NNG15SC76B-029.pdf

Control Number VA-20-00028939

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: This proposed action is for a firm-fixed-price delivery order to be issued under the National Aeronautics and Space Administration (NASA) Solutions for Enterprise-Wide Procurement (SEWP) V Governmentwide Acquisition Contract (GWAC) for the renewal of brand name Document Storage Systems, Inc. (DSS) Telecare Record Manager (TRM) Plus and Triage Expert Dual Purpose (TEDP) Tier Three software licenses and maintenance support.

3. Description of the Supplies or Services: VA, Veterans Health Administration (VHA) has a requirement for the renewal of brand name DSS TRM Plus and TEDP-Tier Three software licenses and maintenance support currently in VA’s production environment.

To support the TRM solution currently in production throughout Veterans Integrated Service Networks (VISN) 1, 7, 10, 19, 20, and 23, VHA requires the renewal of 12 TRM Plus licenses, 1 TRM Call Log Reporter license, 1 Telecare Record Plus Reporting SQL license, and 1 TEDP-Tier Three license. The proposed license renewals will provide VHA with continued use of its existing TRM Plus and TEDP-Tier Three software and support, which are highly specialized software applications used by VA Telecare staff to provide telephone triage and informational services to Veterans, thereby allowing VA to comply with VHA Directive 2007-033 for 24/7 access to medical advice. TRM Plus is a complete telephone liaison care management software solution that provides access to telephone treatment protocols to update and organize information from different categories of patient calls. TEDP-Tier Three is a clinical software application used by nurses who provide telephone triage services to Veterans. TEDP-Tier Three supports nurse clinical decision making by systematically assessing a Veteran's symptoms through the use of electronic algorithms with branching clinical logic, while providing reference health education information via a clinical library during the process. TEDP- Tier Three allows the nursing triage staff to identify emergencies and reduces unnecessary clinic visits. This information is then integrated with the patient’s actual health record.

Additionally, the telephone triage system provides the support described and includes a series of VA designed business rules which vary by clinical department and are applied during each triage encounter. There are also national business rules incorporated into the TRM Plus software. Business rules are developed nationally for the telephone triage product and apply to all VA medical facilities. After beta testing several years ago, it was determined that these products would be used nationally by VHA medical facilities. VHA has integrated this software into both its computer hardware and clinical software environments. Both the Veterans Information Systems and Technology

VISN 10 Telecare Record Manager Software Control Number VA-20-00028939 Licenses and Support

Architecture (VistA) and Computerized Patient Record System (CPRS) reside on the currently fielded triage systems. Documentation is automatically created in the background during the triage process and saved as a triage encounter record. The proposed effort shall also provide support for TRM Plus and TEDP-Tier Three to ensure the software remains operational. This support includes patches, bug fixes and maintenance that will require a source to have access to both TRM Plus and TEDP-Tier Three. The period of performance shall be from April 1, 2020 through March 31, 2021 and will include two 12-month option periods for continued license renewals and maintenance support.

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: Based upon continued market research, as described in section 8 of this document, it is determined that limited competition is available among resellers of TRM Plus and TEDP-Tier Three software license and support renewals. TRM Plus and TEDP-Tier Three software has been used within VHA since 2008. The TRM Plus and TEPD-Tier Three software are the only software applications that meet all of VA’s interoperability and compatibility requirements. Specifically, both TRM Plus and TEDP-Tier Three software are enhanced base-line commercial-off-the-shelf software products that VA information technology staff and VHA clinical staff use to provide a custom VHA nursing telephone liaison care management system commonly referred to in the VHA as VHA Clinical Nursing Telephone Triage System. This VHA Clinical Nursing Telephone Triage System is installed at the VISN level and serves 59 VHA medical centers across 26 states. TRM Plus and TEDP-Tier Three software permits the user to access administrative and clinical information in the Veteran medical record known as the CPRS while launching the TEDP-Tier Three application should clinical algorithms be needed to evaluate the Veteran caller. TRM Plus and TEDP-Tier Three software are the only clinical software applications that have the ability to interface with both VistA and CPRS and meet VA’s interoperability and compatibility requirements. VistA and CPRS are currently only coded to work with TRM Plus and TEDP-Tier Three software which are embedded together. Use of any other software would result in duplicated efforts to recode and reconfigure the existing triage systems that use VistA and CPRS.

