P02 - 36C10X25Q0015 - RFI - Veterans Health Administration - National Enterprise Imaging Systems_Budget Est..docx

SUBJECT*

RFI - Veterans Health Administration National Enterprise Imaging Systems

GENERAL INFORMATION

Department of Veterans Affairs

5202 Presidents Court, Suite 103 Frederick MD 21703

POINT OF CONTACT*

Contract Specialist Zachery Minns Zachery.Minns@va.gov

Contracting Officer Justin Cole Justin.Cole4@va.gov

ADDITIONAL INFORMATION

AGENCY’S URL

URL DESCRIPTION

AGENCY CONTACT’S EMAIL ADDRESS

EMAIL DESCRIPTION

Request For Information (RFI) Request For Information (RFI)

DESCRIPTION

Department of Veterans Affairs (VA) Veterans Health Administration (VHA) National Enterprise Imaging Systems Request for Information (RFI)

I. INTRODUCTION:

This RFI is issued by the Department of Veterans Affairs (VA), Strategic Acquisition Center, Frederick, MD (SAC-F), for information and planning purposes only and does not constitute a solicitation nor does it restrict the Government as to the ultimate acquisition approach. In accordance with Federal Acquisition Regulation (FAR) 15.201(e), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract.

Pursuant to FAR Part 10.002(b)(2)(iii) and (viii) (Market Research), the purpose of this RFI is to understand industry capabilities related to national enterprise imaging systems and to collect information to enable further development of a future acquisition strategy to include socio-economic consideration and methods.

Any information received from a contractor in response to this RFI may be used in creating a solicitation. Any information received which is marked with a statement, such as “proprietary” or “confidential,” intended to restrict distribution will not be distributed outside of the Government, except as required by law.

The Government is not responsible for any cost incurred by industry in furnishing this information. All costs associated with responding to this RFI will be solely at the interested vendor's expense. Not responding to this RFI does not preclude participation in any future Request for Proposal (RFP), if any is issued. Any information submitted by respondents to this RFI is strictly voluntary. All submissions will become Government property and will not be returned. Interested vendors are responsible for adequately marking proprietary, restricted or competition sensitive information contained in their response.

II. RFI RESPONSE INSTRUCTIONS

NOTE: The capability package must be clear, concise, and complete. VA is under no obligation to provide feedback to the company, or to contact the company for clarification of any information submitted in response to this RFI.

RFI responses must include:

A. Company Information:

1. Company Name;

2. Company Address;

3. Point of contact name;

4. Telephone number

5. Email address

6. CAGE/SAM UEI under which the company is registered in the System For Award Management (SAM);

7. Small Business Administration (SBA) VetCert certification (if applicable);

B. Brief summary describing your company’s technical approach to meeting the requirements, to include:

1. List any previous or existing contracts you have with the VA where similar work was performed to this requirement. Also, is there an existing contract vehicle you recommend be used for this procurement?

1. Responses to questions

1. If your company is a Small Business, also include the following:

2. The intent and ability to meet set-aside requirements for performance of this effort.

2. Information as to proposed team members, the percentage of work each is to perform, and which PD requirements would be subcontracted.

Responses are due by 10:00 AM ET November 25, 2024. Submit your responses directly to Zachery Minns; Zachery.Minns@va.gov and Justin.Cole4@va.gov.

Please direct any questions to:

Contract Specialist: Zachery Minns; Zachery.Minns@va.gov AND

Contracting Officer: Justin Cole; Justin.Cole4@va.gov

All responsible sources may submit a response in accordance with the following:

All proprietary/company confidential material shall be clearly marked on every page that contains such.

Please keep your response to no more than 10 pages.

III. REQUIREMENT DESCRIPTION:

This RFI is issued for the purpose of collecting budgeting information about a potential national enterprise imaging systems to serve Veterans Health Administration (VHA) facilities as described below.

1. The VHA Enterprise Imaging (EI) initiative, currently in the market research phase, is evaluating current and future capabilities for solutions that provide secure acquisition, storage in a FedRAMP-certified cloud, retrieval, communication, viewing, reporting, documentation, importing/exporting/exchange, workflow management, referring clinician and patient access and review, image integration into VHA electronic health record (EHR), and other critical functionality for all VHA clinical domains using imaging. Clinical domains include, but are not limited to, the following areas: radiology (including nuclear medicine), speech pathology, cardiology/vascular imaging (invasive and noninvasive), endoscopy, scope and other light-based imaging, medical photography, anatomic pathology and cytology, dental imaging, eye/ophthalmologic imaging, radiation oncologic imaging and treatment planning data, wound imaging, procedural imaging, and point of care ultrasound (POCUS).

