IR212 2- NHTM Zeiss Forum -JA -final to post.pdf

Zeiss FORUM licenses, maintenance and support services VA-21-00064067

JUSTIFICATION FOR OTHER THAN FULL AN OPEN COMPETITION

1. Contracting Activity: Department of Veterans Affairs (VA)

Office of Procurement, Acquisition, and Logistics Technology Acquisition Center 23 Christopher Way

Eatontown, New Jersey 07724

2. Description of Action: The proposed sole source action is for a firm-fixed price delivery order for Brand Name Carl Zeiss FORUM software licenses, maintenance, and support services with PROAIM Americas, LLC. (PROAIM), 16024 Manchester Road, Suite 200, St. Louis, MO 63011.

3. Description of the Supplies or Services: The Department of Veterans Affairs (VA) Office of Electronic Health Record Modernization (OEHRM) provides program management and oversight for the replacement of the Veterans Heath Administration’s (VHAs) legacy electronic health record, with the Cerner implementation of the new Electronic Health Record (EHR). VA requires the legacy systems to have their existing Ophthalmology Picture Archiving and Communication System (PACS) and/or eye imaging modalities interfaced and configured to communicate with Cerner. This includes the Carl Zeiss FORUM PACS Ophthalmology. The Carl Zeiss FORUM PACS Ophthalmology system is a Multi-Veterans Integrated Service Network (VISN) wide platform. This effort is to ensure that a cross-reporting infrastructure remains intact and allows VISN facilities to maintain and upgrade their existing Carl Zeiss FORUM PACS infrastructure. The current Carl Zeiss FORUM Ophthalmology PACS systems require configuration, cut-over services, and interface development services. These services will allow Carl Zeiss FORUM PACS and eye imaging end-point device information to send/receive information into the new VA Cerner EHR. This requirement includes software, virtual infrastructure licenses and professional services to be upgraded at 53 VA facilities. The proposed action is for brand name Carl Zeiss FORUM PACS software licenses, maintenance and support services. The period of performance for this effort is for a 36-months base period to support a staggered delivery schedule that aligns with Cerner implementation of the new EHR across VA. The total estimated value of the proposed action is

4. Statutory Authority: The statutory authority permitting other than full and open competition is 41 U.S.C. 3304(a)(1) as implemented by the Federal Acquisition Regulation (FAR) 6.302-1 entitled, “Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements.”

5. Rationale Supporting Use of Authority Cited Above: The proposed source for this action is PROAIM Americas, LLC., 16024 Manchester Road, Suite 200, Ellisville, MO 63011. Carl Zeiss Meditec Inc. has an exclusive partnership agreement in place with PROAIM. Presently PROAIM is the only authorized supplier of the required Carl Zeiss FORUM PACS software, maintenance and support to the United States Government.

The Carl Zeiss FORUM PACS are currently deployed in more than 100+ Veterans Affairs Medical Centers (VAMCs) across the enterprise. Another software product, other than Carl Zeiss FORUM, would be unable to integrate with the existing Carl Zeiss FORUM PACS management platform due to the proprietary source code required to provide the licenses, maintenance and support. The Carl Zeiss FORUM PACS analyze images for diagnosis/trend tracking that clinical staff are dependent on for accurate diagnosis. Failure to acquire brand name Carl Zeiss FORUM PACS software, maintenance and support services would leave VHA without an integrated eye PACS for EHRM operations. Without an integrated eye PACS, VA providers will be unable to accurately diagnose ophthalmology related issues for patients, resulting in the need to outsource those care services to external community providers.

Due to these proprietary constraints, the procurement of any alternate brand would necessitate the complete replacement of the existing Carl Zeiss FORUM infrastructure in place. This replacement effort would result in substantial duplication of costs that would not be recovered through a new competitive acquisition. Specifically, it is estimated it would cost approximately $54,000,000.00 to implement a new Ophthalmology PACS System across VA. On top of the duplicative costs, the removal of the Carl Zeiss FORUM PACS and transitioning to another vendor is estimated to take 5-6 years and would require a change in workflow which would be highly disruptive to patient care and poses a patient safety risk. These estimates are based on previous eye PACS procurements. Currently, VA has Carl Zeiss FORUM PACS hardware/software across 100+ plus locations (comprised of VAMCs and Regional Data Centers) and has invested ten (10) years of project and implementation time to support logistics, travel, VA site outage maintenance windows and other local ad-hoc coordination needs.

Additionally, VA has conducted regional wide training sessions in that 10-year time span that introduced proprietary Carl Zeiss FORUM PACS knowledge to implement, manage and conduct break/fix support across the existing VA infrastructure. Using a new vendor’s platform would require that platform be implemented in the 100+ VAMCs replacing the current ophthalmology PACS platform. This would delay the Cerner transition for these VISNs, requiring VA lab technicians and managers to learn, operate and manage a new system and workflows as part of the Cerner integration would add unnecessary complexity and duplicative activities thereby compromising patient care.

6. Efforts to Obtain Competition: Market research was conducted, 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. Additionally, the proposed action will be synopsized on the Contracting Opportunities Page in accordance with FAR 5.201. Any proposals that are received shall be evaluated.

7. Actions to Increase Competition: The Government will continue to conduct market research to ascertain if there are changes in the marketplace that would enable future actions to be competed.

8. Market Research: Market research was conducted by Government’s technical experts in July 2021 by reviewing alternate products to Carl Zeiss FORUM PACS, which consisted of Topcon Corp, AFGA and Carestream Health for Ophthalmology

PACS Imaging. While other software solutions from alternative manufacturers exist, none of these can meet VA’s requirements as no other product has access to the proprietary cutover and upgrade software that the Carl Zeiss FORUM PACS database uses at VAMCs currently in place across the VA. Only brand name Carl Zeiss FORUM software and services can be used to upgrade the existing system to interface and communicate with Cerner and avoid the duplicative time and cost as outlined in Section 5 of this document. Based on this market research, VA’s technical experts confirmed that only brand name Carl Zeiss FORUM PACS software, maintenance and support services can meet all of VA’s requirements for this effort.

Additional Market Research was conducted in August 2021 to ascertain the ability of any other source, besides PROAIM, to provide the required Carl Zeiss FORUM PACS products and services. The research consisted of a Request for Information (RFI) posted on National Aeronautics and Space Administration (NASA) Solutions for an Enterprise-Wide Procurement (SEWP) V Government Wide Acquisition Contract (GWAC). The RFI closed on August 26, 2021 with no responses received.

However, PROAIM provided a letter from Carl Zeiss FORUM to the Contracting Officer stating that the Carl Zeiss FORUM products and services are only authorized to be sold through the Small Disadvantaged Owned Business, PROAIM. In addition, on August 26, 2021 the Contract Specialist reached out to Carl Zeiss FORUM and confirmed that PROAIM is the only authorized provider of Carl Zeiss FORUM to the Government.

Facts: None.

Approval

In my role as procuring activity Advocate for Competition, based on the foregoing justification, I hereby approve the acquisition of brand name Zeiss FORUM Licenses, maintenance and support services, on an other than fair opportunity basis pursuant to the authority cited in paragraph 4 above, subject to availability of funds, and provided that the property and services herein described have otherwise been authorized for acquisition.