36C25020D0008-001.pdf

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A)

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C250-19-AP-5193

1. Contracting Activity:

Network Contracting Office 10 24 Frank Lloyd Wright Drive Lobby M, Suite 2200 Ann Arbor, MI 48105

Purchase Request/2237 #: 583-20-1-190-0002

2. Nature and/or Description of the Action Being Processed: A comprehensive, consolidated Picture Archiving and Communication System (PACS) fee-per-use program developed and utilized by the VISN 10 Imaging Committee. PACS services is a digital imaging system deployed throughout VISN 10 and it is necessary to continue the existing maintenance of PACS that interfaces with CPRS and VISTA web as well as multiple Plug-in applications. Provides 24/7/365 customer support including engineers and a help desk and a minimal, guaranteed on-site repair time of less than 4 hours. This will be a new contract that is a follow-on effort from the past VISN 10 BPA, VA251-15-A-0035, established against GSA Contract GS-35F-0134X and for the past Ohio awards established against DLA HTME Contract SPM2D1-11-D-8305. Both the GSA and DLA contracts have expired; therefore, the VISN 10 This is anticipated to be an indefinite-delivery, indefinite quantity, firm-fixed price contract.

FAR 13.5 Simplified Procedures for Certain Commercial Items: This procurement is for PACS services in accordance with FAR 13.5 Simplified Procedures for Certain Commercial Items and specifically FAR 13.501 Special Documentation Requirements, where acquisitions conducted under Simplified Acquisition Procedures are exempt from the requirements of FAR Part 6, but still require a justification using the format of FAR 6.303-2.

3. Description of : The Philips PACS is designed to meet the ever expanding requirements our patient care imaging need.

This product is for the entire VISN 10 community. Vendor is responsible for providing all hardware, software remote and on-site support necessary for comprehensive imaging solutions and maintenance. VA/VISN facilities will pay a per study cost, and will not be responsible for owning, supporting or maintaining computer or software systems.

Additionally, there will be hardware refresh/replacements as systems age or newer technology becomes available along with continued software upgrades and support for additional modalities or system enhancements. The system should provide a storage array system that allows for less hardware and a smaller footprint to easily fit into limited space. A virtual environment computing system should be in place that allows for easier creation of additional storage once storage modules are at capacity. The virtual environment also means that the system is much more reliable and easier to replicate should there be a hardware r user access to patient data. The PACS should use Data Transfer Syntax (SDT) technology for high speed/high quality image distribution. Due to the increasing need to view images from other facilities, a

Federated viewer is also necessary to provide proper patient care. Federation allows you to share data between autonomous healthcare institutions and view patient images from all contributing institutions, regardless of where and when they were created.

Estimated Value: per year. If all option periods, including FAR 52.217-8, were exercised the maximum anticipated value is . The Contracting Officer intends to establish a $6.5 million ceiling for the ID/IQ. The resulting contract will be established with a base year and three, four-month option periods.

Site Average Study

Volume (per year)

Ann Arbor 63,800 Battle Creek 36,900 Chillicothe 25,821 Cincinnati 60,871 Cleveland 121,493 Columbus 35,283

Dayton 73,292 Detroit 75,000

Indianaoplis 91,600 Northern Indiana 53,750

Saginaw 29,680 Total 667,490

4. Statutory Authority Permitting Other than Full and Open Competition:

( ) (1) Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements per FAR 6.302-1;

( ) (2) Unusual and Compelling Urgency per FAR 6.302-2;

( ) (3) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert Services per FAR 6.302-3;

( ) (4) International Agreement per FAR 6.302-4 ( ) (5) Authorized or Required by Statute FAR 6.302-5;

( ) (6) National Security per FAR 6.302-6;

( ) (7) Public Interest per FAR 6.302-7;

FAR 13.5 Simplified Procedures for Certain Commercial Items: The authority for applying the Simplified Procedures for Commercial Items of FAR 13.5 is 41 U.S.C. 1901 and is implemented by for restricting competition on this procurement via FAR 13.106- 1(b)(2).

5.

Acquisition Requires the Use of the Authority Cited Above (applicability of authority):

Long-term follow on contract is in the acquisition planning stage. Due to the value (over $7 million) and the implementation timeline (12-18 months) associated with the requirement, a

- ncumbent, Philips, as their hardware/software is already in all VISN facilities.

There are no other sources that can meet the requirement other than the manufacturer, Philips due to the proprietary data transfer syntax (DTS), known as the iSyntax, method of compressing data to deliver diagnostic quality imaging to unlimited users across the VISN 10 organization at unparalleled speed. With this level of data transfer, patients receive a better quality of care. The iSyntax method of data compression pushes the limit of data compression and no other system can surpass that compression. Philips instituted and uses ss to patient data. Since iSite was installed, VPN tunneling has been used to enable the use of off-site reading rooms for image interpretation during off hours for our emergency patients. Off-site reading rooms enable affiliate organizations such as Indiana University (IU Health) and The University of Michigan to provide higher quality image interpretation for VA facilities. Additionally, the Philips system supports the educational components of both affiliate universities and has a unique and complex workflow that supports the residency and fellowship training programs.

This workflow is critical to the support of the VA Indianapolis and Ann Arbor. Any change to the workflow may impact the educational program at each university and degrade the radiologist and resident support that is currently provided, especially on off-tours and holidays. Additionally, VA Indianapolis has a single VA radiologist. Ninety plus percent of all interpretations utilize a multi-million dollar healthcare resources contract with the affiliate, and a majority of these exams are interpreted off-site, via National Teleradiology (who utilize Philips iSite). A change in vendor would have a great impact on the scarce medical contract because the interpreting workflow that has been designed and relied upon for the last 13 years to interpret would be jeopardized. Philips iSite complies with all information security policies and procedures for data handling and offsite storage. Veteran patients frequently move from one location to another and the ability to view diagnostic quality images from other facilities has always been a challenge. Philips iSite PACS now has y images acquired at different VA facilities. This means that any VA that has Philips iSite will be able to view images from other Philips iSite facilities within the VA system. With the federated viewer this challenge has been minimized. The majority of commercial PACS currently within the VA are Philips iSite.

This means that if a patient has been imaged at another VA there is a high likelihood that a prior imaging study will be available for comparison when reading new studies. The level of patient care and quality of the interpretation will dramatically improve. This also will reduce the potential of a misread thereby decreasing the chance for a tort claim.

This is an existing system consisting of hardware, software and 24/7/365 remote customer support including engineers and a help desk. It also includes 2-4 hour on-site repair time that is necessary to maintain existing patient imaging exams as well as future imaging exams for all modalities in radiology including but not limited to MRI, CT, Diagnostic Radiology, Interventional Radiology, Nuclear Medicine, and Ultrasound procedures. The loss/disruption of these services could prove to be fatal to patients who are depending on radiologists to access these studies and provide clinical guidance. There is no other hardware, software, or customer support provider that can directly replace the Philips iSite system without the possibility of losing patient studies and increasing workload to the radiology administrators