P03_JnA_Redacted.pdf

VISN 7 Nuance PowerScribe Control Number VA-24-00085717

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 brand name Nuance PowerScribe dictation software and Nuance hardware with warranty, professional services, and training.

3. Description of the Supplies or Services: VA Veterans Integrated Services Networks (VISN) 7 has a requirement to expand the existing Nuance PowerScribe Picture Archiving and Communication System (PACS) dictation system and acquire 4 term licenses for brand name Nuance PowerScribe with 1 term license for ModLink add-on, 130 Nuance PowerMic III microphones, Pro-service installation for Nuance PowerScribe and ModLink at eight sites, On-site Professional Training Class at eight sites, and technical support to customize Nuance PowerScribe software interfaces.

The existing VISN 7 Philips VuePACS uses Nuance PowerScribe infrastructure to accurately and efficiently dictate findings and observations from medical images.

The VISN 7 team is working to expand existing Nuance PowerScribe infrastructure VISN-wide to be interoperable with existing VISN 7 VA owned VuePACS. The required expansion of Nuance PowerScribe dictation proprietary software and Nuance proprietary hardware including the microphones must be interoperable with the existing VISN 7 VuePACS, also including the warranty, professional services and training, to ensure a common interface that facilitates the care of patients referred within a VISN, to reduce time spent on manual data entry allowing radiologists to focus on interpreting images and making critical clinical decisions by automating report building and data entry, to reduce the cost of equipment and maintenance contracts, to share technical expertise within a VISN, and to ensure continuity of service in the event of a disaster. In addition, VA requires maintenance and technical support that includes software updates, bug fixes, general product consultation, and upgrade support during normal business hours to ensure the software continues to function as intended, and access to designated Nuance points of contact who possess expert knowledge of Nuance technologies as well as have access to Nuance�s proprietary knowledge, development, and source code to create scripts that allow the Nuance PowerScribe to communicate with other custom applications at VA. Performance is 12 months from date of award, with two 12-month option periods. The total estimated value of the proposed action is

, inclusive of all option periods.

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 on market research, as described in Section 8 of this document, only Nuance and its authorized resellers can provide the required brand name Nuance PowerScribe dictation software and Nuance hardware with warranty, professional services, and training. Any other brand name Original Equipment Manufacturer (OEM) dictation software and hardware with warranty, professional services, and training cannot meet VA�s functional requirements as stated herein. Specifically, only Nuance and authorized Nuance PowerScribe resellers are capable of providing the required software, hardware and support that is interoperable and compatible with existing VISN 7 VuePACS for the radiology system which is based on Nuance PowerScribe infrastructure. The current Nuance PowerScribe infrastructure communicates through a source code that is based on Nuance�s proprietary data. No other OEM can provide the required interoperability and compatibility without access to this source code. To introduce another OEM�s dictation software would put the radiology system currently being run by Nuance PowerScribe at risk. Replacing VA�s Nuance PowerScribe infrastructure with another solution would require purchasing, designing, implementing, and training for a new platform for dictation. This redesign/replacement is estimated to cost over $450,000 for the software procurement. Based on previous similar efforts, VA technical subject matter experts estimate that a team of seven IT Specialists would require a minimum of 6-12 months to change the interface from the existing VA PACS to a new dictation software. The estimated cost for this work is approximately $568,500.00. The total duplicated cost for both software and implementation is $1,018,500. In addition, there is the untenable and substantial risk of unavailability of the content during the transition to an alternative OEM solution, resulting in decreased radiologist productivity due to longer manual report creation and risk of misdiagnosis due to lack of software features. Any corruption or loss of data from this process would cause significant disruption to service across VISN 7 as VA Radiologists would lose access to existing work and files associated with Nuance PowerScribe. As a result, this would greatly impact the service to our nation�s Veterans and the overall success of VISN 7 radiology department.

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 undersigned VA technical representative determined that limited competition is available among authorized resellers for brand name Nuance PowerScribe dictation software and Nuance hardware with warranty, professional services, and training. 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 Contract 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 conducted web-based market research in June 2024 by reviewing other similar dictation software from multiple OEMs including eRAD PACS Viewer, 3M M*Modal Fluency, and nVoq AI.

While these other OEMs offer dictation software products, none of these products can meet the VA�s functional requirements as previously discussed. Only Nuance PowerScribe and its authorized resellers have access to Nuance�s proprietary source code to provide the necessary required interoperability and compatibility with the existing VISN 7 VuePACS. Specifically, none of the other OEM can provide the access to Nuance PowerScribe�s source code necessary to interface and create scripts with existing Nuance PowerScribe infrastructure. Additionally, VA networking Subject Matter Experts regularly review industry trade publications and conduct internet research to ascertain if any other brand name dictation software is available and interoperable. Based on all of these market research efforts, the Government�s technical experts have determined that only brand name Nuance PowerScribe dictation software and Nuance hardware with warranty, professional services, and training can meet the Government�s requirements.

Additionally, the Contract Specialist (CS) conducted market research in June 2024 using the NASA SEWP V GWAC market research and provider lookup tools to determine what vendors are capable of providing the full requirement. Based on this market research, the CS identified several SDVOSBs that are Nuance authorized resellers able to provide the required brand name products to meet the Government�s needs for this effort.

9. Other Facts: NA

10. Technical/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 because NASA SEWP GWAC prices have previously been determined fair and reasonable.

Additionally, price competition is expected among authorized resellers for this action.

Additional price analysis may be performed in accordance with FAR 15.404-1(b).

12. Contracting Officer Certification/Approval: 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 Nuance PowerScribe dictation software, Nuance hardware with warranty, professional services, and training 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 products and services herein described have otherwise been authorized for acquisition.