Redacted JA.pdf

Document Storage System (DSS) VistA Chemotherapy Manager - VA-26-00001082

JUSTIFICATION FOR AN EXCEPTION TO FAIR OPPORTUNITY

1. Contracting Activity: Department of Veterans Affairs (VA)

Office of Procurement, Acquisition, and Logistics Technology Acquisition Center (TAC) 23 Christopher Way Eatontown, New Jersey 07724

2. Description of Action: This proposed action is for a firm-fixed-price Delivery Order issued under the National Aeronautics and Space Administration (NASA) Solutions for Enterprise-Wide Procurement (SEWP) V Government-Wide Acquisition Contract Manager (GWAC) for Brand Name Document Storage Systems, Inc., (DSS) Veterans Health Information System and Technology Architecture (VistA) Chemotherapy Manager (VCM) software maintenance and two (2) annual limited licenses for the Cincinnati and Cleveland hospitals.

3. Description of the Supplies or Services: The VA, Veterans Health Administration (VHA) Veterans Integrated Service Network (VISN) 10 has a requirement for VCM software maintenance for the Ann Arbor, Detroit, Cincinnati, Cleveland, Dayton, Fort Wayne, and Indianapolis locations and two (2) annual limited licenses for the Cincinnati and Cleveland hospitals.

VCM is a VA specific windows-based software decision support and ordering system.

VCM is fully integrated with VistA and provides for seamless electronic interaction between the ordering oncologist and pharmacist. This integration allows the oncologist to have an extremely efficient method for preventing medication errors due to misinterpretation of hand-written orders. This software is focused on patient safety and ensures that prescription order sets are integrated and complete and that dosing is appropriate. With VCM, the clinical practice of oncology becomes automated from the assignment of therapy to the calculation of chemotherapy doses to the documentation of care. Patient safety is maximized, clinical efficiency is increased, patient information is secure, documentation of patient care is streamlined, and interfaces with VistA/computerized patient record system. VA requires brand name DSS VCM software maintenance with the existing VCM infrastructure protocol and functionality for continued operational availability. The required DSS VCM software maintenance and technical support services to provide the appropriate VHA staff with the resources they need to provide safe and accurate care to the Veterans. Software maintenance includes all new fixes, patches, corrections, releases, updates, versions, and upgrades to the software. Technical support consists of a range of services providing support Monday through Friday from 8am to 8pm EST, and assistance for the software via telephone, e-mail, or website.

The period of performance is October 1, 2025 through September 30,2026, plus two 12-month option periods, if exercised. The total estimated price of the proposed action including all Options is .

4. Statutory Authority Cited: 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 41 U.S.C. Section 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: Based on the market research described in Section 8 of this justification, it has been determined that limited competition is available for the DSS software license, maintenance support, and two license among authorized resellers. Maintenance is required for software updates and patches to VHA’s current DSS VCM software. The software license subscription and maintenance are required to ensure VHA can successfully support the VCM infrastructure and that the existing DSS VCM software remains operational. VISN 10 facilities are currently scheduled to transition to the new electronic health record (EHR) over the next two to three years. Based upon previous acquisition history, any other solution would require extensive development and time for a transition and new system implementation. The costs due to VistA’s programming language and interfacing requirements is estimated to be approximately . The timeline is estimated to be a minimum of 3 years to develop an enterprise-grade solution.

Some of the work involved includes specifications receiving for hardware, server approval including authority to operate with VA Office of Information Technology and VA Healthcare Technology Management approval, server setup, interface development with possible code modification for system mapping to HL7 industry standard requirements, interface testing and regression testing for baseline validity, development of drug library in replacement system, transcribing existing hematology and oncology regimen templates, testing of each transcribed template (441 templates estimated per site), importing legacy patient treatment care plans to replacement system, and pharmacy/oncology/nursing user training on replacement system. In addition to identifying programmers able to program in Massachusetts General Hospital Utility Multi-Programming Systems (MUMPS), there are data elements that are transmitted between DSS, VistA and the analytics platform that must be developed to match between the systems and transmitted between the platforms when called upon by each application. DSS VCM is unique in being able to seamlessly integrate with VistA. The VA is currently not accepting NSR’s (new service request) for interface development for VistA due to the impending migration to the new federal EHR. The DSS VCM software must constantly communicate with VistA to pull up a patient’s latest vitals, lab results, pharmacy orders to allow the physicians to make informed treatment decisions at any given time during the patient’s treatment.

