P03 LSJ OVER SAT Pyxis_405-20-3-7077-0091_06-08.pdf

VHAPM Part 808.405-6 Limiting Sources Original Date: 08/30/2017 Revision 02 Eff Date: 02/21/2020

LIMITED SOURCES JUSTIFICATION

ORDER >SAT

FAR PART 8.405-6

Acquisition Plan Action ID: 36C241-20-AP-0994

(1) Contracting Activity: Department of Veterans Affairs, VISN 1, WRJ Medical Center, 405-20-3- 7077-0091.

(2) Description of Action: This acquisition is conducted under the authority of the Multiple-Award Schedule Program (41 U.S.C. 152(3) and 40 U.S.C. 501). Ordering additional Pyxis systems to use in the CBOC’s we support. This is follow-on to an original FSS contract.

Order against: FSS Contract Number: 36F79718D0454

Name of Proposed Contractor: Carefusion Solutions, LLC Address: 3750 Torrey View Ct.

City, State, Zip: SanDiego CA 92130 Phone: (888) 876-4287

(3) Description of Supplies or Services:

The estimated value of the proposed action is $ 260,715.00. WRJ medical center is requesting 7 additional Pyxis systems, MESR2B-0H-0N2U0M0B0V, MEDSTATION, ES, MAIN, 2 DR, and RSR- MED, SRM, ROUNDOFFSET, 12 FT, LT, for our supported CBOC’s to be on the same system as the hospital.

(4) Identify the Authority and Supporting Rationale:

FAR 8.405-6(a)(1)(A): An urgent and compelling need exists and following the ordering procedures would result in unacceptable delays:

FAR 8.405-6(a)(1)(B): Only one source is capable of providing the supplies or services required at the level of quality required because the supplies or services are unique or highly specialized;

FAR 8.405-6(a)(1)(C): In the interest of economy and efficiency, the new work is a logical follow-on to an original Federal Supply Schedule order provided that the original order was placed in accordance with the applicable Federal Supply Schedule ordering procedures. The original order must not have been previously issued under sole source or limited source procedures.

FAR 8.405-6(b): Items peculiar to one manufacturer:

A patent, copyright or proprietary data limits competition. The proprietary data is:

These are “direct replacements” parts/components for existing equipment.

Peculiar in Application: The material/service must be compatible in all aspects (form, fit and function) with existing systems presently installed/performing. WRJ hospital currently has the Pyxis system in use throughout the hospital. These additional systems will be used by CBOC’s in our medical system. They will need to integrate with existing Pyxis system for continuity of care and service to our Veterans.

Revision 02 Eff Date: 02/21/2020

(5) Describe Why You Believe the Order Represents the Best Value consistent with FAR 8.404(d) to aid the contracting officer in making this best value determination:

A procurement strategy with BD/Carefusion Solutions LLC is deemed as affording the best value to the government, as this strategy best achieves:

Price Reasonableness: The pricing offered by BD/Carefusion via FSS Contract:

36F79718D0454 best achieves price reasonableness, providing the VA with a 7% discount off list price, and an additional 6% discount off the FSS pricing. The pricing offered s equivalent to the IGCE value of $270,615.00

Performing a cost analysis comparing BD/Carefusion to the SDVOSB vendors VHSS and MicroTech, requires segregating pricing segments to provide an accurate determination of price reasonableness.

To achieve an equitable comparison, the pricing of the vendor items #323 and #347 were isolated from the annual fee licensing component.

The annual licensing fee for the existing Pyxis MedStations at VAMC White River Junction are paid separately from a separate Fund Control Point.

When considering best value, it was deemed to be more efficient and practical that the annual licensing fees be paid in a lump sum to one vendor. This reduces additional account administration, reducing oversights and errors in paying separate licensing fees to different vendors, for the VAMC and the CBOCS.

Including the licensing fees in the total allocation increases the total acquisition cost and diminishes “price reasonableness.” The cost variance in excess of the baseline would then exceed the funded amount by $6,914.80 (2.54%) for VHSS, and by $9,113.88 (3.35%) for MicroTech.

COVID-19 operations have further constrained funding availability, narrowing the margin for best value determination.

Easy Interface and Integration of Technology: Allows CBOCs to align medicine dispensation and achieve consistency with compatible standardized platforms with VAMC White River Junction.

Expediency and Accuracy: Decentralized medication management affords convenience and accuracy.

Clinical Efficiency: Standardization to the Pyxis MedStation ES Main System affords efficiency and cost savings by eliminating the need to retrain clinical staff.

Economy of Stewardship: Allows CBOCs to streamline medication inventories and reduce costs.

(6) Describe the Market Research Conducted: Traditional market research was conducted: VetBiz, Mandatory Sources, SAC, NSSL, NAC, GSA Advantage, GSA E-Library, and the SBA database.

Distribution of the Pyxis Platform is limited in the market. Solicitations were received from two SDVOSB vendors In Accordance with 38 USB 8127(d). The pricing offered by the SDVOSB vendors, exceeded the IGCE by 2.54% and by 3.35%, respectively. Neither price listing satisfied best value to the Government. There are no small business vendors authorized to distribute for BD/Carefusion Solutions LLC. Additionally, there is no NMR Class Waiver of the Carefusion GSA Contract NAICS/FSC/Description or the preferr NAICS/FSC/Description. Therefore, the procurement could not be legally set aside for any small business vendor, other than the OEM. The best value would be afforded by the GSA FSS Contract: 36F79718D0454 for the large business manufacturer, Carefusion Solutions LLC. The price that best-achieves price reasonableness is that offered via FSS 36F79718D0454 with a total discount of 13%.