2. Estimated annual volume of VHA imaging may exceed 25 million exams when all imaging specialties are included.

3. Important features of interest for VHA EI will include, but are not limited to, integration with current and future VHA EHRs, universal availability of images and reports on all VA desktops, specialty-specific diagnostic viewers and clinical tools or compatibility with third party specialty-specific diagnostic viewers, specialty-specific integrated artificial intelligence (AI) functionality, integrated voice recognition, reporting, communication, quality improvement, quality assurance, and data mining capabilities for use in all clinical domains, interfaces for all image acquisition modalities/devices as well as workflow capabilities in each clinical domain, ability to manage and archive DICOM and non-DICOM images, bidirectional exchange of images with DOD and community (non-VHA) partners, and viewing capabilities for ordering/referring providers and patients. Multimedia integration of image data for use in VHA’s EHR is also preferred.

4. VHA is currently surveying industry to identify potential vendors who would be capable of providing VHA with a best in breed, next generation enterprise imaging archive and supporting infrastructure that incorporates at a minimum the following preliminary features:

· Hybrid cloud-based vendor neutral archive with local image cache at VHA facilities, if required, for optimal display, redundancy, and contingency operations;

· Rapid, on-demand access to images across the enterprise;

· Master patient index (MPI) to address VA’s conversion from VistA to Oracle Health EMR and the change in primary identifier from SSN to EDIPI. System must be able to seamlessly function with both VistA and Oracle Health or other potential EMR interfaces and be able to utilize the appropriate primary patient identifier for each respective system to uniquely identify patients and ensure a patient’s data appears as a singular instance within the enterprise imaging archive;

· Migration, reconciliation, and data cleansing of all studies currently in Vista Imaging, Oracle Health CAMM 7, and other VHA clinical image repositories, including non DICOM imaging and scanned documents to the Enterprise Imaging system. This is approximately 80 petabytes comprising >17 billion individual images. Some studies may need to be migrated from the systems of origin;

· Zero footprint web viewer compatible with VA baseline PC image and associated browser;

· Advanced Artificial Intelligence (AI) support including third-party vendor integration/support across all listed imaging specialties. Response should not be limited to imaging. VHA is interested in how AI can be applied to local and cloud storage management, provider workflow management, EI system study routing, work prioritization, patient safety and demographic information verification, system administration, and research.

· System must be expandable to diagnostic review, interpretation and reporting of multi-specialty imaging;

· Parties answering this RFI should note VHA considers all listed imaging specialties equally important to the enterprise imaging system. Vendor responses should consider that some specialties may need to provide end-to-end workflows within their proposed system;

· Innovative ways research data can be collected and accessed during the following image migration and presented to quality management and research personnel;

· Research data must be archived in a secure anonymized silo within the EI system.

· The VHA requests a budgetary quotation for initial implementation, first warranty year, four years of post-warranty service and support for a National Enterprise Imaging System

· Diagnostic Users:

i. Radiologists: 1200

ii. Cardiologists: 1000

iii. Pathologists: 1000

iv. Dentists: 1000

· Concurrent Enterprise Users: 90,000+

· Number of production EMR instances: 125

· Number of required HL7 interfaces: 1,500

· Total number of Petabytes to be migrated 80

· Total Annual Study Volumes: 25 million a year should we opt to include scanned documents.

i. Radiology: 11,000,000

ii. Cardiology: 415,000

iii. Pathology: 950,000

iv. Point of Care Ultrasound: 300,000

v. Dental Imaging: -1,650,000

vi. Ophthalmology: 1,500,000

vii. Scope - Surgery- Video: 500,000

viii. Clinical Video: 275,000

ix. Radiation Oncology: 15,000

x. Dermatology - Wound Care: 100,000

Specialty Areas:

1. Radiology and Nuclear medicine.

2. Cardiology: Cath, Echo, EKG and Holter Monitor.

3. Pathology.

4. Point of Care ultrasound (POCUS) to include a mechanism for exam accessioning, reconciling study into correct patient record, and a workflow to archive notes and study comments by persons using POCUS devices.

5. Dental Imaging, both planar and 3D.

6. Ophthalmology service and Diabetic Retinopathy “tele-retinal” program including visible light photography and ocular coherence tomography.

