36C10B26Q0453_RFI VHA Radiology and Cardiology Enterprise Imaging System.pdf

Request For Information (RFI)

RFI: 36C10X24Q0024

SUBJECT RFI - Veterans Health Administration Radiology and Cardiology

Enterprise Imaging System

DESCRIPTION

Department of Veterans Affairs (VA)

Veterans Health Administration (VHA) Request for Information (RFI)

I. INTRODUCTION:

This RFI is issued by the Department of Veterans Affairs (VA), Technology Acquisition Center (TAC), for information and planning purposes only and does not constitute a solicitation nor does it restrict the Government as to the ultimate acquisition approach. In accordance with Federal Acquisition Regulation (FAR) Overhaul 15.101(c), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract.

Pursuant to FAR Overhaul Part 10 (Market Research), the purpose of this RFI is to understand industry capabilities related to national enterprise imaging systems and to collect information to enable further development of a future acquisition strategy to include socio-economic consideration and methods. This RFI is related to earlier RFI #’s 36C10X24Q0024 and 36C10X25Q0015.

Any information received from a contractor in response to this RFI may be used in creating a solicitation. Any information received which is marked with a statement, such as “proprietary” or “confidential,” intended to restrict distribution will not be distributed outside of the Government, except as required by law.

The Government is not responsible for any cost incurred by industry in furnishing this information. 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 Request for Proposal (RFP), if any is issued. Any information submitted by respondents to this RFI is strictly voluntary. All submissions will become Government property and will not be returned. Interested vendors are responsible for adequately marking proprietary, restricted or competition sensitive information contained in their response.

II. RFI RESPONSE INSTRUCTIONS

NOTE: The response to this RFI must be clear, concise, and complete. VA is under no obligation to provide feedback to the company, or to contact the company for clarification of any information submitted in response to this RFI.

RFI responses must include:

A. Company Information:

1. Company Name;

2. Company Address;

3. Point of contact name;

4. Telephone number

5. Email address

RFI: 36C10B26Q0453

6. CAGE/SAM UEI under which the company is registered in the System for Award Management (SAM);

7. Small Business Administration (SBA) VetCert certification (if applicable).

B. Responses to the following two (2) areas:

1. List any previous or existing contracts you have with the VA where similar work was performed to this requirement. Also, is there an existing contract vehicle you recommend be used for this procurement?

2. Responses to all parts of questions 1-13 in Section IV of this document

Responses to this RFI shall be submitted electronically by 10:00 AM EST, June 2, 2026 via email to the TAC points of contact Contract Specialist, Chanté Frith, Chante.Frith@va.gov and Contracting Officer Matthew Truex, Matthew.Truex1@va.gov. Please note “Response to RFI - Veterans Health Administration Radiology and Cardiology Enterprise Imaging System” in the subject line of your response. The email file size shall not exceed 5 MB.

All responsible sources may submit a response in accordance with the following:

All proprietary/company confidential material shall be clearly marked on every page that contains such.

Please keep your response to no more than 15 pages. Responses should be submitted as either a Microsoft Word (.docx) or an Acrobat (PDF) format with Arial or Times New Roman font, 12

pt. minimum that addresses all information. Tables and illustrations may use a reduced font size not less than 8-point and may be landscape. Interested parties should exclude marketing material in order to allow sufficient space for adequately, directly, and substantively responding with the information of most interest to the Government. NO MARKETING MATERIALS ARE

ALLOWED AS PART OF THIS RFI.

mailto:Chante.Frith@va.gov mailto:Matthew.Truex1@va.gov

III. BACKGROUND/REQUIREMENT DESCRIPTION:

This RFI is issued for the purpose of collecting information about the ability of a vendor to meet the requirements for design and implementation of an VHA enterprise wide Radiology and Cardiology PACS as described below.

1. The VHA consolidated Radiology/Cardiology PACS initiative, currently in the market research phase, is evaluating current and future capabilities for solutions that provide secure image acquisition, retrieval, communication, viewing, postprocessing, automated analysis, reporting, documentation, importing/exporting/exchange, workflow management, referring clinician and patient access and review, image integration into VHA electronic health record (EHR), and other critical functionality for image-centric VHA clinical programs. Clinical domains include, but are not limited to, the following areas: radiology (including nuclear medicine) and cardiology/vascular imaging (invasive and noninvasive).

