P03 JA TAC Revised Final VISN 4 ITM Software and Support_Redacted.pdf

Infusion Therapy Manager (ITM) Software and Support - VISN 04 VA-24-00012539

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 task order under the National Aeronautics and Space Administration (NASA) Solutions for Enterprise- Wide Procurement (SEWP) V Governmentwide Acquisition Contract (GWAC), for six brand name Document Storage Systems Inc. (DSS) Infusion Therapy Manager (ITM) term software licenses for six locations, training and support, with options for up to three additional locations.

3. Description of Supplies or Services: The VA, Veterans Health Administration (VHA) Veterans Integrated Service Network (VISN) 04 - Logistics Hub, has a requirement for brand name Infusion Therapy Manager (ITM) software, training and support.

Specifically, VA requires six term licenses in the base year with two 12-month option periods for continued subscriptions, as well as options for three additional term licenses, with training and support, and two 12-month option periods for the additional licenses. VA requires a web-based decision support tool that manages evidence-based protocols as part of an intuitive workflow for the ordering of infusion therapy across multiple medical specialties. VA requires that the tool interoperate with Veterans Health Information Systems Technology Architecture (VistA). It must provide VistA integrated drug order entry, safety features and expanded workflow to support High Reliability Organization (HRO) principles within the software suite based on clinical guidelines and tailored to each facility’s preferences. VA requires an infusion therapy software that works across departments such as oncologists, gastroenteroly, rheumatology, neurology, endocrinology and clinical pharmacy specialists in a comprehensive suite. VA requires automation of complex chemotherapy administration based on evidence-based treatment plans using the existing server infrastructure that is also interoperable with VistA application. The software is required to streamline workflows for chemotherapy, immunotherapy, hydration, anti-coagulation and antibiotic therapy. These features assist medical staff in order entry, as well the standardization of practices with the latest clinical evidence through decision support.

VHA requires training for new users and additional training on any major upgrades or changes to the program. VHA also requires standard maintenance support for the subscription software including 24x7 helpdesk to ensure any issues with the end-users are addressed immediately to ensure continuity of care to our Veterans. The following facilities have an immediate need for this software: Altoona, Erie, Lebanon, Philadelphia, Pittsburgh and Wilmington. VHA may require additional optional term licenses, training and support for three more locations. The period of performance shall be 12 months from implementation after a February 1, 2024, proposed award date, with two 12-month option periods. The total estimated value of the proposed action is inclusive of all options.

4. Statutory Authority: Pursuant to Federal Acquisition Regulation (FAR) Subpart 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 Federal Acquisition Regulation (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: Currently, five of the participating VISN 4 facilities have Vista Chemotherapy Manager (VCM) software.

This software will no longer be supported or updated after December 31, 2023. VA requires the DSS ITM subscription software to replace the VCM software. The DSS ITM software is the only comprehensive commercially available oncology software that can meet all of VA’s need. Specifically, the DSS ITM software is the only software available that provides a single comprehensive suite to be used throughout multiple VA departments (i.e. oncologists, gastroenteroly, rheumatology, neurology, endocrinology and clinical pharmacy specialists). The DSS ITM software is also the only commercially available software that can interoperate with VistA. Finally, DSS ITM software is the only software that can operate on VA’s existing sever infrastructure. If VISN 4 were to switch to a different Chemotherapy Management software, VA would have to identify multiple software for individual departments (pharmacy medication management software, scheduling software, clinical decision-making software for providers). This would cause administrative burden to procurement, implement, training and integrate multiple software into a cohesive solution. Further, VA would need to incur the cost of integrating with VistA and reprocure the existing server environment. Switching to a different software solution, VA would incur costs of replacing up to six servers estimated to cost up to $100,000 each as well as an estimated $1,000,000 for implementation, training and to integrate with VITSA. There is also an estimated cost of $4M for various different software licenses that would be needed to replace the current software. These estimates are based on historical knowledge and previous acquisition history. The duplicated costs would not be recovered through competition. In addition to the cost, the timeline to procure and implement multiple new softwares across multiple departments, would take up to 24-months. This estimated timeline is based on a minimum of 18-months to get an Authority to Operate plus installation, integration and training. During the time VA is without an oncology software, orders would have to be managed separate from VistA and would have to be manually entered into VistA by the providers, creating burden on providers and increasing the risk of transcription errors ultimately impact patient safety. Due to the propriety nature of the ITM software, only the software manufacturer or an authorized reseller can provide the training and support required.

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. However, the undersigned VA technical representative determined that limited competition is available among authorized resellers for brand name ITM software, training and support. In accordance with FAR 16.505(a)(4)(iii)(A)(2), this justification will be provided with the solicitation to all interested NASA SEWP V GWAC holders.

In accordance with FAR 5.301 and FAR 16.505(b)(2)(ii)(D), and 16.505(a)(4)(iii), the award notice for this action will be synopsized and this justification will be made publicly available within 14 days after award on the Federal Business Opportunity website.

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: When conducting market research in December 2023, the Government’s technical experts reviewed similar oncology software products, such as and . As a result of the market research, the technical experts confirmed that these software solutions do not support all required departments needed for the infusion therapy software. None of these products interoperate with VistA and none can operate in the existing server environment. As explained in Section 5, the ITM oncology software is the only available software that can meet all of VA’s requirements.

Additional market research was conducted in November 2023, which indicated that multiple resellers are available for the DSS ITM software on NASA SEWP.

9. Other Facts: None

10. Technical and Requirements Certification: I certify that the supporting data under my cognizance, which are included in this justification, are accurate and complete to the best of my knowledge and belief.

11. Fair and Reasonable Cost Determination: I hereby determine that the anticipated price to the Government for this contract action will be fair and reasonable based on a comparison of the successful quote to the Independent Government Cost Estimate.

Additionally, pricing for products awarded on NASA SEWP V GWAC have already been determined to be fair and reasonable and more competitive pricing may result from competition.

12. Procuring Contracting Officer Certification: I certify that this justification is accurate and complete to the best of my knowledge and belief.

Approval

In my role as procuring activity Advocate for Competition, based on the foregoing justification, I hereby approve the acquisition of brand name DSS ITM software, training and support, on an other than fair opportunity basis pursuant to the statutory 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.