36C10X24Q0024 - RFI - Veterans Health Administration - National Enterprise Imaging Systems.pdf

Request For Information (RFI)

RFI: 36C10X24Q0024

SUBJECT* RFI - Veterans Health Administration Multi-Veterans Integrated Services

Network (VISN) Picture Archive and Communication System (PACS) with

Integrated National Teleradiology Program (NTP) and Cardiology Capabilities

GENERAL INFORMATION

CONTRACTING OFFICE’S ZIP CODE* 21703

SOLICITATION NUMBER* 36C10X24Q0024

RESPONSE DATE/TIME/ZONE 11-26-2025 10:00 EASTERN TIME, NEW YORK,

USA

ARCHIVE 15 DAYS AFTER THE RESPONSE DATE

RECOVERY ACT FUNDS N

PRODUCT SERVICE CODE* DA10 – Business Application/ Application

Development Software as a Service

NAICS CODE* 541511 – Custom Computer Programming Services

CONTRACTING OFFICE ADDRESS Strategic Acquisition Center - Frederick

Department of Veterans Affairs

5202 Presidents Court, Suite 103

Frederick MD 21703

POINT OF CONTACT*

Contract Specialist

Brandi Luna

Brandi.Luna@va.gov

Contracting Officer

Justin Cole

Justin.Cole4@va.gov

ADDITIONAL INFORMATION

AGENCY’S URL

URL DESCRIPTION

AGENCY CONTACT’S EMAIL

ADDRESS

EMAIL DESCRIPTION

mailto:Justin.Cole4@va.gov

DESCRIPTION

Department of Veterans Affairs (VA)

Veterans Health Administration (VHA)

Multi-VISN, NTP and Cardiology PACS

Request for Information (RFI)

I. INTRODUCTION:

This RFI is issued by the Department of Veterans Affairs (VA), Strategic Acquisition Center, Frederick, MD (SAC-F), for information and planning purposes only and does not constitute a solicitation no does it restrict the Government as to the ultimate acquisition approach. In accordance with Federal Acquisition Regulation (FAR) 15.201(e), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract.

Pursuant to FAR Part 10.002(b)(2)(iii) and (viii) (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.

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 capability package 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

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. Brief summary describing your company’s technical approach to meeting the requirements, to include:

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 questions 1 – 68.

3. If your company is a Small Business, also include the following:

a. The intent and ability to meet set-aside requirements for performance of this effort.

b. Information as to proposed team members, the percentage of work each is to perform, and which PD requirements would be subcontracted.

Responses are due by 10:00 AM EST, November 26, 2025. Submit your responses directly to Zachery Minns; Brandi.Luna@va.gov and Justin.Cole4@va.gov.

On December 1, 2025 – December 3, 2025 VHA will be available for industry engagement at the Radiological Society of North America (RSNA) – 111th Scientific Assembly and

Annual Meeting located in Chicago IL.

An Industry Day will be planned at a later date regarding this requirement.

Please direct any questions to:

Contract Specialist: Brandi Luna; brandi.luna@va.gov AND

Contracting Officer: Justin Cole; Justin.Cole4@va.gov

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 30 pages.

mailto:Brandi.Luna@va.gov mailto:brandi.luna@va.gov

III. 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 a multi-VISN PACS with integrated NTP and enterprise Cardiology capabilities 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 5 million exams when imaging specialties are included across an initial 5 VISNs combined radiology/cardiology, and NTP.

3. Important features of interest for VHA multi-VISN 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 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-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

EMR and the change in primary identifier from SSN to 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. Response should not be limited to image analysis. VHA is interested in how AI can be applied to provider workflow management, EI system study routing, work prioritization, results tracking and notifications, patient safety and demographic information verification, system administration, and research. 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 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 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. sitecode-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;

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

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

• Archiving and Image/report distribution to VA enterprise;

• 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 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 VPN 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 OS patching, 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 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 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:

Requirements Questions:

1. Is your system authorized to operate in the VA enterprise cloud? Are you FedRAMP high certified? Do you have any PACS deployments hosted in a FedRAMP high certified data center?

2. What is your current market share for PACS deployments of multi-hospital systems over 5 million annual exams/studies?

3. What is the current yearly volume of your largest PACS deployment? What is your 2nd largest?

4. Does your company currently have a working deployment of a combined radiology/cardiology PACS system? If yes, please give details of the size, scope and functionality.

5. List your company’s five largest PACS customers. For each customer, please include the following:

a. Number of studies/volumes per customer;

b. Number of imaging modalities per customer;

c. Number of users per customer.

6. Do you have any system deployments greater than 5 million annual exams/studies where image viewing is done exclusively across the WAN/Internet?

7. Has your company ever participated in 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?

8. System must have a feature-rich zero-footprint encrypted streaming end user interface, optimized for WAN and low bandwidth remote accessibility. List client features and tools, both native and third party by specialty. List available compression options. Describe your streaming technology and how it is superior to other technologies.

9. Describe the techniques used to optimize system performance across the WAN in respect to both image streaming and study ingest/acquisition.

10. What compression methodology is used?

11. What is the minimum recommended bandwidth and maximum latency for image viewer functionality across the WAN?

12. List hardware and OS requirements for all end user clinical workstations across the various clinical specialties.

13. What voice recognition systems do you support and what are your top 3 recommendations?

14. Describe your full suite of workflow tools that optimize quality, timeliness and reading efficiency.

15. Describe AI or advanced functionality of the system to drive radiologist and cardiologist worklists and hanging protocols.

