HT0011-16-P-0011-MHS_EMRAM_Asssessments-J A-JA17-0008.pdf

Tracking#JA17-0008

Justification and Approval for Other than Full and Open Competition Sole Source Acquisition

FAR Subpart 6.3 Other Than Full and Open Competition,

1. Identification of the agency and contracting activity: Directorate of Procurement, Contract Operations Division, Falls Church in support of the Program Executive Office, Defense Healthcare Management System (PEO DHMS) for Defense Healthcare Management System Modernization (DHMSM).

2. Nature and/or Description of Action being approved: This Justification and Approval (J&A) supports a sole source acquisition with Health Information Management Systems Society (HIMSS) Analytics to collect, analyze and distribute essential health IT data related to products, costs, metrics, trends and purchase decisions for the DoD Electronic Health Record. This includes the Electronic Medical Record Adoption Model Assessment and the HIMSS Usability-specific assessment.

3. Description of Supplies/Services: The use of HIMSS Usability Principles for defining and testing DoD EHR usability are part of the DHMSM Contract’s1 requirements, Quality Assurance Surveillance Plan, and the Acquisition Program Baseline. The Health Information Management Systems Society (HIMSS) Analytics Electronic Medical Record Adoption Model (EMRAM) assesses an organization’s clinical and business analytics capabilities. Certification requires an organization to describe and demonstrate how operational, clinical, and business areas and leaders at different levels use clinical and business information that is collected in various information technology systems to monitor and improve operations on a regular basis. More specifically, the organization must demonstrate through case studies that analytics was used to identify issues that need to be improved, and that analytics is used to monitor and track improvements over time. Summarily, the organization must demonstrate that it uses its analytics capabilities to influence clinical and business decision making towards issue identification, resolution, and improvement. This requirement is a 12 month period of performance and the estimated value of this requirement is $XXX,XXX.XX. Fiscal Year 16, 17 Research Development Test and Evaluation (RDT&E) funds will be used to fund this requirement.

DHMSM requests HIMSS Analytics to use their EMRAM tool to provide two (2) assessments on Military Health System (MHS) GENESIS implementation.

Assessment 1 - The Contractor shall complete an EMRAM assessment consisting of a pre-MHS GENESIS implementation and a post-MHS GENESIS implementation assessment. The assessment will help MHS understand the current Electronic Health Record (EHR) technology adoption state and to establish a baseline from which the MHS can measure its EHR implementation progress at Initial Operational Capability (IOC) Medical Treatment Facilities (MTFs) and satellite sites.

Assessment 2 - The Contractor shall complete an independent, objective usability assessment that assesses the user’s capability to achieve a specific set of tasks effectively and efficiently on MHS GENESIS. This assessment will study the top three (3) HIMSS usability principles: 1) forgiveness and feedback, 2) increased efficiency, and 3) minimize cognitive load. The EHR shall use the EMRAM tool to assess usability that consists of a pre-MHS GENESIS implementation and a post-MHS GENESIS implementation assessment. The assessment will help MHS understand the current EHR technology usability and to establish a baseline from which the MHS can measure its EHR implementation progress at IOC MTFs and satellite sites.

Background: The Military Health System awarded the DHMSM contract to provide and deploy the EHR, MHS GENESIS, to its hospitals, clinics, and dental clinics (MTFs) where healthcare is provided to active duty and retired military personnel and their family members. The contract requirements include the use of HIMSS Usability Principles for defining and testing EHR usability and the MHS needs a way to easily and quickly measure the progress and effectiveness of the implementation project in order to demonstrate and report to higher authorities on the progress of this critical healthcare information technology project.

1 The DoD Healthcare Management System Modernization (DHMSM) contract was awarded on July 29, 2015 to Leidos, Inc. after full and open competition. The contractor will provide an off-the-shelf electronic health record system, MHS GENESIS, for deployment across the DoD enterprise.

Objectives: Procure DoD EHR Adoption Model and Initial Operating Capability IOC Usability Assessments.

Conduct an assessment that results in an official EMR Adoption Model (EMRAM) score and EMRAM validation.

Develop usability criteria using the EMRAM to officially determine whether a facility officially meets the EMRAM-based usability criteria.

