S02_DSS VISTA _JA_Redacted.pdf

DSS VistA Integrated LiveData PeriOp Manager Maintenance CONTROL NUMBER VA-25-00093205

JUSTIFICATION

FOR AN EXCEPTION TO FAIR OPPORTUNITY

1. Contracting Activity: Department of Veterans Affairs (VA) Technology Acquisition Center 23 Christopher Way

Eatontown, NJ 07724

2. Description of Action: This proposed action is for a firm-fixed price Delivery Order (DO) issued under the National Aeronautics and Space Administration (NASA) Solutions for Enterprise-Wide Procurement (SEWP) V Government-Wide Acquisition Contract (GWAC) for the maintenance and support of the 16 existing, VA owned, brand name Document Storage System (DSS) Veterans Health Information Systems and Technology Architecture (VistA) Integrated LiveData Perioperative (PeriOp) Manager subscriptions.

3. Description of the Supplies or Services: The Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Veterans Integrated Service Network 10, Cleveland VA Medical Center (VAMC) Surgical Department has a requirement for the maintenance, technical support, project management, training and consulting services for the 16 existing, VA owned perpetual license, brand name DSS VistA Integrated LiveData PeriOp Manager subscriptions for surgical suites. The PeriOp system acts as an operating room (OR) scheduler, a usage and staff analyzer, and a board display system for procedure tracking which are integrated with VistA/Computerized Patient Record System (CPRS) for patient procedures. DSS VistA Integrated LiveData PeriOp Manager is a software service that integrates patient data in real-time. This data is then used by critical care team members and clinical staff to assist in tracking, managing, and improving surgical performance pertaining to patient safety, surgical throughput, utilization and efficiency, and surgical quality of care. The proposed action is to procure DSS VistA Integrated LiveData PeriOp Manager maintenance and support for 16 existing software systems/licenses that are configured through the Cleveland VAMC Operating Rooms, Outpatient Surgical Center, and associated waiting rooms. The DSS VistA Integrated LiveData PeriOp Manager includes multiple modules that assist in fulfilling the following key dimensions: 1) PreOP Board, a dynamic digital checklist of patient preparation for surgery; 2) OR Dashboard with Active Time Out, integrates patient data from CPRS and VistA, Anesthesia Information System, and monitoring devices with automated surgical workflow for display on wall-mounted screens in the OR; 3) OR-Schedule Board, a dynamic, real-time view of the day’s surgical caseload on wall-mounted screens throughout the perioperative suite, staff lounges, Surgical Processing Service, and desktop computers connected to secure hospital networks; 4) Family Waiting Board, displays Health Insurance Portability and Accountability Act-compliant patient status information to authorized family members; and 5) Analytics, allows the Cleveland VAMC to better track data in real time. DSS training includes on-site or remote training to nurse managers and Chief of Surgery, educating them on new enhancements in the Analytics package. The maintenance and support includes bug fixes, minor release upgrades, and telephone support Monday through Friday, 8:00 AM to 7:00 PM Eastern Time. Further, the DSS PeriOp annual premium maintenance and technical support services shall include 24x7x365 support and two trips to each facility to ensure the system remains fully operational.

The period of performance shall be a 12-month base period, with two 12-month option periods. The total estimated value of the proposed action is inclusive of options.

4. Statutory Authority: 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 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 market research, as described in Section 8 of this justification, it has been determined that limited competition is available among authorized resellers of the required brand name DSS VistA Integrated LiveData PeriOp Manager maintenance and support services. Only DSS brand name subscriptions, including training and maintenance support, meet all of the VA’s requirements, specifically compatibility and interoperability with VA’s existing infrastructure integrated with VistA and CPRS. No source other than DSS and 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 the DSS VistA integrated LiveData PeriOp Manager as currently deployed.

Currently, the Cleveland VAMC has 16 DSS VistA Integrated software systems deployed throughout the main campus and satellite clinics. Based on previous acquisition history, VA estimates that to replace the underlying system would cost an estimated This estimate includes system procurement to include both hardware and licensing, full deployment and configuration within clinical and surgical environments, integration with VistA and existing workflows, integration with other supporting platforms including medical equipment and monitoring systems, ongoing software maintenance, technical support, training, onboarding, change management, and project management resources throughout the implementation lifecycle. The current DSS VistA Integrated LiveData PeriOp Manager system is fully integrated into the Cleveland VAMC perioperative workflows and has been critical to supporting real-time surgical scheduling, patient tracking, and care coordination across surgical teams.

These duplicated costs are unlikely to be recovered through competition. Additionally, any such replacement would also require extensive development effort to fully integrate with VA systems (VistA/CPRS). Specifically, this development effort would include installation, configuration and integration services. VA estimates that this effort would take over two years to accomplish, during which time VA would also need to maintain its existing DSS VistA Integrated LiveData PeriOp Manager. This estimate of time is based on previous acquisitions of similar size and scope.

