized on the Contracting Opportunities Page in accordance with RFO FAR

5.201. Any proposals that are received shall be evaluated.

7. Actions to Increase Competition: The Government will continue to conduct market research to ascertain whether there are changes in the marketplace that would enable future actions to be competed. VHA and VISN 2 will continue to research and monitor whether there are emerging products that enter the marketplace that are interoperable and compatible with VA community facilities, platforms, services, and software.

8. Market Research: The Government’s technical experts conducted market research from January 2026 through March 2026 on products and software similar to Medicom’s Imagex. Specifically, the Government evaluated alternative enterprise imaging and health information exchange solutions, including Intelerad (InteleShare/IntelePACS), Nuance PowerShare, Ambra Health, InterSystems HealthShare, Life Image, and Change Healthcare enterprise imaging platforms.

None of these solutions are able to meet VA’s requirement for a fully federated health information network and seamless communication internally and externally, as noted in Section 5 of this justification. Further, while several products reviewed offered partial capabilities such as image storage, radiology workflow, or limited data exchange, none met the Government’s full requirements for a fully federated enterprise solution. For instance, solutions like those from Intelerad and Life Image, provide a subset of these requirements are primarily imaging-focused solutions.

Others like Nuance PowerShare and Ambra Health rely on hub-based or centralized exchange models. InterSystems HealthShare / Change Healthcare offered health data integration capabilities but would require significant customization, additional infrastructure, or separate imaging solutions to meet combined imaging and clinical exchange requirements.

On March 25, 2026, Medicom confirmed that it is the sole source provider for the Medicom Imagex software, including support, maintenance, and training, and that no authorized distributors or resellers exist. Based on the market research and technical evaluation, VISN 2 concluded that only Medicom Technologies can provide a fully interoperable, federated solution capable of securely connecting disparate health information silos and supporting efficient search and exchange of clinical data across VA systems.

9. Other Facts: None.