Redacted JA - V23 CTM Plus.pdf

VISN23 CTM+ CONTROL NUMBER VA-26-00079423

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: The proposed action is for a firm-fixed-price task order to be issued under the National Aeronautics and Space Administration (NASA) Solutions for Enterprise-Wide Procurement (SEWP) V Government-Wide Acquisition Contract (GWAC) for the procurement of brand name Document Storage System (DSS) Consult Tracking Manager Plus (CTM+)subscription, maintenance and training.

3. Description of the Supplies or Services: VA, Veterans Health Administration (VHA), Veterans Integrated Services Network (VISN) 23 requires renewal of eight (8) DSS CTM+ annual perpetual licenses. The contractor shall also provide VISN 23 with CTM+ training annually. The software solution, which VISN 23 has utilized since 2020, effectively supports and enhances efficient management of both clinical and community care consultations (consults), follow-up orders and/or return appointments, which are called Return to Clinic (RTC) orders that support the ‘No Veteran Left Behind’ initiative.

Open consults are a major issue for all Veterans and VA healthcare providers and VISN 23 requires an enhanced ability to monitor and track consults and other events within facilities. Renewal of the CTM+ perpetual licenses will provide tools necessary to allow VISN 23 to continue to accomplish this objective effectively and efficiently. VA requires a consult tracking management solution that is compatible and interoperable with VistA and CPRS. VA requires a solution that has the ability to provide real-time monitoring capabilities with VistA and the ability to provide the required functionality and interoperability with existing VA systems. Further, VA requires a software solution that is capable of collecting Health Level-7 international standards to transfer patient clinical and administration data. VA requires a solution that delivers actionable patient information and medical knowledge into the workflow of clinicians at the point of care.

This enables caregivers to intervene faster and more efficiently, providing better and safer care. Better decisions alter the healthcare experience and outcome for each patient while reducing costs. This web-based solution streamlines workflow and provides program administrative oversight to a complicated system, thus ensuring Veterans consult needs are scheduled quickly and follow-ups are performed in a timely manner.

The VA requires a solution that is is Veterans Health Information Systems and Technology Architecture (VistA) integrated solution that provides real-time, up-to-date dashboard views of the status of all consults, displayed by service line. Users can take necessary actions on the consult from within the dashboard without going to the Computer Patient Record System (CPRS) where all data is maintained in VistA in the appropriate files. The Contractor shall provide this solution at the following eight (8) VISN 23 sites: Nebraska-Western Iowa, Central Iowa, Iowa City, Black Hills, Fargo, Sioux Falls, St. Cloud and Minneapolis. The base period of performance shall be 12-months from 09/01/2025-08/31/2026, with two (2) 12-month option periods. The total estimated price of the requirement, including options,

4. Statutory Authority: Pursuant to Federal Acquisition Regulation (FAR) 16.505(a)(4), the brand name requirement described herein 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 extensive market research, as described in Section 8 of this justification, it was determined that competition is viable among resellers of the DSS CTM+ software solution. Only the brand name DSS CTM+ software solution can meet VA’s requirements. VA has one of the largest patient and non-patient record data sets in the United States. VISN 23 requires a solution that enables staff members the ability to analyze outstanding consults and RTC orders in real time to identify those beneficiaries that require follow-up contact to achieve the goal of ensuring no Veteran is left behind. Without use of this software, VISN 23’s open consults and unscheduled RTCs would continue to be a major issue for all Veterans and VA healthcare providers within the agency. DSS CTM+ providesa consult tracking management solution that is compatible and interoperable with VistA and CPRS. DSS CTM+ provides a solution that has the ability to provide real-time monitoring capabilities with VistA and the ability to provide the required functionality and interoperability with existing VA systems. Further, DSS CTM + provides a software solution that is capable of collecting Health Level-7 international standards to transfer patient clinical and administration data. Only the required brand name CTM+ is fully interoperable with VistA and capable of meeting these functional requirements. The DSS CTM+ software solution is the only known solution that would not require local enhancements or modifications of the VistA application. Specifically, no other existing software is compatible with both VistA and CPRS systems, specifically the Consult Tracking and Consult Toolbox components within VistA/CPRS. DSS developed the proprietary CTM+ software to integrate with VistA and CPRS, allowing the user to manage their daily consult workload with an interactive web-based solution.

