JA for DSS MHS FY 25 1.30.25 Final - Redacted.pdf

DSS MHS Control Number VA-25-00034419

JUSTIFICATION FOR AN EXCEPTION TO FAIR OPPORTUNITY

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 a firm-fixed-price (FFP) delivery order for the renewal of 155 Document Storage System (DSS) brand name Mental Health Suite (MHS) term software licenses, maintenance, and Tier 3 technical support to be issued under the National Aeronautics and Space Administration (NASA) Solutions for Enterprise-Wide Procurement (SEWP) V Government-wide Acquisition Contract (GWAC).

3. Description of the Supplies or Services: The proposed action is to renew 155 DSS MHS software licenses, software maintenance, and Tier 3 technical support for use at VA healthcare facilities. The 155 DSS brand name MHS term software licenses are required for 67 Large Hospitals; 68 Medium Hospitals; and 20 Small Hospital licenses.

VA requires a software system that facilitates treatment planning in mental health care settings, and that interfaces with VA’s Veterans Health Information System Technology Architecture (VistA) and its Computerized Patient Record System (CPRS). The existing DSS brand name MHS software facilitates treatment planning as it interfaces with CPRS and VistA to allow VA mental health clinicians to use the graphical user interface (GUI) functionality to easily enter information related to the Veteran’s mental health care (e.g., problems and medications). The software interface also allows for documenting the completed treatment plan in the CPRS Progress Note Tab and completing the VistA clinical encounter in the Veteran’s electronic health record (EHR). In addition, the DSS brand name MHS software allows multiple clinicians to contribute to the same treatment plans, which increases the completeness and accuracy of the Veteran’s Mental Health treatment plan, minimizing the impact of errors due to copy and paste and providers adding multiple addendums. DSS brand name MHS software focuses on incorporating the Recovery Model of treatment in Veteran care and planning, while supporting compliance with requirements set forth by the Joint Commission and the Commission on Accreditation of Rehabilitation Facilities. Both organizations have requirements associated with care planning for behavioral healthcare settings that are specific, and difficult to meet without utilizing care planning software tools. Deficits in care planning are among the most frequent issues identified in accreditation site visits, resulting in the need for care planning software. The utilization of the DSS brand name MHS software alleviates these deficits.

The required maintenance support includes upgrades, bug fixes, minor-release upgrades, and troubleshooting Monday through Friday, 8:00 am to 7:00 pm Eastern Time, via electronic, telephone, and on-site tasking. Emergency maintenance is also provided for all MHS licenses 24 hours a day, 7 days a week, 365 days a year. The required Tier 3 technical support includes Tier 3 resolution of problems experienced using the DSS MHS software.

DSS MHS CONTROL NUMBER VA-25-00034419

The period of performance shall be March 27, 2025, through March 26, 2026. The total estimated value of the proposed action is .

4. Statutory Authority: Pursuant to Federal Acquisition Regulation (FAR) 16.505(a)(4), the following brand name requirement is being justified and approved as an exception to fair opportunity under the statutory authority of Section 41 U.S.C. 4106(c)(2) as implemented by FAR 16.505(b)(2)(i)(B), entitled “Only one awardee is capable of providing the supplies or services required at the level of quality required because the supplies or services ordered are unique or highly specialized.”

5. Rationale Supporting Use of Authority Cited Above: There is no other brand name treatment planning software that can meet VA’s requirements for interoperability and compatibility with VA’s existing EHR infrastructure. Any other brand name software would require an extensive, time-consuming redesign and redevelopment effort. Any other source would have to develop the capability to integrate with VA’s Text Integration Utility (TIU) software suite. Specifically, any other brand name product would need to adapt its capabilities to operate within VA’s TIU framework to (a) generate and format text and other data for storage within the VistA platform; (b) store data and documents using standardized TIU file structures; (c) interface with TIU document management tools that allow users to create, complete, amend, delete, lock, authenticate, send, assign, and reassign documents; (d) incorporate the TIU hierarchy for generated documents, resulting in interdisciplinary “parent” and “child” notes; (e) incorporate all requisite TIU definitions, parameters, and components, and (f) incorporate various types of data, data capture processes, and data sources. In addition to interoperability with TIU, any other source would have to develop the capability to interface fully with the VistA EHR and its various components, such as the patient registration and eligibility system, the patient scheduling system, problem lists, consult and referral management systems, historical document libraries, the patient care encounter/visit tracking system, incomplete record tracking, clinical and administrative reporting systems, the patient record flag system, and various additional systems within the VistA Mental Health software package. For examples of the latter, (1) the product must interface bidirectionally with the Mental Health Assistant (MHA) software, a VistA/CPRS tool that enables mental health clinicians to administer psychological tests to Veterans as part of their care. The treatment planning software product must interface broadly with MHA in order to locate and retrieve specified test scores and embed these into treatment plans over time in order to monitor Veterans’ progress, and (2) the product must be able to retrieve and embed into Veterans’ treatment plans data from VistA, reflecting patients’ diagnoses, medications, allergies, adverse reactions, past and future appointments, hospital discharge summaries, general health summaries, and the results of imaging studies, laboratory studies, and interdisciplinary consults. Capabilities required of another source would also include functional integration (launch and operation) within the CPRS GUI as well as interoperability with various specific CPRS components and processes; including the clinical reminder system, note templates, encounter completion processes, patient record flag/alerts, various EHR graphic displays, the generation of printable documents, and others. Required capabilities also include compatibility with all other VistA and CPRS add-on tools and software packages maintained by the Veterans

Health Administration (VHA) and its subordinate clinical services. Only the DSS brand name MHS software can meet all the aforementioned interoperability and compatibility requirements.

