Attachment 3 - Addendum to FAR 52.212-2.pdf

CLINICAL DECISION SUPPORT TOOL

ADDENDUM TO FAR 52.212-2 EVALUATION – COMMERCIAL ITEMS

1.0 BASIS FOR AWARD

This source selection will be conducted in accordance with Federal Acquisition Regulation (FAR) Part 12, Acquisition of Commercial Products and Commercial Services in conjunction with FAR Part 15, Contracting by Negotiation, as supplemented by the Defense Federal Acquisition Regulation Supplement (DFARS). These regulations are available electronically at https://www.acquisition.gov/.

The Government will select the Offerors whose proposals offer the “best value” to the Government using the trade-off method. Best value means the expected outcome of an acquisition that, in the Government’s estimation, provides the greatest overall benefit(s) in response to the requirement. The Offerors are advised that the lowest priced proposal(s) meeting the solicitation requirements may not be selected for an award if an award to a higher priced Offeror is determined to be more beneficial to the Government. However, the perceived benefits of the higher priced proposal must merit the additional price.

Contract terms and conditions consistent with customary commercial practices are specified in the solicitation, with otherwise tailored terms and conditions specified in the Addendum to the solicitation.

The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

FACTOR 1 – TECHNICAL

SUBFACTOR 1 – ACCESSIBILITY

SUBFACTOR 2 – QUALITY OF CONTENT

FACTOR 2 - PRICE

The Government intends to evaluate proposals on a best value tradeoff process. The Government may award to other than the lowest-priced offer or other than the highest rated proposal. In determining the Technical factor rating, the Quality of Content subfactor is more important that the Accessibility subfactor. The Technical factor is significantly more important than price. However, price is not irrelevant. As the range of technical merit narrows, price will become more significant.

2.0 EVALUATION APPROACH

FACTOR 1 – TECHNICAL

The Government will evaluate the offeror’s proposal under two subfactors, Accessibility and Quality of Content. After evaluating and assigning a rating to each subfactor, the Government will assign an overall rating to the Technical Factor. In determining the Technical Factor rating, the Quality of Content subfactor is more important that the Accessibility subfactor. The Accessibility subfactor will be evaluated on an Acceptable/Unacceptable basis.

https://www.acquisition.gov/

The Quality of Content subfactor and the overall Technical Factor will be evaluated according to the following table:

Overall Adjectival Ratings Adjectival Rating Description

Outstanding Proposal demonstrates an exceptional approach and understanding of the requirements, contains multiple strengths and/or at least one significant strength

Good Proposal demonstrates a thorough approach and understanding of the requirements and contains at least one strength or significant strength

Acceptable Proposal demonstrates an adequate approach and understanding of the requirements

Marginal Proposal has not demonstrated an adequate approach and understanding of the requirements

Unacceptable Proposal does not meet requirements of the solicitation and thus, contains one or more deficiencies and is un-awardable

*Tables defining these ratings more specifically for each of the three elements under the Quality of Content subfactor are provided below.

An Unacceptable rating under any subfactor will result in the overall Technical Factor to be rated Unacceptable. Proposals rated Unacceptable under the Technical Factor will be ineligible for award.

SUBFACTOR 1 – ACCESSIBILITY

The Government will evaluate the offeror’s response to the accessibility requirements in 2.3, particularly sections 2.3.5 and 2.3.9 of the Statement of Work (SOW) which are critical are in the military operational environment.

This subfactor will be evaluated on an Acceptable/Unacceptable basis according to the following ratings in the table below. Proposals rated as “Unacceptable” in subfactor 1 – Accessibility shall not be evaluated further.

Adjectival Rating Description Acceptable Proposal meets the requirements of the solicitation.

Unacceptable Proposal does not meet the requirements of the solicitation.

SUBFACTOR 2 – QUALITY OF CONTENT

Element 1: Author Expertise Element 2: Expert Recommendations Element 3: Atypical Presentations

The Government will search, in the offeror’s DVD, a total of thirty-five (35) clinical queries on common diseases and clinical controversies in the content areas described in 2.1.12 of the SOW to the evaluate the quality of the content of the offeror’s proposed solution in three areas: Author Expertise, Expert Recommendations, and Atypical Presentations.

The Offeror must deliver five (5) commercial-quality DVDs to address listed below two (2) business days after the proposal deadline. (i.e., The Government must be in possession of the DVDs two (2) business days after the deadline.) The Government will search, in the offeror’s DVD, a total of thirty-five (35) clinical queries on common diseases and clinical controversies (issues in which the medical community is not in consensus on diagnosis and/or management) in the content areas described in Section 2.1.12 inclusive of the SOW to the evaluate the quality of the content of the offeror’s proposed solution in three areas: Author Expertise, Expert Recommendations, and Atypical Presentations. These cases will reflect a wide range of subjects from 2.1.12 and will be selected based on recent searches in Point-of-Care References, the clinical query having a treatment or diagnostic recommendation, and the clinical query not being too broad (e.g., treatment of hypertension will not be one of the topics).