2. Estimated annual volume of VHA imaging may exceed 12 million Radiology and Cardiology exams across 18 VISNs.

3. Important features of interest for VHA enterprise PACS will include, but are not limited to, integration with current and future VHA EHR, universal availability of images and reports on all VA desktops, specialty-specific diagnostic viewers and clinical tools or compatibility with third party specialty-specific diagnostic viewers, specialty-specific integrated artificial intelligence (AI) functionality, integrated voice recognition, reporting, communication, quality improvement, quality assurance, and data mining capabilities for use in all clinical domains, interfaces for all image acquisition modalities/devices as well as workflow capabilities in each clinical domain, ability to manage and archive Digital Imaging and Communications in Medicine (DICOM) and non-DICOM images, bidirectional exchange of images and reports with DoD and community (non-VHA) partners, and viewing capabilities for ordering/referring providers and patients. Viewing capabilities on non-Government Furnished Equipment (GFE) mobile devices and multimedia integration of image data for use in VHA’s EHR is also preferred.

4. VHA is currently surveying industry to identify potential vendors who would be capable of providing VHA with a best in breed, enterprise class Vendor Neutral Archive (VNA) and viewer with supporting functionality that incorporates at a minimum the following preliminary features:

• Rapid, on-demand access to images across the enterprise;

• Master patient index (MPI) to address VA’s conversion from VistA to Oracle Health

Electronic Medical Records (EMR) and the change in primary identifier from Social Security Number (SSN) to Electronic Data Interchange Personal Identifier (EDIPI).

System must be able to seamlessly function with both VistA and Oracle Health or other potential EMR interfaces and be able to utilize the appropriate primary patient identifier for each respective system to uniquely identify patients and ensure a patient’s data appears as a singular instance within the enterprise imaging archive;

• Migration of all studies and reports currently in local/VISN PACS and cardiology PACS.

This is approximately 20 petabytes comprising >2 billion individual images. Some studies may need to be migrated from the systems of origin;

• Zero footprint web viewer compatible with VA baseline PC image and associated browser;

• Advanced Artificial Intelligence (AI) support including third-party vendor integration/support across all listed imaging specialties. At a minimum, AI modules will include: Intracranial Hemorrhage, Large Vessel Occlusion, Mammography Density, Quality and breast nodule detection, and lung nodule detection;

• System must be expandable to diagnostic review, interpretation and reporting of multi-specialty imaging;

• Ad hoc query retrieve capability with all non-integrated VHA PACS and DoD PACS systems;

• Ability to store, transfer, reprocess and display Nuclear Medicine raw image data;

• Full functionality nuclear medicine processing capabilities integrated within viewer;

• Innovative ways research data can be collected and accessed during the following image migration and presented to quality management and research personnel;

• Functionality for segregation, curation and tracking use of large image and report data sets for research, AI assurance and other functions as authorized;

• Research data must be archived in a secure anonymized silo within the EI system;

• Integrated voice recognition (VR) for site/VISN-based reporting, cross-VISN reporting and enterprise-wide reporting for NTP. VHA is open to both cloud-based and workstation-based VR

• System must include a worklist/assignment engine that presents Radiologists and Cardiologists with studies that they are credentialed to read and has configurable logic for assignment and workload balancing;

• Functionality for automated population of templated reports using DICOM Structured Report (SR)and AI analysis;

• Routine redundant archiving of final reports in image series;

• Functionality to support automated assignment of case reviews and tracking of results for

Ongoing Professional Performance Evaluation (OPPE);

• Functionality for identification and annotation of cases for peer learning activities;

• All components of the system must support VA’s current user authentication methodology;

• Enterprise support for National Telestroke Program image viewing;

• Enterprise support for national Tumor Board image review;

• Custom workflows specific to VHA National Teleradiology Program in alignment with