VA estimates that for another source to complete all the integration required for an alternative solution as outlined above, it would take a minimum of 18 months and approximately in duplicated costs. These estimates are based on previous efforts for similar design and development work. The effort would require a team consisting of, at minimum, a Project Manager, a Massachusetts General Hospital Utility Multi-Programming System Developer, a GUI Developer and at least two (2) Quality Assurance Analysts. This estimate for the required team is based on previous efforts for similar design and development work. Additionally, due to the complexities associated with treatment planning software, additional time and costs would be required to re-train all VA mental health clinicians to use any new software suite resulting in additional delivery delays and duplicated costs. The DSS MHS brand name treatment planning suite is the only software capable of enabling VA mental health teams to develop and implement interdisciplinary treatment plans that incorporate the TIU data framework and functionalities that live and operate within the VistA EHR environment, and that are developed, managed, and displayed by way of the CPRS GUI. This systemic interoperability and compatibility are a critical requirement, as it ensures that treatment planning for Veterans with mental health is integrated as part of Veterans’ overall healthcare documentation and planning. Failure to procure treatment planning software would negatively impact the quality and safety of mental health care provided to Veterans nationwide. Documentation of care planning would be splintered and disjointed. Continuity of care would be negatively impacted each time Veterans transition between mental health providers and programs, lacking a cohesive, collaborative plan of care. Not having the existing DSS brand name MHS software would make treatment planning by VA mental health clinicians more time consuming, less coordinated, and less effective, reducing the timeliness and efficiency of care provided to Veterans needing mental health services. Safety of care would also be compromised, as goals for suicide risk mitigation, safety planning, and symptom reduction would fail to transfer between levels of care or adapt as Veterans’ needs change. Veterans’ experience of care would also be negatively impacted, as it would become impracticable for providers to develop and present to Veterans a personalized, integrated, recovery-focused plan for their care. Selecting another product in lieu of DSS’s brand name MHS software would abruptly disrupt the creation and use of mental health treatment plans across VHA. This disruption would continue for at least 18 months as a new vendor worked to develop the interoperability and compatibility with VistA/CPRS needed for the product to function. During this time, clinicians would have no ability to develop a living, integrative, interdisciplinary mental health treatment plan for any Veteran. Documentation of care planning would be disjointed and focused only on specific mental health programs. Continuity between levels of mental health care would be disrupted, as there would be neither a cohesive nor a collaborative plan of care to follow Veterans as their needs change. Not having the necessary tools would make treatment planning more time consuming, reducing the timeliness and efficiency of mental health care provided to Veterans. Safety of care for Veterans would also be compromised, as goals for suicide risk mitigation, safety planning, and symptom reduction would fail to transfer between levels of care or adapt as Veterans’ needs change.

Maintenance and Tier 3 technical support for the DSS MHS software is required to ensure that MHS software continues to work with the various components of Vista/CPRS. Since the VistA and CPRS EHR applications themselves undergo frequent updates and modification, any interconnected software must also be updated to ensure it remains operational and compatible and interoperable with CPRS and VistA. To perform this needed software maintenance and provide technical support for MHS, a non-Original Equipment Manufacturer (OEM) would require access to DSS MHS’s proprietary data to include the source code. The Government does not possess the proprietary technical data or code for the DSS software to offer to a non-OEM. Without this technical data, no other source has the ability to provide the aforementioned MHS software maintenance and technical support other than DSS or a reseller. This code is required to ensure all services provided are properly configured. Failure to acquire the maintenance support and Tier 3 technical support would prevent VA from obtaining software upgrades and risk interoperability concerns with VistA/CPRS applications.

6. Efforts to Obtain Competition: Market research was conducted, details of which are in the market research section of this document. It was determined that limited competition is viable among resellers for the required software licenses renewal, maintenance, and Tier 3 technical support. In accordance with FAR 16.505(a)(4)(iii)(A)(1), this justification will be provided with the solicitation to all appropriate NASA SEWP V GWAC holders.

Furthermore, in accordance with FAR 5.301, 16.505(b)(2)(ii)(D), and 16.505(a)(4)(iii), the award notice for this action will be synopsized on the Sam.gov website and this justification will be made publicly available within 14 days of award.

7. Actions to Increase Competition: To remove or overcome barriers to competition in future acquisitions for the requirements described herein, the Government will continue to conduct market research to determine if there are any products or services available that will enable future requirements to be competed.

8. Market Research: Market research was conducted by the Government’s subject matter experts by reviewing similar software via internet searches in October 2024.

Products reviewed included AdvancedMD/NueMD Mental Health EHR, AthenaHealth EHR, AZZLY Rize, Cerner EHR, Cerner OnePlan, Simple Practice, Therapy Notes, Valant EHR, Theranest, and Neuroflow. This market research concluded that none of these products can meet all of VA’s interoperability and compatibility requirements as outlined in Section 5 of this document. None of the reviewed products can support the integrated care system that VA requires, offering a living, integrated, interdisciplinary treatment plan that work within VA’s TIU data framework, operate within and interface with other elements of the VistA EHR environment, and are integrated within the CPRS GUI. Only DSS MHS software licenses can meet all of VA’s needs. In addition, the Contract Specialist conducted market research in January 2025 by using the NASA SEWP V GWAC Provider Lookup Tool, which resulted in the identification of 5 potential capable sources that can provide the DSS brand name software, including two (2) Service-Disabled Veteran-Owned Small Business re-sellers.

9. Other Facts: None

Approval

In my role as procuring activity Advocate for Competition, based on the foregoing justification, I hereby approve the acquisition for the renewal of DSS MHS software licenses, maintenance and Tier 3 technical support on an other than fair opportunity basis pursuant to the authority cited in Section 4 above, subject to availability of funds, and provided that the property and services herein described have otherwise been authorized for acquisition.