The system must also be able to send data back to VistA for populating progress notes, lab information, pharmacy orders, and nursing orders in the patient’s chart in the electronic medical record (EMR). Even if another solution could be introduced there would be major delays and gaps in treatment to Veteran patients while the interfaces are developed and templates re-built, costing the VA significant amounts of time and money to ensure those patients are still treated timely and safely with minimum equivalent treatment plans.

Additionally, software maintenance is required, including but not limited to all new fixes, patches, corrections, releases, versions, and upgrades to the software.

Technical support consists of a range of services providing support Monday through Friday from 8am to 8pm EST, assistance for the software via telephone, e-mail, or website. These updates and patches provide new feature sets, address program errors in prior software versions, and provide security enhancements. Only DSS, through an authorized reseller, can provide the necessary software upgrades and patches because of the propriety source code required to develop and implement software updates. Since the software is proprietary, a legal restriction is placed on access to the software code that is required to develop upgrades and patches to the software. Without this access, it is impossible for another source to modify the software code as necessary to provide the required patches and upgrades. No source other than a DSS authorized reseller can provide the required maintenance support described herein, such as assistance via phone and email, as well as all software upgrades and patches. Furthermore, if the brand name DSS software maintenance was not procured, the existing installed systems will lose vendor support and updates for managing the hazardous medication order and unable to maintain compliance with Pharmacy Benefits Management guidance of at least 90% of all chemotherapy used in the VA facilities having power plans/order sets to prescribe chemotherapy/hazardous medications. Not having the DSS VCM software implemented across the VISN would have adverse effects on the oncology treatment plan selection, development, and utilization putting the most critically ill patients at risk of receiving inappropriate care, inaccurate hazardous/antineoplastic medication dosing, illness, or possible death.

6. Efforts to Obtain Competition: Market research was conducted, details of which are in

Section 8 of this document. This effort did not yield any additional sources that can meet the Government’s requirements. It was determined that limited competition is viable among authorized resellers from the required brand DSS VCM software maintenance. 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 whether there are changes in the marketplace that would enable future actions to be competed. Specifically, OIT will continue to monitor market trends, new/emerging products, looking for compatible and more advanced technologies to meet VA needs.

8. Market Research: The Government’s subject matter experts conducted market research on similar systems in March 2025. The following four alternative oncology software solutions were reviewed: OncoEMR, Endosoft, Elekta MOSAIQ, and iKnowMed Oncology EHR. Although these similar oncology solutions have EMR compatibility they would require significant customization, as detailed above, for compatibility within VA’s infrastructure and not work as a provided base solution according to Presidential Executive Order Ensuring Commercial, Cost-Effective Solution in Federal Contracts. Due to the propriety data and code of the currently implement DSS, Inc. VistA Chemotherapy Manager system, maintenance and support is not able to be administered by a third party.

The Contract Specialist conducted additional market research, in May 2025, by identifying 5 contract holders that are resellers of Brand Name “Document Storage Systems” by utilizing the NASA SEWP V GWAC Market Research Tool and Provider Lookup. Of these five resellers, two are verified Service-Disabled Veteran-Owned Small Businesses (SDVOSBs), two are Woman-Owned Small Businesses, and one is a Small Businesses. Furthermore, NASA SEWP has a dynamic catalog where line items can be added based on customer requests provided that the required item or service is within the scope of the NASA SEWP V contract suite and therefore additional competition may be achieved.

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. Determination of Best Value: I hereby determine that the anticipated price to the

Government for this action will be fair and reasonable because NASA SEWP V GWAC prices have previously been determined fair and reasonable. Additionally, the successful quote will be compared to the published price lists on the NASA SEWP V GWAC price catalog of the successful offeror. Finally, the successful quote will be compared with the Independent Government Cost Estimate.

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 DSS, Inc., VistA Chemotherapy Manager (VCM) software maintenance and two annual limited license for the Cincinnati hospital 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 property and services herein described have otherwise been authorized for acquisition.