This would result in extensive delivery delays of at least two years and duplicative costs of at least $1M that could not be recuperated through competition. These estimates are based on both similar efforts and previous failed attempts by other sources to provide an interface with both VistA and CPRS. The TRM Plus and TEDP-Tier Three software licenses are already fully integrated into the VistA CPRS system utilizing this software.

Having software that integrates with VistA and CPRS is critical so clinicians can access and evaluate a patient’s medical records during the triage process. Failure to access patient records would result in incomplete information with which to advise the patient.

VA has many years invested in the customization of the TRM Plus and TEDP-Tier Three software licenses to meet the current and ongoing architecture needs of VA. To work with another manufacturer’s product to achieve the current level of functionality of this software would require extensive rework and high-level programing along with system design expertise to customize and retrofit another software product to meet the needs currently met by the existing software products which have been used for many years. To date, VA has not identified any other vendors who can successfully integrate their software with VistA and CPRS. In addition, TRM Plus and TEPD-Tier Three are proprietary software products owned by DSS. Inc; therefore, support for these products can only be provided by DSS, or one of their authorized resellers. Only these sources have access to the proprietary code needed to support the TRM Plus and TEDP-Tier Three software licenses and ensure all services provided are properly configured.

6. Efforts to Obtain Competition: Market research was conducted, details of which are in section 8 of this justification. This effort did not yield any additional sources that can meet the Government's requirements. However, the Government determined that limited competition is available among resellers for brand name DSS licenses, as well as software maintenance and 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 Federal Business Opportunities website and this justification will be made publicly available within 14 days of award.

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: The Government’s technical experts have conducted market research using internet searches looking for alternative software products with compatible electronic triage protocols that could be readily integrated with VistA and CPRS. VA’s technical experts reviewed TRM related software products such as athenaClinicals, WinMed, Kareo, Naturongo, and HealthyHealth by reviewing online product descriptions and determined that while they provide some of the functionality provided by TRM Plus, none of these products are compatible with CPRS or VistA. It was determined, as of February 2020, that the dual products of TRM Plus and TEDP- Tier Three are the only software products that can meet VA’s specified healthcare requirements that permit full and seamless integration with VistA and CPRS without significant development, configuration, and associated testing duplicating what VA has already invested in and completed.

In February 2020, the Contract Specialist conducted market research to ascertain the extent of limited competition among resellers of the required software licenses and support renewals. Using the Provider Look-up tool on the NASA SEWP V GWAC website, two Service-Disabled Veteran-Owned Small Businesses (SDVOSB) (Minburn

Technology Group, LLC (Minburn) and ThunderCat Technology, LLC (ThunderCat)) in group B2 and three small businesses (Carahsoft Technology Corporation (Carahsoft) in group A, GMC Tek, LLC (GMC) in group C and Avertium Tennessee, Inc (Avertium)) in group C were identified as resellers of the required DSS license renewals and support.

However, additional market research via direct communication with a DSS representative revealed that Minburn Technology was the only SDVOSB reseller of the TRM and TEDP-Tier Three software and support and that ThunderCat Technology, while listed on the SEWP Provider Lookup as an SDVOSB reseller, was in fact not a partner of DSS and is not licensed to resell DSS software. Further, DSS confirmed, via a signed, letter that other than Minburn, small business reseller GMC and large business Ideal System Solutions, Inc. were the only companies also licensed to resell DSS products and support services. As a result, the market research ultimately identified one SDVOSB (Minburn) and one small business reseller (GMC) of the required DSS software on NASA SEWP; therefore, the RFQ will be issued to current NASA SEWP SDVOSB and Small Businesses contract holders in groups B2 and C respectively.

9. Other Facts: None