NTP NextGen PACS: https://sam.gov/opp/b556ed4b32cb4caabd4878bf59af9ab5/view

• System should include an integrated HL7 broker for inbound and outbound message normalization;

• System must be DICOM promiscuous and must normalize all VistA Radiology exams to a consistent format, e.g. site code-MMDDYYYY-###;

Specialty Areas:

1. Radiology and Nuclear medicine:

• Archiving and Image/report distribution to VA enterprise, including academic and community partners / affiliates and DoD;

• Full featured radiology diagnostic review and reporting system;

• DICOM Modality Worklist Provider;

2. Cardiology: Cath, Echo, MR, CT, EKG and Holter Monitor:

• Archiving and Image/report distribution to VA enterprise;

https://sam.gov/opp/b556ed4b32cb4caabd4878bf59af9ab5/view

• Full featured cardiology diagnostic review and structured reporting system for invasive and non-invasive procedures;

• A strong preference for a zero-footprint diagnostic display and structured reporting client;

• Post acquisition reprocessing of Echo studies. This functionality must be vendor agnostic;

• DICOM Modality Worklist Provider;

• Advanced Visualization Tools for Echo, Cardiac CT/MR, and Nuclear Cardiology;

• Cardiac focused AI image analysis and reporting tools;

3. National Teleradiology Program

• Pre-Read QA worklist for NTP Support allowing NTP Support to review images submitted for interpretation and query/retrieve additional relevant studies from any PACS in VHA;

• Integration with Foundations from Health Level for STAT Portal and clinical analytics;

• Integration with NTP’s mammography tracking system;

4. The VNA is expected to be able to store, display, and provide image retrieval of pathology, point of care ultrasound (POCUS), dental imaging, retinal imaging, and radiation oncologic imaging and treatment planning data (store and retrieve).

General Requirements

VHA consolidated PACS is envisioned (subject to change) to meet the following major characteristics which will be described in detail in any potential subsequent solicitation:

1. Intuitive, stable, fast and easy to use zero footprint user interface for the viewer;

2. Specialty viewers for listed imaging specialties, with future expansion to serve as a single

VHA PACS/Enterprise Imaging system;

3. Advanced AI options for image analysis, including stroke and mammography, as well as workflow and results tracking AI functionality;

4. HL7 interfaces to all current VA VistA and Oracle Health systems;

5. Supports all VNA image and document management standards, such as Integrating the

Healthcare Enterprise (IHE);

6. Dose tracking and alerting system to include collecting dose data of migrated studies going back to an agreed upon date;

7. Viewer should be designed with a focus on human factors to optimize viewing efficiency, while minimizing viewer fatigue and the incidence of repetitive motion injuries;

8. System must support cross-site collaboration, reading and reporting. This is to function in both VistA and Oracle Health environments;

9. Viewer supports on-the-fly 3D and other advanced visualization and analysis capabilities;

10. Viewer must provide support for archive teaching and research cases with deidentification of patient information;

11. Viewer must support export of deidentified reports and images;

12. System must support the electronic transfer and reconciliation of electronic images and other records and between VA and outside providers/institutions;

13. Provide automated auto-linking/registration of multi-slice images across series among current and prior exams;

14. Integrated multi-specialty, industry standards body compliant peer review-OPPE functionality with on demand and assigned workflows. Peer review will incorporate system separate workflow and scoring methodologies for VHA peer reviews. Access to this functionality must be controlled by site and/or group practice. Groups should not be able to see each other’s peer reviews;

15. Seamless API integration with vendor provided voice recognition. Vendor will provide VR option(s) for VHA to select from. VHA will select a single voice recognition system that shall be supported by the vendor;

16. All applications installed on diagnostic workstations must allow updates without requiring elevated privileges;

17. Enterprise-based VR profiles allowing users to utilize alterative workstations and/or reading centers with minimal to no user reconfiguration required;

18. VR reporting system must be able to support connection to all VA facilities each with their own HL7 interface. VR system must also be able to support an interface to Oracle Health OpenLink as sites convert over at least the next decade;