The use of any other software solution would require VA to build customized tools, scripts, and processes to utilize a non-DSS solution. It is estimated that the testing, development, configuration and integration of any other software solution would result in a duplicative costs of and take at least one year to complete. These estimates are based upon previous testing, development, configuration, and integration efforts of similar size and scope. It is not expected that these costs would be recovered through competition.

Finally, DSS CTM+ software solution is a proprietary software product; therefore, only DSS or its authorized resellers can provide maintenance on its software products. The proprietary data and source code is required to ensure all DSS CTM+ software solution updates and patches are properly pushed through to the fielded software and to ensure the software is properly configured. Access to this code is also required to ensure all services provided on the DSS CTM+ software solution are properly configured. No source other than DSS or its authorized resellers have access to the proprietary data and source code necessary to provide the required patching and version upgrades/enhancements and security updates for DSS CTM+ software solution.

Without acquiring the DSS CTM+ software solution, the VISN 23 Medical Centers will be unable monitor and track consults and ultimately provide timely care to Veterans.

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. However, it was determined that limited competition is available among authorized resellers for brand name DSS software license support. 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: Government technical experts conducted market research from May 2025 through June 2025 by reviewing similar software providers via VA intranet and internet searches to determine if they could meet the Government’s requirements.

This process included a review of primary literature to review the program, VISTA Fast Healthcare Interoperability Resources (FHIR) Data Loader, which is offered through multiple companies. . The VISTA Fast Healthcare Interoperability Resources (FHIR) Data Loader was deemed to not meet our requirements as it is used for creating synthetic patient data and loading it into the VistA EHR. The multiple programs offered through software providers Carahsoft and ImmixGroup were also reviewed, and none were determined to meet the VA’s requirements due to their inoperability with Vista /

CPRS.

Additionally, through a separate internet search, a homegrown product called Consult Dashboard was identified, which was developed by the VA in Illinois, which was also reviewed. It was determined that the Consult Dashboard was read-only and not bi-directional with VistA/CPRS and did not interface with the Consult Toolbox component within VistA/CPRS or manage Return to Clinic Orders. All of the alternate solutions identified could not meet VA’s requirements due to their inoperability with VistA and CPRS. Based on these reviews, it was determined that none of the other products could provide the necessary software and accompanying maintenance that could interoperate and communicate with VA systems (VistA and CPRS). Additionally, no other company has access to the proprietary source code and technical data required for software installation, maintenance, and training services.

DSS confirmed that they are the manufacturer and sole distributor of the DSS CTM+ products, which are sold exclusively through two (2) NASA SEWP V GWAC authorized resellers, one (1) being a Service-Disabled Veteran-Owned Small Business (SDVOSB) and the other a Historically Underutilized Business Zone (HUBZone) Small Business (SB). Based on this information, there is a reasonable expectation of competition on the NASA SEWP V GWAC among SB concerns for the DSS CTM+ annual perpetual licenses sought for renewal. The NASA SEWP V GWAC has a dynamic catalog where items can be added based on customer requests, ensuring that required items or services within the scope of the NASA SEWP V GWAC can be added daily. The Contracting Officer has determined that this action is within scope of the NASA SEWP V GWAC in a separate determination.

9. Other Facts: N/A

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.

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 anticipated competition and discounts among multiple value-added resellers of the required brand name license, maintenance and training described herein. Additionally, further price analysis of quotes received will be conducted to determine fair and reasonable price. Finally, pricing of products awarded under NASA SEWP V GWAC have already been determined to be fair and reasonable.

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

Advocate for Competition Approval

In my role as procuring activity Advocate for Competition, based on the foregoing justification, I hereby approve the acquisition of brand name Document Storage System (DSS) Consult Tracking Manager Plus (CTM+) annual perpetual licenses, maintenance 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 services herein described have otherwise been authorized for acquisition.