7. Scope - Surgery- Video.

8. Clinical Video including Sleep, Mental Health, and Neurology.

9. Radiation Oncology treatment planning, imaging in DICOM, DICOM RT, and proprietary formats

10. Dermatology - Wound care and other medical documentation photography including non-destructive image annotations.

A detailed functionality matrix is provided as Attachment A

GENERAL REQUIREMENTS

VHA Enterprise Imaging System is envisioned (subject to change) to include the following major characteristics which will be described in detail in any potential subsequent solicitation:

1. Intuitive, stable, fast and easy to use zero footprint user interface for the EI viewer;

2. Specialty viewers for all ten listed imaging specialties;

3. A patient portal where veterans can view and download medical imaging and other records. The proposed system should enable telemedicine providers to communicate and display encounter information with the patient in real time.;

4. Advanced AI options for all ten listed specialties with special attention to pathology;

5. HL7 interfaces to all current VA VistA and Oracle Health systems;

6. Supports all VNA image and document management standards, such as Integrating the Healthcare Enterprise (IHE);

7. Dose tracking and alerting system. To include collecting dose data of migrated studies going back to an agreed upon date;

8. Viewer should be designed with a focus on human factors to optimize viewing efficiency, while minimizing viewer fatigue and the incidence of repetitive motion injuries;

9. EI system must support cross-site collaboration, reading and reporting. This is to function in both VistA and Oracle Health environments;

10. Viewer supports on-the-fly 3D and other advanced visualization and analysis capabilities;

11. Viewer must provide support for archive teaching and research cases with deidentification of patient information;

12. EI viewer must support export of deidentified reports and images;

13. EI system must support the production and labeling of exportable media;

14. EI system must support the electronic transfer and reconciliation of electronic images and other records and between VA and outside providers/institutions;

15. Provide automated auto-linking/registration of multi-slice images across series among current and prior exams;

16. Integrated multi-specialty, industry standards body compliant peer review-OPPE functionality with on demand and assigned workflows. Peer review will incorporate system separate workflow and scoring methodologies for VHA peer reviews. Access to this functionality must be controlled by site and/or group practice. Groups should not be able to see each other’s peer reviews;

17. Seamless API integration with vendor provided voice recognition (VR). Vendor will provide VR option(s) for VHA to select from. VHA will select a single VR system that shall be supported by the vendor;

· Enterprise-based VR profiles allowing users to utilize alternative workstations and/or reading centers with minimal to no user reconfiguration required;

· VR reporting system must be able to support connection to all VA facilities each with their own HL7 interface. VR system must also be able to support an interface to Oracle Health as sites convert over at least the next decade;

· VR system and all system components will be designed with 99.99% uptime goal with failover redundancy;

· VR system must support global and user specific templates;

· VR system must support VA defined diagnostic codes;

· VR system shall incorporate capabilities of prepopulating measurements;

contrast, and radiation dose information into structured reporting format.

18. Seamless API integration with Oracle Health Virtual Desktop Infrastructure (VDI);

19. Seamless API integration with VA/DoD Joint Longitudinal Viewer (JLV), which requires the use of Clinical Context Objects Workgroup (CCOW);

20. The EI viewer will be typically launched from the EMR with pass-through authentication from the native operating system. However, it must support launching as a stand-alone viewer using Single-Sign On (SSO), Windows Integrated Authentication (WIA) or LDAP via PIV/CAC cards;

21. System must exceed current functionality of Vista Imaging with the ability to scale up in both storage and specialty imaging capabilities;

· Archiving of electronic medical images;

· Archiving of non DICOM electronic images including importation of PDF documents from file shares. (VistA Imaging Importer);

· All existing DICOM, non DICOM imaging and scanned documents must be migrated and available in the new Enterprise Imaging system;

· Enterprise clinical display;

· Import and archiving of scanned documents;

· Tele-reader and reporting functionality for existing specialties (tele retinal).

22. Business intelligence reporting system;

23. Natural language report search tool that is available to all end users;

24. Full security auditing with notification capabilities;

25. System must be joined to the VA.gov domain;

26. Access control must be conformant with VA’s Least Privileges policy;

27. Supports current VA order and encounter based workflows;

28. Provide DICOM modality worklist for both order and consult based exams;

29. Both EDIPI and SSN must be supported for patient identification. The system must be able to normalize SSN to EDIPI during migration;

30. System must support section 508 accessibility;

31. The EI system must incorporate fault tolerant application and storage gateways at each medical center;

32. The EI system must provide local storage at a facility for system performance and business continuance;

33. EI system must continue to function locally in the event facility cloud link is severed;

34. Vendor must provide 24x7x365 technical support with off-hours escalation to senior level support within 15 minutes of initial call;