19. All system components will be designed with 99.99% uptime goal with failover redundancy;

20. VR system must support global and user specific templates;

21. VR system must support VA defined diagnostic codes;

22. VR system shall incorporate capabilities of prepopulating measurements;

contrast, and radiation dose information into structured reporting format;

23. Seamless API integration with VA/DoD Joint Longitudinal Viewer (JLV), which requires the use of Clinical Context Objects Workgroup (CCOW) to pass patient context of open exams;

24. The viewer will be typically launched from the EMR with pass-through authentication from the native operating system. However, it must support launching as a stand-alone viewer using Single-Sign On (SSO), Windows Integrated Authentication (WIA) or LDAP via PIV/CAC cards;

25. Archiving of electronic medical images;

26. Archiving of non DICOM electronic images including importation of PDF documents from file shares. (VistA Imaging Importer);

27. All existing DICOM, non-DICOM imaging and scanned documents must be migrated and available in the new PACS;

28. Import and archiving of scanned documents;

29. Business intelligence reporting system; including standard enterprise reports and user customizable Boolean search and reporting capabilities for all components;

30. Natural language report search tool that is available to all end users;

31. Full security auditing and automated archiving of audit trails, with notification capabilities;

32. If not a 100% SaaS solution, system must be joined to the VA.gov domain;

33. Access control must be conformant with VA’s Least Privileges policy; specifically, roles and worklists should be designed in support of this; system must be able to separate radiology and cardiology worklists by site, VISN, and NTP to support least privilege access;

34. Supports current VA order and encounter based workflows;

35. Provide DICOM modality worklist for both order and consult based exams;

36. Both EDIPI and SSN must be supported for patient identification. The system must be able to normalize SSN to EDIPI during migration;

37. System must support section 508 accessibility;

38. Vendor must provide 24x7x365 technical support with off-hours escalation to senior level support within 15 minutes of initial call;

39. Vendor must provide an ongoing commitment to VHA for continuous product development and enhancement to ensure that the system remains on the latest commercially available version. This may include the development of additional client functionality to meet VA needs;

40. Remote support will be provided via VA site-to-site Virtual Private Network with accompanying VA mandated annual information security and privacy training along with background investigations. Vendor and all subcontractors must agree to comply with all applicable VA security requirements;

41. Vendor will be responsible for all Operating System (OS) patching, Anti-Virus (AV) updates, and vulnerability remediation in accordance with published VA and DHS timelines, and application updates/upgrades to meet VA security requirements. Windows OS patches are available via an internal WSUS repository. Linux servers must also be patched and can be managed through the VA RHEL satellite server provided the Linux servers meet the VA baseline. If Linux-based and not configured in accordance with VA baseline, vendor will be responsible for managing updates independent of the VA satellite server;

42. Software maintenance for the system and associated components to include updates and upgrades and all requisite security maintenance to remain in compliance with NIST, FISMA, and VA security standards will be provided and installed by the vendor;

Architecture

1. The overall system architecture shall be deployed in one of three configurations to achieve optimal display, redundancy, and contingency operations to achieve 99.99% uptime performance:

• 100% SaaS in a FedRAMP certified high environment;

• VA Enterprise Cloud (VAEC) deployed across two regions;

• Hybrid cloud VAEC (core system) with on-prem deployment in VA enterprise data centers;

2. The overall system design shall have redundancy and fault tolerance for components to eliminate single points of failure as the PACS is a mission/life critical application that is required to be online 24x7x365;

3. System is deployed with encryption of sensitive data at rest;

4. System will be designed to optimally utilize bandwidth across the VA Wide Area Network (WAN) and to/from the cloud-based components;

5. System will be configured for optimal functionality across the WAN to unlimited number of end users at home with data transfer rates sufficient to maintain image viewing and reporting functionality within clinically acceptable range;

6. All components will be deployed in accordance with applicable VA information security requirements;

7. For sites that utilize Oracle Health as their EMR, the system will be able to uniquely identify the patient via both EDIPI and SSN. The PACS application will utilize an MPI such that a query from an end user will correctly utilize the appropriate patient ID parameters in the query to successfully execute the Q/R. That patient will appear as a single instance within the system and reports will be issued to the originating site utilizing the site’s native patient ID parameters;