DSS VistA Integrated LiveData PeriOp Manager is currently the only brand of surgical workflow management software that can specifically integrate with VistA and CPRS.

DSS software provides direct, bi-directional, real-time updates directly to the medical record allowing real-time processing, tracking and management of clinical/surgical consults. Due to the proprietary nature of the data and source code, only DSS or an authorized reseller is qualified to provide the necessary maintenance service. DSS also provides direct support for VA’s Consult Toolbox options. DSS uses up-to-date web technology to fully automate manual processes and address pivotal pain points within the VA concerning proper closure of clinical/surgical consults. Due to real-time integration with VistA, CPRS, and Oracle, DSS enables instant visibility into scheduled appointments and provides tools to ensure proper linkage between the clinical/surgical consult and scheduled appointment to consume live updates instantly. DSS provides real-time work cues to clinicians as well as Advanced Medical Support Assistants responsible for scheduling. Utilizing real-time data ensures accurate scheduling, prevents conflicts and optimizes VA Surgical Wait Times. Only DSS has the access required to fully integrate with VistA, CPRS, and Oracle. DSS is the only system that is compatible with the existing VistA platform and is compatible with Oracle.

The information provided by the DSS VistA Integrated LiveData PeriOp Manager is crucial for both patient families and VA employees. This system allows the families of Veterans to receive timely updates regarding the status and progression of surgical procedures. For VA employees, the system facilitates efficient communication and coordination during and after surgical procedures, thereby supporting patient care and operation effectiveness. An inability to procure the required DSS software support would directly and adversely impact Veteran patient care, posing risk to Veteran safety and surgical outcomes. Additionally, without DSS or its authorized resellers monitoring and maintaining the system, the Government would be vulnerable should application errors occur. Errors in the application can affect the scheduling of Veterans' procedures, causing delays or double-bookings in OR rooms, which negatively impacts patient outcomes and public trust in VA to provide timely, complete care to its Veterans.

Environmental Management Services might not get the correct alerts to clean newly vacated ORs quickly and promptly, resulting in a backlog of cases. Additionally, staff will also be impacted should the application fail or cause scheduling errors and DSS is not able to troubleshoot and correct the issue. Staff may be assigned incorrectly based on incorrect inputs. Only DSS or authorized resellers can provide the necessary software maintenance and support because of the proprietary source code required to develop and implement software updates. This code is also needed to ensure all services provided are properly configured. Therefore, this continued maintenance and support is required to maintain the integrity and security of the existing VA owned brand name DSS VistA Integrated LiveData PeriOp Manager system.

Failure to procure the needed brand name DSS VistA Integrated LiveData PeriOp Manager maintenance and support would have a negative effect on VA's healthcare operations at the Cleveland VAMC, which overall affects the Veterans that the Cleveland VAMC is providing care for on a daily basis.

6. Efforts to Obtain Competition: Market research was conducted, details of which are in Section 8 of this justification. This effort did not yield any additional sources that can meet the Government’s requirements. However, the undersigned VA technical representative determined that limited competition is available among authorized resellers for brand name DSS VistA Integrated PeriOp Live Data Manager maintenance and 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: In order to remove or overcome barriers to competition in future acquisitions for this requirement, 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: Market research efforts were conducted by VA subject matter experts from July through September 2025. VA’s technical experts conducted market research by reviewing other similar software maintenance and support services, which included CoreyPeriop and Perioptimization.

Based on all of the market research conducted during 2025, the Government’s technical experts determined that none of the other providers, such as CoreyPeriOp and Perioptimization, could provide the software maintenance and support for the currently fielded PeriOp system. Access to DSS's proprietary data and source code is required to provide the required software maintenance and support on the currently fielded software. Access to this code is required to ensure all the services provided to the software are properly configured. No source other than DSS and its authorized resellers have access to the proprietary data and source code necessary to provide the required maintenance and support for the DSS Live Data PeriOp system as currently deployed.

As such, the Government's technical experts determined that only the brand name DSS Live Data PeriOp maintenance and support can meet all of VA's needs.

Additional market research was conducted in July 2025 utilizing the NASA SEWP V GWAC Provider Lookup tool to determine whether the brand name DSS VistA Integrated LiveData PeriOp Manager products and support services are available from NASA SEWP V GWAC holders. It was determined that there are two authorized resellers of the brand name DSS VistA Integrated LiveData PeriOp Manager maintenance and support services that hold current GWACs. The results found one Service-Disabled Veteran-Owned Small Business, and one Historically Underutilized Business Zone (HUBZone)/Woman-Owned Small Business (WOSB), both of which are Authorized Resellers. Therefore, limited competition is anticipated.

9. Other Facts: None.

10. 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.

11. 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 limited competition. Additionally, NASA SEWP V GWAC has already determined the prices on contract to be fair and reasonable and more competitive pricing may result from competition. Finally, the successful quote will be compared to the Independent Government Cost Estimate.

12. Contracting Officer Certification/Approval 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 brand name DSS Vista Integrated LiveData PeriOp Manager maintenance and support 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.