Scope: Procure an industry recognized, independent, objective DoD EHR adoption model assessment and usability assessment utilizing HIMSS Usability Principles at IOC MTFs and satellite sites, in accordance with the DHMSM contract requirements.

Assessment 1 - Conduct an EHR adoption model assessment for the IOC MTFs and satellite sites. The assessment would consist of a pre-EHR implementation assessment and a post-EHR implementation assessment for the IOC sites. The assessment will help MHS understand the current EHR technology adoption state and to establish a baseline from which the MHS can measure its EHR implementation progress.

Assessment 2 - Conduct an EHR usability assessment for the IOC MTFs and satellite sites. The assessment would consist of a pre-EHR implementation assessment and a post-EHR implementation assessment. The assessment will help MHS understand the current EHR technology usability to support the fielding of MHS GENESIS to sites beyond IOC. The usability assessment will measure the top 3 HIMSS usability principles:

a) Forgiveness and Feedback

b) Increased efficiency and

c) Minimize cognitive load

Period of Performance: The estimated period of performance will be date of award plus 12 months. The estimated dollar value for this requirement is $XXX,XXX.XX for the 12 months of service using FY 16, 17 RDT&E funds.

4. Statutory Authority Cited permitting other than full: The statutory authority permitting other than full and open competition for this requirement is 10 U.S.C. 2304(c)(1) and in accordance with FAR 6.302-1(a)(2) -- Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements.

5. Reason for Authority Cited: The use of HIMSS Usability Principles for defining and testing DoD EHR usability are included in the DHMSM Contract’s requirements, Quality Assurance Surveillance Plan, and the Acquisition Program Baseline. Use of the HIMSS Usability Principles for defining and testing EHR usability are only available through HIMSS Analytics. HIMSS Analytics is the only supplier that has a tool that is the industry standard that supports certification of user adoption and usability metrics. This Electronic Medical Records Adoption Model tool is proprietary and not licensed to any vendors. HIMSS Analytics is the only permitted entity to use the HIMSS proprietary algorithm. Therefore, no other vendor, other than HIMSS Analytics, can satisfy this requirement.

6. Efforts to Obtain Competition: Market Research was developed to analyze health IT analysis companies to determine if any other adoption model certification was available. HIMSS Analytics is the only organization in the world with specific EMRAM, analytic tools, and expertise to provide certification of MHS GENESIS for user adoption. Other vendors researched neither provide software to manage health records and are trained on the use of EMRAM so they can help their clients through the EMRAM stages, but these vendors are not licensed to use the EMRAM tool, nor are they authorized to provide the assessment that results in an official EMRAM score and EMRAM validation. There are no other organizations in the world, other than HIMSS Analytics, that are able to provide an EMRAM score or an EMRAM validation.

7. Actions to Increase Competition: To access the interest and capability present in the commercial marketplace, a sources sought notice was posted on FBO on August 19, 2016, putting other potential vendors on notice to increase market pool for future similar or the same requirement. When the sources sought notice closed on September 2, 2016, no responses were received. Because the Government sources sought notice informed all interested parties and the Government received no responses, the Government determined that further discussions were unnecessary.

8. Market Research: The Market Research indicated one (1) company, HIMSS Analytics, has an internationally recognized standard for studying EHR adoption. This EMRAM has the capability of studying an EHR to determine the user adoption and usability. EMRAM is proprietary, trademarked tools that help MHS determine the user adoption and user efficiency. There are no other organizations in the world, other than HIMSS Analytics, that are able to provide an EMRAM score or an EMRAM validation.

9. Other Facts: Sole Source

10. Interested Sources: HIMSS Analysis

11. Methods to overcome barriers: HIMSS Analytics’ EMRAM tool is a proprietary and trademarked tool, currently no other vendors are authorized to use this tool which is essential to perform the required assessment of this requirement. Based on proprietary and trademark restrictions and the need for DHA/PEO to continue use of EMRAMM tool for an EMRAM score and validation, there are currently no methods to overcome barriers.

However, the Government will continually explore the matter as circumstances evolve throughout the EHR’s lifecycle as it seeks to maximize competition and reduce lifecycle costs.