JEFO_CHPL.pdf

Justification for an Exception to Fair Opportunity

1. Identification of the agency and contracting activity.

a. Federal agency and contracting activity. HHS. Program Support Center

b. Sponsoring organization. Office of the National Coordinator (ONC), Office of Certification and Testing

c. Project Officer Information.

Project Officer Name. Scott Purnell-Saunders

Mailing address. 330 C Street SW, Washington DC, 20201

E-mail address. Scott.purnell-saunders@hhs.gov

Telephone number. (202) 720-2907

2. Nature and/or description of the action being approved.

a. Acquisition purpose and objectives.

The overall purpose of the ONC programs is to facilitate and expand the secure, electronic movement and use of health information among organizations according to nationally recognized standards. The purpose of ONC’s Certification Program as mandated by the HITECH Act is to establish and execute a process for certifying health information technology (HIT), including Electronic Health Records (EHRs) that can be purchased by providers to help them become meaningful users and eligible for incentives offered by CMS. The testing of HIT products will be conducted against the criteria and standards adopted by the Secretary as described in the ONC Final Rule for Standards, Implementation Specifications, and Certification Criteria. All certified products will then be posted on the Certified Health IT Product List (CHPL) .

The purpose of this acquisition is to provide continued support for the development and maintenance of the CHPL. The ONC CHPL is an online production system which operates 24 hours a day 365 days a year and is the official source for all Certified EHR Technology under the ONC HIT Certification Program. The CHPL provides the authoritative, comprehensive listing of Complete EHRs and EHR modules that have been tested and certified under the ONC EHR Certification Program. This system is relied upon by the Centers for Medicare and Medicaid Services as an integral part of their EHR Incentive program as well as all 50 states who utilize the ONC CHPL for State EHR incentive programs.

This request is to sole source the contract to Deloitte for the continued development and upgrades to the CHPL needed to support the full implementation of the ONC HIT Certification program which begins in January 2014.

b. Project background. The ONC CHPL was initially designed and built in 2010. The ONC Certified HIT Product List (CHPL) is the sole authoritative and comprehensive listing of Complete EHRs and EHR Modules that have been tested and certified under the ONC Temporary Certification Program and the ONC HIT Certification Program.

The ONC CHPL is an online production system which operates 24 hours a day 365 days a year. This system is relied upon by the Centers for Medicare and Medicaid Services as an integral part of their Electronic Health Record (EHR) Incentive program as well as all 50 states who utilize the ONC CHPL for State EHR incentive programs. The ONC CHPL is the resource and vehicle by which the CMS EHR Certification ID is generated and provided to participants for attestation under the EHR Meaningful Use incentive programs.

Deloitte Consulting, LLP was awarded contract number HHSP23320095633WC/HHSP23337009T to manage and maintain the CHPL through a competitive process in 2011. The contract was awarded with a Period of Performance from September 30, 2011 through March 29, 2013.

This period was then extended through September 30, 2013, with an increase of $209,935.53 to the contract amount. The total obligated amount on the contract is $643,721.77.

3. Description of the supplies or services required to meet the agency’s needs (including the estimated value).

a. Project title. Certified Health IT Product List (CHPL) Development

b. Project Description

This project is in support of continued CHPL development which will enable ONC to continue to build and maintain the software including code development, programming support, and bug fixes. Web page re-design, configuration, and customization, and user interface design and development with usability testing are some of the additional features that this contract will support. Some other requirements for this contract will be as follows:

The development of mobile platform(s) to serve as alternate means of interaction with CHPL data;

Develop a more robust Quality Assurance process to ensure the current and future integrity of the ONC CHPL platform;

Development of a data repository of historical data to be used to store data from the 2011 Certification Program;

Improvement of current data access to allow for more customized reporting for internal and external stakeholders; and

Training and user support to ONC and other stakeholder users, such as CMS, Regional Extension Centers (RECs), States, etc., including documentation and inquiry support as necessary.

Requirement type.

Research & development (R&D) R & D support services

Support services (non-R&D)

Supplies/equipment

Information technology (IT)

Construction

Architect-engineer (A & E) services

Design-build

Other (specify): ____________________

Type of action.

New requirement Follow-on

Other (specify): ______________________

Proposed contract/order type.

Firm-fixed-price Other fixed-price (specify, e.g., fixed-price award-fee, fixed-price incentive-fee): __________ Cost-plus-fixed-fee Other cost reimbursement (specify, e.g., cost-plus-award-fee, cost-plus-incentive-fee): ___________ Time and materials Indefinite delivery (specify whether indefinite quantity, definite quantity, or requirements): ___________

Other (specify): ___________

Completion Form Term form

Acquisition identification number. Requisition OS115587 commits $613,012 for the base period of performance.

c. Total estimated dollar value and performance/delivery period.

