VHA Bi-Directional Imaging Exchange RFI.docx

SUBJECT*

RFI - Veterans Health Administration Enterprise Bi-Directional Image and Report Exchange System

Request For Information (RFI) Request For Information (RFI)

DESCRIPTION

RFI: 36C10B26Q0076

RFI: 36C10X24Q0024

Department of Veterans Affairs (VA) Veterans Health Administration (VHA) Request for Information (RFI)

I. INTRODUCTION:

This RFI is issued by the Department of Veterans Affairs (VA), Technology Acquisition Center (TAC), for information and planning purposes only and does not constitute a solicitation no does it restrict the Government as to the ultimate acquisition approach. In accordance with Federal Acquisition Regulation (FAR) 15.201(e), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract.

Pursuant to FAR Part 10.002(b)(2)(iii) and (viii) (Market Research), the purpose of this RFI is to understand industry capabilities related to national enterprise imaging systems and to collect information to enable further development of a future acquisition strategy to include socio-economic consideration and methods.

Any information received from a contractor in response to this RFI may be used in creating a solicitation. Any information received which is marked with a statement, such as “proprietary” or “confidential,” intended to restrict distribution will not be distributed outside of the Government, except as required by law.

The Government is not responsible for any cost incurred by industry in furnishing this information. All costs associated with responding to this RFI will be solely at the interested vendor's expense. Not responding to this RFI does not preclude participation in any future Request for Proposal (RFP), if any is issued. Any information submitted by respondents to this RFI is strictly voluntary. All submissions will become Government property and will not be returned. Interested vendors are responsible for adequately marking proprietary, restricted or competition sensitive information contained in their response.

II. RFI RESPONSE INSTRUCTIONS

NOTE: The capability package must be clear, concise, and complete. VA is not under any obligation to provide feedback to the company, or to contact the company for clarification of any information submitted in response to this RFI.

RFI responses must include:

A. Company Information:

1. Company Name;

2. Company Address;

3. Point of contact name;

4. Telephone number

5. Email address

6. CAGE/SAM UEI under which the company is registered in the System for Award Management (SAM).

7. Small Business Administration (SBA) VetCert certification (if applicable).

B. Brief summary describing your company’s technical approach to meeting the requirements, to include:

1. List any previous or existing contracts you have with the VA where similar work was performed to this requirement. Also, is there an existing contract vehicle you recommend be used for this procurement?

1. Responses to questions 1 – 34 and contractor business questions 1-7.

1. If your company is a Small Business, also include the following:

2. The intent and ability to meet set-aside requirements for performance of this effort.

2. Information as to proposed team members, the percentage of work each is to perform, and which PD requirements would be subcontracted.

Responses to this RFI shall be submitted electronically by 10:00 AM EST, December 18, 2025 via email to the Technology Acquisition Center (TAC) point of contacts Contract Specialists, Chanté Frith, Chante.Frith@va.gov, Laura Startek, Laura.Startek@va.gov and Contracting Officer, Matthew Truex, Matthew.Truex1@va.gov. Please note “Response to RFI – Veterans Health Administration Enterprise Bi-Directional Image and Report Exchange System” in the subject line of your response. The email file size shall not exceed 5 MB.

Questions and Answers (Q&A) cut-off date: December 5, 2025 by 12:00 PM (Noon) ET

WARNING: Please do not wait until the last minute to submit your responses! To avoid submission of late responses, we recommend the transmission of your response file 24 hours prior to the required response due date and time. Please be advised that timeliness is determined by the date and time an Offeror’s response is received by the Government not when an Offeror attempted transmission. Offerors are encouraged to review and ensure that sufficient bandwidth is available on their end of the transmission.

An Industry Day may be planned at a later date regarding this requirement.

Please direct any questions to:

Contract Specialist: Chanté Frith, Chante.Frith@va.gov

Contract Specialist: Laura Startek, Laura.Startek@va.gov

Contracting Officer: Matthew Truex, Matthew.Truex1@va.gov

All responsible sources may submit a response in accordance with the following:

All proprietary/company confidential material shall be clearly marked on every page that contains such.

Please keep your response to no more than 30 pages. Responses should be submitted as either a Microsoft Word (.docx) or an Acrobat (PDF) format with Arial or Times New Roman font, 12 pt. minimum that addresses all information. Tables and illustrations may use a reduced font size not less than 8-point and may be landscape. Interested parties should exclude marketing material in order to allow sufficient space for adequately, directly, and substantively responding with the information of most interest to the Government. NO MARKETING MATERIALS ARE ALLOWED AS PART OF THIS RFI.

