GS-35F-0589X-010.pdf

Control Number VA-20-00020745

LIMITED SOURCES JUSTIFICATION

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: The proposed action is for the issuance of a sole source firm-fixed-price (FFP) task order for software add-ons, installation and maintenance in support of existing Picis Clinical Information System (CIS)/Anesthesia Record Keeping (ARK) systems installed at seven (7) Veteran Integrated Service Network (VISN) 8 facilities with Picis Clinical Solutions, Inc., 100 Quannapowitt Pkwy, Ste 405, Wakefield

MA 01880.

3. Description of the Supplies or Services: The VISN 8 CIS/ARK program has a requirement for an add-on decision support rule-based notification Sepsis screening tool for existing Picis CIS/ARK systems installed at seven (7) VISN 8 facilities. The Picis CIS/ARK was purchased by VISN 8 in 2010 using a national mandated acquisition package. The Picis CIS/ARK is the electronic medical record for the Intensive Care Units (ICUs), Post Anesthesia Care Units (PACUs) and Operating Rooms (ORs) across seven (7) VISN Facilities: Miami, Gainesville, Orlando, Tampa, West Palm Beach, Bay Pines and San Juan. VISN 8 is the largest, most complex VISN within the Department of Veterans Affairs (VA) and currently has Picis installed in 229 ICUs, 96 PACU and 105 ORs. The Picis databases are installed and configured on VA owned virtual servers (Windows 2012 Enterprise with Microsoft SQL 2012 Enterprise) including storage. The required add-on tool will help VISN 8 providers and clinicians improve the quality of Veteran care through a rule-based notification system. This add-on Sepsis support tool will use data from the existing Picis databases, to include vital signs and laboratory results, to notify clinicians with a red beacon in the patient band in the application when an elevated risk of Sepsis is detected. Services required include installation and configuration, testing, remote phone and email go-live support, and delivery of an integrated Sepsis screening feature using clinical assessment data, physiological data, and laboratory results into a rules-based assessment alert feature.

4. Statutory Authority: This acquisition is conducted under the authority of the Multiple- Award Schedule Program. The specific authority providing for a limited source award is Federal Acquisition Regulation (FAR) 8.405-6(a)(1)(i)(B), “Only one source is capable of providing the supplies or services required at the level of quality required because the supplies or services are unique or highly specialized.”

5. Rationale Supporting Use of Authority Cited Above: The proposed source is Picis Clinical Solutions, Inc., 100 Quannapowitt Pkwy, Ste 405, Wakefield MA 01880. Based on extensive market research, it was determined that Picis is the only source capable of satisfying VA’s requirements discussed above. As the original developer of VISN 8’s

VHAEASGARNEL

Cross-Out

VISN 8 PICIS Sepsis Screening Application Control Number VA-20-00020745 existing CIS/ARK system, Picis is the sole-owner of its proprietary source code and no other vendor has access to Picis’s code. Further, Picis does not currently sell its products through any reseller channels. Only Picis publishes a Sepsis screening tool that is compatible and interoperable with the existing Picis CIS/ARK currently deployed in VISN 8. Use of another Sepsis screening tool with the existing Picis CIS/ARK would present several technical challenges. Specifically, another tool would be required to interface with the physiological data captured in the Picis database as use of this data is required for generating the rules-based Sepsis alerts based on the health of individual patients, in addition to interfacing with Veterans Health Information System and Technology Architecture (VistA). Use of another tool would require development of those interfaces, in addition to changes in workflow, system design, system integration, and communication interfaces. Additionally, use of data already captured in Picis CIS/ARK would require express authorization of Picis to export to a third-party tool.

Further, use of a third-party tool would require separate maintenance support. Based on the above, it is anticipated the costs of acquiring, configuring, integrating and maintaining a third-party tool would be prohibitive, and exceed any anticipated cost savings potentially available through competition. As a result, Picis is the only source that can meet VA’s need to seamlessly implement and support the installation of the add-on product into the existing platform, due to the vendors unique ability to interface with the physiological data devices in the ICU’s, PACU, and Anesthesia environments, via already implemented custom device/equipment and interface with VIstA.

Additionally, Picis is the only source capable of providing the required maintenance support services for this tool, as only Picis has access to the source code required to develop and implement the required patches, fixes and upgrades to the tool throughout the period of performance. Failure to acquire this tool will have a negative impact on patient care. VA is looking to expand early warning monitoring tools from the medical-surgical floors into the emergency department and ICU in an effort to better equip its providers and clinicians with real-time alerting, clinical decision support, and protocol reminders. This tool will improve patient quality of care by alerting clinicians in real-time on the elevated risks of Sepsis based on the patient’s own physiological data.

6. Efforts to Obtain Competition: Market research was conducted September 2019, 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. In accordance with FAR 5.301 and 8.405- 6(a)(2), the award notice for this action will be synopsized on the Federal Business Opportunities Page (FBO) and the justification will be made publicly available within 14 days of award.

7. Actions to Increase Competition: All future requirements will be handled on a case-by-case basis to determine any future acquisition strategy.

8. Market Research: Market research was conducted by VA technical personnel in September 2019. VA technical personnel reviewed research reports on Sepsis tools and conducted their own web-based market research. Based on this research, VA determined that while other companies offer similar tools, including Cerner, Epic and MEDITECH, many of those tools are modules within their own proprietary electronic health record or are not currently integrated with the Picis CIS/ARK databases and would require authorization from Picis for such integrations as the existing Picis CIS/ARK databases are proprietary to Picis. As a result, these other tools do not meet the Government’s requirements to be interoperable and compatible with the existing Picis CIS/ARK databases. Satisfying these requirements would be cost prohibitive as it would require developing additional interfaces, changes in workflow and would require the express authorization from Picis to implement. Picis is the sole-owner of its proprietary source code and no other vendor has access to Picis’s code. Further, Picis does not currently sell its products through any reseller channels. Picis was contacted in June 2019 and confirmed in a letter that it is the sole-owner and provider of Picis products and services and does not have any authorized resellers. A copy of this letter has been included in the contract file. Only Picis publishes a Sepsis screening tool that is compatible and interoperable with the existing Picis CIS/ARK currently deployed in VISN 8. Additionally, no other source is capable of providing the required maintenance services as only Picis has access to the proprietary source code necessary to implement the patches, fixes and upgrades which constitute the maintenance services.

9. Other Facts: None.