8. Intuitive Graphical User Interface (GUI) based study management tool for image/demographic modification and reconciliation for VHA clinical application coordinators;

9. System must support and the vendor must demonstrate a functional Integrating the Healthcare Enterprise (IHE) Imaging Objects Change Management profile and workflow;

10. Integrated artificial Intelligence (AI) Platform;

11. Mechanism for multi-specialty conferences and tumor boards. This must include collaboration and annotation tools and multi-party screen control;

12. Mechanism for health care providers to remotely review cases with patients;

13. Module for notification of both critical and non-critical results to providers;

14. System must accept and auto-reconcile studies from DoD. System must maintain DoD studies in an administrative area that excludes general access until that patient is eligible for VA care;

15. System must be able to electronically exchange studies with DoD, fee basis partners and other outside entities VHA chooses;

IV. RFI QUESTIONS:

Contractor Business Questions:

VHA is currently modernizing its Electronic Health Record with VISN go live projects running through 2031. It’s in the best interest of VHA and the Veterans that any potential Radiology and Cardiology Enterprise Imaging System be in production in advance of VISNs transition to the new Federal Electronic Health Record.

For the purposes of this response, assume that each VISN is comprised of 10 separate facilities and the average VISN annual study volume is 600,000 radiology exams and 50,000 echocardiography exams. The expectation is that a minimum of 2 years of historical reports are migrated prior to go live and that an expedited pre-fetching workflow is implemented. Expect to connect to a VHA enterprise HL7 broker. Facility level DICOM routers will route studies from local modalities to the Enterprise Imaging System. End user training is expected to be 75% virtual.

1. What is your company’s expected timeline to configure and implement a cloud-based system from the time of award to the point where you can begin transitioning the first VISN Radiology and Cardiology system? System must be deployed in the VA Enterprise Cloud (VAEC via IaaS) or in a commercial cloud with FedRAMP high certification (SaaS).

2. With regard to the timeline for transitioning all 18 VISNs to the new system:

1. How long do you expect it to take to transition each VISN to the new system?

2. How many VISN(s) would you be able to transition concurrently?

3. How long do you expect to take to transition all 18 VISNs to the new system?

4. What additional VA or third-party resources would be most effective in supporting and expediting your deployment schedule?

3. Are you able to concurrently implement a fully functional Cardiology solution and transition Cardiology to your system in parallel with Radiology at each VISN?

4. The current list of PACS vendors in the VHA includes: (1) Philips Intellispace, (2) Philips

Vue, (3) Carestream (legacy version) (4) Agfa, (5) Optum), (6) Visage, and (7) Intelerad.

Based on previous experience, do you anticipate any differences in the expected timeline between these vendors for transition to your system. Please list any anticipated barriers.

5. Has your company ever participated with a consortium of consultants, imaging, IT and EHR vendors that delivered large regional and or national level enterprise imaging systems? If yes, describe the project and vendors involved. Was your company the prime contractor? If not, who did your company work with?

6. Is your system authorized to operate in the VA enterprise cloud? Are you FedRAMP high certified or do you expect to attain it within 6 months? Do you have any PACS deployments or components of your system hosted in a FedRAMP high certified data center?

7. What key questions do you need to see answered in a future PWS/SOW before you decide to respond to the solicitation?

8. What do you foresee as the biggest risks in meeting/performing the requirements outlined herein?

9. Are there additional features and functionality not mentioned in this RFI, that your company feels are essential for an enterprise, consolidated radiology and cardiology PACS with integrated NTP capabilities?

10. Describe how your company can maintain and administer the entire system using a managed service model.

11. Describe how VHA sustainment technical support and administration teams should be constructed to support your proposed enterprise system. FTE projections are expected.

12. Describe any innovative solutions your company would propose to expedite historical exam migration. In particular, can your company migrate exams outside of DICOM transfer?

13. Please outline any specific technical capabilities your company possesses that positions your company for success with such a large, complex deployment?