III. REQUIREMENT DESCRIPTION:

This RFI is issued for the purpose of collecting information about the ability of a vendor to meet the requirements for design and implementation of a multi-VISN Bi-Directional Image Exchange program with integration between VHA and outside community-based partners.

The implementation of the Mission Act and the PACT Act has resulted in greater numbers Veterans eligible for VA care and greater numbers of Veterans obtaining imaging studies outside of VA, many of whom continue to receive clinical care within VA. The goal of the VA is to manage all clinically relevant medical imaging, whether performed on-site at a VA medical center or in the community. Effective care coordination depends upon timely access to medical images and reports. VA requires an efficient and cost-effective electronic image location, viewing, and transfer solution that will allow its facilities to bidirectionally share images with their community care partners, thereby eliminating or greatly reducing the need for use of transportable media for transfer of images and reports.

VA seeks to establish, in partnership with an established commercial vendor, an enterprise system that will provide state of the art technology for automated transfer and tracking of community care imaging as well as the development and iterative expansion of a community care network for image and report sharing for all VA medical facilities encompassing all sites of care. Through this system, VA seeks to establish a standard requirement and workflow for community care partners to interact with VA for bi-directional image and report sharing.

Estimated annual volume of imaging may exceed 2 million studies

Important features for the enterprise Bi-Directional Image and Report Exchange System will include, but are not limited to:

· Integration with all current and future VHA EHR.

· Integration with current and future Integrated Veteran Care referral systems (i.e. Health Share Referral Manager, HSRM) for automated outbound transfer.

· Integrate with all existing and future Commercial PACS, VistA Imaging, Computerized Patient Record System (“CPRS”), Compass DICOM router or any other DICOM router provisioned by the VA.

· Universal availability for bidirectional exchange of images and reports with VA Medical Centers, DoD and community (non-VHA) partners.

· Ability to exchange all types of DICOM compatible images along with associated HL-7 data reports maintaining native file types. This includes, but is not limited to all radiology, nuclear medicine, cardiology, dental, retinal, radiation oncology examinations and reports.

VHA is currently surveying industry to identify potential vendors who would be capable of providing VHA with the best image sharing solution that incorporates at a minimum the following preliminary features:

· On-demand access to images and reports across the entire exchange network.

· A highly functional image and report sharing network that includes VA Medical Centers and non-VA Medical Centers and standalone imaging facilities.

· Ability to request images and reports from community partners within the application and from EHR scheduling messages.

· System should include a fully functional HL7 system for inbound and outbound message normalization.

· System will function and interconnect with existing community partner competing image and report exchange systems.

· A single zero footprint user interface for all system roles.

· Advanced Artificial Intelligence (AI) supports imaging order awareness, patient identification, bidirectional image routing, and record reconciliation.

· Ad hoc query retrieve capability with and from VISTA Imaging, all VHA PACS, and DoD PACS systems.

· Innovative functionality for research data to be securely collected and distributed.

· All connection work efforts will be completed by the vendor on behalf of VHA.

· 80 percent of connections for the community partner exchange network must be completed in 6 months.

· System must be capable of bi-directional exchange of DICOM and HL7 data for Radiology, Nuclear Medicine, Echocardiography, EKG, Cardiac Catheterization, Electrophysiology, Ophthalmology, Dental and Pathology Whole Slide Imaging.

· The system will integrate into VHA systems that manage community care referrals. Integration will enable these systems to transfer images and reports in accordance with standard business rules to and from community partners in a seamless manner. This integration may require the use of HL7, FHIR and custom coding. Vendor should be ready to demonstrate any existing integration work they have done at customer locations.

· The system shall maintain the status of all exchanges in real time and notify VHA when a community referral has been completed.

· The system will maintain a user accessible log of all images and reports that comply with VHA requirements for notice of disclosure.

· A complete analytics portal that will display exchange volumes and system utilization. The system will provide standard utilization reports for each individual medical center and for their associated community partners.

· Utilizes a persistent send feature so DICOM is not lost during transmission.

· Broadcast queries to the community to locate VA patients’ prior images in the private sector.

· Secure DICOM gateway by way of FIPS 140-2 validated connection with VA TIC.

· Automation solutions such as Automated Federated Search, Patient Matching, Automated Internal Pre-fetch, and Electronic Requests.

· Ability to import images and reports from physical media and various file types (i.e. – CD/DVD, pdf, paper, fax).

· Automated internal prefetch routes data internally using trigger events to ensure data is available where clinicians need it, for example, automated routing to a private sector facility should a Veteran’s care continue there. For example, procedure code mappings and advanced routing rules.

· Audit logs for all studies shared and imported.

