Redacted LSJ for AF PharmASSIST - Innovation Assoicates.pdf

LIMITED SOURCE JUSTIFICATION

1. Defense Logistics Agency (DLA) Troop Support, Directorate of Medical Materiel, is the contracting activity. This acquisition is being conducted under the Multiple Award Schedule Program and is being approved as a Limited Source Justification to restrict competition to a single Federal Supply Schedule (FSS) contractor.

2. The action submitted for approval covers the purchase of brand name Innovation

Associates PharmAssist ROBOTx automated medication dispensing system for the BX satellite pharmacy at Shaw AFB.

3. The required pharmacy automation equipment is available on Innovations

Associates Federal Supply Schedule (FSS) contract V797P-4324a which expires May 30, 2012. The total estimated dollar value is $158,027.00.

4. In accordance with FAR 8.405-6(b)(1) and FAR 16.505(b)(2)(ii), 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. The PharmAssist ROBOTx System is an automated medication dispensing system for oral solid medications with linked and computerized quality assurance software. The system is integrated with the Composite Health Care System (CHCS) using digital imagery and bar code technology incorporated into the entire paperless, prescription filling process. The PharmAssist system is the Air Force’s sole pharmacy dispensing system and has successfully completed the certification and accreditation process for information technology security:

DIACAP, Certificate of Networthiness, and Certificate to Operate.

The primary factors in selection of a robotic refill system are:

(1) No cross contamination between medications. Cross contamination of products is a significant patient safety issue and the primary consideration in system selection. The PharmASSIST Robotic Refill System prevents cross contamination between medications, unlike other similar robotic systems.

(2) Availability of the optical original prescription image when checking the refilled prescription. The PharmASSIST Robotic Refill System is one of the only systems on the market capable of synchronizing optical images for two or more pharmacies on a single CHCS host. All systems on the market will synchronize only between their own computer systems. Pharmacies with the PharmASSIST Enterprise (core) System (in place) are unable to synchronize images with another manufacturer’s product. Synchronization provides a significant safety measure verifying accuracy for all prescription fills at various CHCS-hosted pharmacy sites against the original scanned hard copy prescription. Additional safety measures of the PharmASSIST

ROBOTx Dispensing System include utilization of an NDC generic conversion table allowing use with multi-host CHCS systems, and bard code verification before filling the dispensers and an additional safety check with the bare code prior to retrieving the medication for dispensing.

(3) Space requirements for all automated dispensing equipment required in the system. The PharmASSIST ROBOTx Dispensing System has a small footprint that will occupy only a slightly larger area than the currently installed PharmASSIST Enterprise (core) Dispensing System.

(4) Programmable dispensing units that eliminate the need to exchange/ship counting unit component(s). This system is fully programmable on-site to handle all tablet and capsule types and each medication cell is independently controlled, allowing simultaneous counting of different medications. All similar systems require at least some shipping of the dispensing unit’s components when making changes in products. Other systems require shipping for almost all product changes. Medications must be hand counted during the time components are being exchanged. Typically AF pharmacies have a significant number of generic product changes per month. In addition to on-site programming, the cells can be linked to hold the same medication in more than one cell with automatic activation of the second cell for additional prescriptions. The system will always activate the cell containing the largest quantity of medication. This linked cell feature is significant over other applications because it allows the system to hold sufficient quantities of larger tablets/capsules avoiding frequent filling of cells and/or physical damage to products because of weight associated with over-sizing individual cells.

Physical damage to the pharmaceutical products creates waste and can cause inaccurate counting.

(5) Compliance with Air Force Communications Security requirements. Of the available pharmacy automation-type products on the market, PharmASSIST, PYXIS, Omnicell, Audiocare and Solvetech are the only manufacturers that have submitted a request for an AF Communication Agency Certificate of Networthiness. Of these companies, PharmASSIST is the only manufacturer of automated dispensing and robotic refill systems and has successfully completed the certification and accreditation processes for information technology security: DIACAP, Certificate of Networthiness, and Certificate to Operate. Furthermore, the PharmASSIST ROBOTx Dispensing System has several other unique features, essential to the customer, designed to enhance quality, productivity, and customer service. First, the system has internal buffers for holding counted products until a computer controlled release, which allows other items in the queue to be processed out of cycle. Second, the system possesses inventory management capability allowing accurate tracking of product inventory making it possible to manage, maintain, and support a product conversion database for each pharmacy on a possible to manage, maintain, and support a product conversion database for each pharmacy on CHCS host. Next, the system applies the same bar code technology and digital imagery to manual filling of prescriptions that is used for auto filling of prescriptions. This feature ensures unlimited application (all dosage forms as opposed to only solid oral products) to the prescription filling process in a pharmacy, providing maximum mitigation of order entry or product section medication errors.

Medication errors have been cited nationally as significant contributors to hospitalizations and increased physician and emergency room visits creating avoidable significant cost to health care.

Finally, the PharmASSIST ROBOTx Dispensing System is extremely flexible, capable of conforming to both bank teller and assembly line dispensing and is designed for intermediate volume pharmacies. This system will process the majority of the daily refill prescription workload allowing the pharmacy staff more time to appropriately counsel and instruct patients on proper medication usage.

While other vendor’s systems may have some of the above features, only the PharmASSIST ROBOTx Dispensing System encompasses all of the essential features required for the pharmacy at Shaw AFB. The Robotic Refill System to be procured must have these essential features due to the importance of minimizing medication errors (improving the accuracy of the pharmaceutical dispensing process) and more efficiently using the decreasing USAF pharmacy resources.

5. This order represents the best value for the Government. The Veteran’s Administration (VA) has already determined the FSS prices for this system and components to be fair and reasonable pursuant to FAR 8.404(d). The maximum order limitation for this contract is $1,625,000. Although this requirement does not exceeds that threshold, attempts will still be made to seek a price reduction.

The contracting officer has determined that placing this order will represent the best value and will result in the lowest overall cost alternative to meet the Government’s needs.

6. Members of the DoD pharmacy group completed a system-wide reallocation study in August 2000 and made specific recommendations for application of enhanced automation for improving patient safety through reduction of medication errors and improving pharmacy personnel efficiency. Air Force pharmacy took the next logical step and evaluated the existing automation system at various AF pharmacies throughout the United States. The evaluation included all of the major system in the marketplace that had been operation for a significant period of time providing a reasonable comparison, free of initial installation problems associated with most new applications. The determination was made that only Innovation Associates, manufacturers of the PharmASSIST