Sole Source Justification PO.doc

DES Sole Source Filing Justification

Central Purchasing Unit

(For Purchase Requests/Purchase Orders)

DES SOLE SOURCE FILING JUSTIFICATION

Purchase Requests/Purchase Orders NOTE: Every question must be answered or the Sole Source Contract Database (SSCD) will reject the filing.

Please refer to the CPU SharePoint page for Sole Source filing information.

For information on sole source contracts, please review the following Department of Enterprise Services (DES) policy: Policy #DES-140-00, Sole Source Contracts (RCW 39.26.140)

After electronically completing this form, please send to the Central Purchasing Unit.

SECTION 1 – Purchase Request/Purchase Order Information

1.

Administration/Program and Contact Person: BHA/WSH Yvonne LaFrance

2.

Proposed Purchase Date: 12/1/2023 3.

Proposed Delivery Date: 12/1/2023 to 11/30/2024 4.

Vendor Name & Address: UpToDate, Inc., 230 Third Avenue, Waltham, MA 02451 5.

Vendor’s TIN or SSN:

043310941

6.

Purchase Request (PR) Number: PR2329305 and/or Purchase Order (PO) Number (if known):

7.

Purpose of Purchase: To provide access to an online comprehensive diagnosos tool for the clinicians at multiple BHA and DDA facilities (Western State Hospital, Eastern State Hospital, Maple Lane's Oak Cottage, Olympic Heritage, Rainier School, Fircrest School, Lakeland Village, and Yakima Valley School) in the treatment and care of residents and patients. This tool also provides access to an unbiased collection of medical journals and periodicals. This service acts as a substitute for maintaining a medical library and the need to have multiple subscriptions to varioius medical journals.

8.

Funding Source:

Federal:

$0

State:

$50,122.00

Other:

$0

Total:

$50,122.00 SECTION 2 – Ethics Questions

Are any of the Vendor’s staff CURRENT state employees?

YES

FORMCHECKBOX

NO

FORMCHECKBOX

If YES, please provide the following information for EACH current state employee (use a separate sheet of paper, if necessary):

Employee’s Name:

State Agency Where Employed:

Position Title:

Has employee received Ethics Board approval?

YES

FORMCHECKBOX

NO

If Board approval NOT granted, explain why:

Are any of the Vendor’s staff FORMER state employees within two (2) years of the purchase date?

YES

FORMCHECKBOX

NO

FORMCHECKBOX

If YES, please provide the following information for EACH former state employee (use a separate sheet of paper, if necessary):

Employee’s Name:

State Agency Where Last Employed:

Position Title:

Termination Date:

SECTION 3 – Purchase Order Justification Questions

What is the business need or problem that requires this purchase?

This subscription is already in use at Western State Hospital (WSH), Eastern State Hospital (WSH), Maple Lane's Oak Cottage (ML) , Olympic Heritage (OH), and 4 DDA facilities (Rainier School, Firecrest School, Lakeland Village, and Yakima Valley School). These facilities treat patients with a variety of severe psychiatric and medical conditions. The facilities need accurate and timely medical and drug information in order to treat patients safely and effectively. These facilites do not have a medical library or access to medical journals. It is nearly impossible to keep up with the medical literature manually becuase of the enormous volume published monthly. Much of the published literature is considered biased. UpToDate, is an online, updated, nonbiased, physician-authored source of medical information. It summarizes the quality literature into easily searched topics and provides recommendations for clinical decisions. Information is extensive and referenced.

Describe the unique features, qualifications, abilities or expertise of the vendor proposed for this sole source purchase.

More than 20 specialties are covered in depth including more than 10,000 clinical topics. Additionally, there are more than 5,100 drug information entries, 25,00 graphics, and in excess of 100,000 pages of text covering more than 20 medical specialties. UpToDate uses more than 5,100 medically trained authors, editors, and reviewers to search and review over 450 medical journals. UpToDate's experts provide a synopsis for clinicians in the form of concentrated reviews and summations with detailed recommendations and approaches for use in completing their diagnosis. This is unique from any other online medical databases or search engines. More than 25,000 institutions worldwide use UpToDate. To its users, it is a trustworthy site which improves patient care and saves time. Physicians can obtain Continuing Medical Education (CME) credits for using the database. CME is a requirement of licensure. UpToDate has a proven track record of linking directly into the electronic medical records for rapid searcing of medical problems.

3.

What kind of market research did the agency conduct to conclude that alternative sources were inappropriate or unavailable? Provide a narrative description of the agency’s due diligence in determining the basis for the sole source contract, including methods used by the agency to conduct a review of available sources such as researching trade publications, industry newsletters and the internet; contacting similar service providers; and reviewing statewide pricing trends and/or agreements. Include a list of businesses contacted (if you state that no other businesses were contacted, explain why not), date of contact, method of contact (telephone, mail, e-mail, other), and documentation demonstrating an explanation of why those businesses could not or would not, under any circumstances, perform the contract; or an explanation of why the agency has determined that no businesses other than the prospective contractor can perform the contract.

