JA Redacted.pdf

Brillians (SupraVISTA) Software CONTROL NUMBER VA-24-00099842

JUSTIFICATION FOR OTHER THAN FULL AND OPEN COMPETITION

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 sole source action is for a firm-fixed price (FFP) contract effort for the procurement of one (1) Brillians (SupraVISTA) software license, Technical Support and End User Training with SupraVISTA Medical Decision Support Systems (DSS), LLC, 514 Maon RD, Farnham, Virginia 22460- 2301, United States.

3. Description of Supplies or Services: The Veterans Health Administration (VHA), Veterans Integrated Service Network (VISN) regional area 12 (VISN 12) Medical Center (VAMC) has a requirement for the procurement of one (1) Brillians (SupraVISTA) software license, Technical Support and End User Training. The VA requires a solution that has the capability to provide automated rule-based analysis of clinical data at point of care, has the ability to interface with the Veterans Health Information System Technology Architecture (VistA) and is approved on the VA Technical Resource Manual (TRM). VA requires a software license which will allow access for an unlimited number of users to streamline all documentation and will provide automated alerts and problem-centric reports at the point of care.

Specifically, VA requires a software that offers a clinical cognitive support tool that simultaneously deploys inpatient and outpatient note writing features, significantly customizable reports, and searchable labs, imaging, and documentation from all sites within seconds. These required features are central to patient safety, quality of care, and provider productivity. Required technical support includes updates and support for end-users to report any potential bugs to the local Tier- 1 support staff who can test and try to reproduce problem, as well as accepted request enhancements agreed to by the vendor. In addition, required technical support includes resolution of application or configuration errors related to major updates.

For end user training, the Contractor shall provide extensive help and training resources in the form of written documentation, training videos, and various resources at Contractor’s website. The period of performance shall consist of one (1) 12-month base period, with two (2) 12-month option periods to be exercised at the Government’s discretion for continued Brillians subscription renewal, inclusive of technical support and training resources. 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: Based on market research, as described in Section 8 of this document, it was determined that SupraVISTA is the only source capable of satisfying the VA requirements discussed above for the brand name Brillians (SupraVISTA) software license, technical support and training.

Brillians is the only application that has the capability to provide automated rule-based analysis of clinical data at point of care that integrates with VHA’s existing Information Technology architecture. Brillians collects healthcare data from VA systems, including the Computerized Patient Record System (CPRS), one of the front-end applications of VistA located in Albuquerque, NM; Oklahoma City, OK;

Dayton, OH; Orlando, FL; and Altoona, PA using interoperability functionality within the VistA system. Brillians works seamlessly with VistA and CPRS. Brillians is a clinical cognitive support tool that can simultaneously deploy inpatient and outpatient note writing features, significantly customizable reports, and searchable labs, imaging, and documentation from all sites within seconds. As noted in Section 8, no other product can meet these VA requirements. Brillians does not create any data but rather extracts existing data from VistA. This functionality is required in order for VA providers to access healthcare data to maximize the quality of Veterans’ health care across the entire VA enterprise. Furthermore, Brillians is the only product that can meet the VA requirement to provide automated alerts and problem-centric reports at the point of care. This not only saves search time for the clinician but also support staff time that would be spent developing data visualizations or entering in additional data. The Automated data analyzes hundreds of data elements in a patient’s chart and creates a “short list” of items that need clinician’s attention/alerts.

The Problem-centric and System-centric views reports provide an aggregate of all of the relevant data about a given medical condition or a body system. This allows the clinician to find all the information in one place and reduces the risk of clinical errors due to “missed finding.” These are central to patient safety, quality of Veterans care and clinical productivity.

The use of any alternative Clinical Decision Support System (CDSS) software would require the redevelopment of interfaces to integrate with VistA and CPRS and maintain patient context as clinicians move from patient to patient. These efforts to redevelop interfaces will require a multi-year development effort and an estimated cost of at least . These duplicative costs and time are based on previous similar development efforts and would not be recovered through competition.

Additionally, only SupraVISTA can provide the required technical support and training resources services due to proprietary constraints. Specifically, only SupraVISTA can access the proprietary source code necessary to perform these services. Brillians is the only stand-alone Clinical Cognitive Support System software that seamlessly and safely integrates with VHA’s VistA and CPRS and provides the necessary functionality to meet VHA’s requirements.

Due to the limited amount of time that medical providers have to go through a large volume of patient data in Vista/CPRS, lack of a decision support tool that can interface with VistA to provide quick data visualization and analytics would increase risk of errors in patient care. Only the Brillians software can provide the required functionality that will help to prevent potential harm to patients and will assist providers to treat Veterans as quickly and efficiently as possible. Without Brillians, clinicians will lack the ability to generate the critical problem-centric reports and potentially miss important clinical data that could lead to medical errors resulting harm to Veterans and increases potential liability for VA. Brillians is the only CSS software which can meet the requirement to provide clinically relevant data within seconds. This allows clinicians to provide high quality of care in a timely fashion while at the same time prevent clinician burn out and help with staff retention.

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.

The ordering activity will make publicly available the justification along with the solicitation in accordance with FAR 6.302-1(c). 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: Government technical experts conducted market research in October 2024 by reviewing similar software to ascertain if other brands could meet VA’s requirements. Specifically, the Government’s technical experts conducted web-based research on alternative Clinical Cognitive Support System software to include products like UpToDate, Stanson Health Decision Support, Rimidi Clinician Decision Support and Hiani Web by ICT. However, none of these products were found to meet all of VA’s functional and technical requirements. UpToDate does not perform data analysis and does not provide clinical decision support meeting VA’s requirements. Stanson Health Decision Support does not meet VA’s requirements as it is a cloud-based platform and not integrated with VA’s electronic health record.

Rimidi Clinician Decision Support does not integrate with VistA and is not TRM approved for use in VA. Hiani Web by ICT Health offers tools for inventory management, appointment scheduling, and bed management, but does not meet VA’s requirements for clinical decision support. While other networking tools and software solutions from alternative manufacturers exist, they do not meet all of VA’s functional and technical requirements as detailed above. Additionally, no alternative software has the required interfaces in place to integrate with VistA/CPRS and maintain patient context as clinicians move from patient to patient. Therefore, no alternative software solution currently exists or can avoid the duplication of cost and time to meet VA’s requirements as outlined in Section 5 of this justification.

Additionally, the Contract Specialist conducted market research in August 2024 utilizing the National Aeronautics and Space Administration Solutions for Enterprise- Wide Procurement V Government-wide Acquisition Contract Provider Lookup Tool using the key word “SupraVISTA” and a separate search for “Brillians.” The searches yielded no authorized resellers. Additionally, SupraVISTA confirmed it does not have any authorized resellers and they do not plan to have any in the foreseeable future as resellers are not equipped to provide appropriate representation or support due to the highly technical nature of the products. As such, there are no other resellers that can provide the requested Brillians software due to copyright and proprietary reasons.

9. Other Facts: None.