16. Describe prefetching of imaging from EHRs with varied procedure name syntax and available AI functionality that supports this.

17. List available AI modules for each listed specialty and how specialty algorithms would be deployed and managed through a common AI platform.

18. Describe how AI can be applied to provider workflow management, EI system study routing, work prioritization, patient safety and demographic information verification, system administration, and research.

19. The VNA must accommodate storage of non-radiology DICOM images using tag mapping to uniquely associate the images to the correct patient. Describe the process and validation elements for each of the listed imaging specialties.

20. How many installations do you currently have that support Single-Sign On (SSO) or LDAP via CAC/PIV? What is the largest number of user accounts currently supported at a customer base?

21. Describe your capital and operation sales models. How does your company manage and bill ongoing support? VA expects support to be managed through a single party.

22. Describe your tools for advanced visualization such as PET/CT, image fusion, 3D reformatting, etc.

23. Describe the viewing and analysis tools for nuclear medicine viewing to include cardiac nuclear medicine.

24. Describe tools for viewing and image routing for mammography, including but not limited to digital breast and tomosynthesis.

25. Describe your company’s experience in providing point of care ultrasound (POCUS) solutions. Answer should include how the studies are accessioned, captured, and physician point of care notes recorded in the medical record.

26. Can you provide an application-level interface that would allow a bedside provider to create a POCUS order at the bedside?

27. List all file formats your archive can ingest, store and display.

28. Describe how your company can import PDF documents from remote systems outside of

DICOM. Does your method support HL7 and file share retrieval?

29. Describe how your system handles electronic exchange of images and reports to systems outside of VA.

30. What is the minimum and recommended bandwidth for LAN and WAN end to end?

31. Describe all tools available for communication within the viewer, linked with Microsoft

Teams and other collaboration tools between clinicians and/or support staff.

32. Provide recommended OS and hardware specifications (RAM, processor, HDD) for viewing application.

33. Describe all tools available for monitoring and notifying via email or SMS when there are system failures with image ingest.

34. A 24/7/365 help desk, technical support and system monitoring of critical servers and services is required to ensure 99.99% uptime. How is this accomplished? Is the system status data periodically transmitted back to the vendor? What data is in the message? Note that the message cannot include patient identifiers.

35. All system software updates, and full version upgrades and professional services shall be included and provided by the vendor at no additional cost for the duration of any contract. In addition, all hardware upgrades associated with an update/upgrade will be solely the responsibility of the vendor. If the vendor takes exception to the above, please explain in your response.

a. How are upgrades handled? What are the steps?

36. Provide a DICOM conformance statement for your archive.

37. Do you support a mechanism for health care providers to remotely review cases with patients? Outline how this could be accomplished entirely within your system and outline how you could interface with current VA patient portals like My HealtheVet and/or any future veteran access portal.

38. What specific technical capabilities best position your company for success with such a large, complex deployment?

39. What are your company’s strategic development plans for your technology?

40. Please provide a high-level contracting plan to include all subcontractors.

41. Please provide a high-level timeline for implementation.

42. Please provide a high-level workflow and network topology.

43. What additional information will you need from VHA to create a system design and subsequent formal RFP response?

44. Please provide details for how the database for this system will be structured to allow for a highly available patient timeline. Please provide schema, scalability, architecture, and sizing restrictions. Provide details for database functionality in the event of a loss of cloud connections from a national to localized outage.

45. Can the system accept and allow for DICOM Q/R and DICOM push image sharing tools from all platforms? Are there any limitations if solution VNA is also used for another use case within a VHA site or VISN.

46. Describe your migration process and timeline for national level projects.

a. Describe a project where your company migrated large amounts of non DICOM imaging into a new archive.

b. Please provide details for this migration to include:

i. Number of studies

ii. Size of repository

iii. Completed via LAN or WAN?

iv. Provide LAN/WAN link speeds

v. Typical schedule for migration

vi. Time to complete

47. Describe how your database scales to meet performance required for a national level system.

If multiple databases are required, how does your system manage to appear as one system to the end user?

48. Describe how the system would access and display studies that are not yet migrated.

49. Describe how your company can migrate exams outside of a DICOM migration.

50. Detail end user training delivery methods.

51. Describe how administrative and end user training is delivered.

52. Describe what a VHA ongoing support and administration team would look like. FTE projections are expected.

53. All study exceptions should be presented in an administrative graphical user interface by site and specialty. Describe how your company manages this process so responsibility can be shared across a system administration team.

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

55. Are there additional features and functionality not mentioned in this RFI, that your company feels are essential for a multi-VISN, consolidated radiology/cardiology PACS with integrated

NTP capabilities?

Contractor Business Questions:

1. What contract vehicle do you recommend for this requirement?

2. What pricing structure do you recommend?

3. Does your organization have an existing GSA schedule for this type of requirement?

4. What NAICS codes would your company recommend for this action?

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

6. In what format and what kind of supporting documents would be most helpful to include as exhibits in a future PWS/SOW?

7. What do you foresee as the biggest risks in performing the tasks in the draft documentation to meet our requirements?