WSH previously consulted with a medical librarian at the University of Washington. The intent was to gain access of the UW subscription for UpToDate. Due to the restrictive nature of the subscription between the UW and UpToDate, the hospitals and DDA facilities are unable to utilized the UW subscription. WSH also previously reviewed two other databases of medication information: Dynamed and Clinical Key. Neither were considered as robust as UpToDate. They were no literature reviews with recommendations for treatment. Clinical Key was considered more of a PubMed-type database (predominantly a collection of already free to access and historical references. Dynamed had approximately 1/5 of the drug information reference in UpToDate and did not have a good drug interaction search tool. In consulting with graduates whom recently completed pharmacy schools and pharmacy residencies, including a resident from the Veterans Administration, all received training on UpToDate. UpToDate has become the standard of care for the industry. They had not seen or used either Dynamed or Clinical Pharmacology. In addition, this web-based subscription is proprietary. See the attached vendor, sole source letter.

4.

Provide a detailed and compelling description of the costs and risks mitigated by purchasing from this vendor (i.e. learning curve, follow-up nature).

When dealing with the medical care of individuals, the best tool is the most familiar tool. The vast majority of medical professionals are familiar with or have been educated using UpToDate. As the medical care to DSHS patients and residents at WSH, ESH, ML, OH, and 4 DDA facilities, is the driving force for this request, the best risk mitigation to any issues involving those patients and residents are the consistency of care. UpToDate is one vital component to that consistency of care. To minimize cost, the vendor is providing an institutional subscription as it will allow staff to have unlimited access without any additional fees. Most medical facilities and institutions have subscriptions to multiple services to ensure widest availability of knowledge. After comprehensive market research, WSH has decided to mitigate cost by accessing only one service which has been the most comprehensive and suitable subscription service available to meet the needs of WSH and the the other facilities currently using the subscription.

5.

Is the agency proposing this sole source vendor because of special circumstances, such as confidential investigations, copyright restrictions, etc.? Yes FORMCHECKBOX

No FORMCHECKBOX

If YES, please describe:

6.

Is the agency proposing this sole source vendor because of unavoidable, critical time delays or issues that prevented the agency from completing this acquisition using a competitive process?

Yes FORMCHECKBOX

If YES, please describe. (For example, if time constraints are applicable, identify when the agency was on notice of the need for the goods and/or service, the entity that imposed the constraints, explain the authority of that entity to impose them, and provide the timelines which work must be accomplished.)

7.

Is the agency proposing this sole source vendor because of a geographic limitation?

Yes FORMCHECKBOX

If YES, state the basis for this conclusion and the rationale for limiting the size of the geographical area selected.

8.

What are the consequences of not having this sole source filing approved? (Describe in detail the impact to the agency and to services it provides if this sole source filing is not approved.)

UpToDate is widely used by physicians, pharmacists, and nurses at WSH, ESH, ML, OH and and 4 DDA facilities. During prior periods, there have been over 12,000 searches accomplished. Topics include (i) over 4,600 drug information related searches, (ii) over 700 neurology related searches, (iii) over 600 psychiatry-related searches and (iv) over 500 endocrine and diabetes-related searches, as well as many more. This subscription includes additional information not available in previous databases and will result in a significant increase in usage. The medical, pharmacy, and nursing staff will continue to care for patients and residents. But without a proven and reliable source of accurate and timely medical information, the delay could lead to slower treatment times, less accurate care and possible reliance and outdated practices which would not be in the best interest of our patients and residents. Ultimately, denial of this service has the potential to open DSHS and its clinicians to possible incorrect drug dosages, and general errors that could have been prevented with the use of the UpToDate product, as a double check to clinician's knowledge base. As the medical field is rapidly changing, information is the most powerful tool for medical professionals. UpToDate is the most widely used and most practicable product for DSHS on the market. These DSHS facililites have maximized the use of the tool to ensure the best care is provided. Pharmacists, nurses and medical staff have used UpToDate for more than 32 years.

9.

What considerations were given to providing opportunities to this vendor or other small business (e.g., unbundling the goods and/or services acquired)?

None, this service is such that the collection of data and the synthesis of the data require a large collaborative research body. No small business would be able to maintain the communication network required to provide the quality of work accessed through UpToDate.

10.

Since competition was not used as the means for procurement, how did the agency conclude that the costs, fees, or rates negotiated are fair and reasonable? (Please make comparison with comparable vendors, use the results of a market survey, or employ other appropriate means calculated to make such a determination.)

Comparing the price with other services is not an accurate comparison as other services do not provide an all-inclusive subscription. WSH and the participating facilities are confident this subscription is in the best interest of DSHS, and the State. WSH and the participating facilities are receiving substantial cost savings under the institutional subscription option offered by the vendor as referred to in question #4 earlier SECTION 4 – Processing (to be completed by the Central Purchasing Unit)

1. Is this purchase exempt from Sole Source Filing?

Yes

The following exemption applies: ___________________________ This purchase order does not need to be filed as a sole source.

Completed by:

Date:

No This purchase order must be filed as a sole source purchase.

Completed by:

Date:

WEBS Notice:

Posted on _______________________ DSHS CCLS Website:

Posted on _______________________ SSCD Filing:

Filed on _________________________

Last Updated: 03/2022