Revision 02 Eff Date: 02/21/2020

(7) Any Other Facts Supporting the Justification:

a. Why only Pyxis:

White River Junction VA Medical Center currently has 16 Pyxis automated dispensing stations through out the medical center. Not only can trays/cubicles be swapped among Pyxis currently on station, but after greater than 10 years of Pyxis use at this facility, there would be a huge learning curve to implement another brand of automated dispensing cabinet. This would include retraining for nursing, pharmacy, as well as controlled substance compliance officers that utilize, fill, and run reports from Pyxis workstations on a regular basis. In July of 2019, the previous generation of Pyxis was updated two generations to Pyxis ES system. This required not only hardware upgrades (drawers, heads (computer), cubicles), but also major software upgrade that required Pyxis staff to be onsite for 2 weeks. Further, nursing/pharmacy/CSI that utilize Pyxis for filling, dispensing, and reporting, required extensive training in order to facilitate use of the new system.

1) Unique and superior features/technology: The new Pyxis ES system allows decentralized medication management. For example, if one ward does not have a particular medication, nurse can view what pyxis station has the medication and retrieve from that site, particularly critical during WHEN hours when pharmacy is not physically staffed from 11:30 PM to 7:00 AM, not having to call staff in to retrieve a medication.

Further, Pyxis ES supports bar code labeling, providing an additional layer of safety for administration of medications.

2) VISN 1 Standardization: No specific directive to purchase either Pyxis or Omnicell.

Several years-ago VISN was looking into VISN-wide contract to standardize automated dispensing cabinets. However, nearly 50% of sites had Pyxis, and the other 50% had Omnicell. Sites would need a large expenditure to buy into conversion of one automated dispensing cabinet versus the other, along with retraining of numerous staff from multiple services, thus negating a standardization to a specific product

3) Highly-specialized Equipment: Pyxis provides service in three key areas: patient care, workforce, and financial stewardship. With regards to patient care, the availability, timeliness, and adherence to safety are key factors provided by Pyxis automated dispensing cabinets. The Pyxis brand med-stations support the VISN 1 mission of excellence in health care to our Veterans. Pyxis will eliminate the need to retrain, and the need to split automated workstations, to accommodate diverse features of different systems. Pyxis med-dations are already in use at the White River Junction VA Medical Center. The consistency and the ease of interface attenuates the learning curve for nursing, pharmacy, and compliance officers.

4) Efficiency and Economy in Inventory Management: Utilization of a single networked system to view availability of medications at other cabinets within the medical center, reduces excess inventory, outdates of medications not used, as well as increases availability to emergent needs. Overall the inventory management and access to available medications in timely fashion justifies the cost-savings compared with multiple systems/different manufacturers and support financial stewardship.

b. Pyxis Brand Versus Other Brands:

Currently on site for >10 years, staff familiar with registration, use, reporting, and stocking and dispensing from cabinets. All pyxis (#16 units) recently updated, staff extensively trained in order to embrace benefits of new technology. commonality of standardized platform, ability to swap drawers/cubicles and access numerous reports as needed.

Revision 02 Eff Date: 02/21/2020

1) Technology: Affords Efficiency and Economy in Healthcare: Standardizing within the facility facilitates improved inventory management, to prevent overstocking as well as meeting demand for frequently used medications. Running reports for errors, inventory, access, and compliance is greatly enhanced running a sole platform as opposed to running two separate platforms that do not communicate.

2) Standardization: Efficiency and Economy of Uniformity: Currently Pyxis system is in place and utilized by White River Junction VA Medical Center. By going with system currently in use, will not have to retrain numerous staff from several different services that utilize Pyxis on frequent basis. Further, the reporting and inventory management is greatly simplified and provides much more accurate accountability than going across two different systems.

3) Ease of Interface with Existing and Integrating Systems: Efficiency and Economy Via Continuity of Process: The current system is set-up with dedicated server, has programmed backups not only locally but to remote location for storage, and is distributed throughout the medical center. Using a system from another vendor would necessitate establishing new drug file for this system, implementing new user access privileges, and limit interchangeability as well as within system communication that is already inherent in the present utilized system. Opting for a different brand would be costly and disruptive to workflow, and would diminish accurate/effective healthcare.

(8) A Statement of the Actions, if any, the agency may take to remove or overcome any barriers that led to the restricted consideration before any subsequent acquisition for the supplies or services is made: COVID-19 has constrained available funding, narrowing the margin for "price reasonableness" and "best value" determination.

(9) Requirements Certification: I certify that the requirement outlined in this justification is a Bona

Fide Need of the Department of Veterans Affairs and that the supporting data under my cognizance, which are included in the justification, are accurate and complete to the best of my knowledge. I understand that processing of this limited source justification restricts consideration of Federal Supply Schedule contractors to fewer than the number required by FAR Subpart 8.4.

(10) Approvals in accordance with the VHAPM Part 806.3 OFOC SOP:

a. Contracting Officer's Certification (required): I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

04/29/20

SIGNATURE DATE

VAMC White River Junction VT Inventory Mangement Specialist Logistics

FACILITY TITLE SERVICE LINE/SECTION

Linda J. Ward 155235

SIGNATURE

Linda J. Ward, Chief of Contracting, Supply Team 1

NAME AND TITLE

Digitally signed by Linda J. Ward 155235 Date: 2020.05.22 13:24:56 -04'00'

DATE

NC01

FACILITY/NCO/PCO