JA-24-0134B.pdf

CUI//SP-PROCURE

Justification and Approval (J&A) for Federal Acquisition Regulation (FAR) Subpart 13.5 Other than Full and Open Competition

Sole Source Acquisition

Title: XXXXX Army Bridge

J&A Number: JA-24-0134B

1. Identification of the agency and contracting activity:

The requiring activity is the Defense Health Agency (DHA), J7, Leadership, Education, Analysis, Development, Sustainment Division (LEADS), Military Health System (MHS) Medical Library Organizational Management Office Branch (MML OMO). The contracting activity for this acquisition is Professional Services, Defense Health Agency Contracting Activity (DHACA), at DHA.

2. Nature and/or Description of Action being Approved:

This request is for a bridge contract for the point of care database, XXXXX, for the Army. This capability was planned for DHA's enterprise-wide contract which was awarded on 22 March 2024 and is currently under protest through the United States Government Accountability Office (GAO). Therefore, a bridge is needed to meet the urgent MHS needs by ensuring the Government continues the services that are critical to the delivery of medical care across the Army, and which cannot be disrupted while the new award is currently under a protest.

3. Description of Supplies/ Services:

XXXXX is a proprietary database from XXXXX, that provides vital information for providers to use to care for patients in real time. DHA requires an online point-of-care clinical decision support tool which is a clinical decision support product that will cover a broad range of medical disorders and diseases, as well as guide and assist clinicians in differential diagnosis and care and management of the disease, disorder, or issue at hand.

A Firm-Fixed Price bridge will be awarded to the publisher, XXXXX. The period of performance will be for a 1-month base period and two 3-month option periods from 19 April 2024 to 18 November 2024. A 6-month extension period under FAR 52.217-8, extension of services has been included to account for any delays in settling the protest.

TOTAL Contract Value

POP: From 4/19/2024 to 5/18/2025

Estimated Value XXXXX

BASE

POP: From 4/19/2024 to 5/18/2024

Estimated Value XXXXX

Type of Contract (Primary):

FAR 16.202 Firm-Fixed-Price

Options: Yes

Number of Options: 2

POP (All options):

From 5/19/2024 to 11/18/2024

Estimated Value (all options): XXXXX

Funding Type:

Operations & Maintenance (O&M)

Extension of Services: Yes

Clause: 52.217-8

Estimated Value: XXXXX

Number of Months: 6

4. Statutory and Regulatory Authority Permitting Other Than Full and Open Competition:

41 U.S.C. 1901 Simplified Acquisition Procedures

5. Rationale Justifying Use of the Statutory Authority Cited:

The proprietary point-of-care database XXXXX was planned as a subscription services enterprise-wide contract. However, the procurement has been delayed due to protest. The enterprise-wide contract was awarded to the publisher, XXXXX. The enterprise contract was to replace separate XXXXX contracts held by Air Force, Army, and Navy. The Army's contract expired on March 29, 2024, and it was to be covered under the enterprise contract starting March 30, 2024. With the protest, the bridge contract is necessary to ensure the Government avoids a break in service at Army facilities and meets the urgent needs of the Army while the protest under the new award is being resolved. Air Force and Navy still have time on their legacy contracts. Awarding to any other vendor for the short term of this contract would result in unacceptable delays and potentially affect the care of the patients.

Loss of XXXXX presents significant risk to patients. It's detailed, nuanced approach provides the providers - from medics and corpsmen to senior physicians - with critical information that shapes patient care decisions every day. XXXXX provides guidance and assistance in narrowing down and identifying the disease, disorder, or issue at hand. It provides extensive background information to fill in knowledge gaps. It also provides nuanced expert recommendations, advice, guidance, and management strategies for diseases or disorders, including those with atypical presentations or subtypes and in the absence of specialty guidelines or published studies. This is particularly important when evidence is scarce, yet clinicians must make treatment decisions. Without XXXXX, clinicians may lack this crucial support, especially in Graduate Medical Education, Undergraduate Medical Education, and remote locations where clinicians with varied levels of experience rely on this tool for decision making. The absence of XXXXX could potentially lead to increased medical errors, less informed decision making, and poorer patient outcomes due to the lack of expert recommendations and the quality of information provided.

Additionally, the break in service may impact Air Force and Navy Military Treatment Facilities because of migration of Internet Protocol (IP) addresses under DHA. Such IPs may be registered as Army.

6. Efforts to Obtain Competition:

The Government utilized several methods to obtain competition for this effort. A search of the internet and the General Services Administration (GSA) pricelist was conducted by the requiring activity. A Sources Sought Notice (SSN) was previously posted to SAM.gov on 05 December 2023 for a total of 15 days. A Notice of Contract Action (NOCA) is required by FAR Subpart 5.2. The NOCA will be posted to SAM.gov using the combined synopsis/solicitation in accordance with FAR 12.603. Additionally, the previous justification (JA-23-0074) was approved on 06 March 2023. The Government addressed the barriers to competition by surveying the market for any new and potential point of care clinical decision support tool as identified in section 8 below.

7. Determination that Anticipated Cost to the Government will be Fair and Reasonable:

The Contracting Officer hereby determines that the anticipated cost to the Government will be fair and reasonable through a comparison to current and historical pricing of the same required services needed in this bridge contract, an analysis of the Independent Government Cost Estimate, and prices for same or similar services used in the general public.

8. Market Research:

Seeking bridge during protest.

Market Research was conducted between 01 November 2023 to 16 January 2024 in accordance with FAR Part 10. The Government reviewed mandatory sources which returned negative searches. The requiring activity developed a team composed of Graduate Medical Education trainees who tested products using real-life clinical questions, and the requiring office surveyed the market by conducting internet searches, reviewing results of market research from previously awarded contracts with similar scopes, and reviewing pricelist under the GSA Federal Supply Schedules. Market research indicates that there are only two (2) vendors, XXXXX, that offers the proprietary point of care database, XXXXX.

As identified in section 6 above. An SSN and NOCA was previously posted to SAM.gov for a total of 15 days in which only two vendors – XXXXX--responded to the SAM.gov posting by submitting a copy of their capability statement. Vendor capability statements were reviewed by the requiring activity and the DHA Graduate Medical Education Program Director who served as the Subject Matter Expert, and it was found that one only vendor – XXXXX is the only vendor who can provide the point of care database tool as listed in the Statement of Work. It was also found that there is one authorized reseller – XXXXX who can provide the XXXXX database. However, due to the limitations of subcontracting this requirement is not suitable for a small business set-aside.

9. Other Facts:

Loss of this for the Army will severely compromise patient care.

10. Interested Sources:

See section 8 above.

11. Actions to overcome barriers:

The previous contract was solicited and awarded as a sole source effort to XXXXX. The contract was awarded on 22 March 2024. However, the Government was informed that a GAO protest was submitted on 05 April 2024. This short-term bridge is needed to reduce the lapse in service for the Army while the protest is being addressed. Additionally, the Government will continue to conduct market research to determine if there are changes in the marketplace that would enable future actions to be competed.