Mailing Address Defense Health Agency Contracting Activity Attn: Destiny Wood 7700 Arlington Blvd Falls Church, VA 22042

Element 1: AUTHOR EXPERTISE

The Government will evaluate the degree and extent to which the results meet the requirement in Section 2.1.19 inclusive of the SOW. Of note, some articles are written by two (2) authors, such as an Assistant Professor and a Professor. In these cases, the article will be judged solely on the senior author credentials. Also, some medical schools do not include the subspecialty for Professors. In these cases, the Government will conduct an Internet search of the author’s institution to determine the author’s training and/or review author’s published literature.

Rating Author Expertise per 2.1.19

Outstanding More than 80% of authors are Professors Good Between 60% and 79 of authors are

Professors AND 75% of Authors are either Associate Professors or Professors

Acceptable Between 50% and 59% of authors are Professors AND at least 74% of Authors are either Associate Professors or Professors

Marginal Between 40% - 49% of authors are Professors AND Between 60% - 73% of authors are either Associate Professors or Professors

Unacceptable Less than 39% of authors are Professors OR less than 59% of authors are either Associate Professors or Professors

*Percentage will be calculated by dividing the number of topics determined to meet the requirement by the total number of topics.

Element 2: EXPERT RECOMMENDATIONS

The Government will evaluate the degree and extent to which the results meet the requirement in Section 2.1.5 inclusive of the SOW. For clinical topics regarding treatment or management, the Government will determine if the any of recommendations have conflicting, poorly conducted, or no medical society guidelines and/or published research. The Government will only consider recommendations that require a physician order (e.g., medication or intravenous treatment) or consent form (e.g., a surgical procedure). Patient recommendations (e.g., increase exercise) will not be considered. For example, some medical societies recommend treating hypertension with beta blockers and others do not. In this example, the expert author/writer shall recommend when beta blockers should and/or should not be used to treat hypertension. For diagnostic clinical topics, the Government will determine if the any of recommendations have conflicting, poorly conducted, or no medical society guidelines and/or published research. The Government will only consider recommendations that require a physician order (e.g., lab test or radiograph) or consent form (e.g., a surgical procedure). In clinical topics meeting these criteria, the Government will determine if the expert author/writer makes specific management and/or diagnostic recommendation(s) in light of the uncertainty or lack of available evidence. In the beta blocker in the treatment of hypertension example above, the expert author/writer shall state under what conditions, if any, it would be appropriate to prescribe a beta blocker. Also, for treatments with more than one option, the expert author/writer shall state a recommended top choice, second choice, etc., or state that any of the choices are equivalent.

Rating Expert Recommendations per 2.1.5

Outstanding At least 90% of clinical topics have specific recommendation(s)

Good Between 80-89% of clinical topics have specific recommendation(s)

Acceptable Between 70-79% of clinical topics have specific recommendations

Marginal Between 50 -69% of clinical topics have specific recommendations

Unacceptable Less than 49% of clinical topics have specific recommendations

*Percentage will be calculated by dividing the number of topics determined to meet the requirement by the total number of topics.

Element 3: ATYPICAL PRESENTATIONS

The Government will evaluate the degree and extent to which atypical presentations are provided per Section 2.1.4 of the SOW. The Government will review each clinical topic for the clinical presentation, which is generally the history and physical examination findings. The Government will look for language that states “other presentations include,” “patients may also have X symptoms,” or similar language.

Note: Only a subset of the thirty-five (35) queries will involve atypical presentations of diseases.

For some clinical topics, there are no atypical presentations, so these will not be considered further for this item. The Government will consider an atypical presentation missing if the Government’s clinical experts determine it is missing AND the symptom or sign is listed in another reference, e.g., textbook or review article.

Rating Atypical Presentations per 2.1.4

Outstanding At least 80% of clinical topics list atypical presentations

Good Between 60-79% of clinical topics list atypical presentations

Acceptable Between 50-59% of clinical topics list atypical presentations

Marginal Between 25-49% of clinical topics list atypical presentations

Unacceptable Less than 24% of clinical topics list atypical presentations

*Percentage will be calculated by dividing the number of topics determined to meet the requirement by the total number of topics.

FACTOR 2 – PRICE

The Government will evaluate the Total Evaluated Price (TEP) in pricing worksheet (attachment 4). The TEP is the sum of the Subscription Services for the entire Period of Performance, to include the six-month extension period under FAR 52.217.8.

Price Reasonableness. Normally, adequate price competition establishes a fair and reasonable price. For the price to be fair and reasonable in its nature and amount, it should not exceed that which would be incurred by a prudent person in the conduct of a competitive business. If adequate competition is not obtained, the Government will evaluate the reasonableness of the offeror’s TEP utilizing the price analysis techniques described in FAR 15.404-1(b).

Options. The Government will evaluate quotations for award purposes by adding the total price for all options to the total price for the basic requirement. This includes options under FAR 52.217-8, Option to Extend Services, which applies to this solicitation. Evaluation of options under FAR 52.217-8 will be accomplished by adding six months of the Offeror’s price for the last potential period of performance under this contract to the Offeror’s total price.

Completeness. An Offeror’s price proposal is complete when the Offeror’s proposed price and other information adheres to the requirements of the solicitation for Factor 2, Price.