35. Vendor must provide an ongoing commitment to VHA for continuous product development and enhancement to ensure that the EI viewer remains on the latest commercially available version. This may include the development of addition client functionality to meet VA needs;

36. All contractor personnel must comply with VA mandated annual information security and privacy training along with background investigations. Personnel requiring remote access will comply with elevated privilege training and access requirements.;

37. Vendor will be responsible for all OS patching, AV updates, vulnerability remediation in accordance with published VA and DHS timelines, and application updates/upgrades to meet VA security requirements. Windows OS patches are available via an internal WSUS repository. Linux servers must also be patched and can be managed through the VA RHEL satellite server provided the Linux servers meet the VA baseline. If Linux based and not configured in accordance with VA baseline, vendor will be responsible for managing updates independent of the VA satellite server;

38. Software maintenance for the EI system and associated components to include updates and upgrades and all requisite security maintenance to remain in compliance with NIST, FISMA, and VA security standards will be provided and installed by the vendor. All studies currently in Vista Imaging and Oracle Health CAMM 7 including non DICOM imaging and scanned documents must be migrated to the Enterprise Imaging System. At least 100 petabytes comprising over 20 billion individual images;

39. Studies not currently archiving to Oracle Health CAMM 7 or Vista Imaging must be migrated from their systems of origin.

ARCHITECTURE

1. The overall system design shall have redundancy and fault tolerance for components to eliminate single points of failure as the EI viewer is a mission/life critical application that is required to be online 24x7x365;

2. System is deployed with encryption of sensitive data at rest;

3. System will be designed to optimally utilize bandwidth across the VA WAN and to/from the cloud-based components;

4. All cloud-based components will be hosted in a FedRAMP high certified environment;

5. For sites that utilize Oracle Health as their EMR, the system will be able to uniquely identify the patient via both the EDIPI and SSN. Enterprise Imaging application will utilize an MPI such that a query from an end user will correctly utilize the appropriate patient ID parameters in the query to successfully execute the Q/R. That patient will appear as a single instance within EI and reports will be issued to the originating site utilizing the site’s native patient ID parameters;

6. Intuitive GUI based study management tool for image/demographic modification and reconciliation for VHA clinical application coordinators;

7. System must support and the vendor must demonstrate a functional Integrating the Healthcare Enterprise (IHE) Imaging Objects Change Management profile and workflow;

8. Integrated artificial Intelligence (AI) Platform;

9. Artificial intelligence tools for system administration, cloud storage management, diagnostic tools, hanging protocols, relevance rules, case (STAT) prioritization, specialty system routing to appropriate post processing systems, and patient portal that guides and provides patients’ immediate relevant content.

10. Mechanism for multi-specialty conferences and tumor boards. This must include collaboration and annotation tools and multi-party screen control;

11. Mechanism for health care providers to remotely review cases with patients;

12. Module for notification of both critical and non-critical results to providers;

13. Patient communication and notification module used by health care providers and administrative staff. This system will not forward PHI but direct a patient to a portal;

14. Enterprise imaging system must accept and auto-reconcile studies from DOD. EI system must maintain DOD studies in an administrative area that excludes general access until that patient is eligible for VA care;

15. Enterprise imaging system must be able to electronically exchange studies with DOD, fee basis partners and other outside entities VHA chooses;

IV. RFI QUESTIONS:

Requirements Questions:

1. For an EI system of the proposed scale, what is a rough order of magnitude estimate for vendor FTEE to maintain/manage the EI cloud and on-prem infrastructure and separately the FTEE required for daily system administration to include user access, end user support, study reconciliation, exception resolution and other activities required for ongoing management. Note that the intent is to have this be a fully vendor-supported managed service.

2. What is the expected budgeting cost for the complete Enterprise Imaging System described above? Please include options for both capital and per study delivery models.

Contractor Business Questions:

1. What contract vehicle do you recommend for this requirement?

2. What pricing structure do you recommend?

3. Does your organization have an existing GSA schedule for this type of requirement?

4. What NAICS codes would your company recommend for this action?

5. What key questions do you need to see answered in a future PWS/SOW before you decide to respond to the solicitation?

6. In what format and what kind of supporting documents would be most helpful to include as exhibits in a future PWS/SOW?

7. What do you foresee as the biggest risks in performing the tasks in the draft documentation to meet our requirements?

V. Attachments:

Attachment A: Imaging Specialty Functionality Matrix