The period of performance will be from September 30, 2013 through September 29, 2014, with three one-year options beginning September 30, 2014 and ending September 29, 2017. The estimated dollar value of this acquisition (base + 3 option years) is $2,638,786.74.

4. Identification of the exception to fair opportunity (see 16.505(b)(2)) and the supporting rationale, including a demonstration that the proposed contractor’s unique qualifications or the nature of the acquisition requires use of the exception cited. If the contracting officer uses the logical follow-on exception, the rationale shall describe why the relationship between the initial order and the follow-on is logical (e.g., in terms of scope, period of performance, or value).

(A) The agency need for the supplies or services is so urgent that providing a fair opportunity would result in unacceptable delays.

(B) 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.

(C) The order must be issued on a sole-source basis in the interest of economy and efficiency because it is a logical follow-on to an order already issued under the contract, provided that all awardees were given a fair opportunity to be considered for the original order.

See Item 6 below for the supporting rationale.

(D) It is necessary to place an order to satisfy a minimum guarantee.

(E) For orders exceeding the simplified acquisition threshold, a statute expressly authorizes or requires that the purchase be made from a specified source.

5. Determination by the Contracting Officer that the anticipated cost to the

Government will be fair and reasonable.

Award of a time-and-material task order is planned. Certified cost and pricing data will be obtained. A technical and cost analysis will be performed to ensure the proposed labor and material are necessary for contract performance and the proposed price is fair and reasonable. The cost analysis of the loaded labor rates will ensure base labor rates do not exceed ceilings in the base contract.

The cost analysis will also ensure proposed indirect cost rates are in accordance with the contractor’s most recent indirect cost rate agreement and do not exceed ceilings in the base contract.

6. Any other facts supporting the justification.

The transitioning of contractors during this last contract award took an estimated 8 months to complete. This period allowed the new system to be designed and built while the old system remained operational to ensure the proper functioning https://www.acquisition.gov/far/current/html/Subpart%2016_5.html#wp1095799 of all depended ONC programs. This transition resulted in a major setback to the certification program at an additional cost to the government with the two systems being simultaneously operational. Funds that were allocated for planned development were expended for the transition of the systems. We estimate the value of the lost development to be approximately $300,000.00.

At this time the Office of Certification (OCert) anticipates that a transition to another contractor would result in a similar delay as described above, due to the current program development activities which are underway. Currently the CHPL is being redesigned, upgraded and improved to support the additional requirements required by regulation (45 CFR part. 170) to support the 2014 Edition EHR Certification program. An economic impact analysis that was conducted prior to development of the CHPL projected a maximum development of 150 EHR products causing ONC to build a system that can accommodate approximately twice that number. The current product count in support of the 2011 and 2014 ONC certification programs is 3456 which is approximately 23 times more than anticipated. The impacts of a delay at this time in comparison would be much greater given the relative size and complexity of the system as it exists today.

In looking at the magnitude of potential impacts to other HHS stakeholders, more than $9.3 billion in Medicare EHR Incentive Program payments have been made between May 2011 and June 2013, and more than $5.8 billion in Medicaid EHR Incentive Program payments have been made between January 2011 (when the first set of states launched their programs) and June 2013. More than 405,000 eligible professionals, eligible hospitals, and critical access hospitals are actively registered in the Medicare and Medicaid EHR Incentive Programs as of June 2013 and more than 269,000 eligible professionals have registered for the Medicare EHR Incentive Program as of June 2013.

ONC is not capable of absorbing any setbacks at this critical point as preparations are being made to start the new Certification Program in January 2014. The potential impact of any delays on the program in this stage will affect federal stakeholders as well as all external stakeholders who are dependent on the resources provided by this database.

7. Statement of the actions, if any, the agency may take to remove or overcome any barriers that led to the exception to fair opportunity before any subsequent acquisition for the supplies or services is made.

The ONC CHPL is a vital tool in the ONC Health Information Technology (ONC- HIT) Program. This system is relied upon by the Centers of Medicare and Medicaid Services as an integral part of their Electronic Health Record (EHR) Incentive program as well as stakeholders across all 50 states as a resource for their respective incentive programs. The need for the CHPL will continue due to the reliance from CMS as well as the state stakeholders for resources to support their programs. Systems developed by CMS and the states validate against the CHPL for information required for their incentive programs. That validation is done automatically and occurs 24 hours a day.

During the transition to the current contract, resources intended for development of the new system were expended on unplanned system transition. The system that was developed as a result does not have all the planned stability features.

We intend to complete the development of those features that cannot be accommodated in the current contract, with this new acquisition. This will enable us to have a system that is very stable and functioning without constant major upgrades. With this intended established infrastructure at the end of this new acquisition, future transitions of the system can be done quickly. As a result of the new development of features and increased stability, ONC should not experience any further delay or increased cost that would necessitate this needing to be sole sourced in the future. ONC would then be able to acquire the same type of development services at that point through a competitive process.