GENERAL REQUIREMENTS

VHA Bi-Directional Image Exchange System is envisioned (subject to change) to conform to the following major characteristics which will be described in detail in any potential subsequent solicitation:

1. Full security auditing and automated archiving of audit trails, with notification capabilities.

2. If not a 100% SaaS solution, system must be joined to the VA.gov domain.

3. Access control must be conformant with VA’s Least Privileges policy; specifically, roles and worklists should be designed in support of this; system must be able to separate radiology and cardiology worklists by site, VISN, and NTP to support least privilege access.

4. Both EDIPI and SSN must be supported for patient identification. The system must be able to normalize SSN to EDIPI.

5. System must support section 508 accessibility.

6. Vendor must provide 24x7x365 technical support with off-hours escalation to senior level support within 15 minutes of initial call.

7. Vendor must provide an ongoing commitment to VHA for continuous product development and enhancement to ensure that the system remains on the latest commercially available version. This may include the development of additional client functionality to meet VA needs.

8. Remote support will be provided via VA site-to-site VPN with accompanying VA mandated annual information security and privacy training along with background investigations. Vendor and all subcontractors must agree to comply with all applicable VA security requirements.

9. Vendor will be responsible for all OS patching, AV updates, and vulnerability remediation in accordance with published VA and DHS timelines, and application updates/upgrades to meet VA security requirements. Windows OS patches are available via an internal WSUS repository. Linux servers must also be patched and can be managed through the VA RHEL satellite server provided the Linux servers meet the VA baseline. If Linux-based and not configured in accordance with VA baseline, vendor will be responsible for managing updates independent of the VA satellite server.

10. Software maintenance for the system and associated components to include updates and upgrades and all requisite security maintenance to remain in compliance with NIST, FISMA, and VA security standards will be provided and installed by the vendor.

ARCHITECTURE

1. The overall system architecture shall be deployed in one of three cloud hosted configurations to achieve optimal display, redundancy, and contingency operations to achieve 99.99% uptime performance:

· 100% SaaS in a FedRAMP certified high environment.

· VA Enterprise Cloud (VAEC) deployed across two regions.

· Hybrid cloud VAEC (core system) with on-prem deployment in VA enterprise data centers.

2. The overall system design shall have redundancy and fault tolerance for components to eliminate single points of failure as the Information Exchange System is a mission/life critical application that is required to be online 24x7x365.

3. System will be designed to optimally utilize bandwidth across the VA WAN and to/from the cloud-based components.

4. System will be configured for optimal functionality across the WAN to unlimited number of end users.

5. All components will be deployed in accordance with applicable VA information security requirements.

6. For sites that utilize Oracle Health as their EMR, the system will be able to uniquely identify the patient via both EDIPI and SSN. The application will utilize an MPI such that a query from an end user will correctly utilize the appropriate patient ID parameters in the query to successfully execute the Q/R. That patient will appear as a single instance within the system and reports will be issued to the originating site utilizing the site’s native patient ID parameters.

7. Integrated Artificial Intelligence.

8. Mechanism for multi-specialty conferences and tumor boards. This must include collaboration and annotation tools and multi-party screen control.

9. System must accept and auto-reconcile studies from DoD. System must maintain DoD studies in an administrative area that excludes general access until that patient is eligible for VA care.

10. System must be able to electronically exchange studies with DoD, fee basis partners and other outside entities VHA chooses.

IV. RFI QUESTIONS:

1. Is your system authorized to operate in the VA enterprise cloud? Are you FedRAMP high certified? Do you have any deployments hosted in a FedRAMP high certified data center?

2. What is your current market share for deployments of multi-hospital systems over 5 million annual exams/studies?

3. What is the current yearly volume of your largest deployment? What is your 2nd largest?

4. List your company’s five largest customers. For each customer, please include the following:

a. Number of studies/volumes per customer.

b. Number of users per customer.

5. Has your company ever participated in a consortium of consultants, imaging, IT and EHR vendors that delivered large regional and or national level systems? If yes, describe the project and vendors involved. Was your company the prime contractor?

6. List hardware and OS requirements for all end user clinical workstations across the various clinical specialties.

7. Describe AI or advanced functionality of the system to drive the information exchange and reconciliation processes.

8. Describe prefetching of imaging and reports from Archives and Electronic Health Records with varied procedure name syntax and available AI functionality that supports this.

9. Describe how AI can or has been integrated with your system to optimize workflow management, system study routing, work prioritization, patient safety and demographic information verification, system administration, and research.

10. How many installations do you currently have that support Single-Sign On (SSO) or LDAP via CAC/PIV? What is the largest number of user accounts currently supported at a customer base?

11. Describe your capital and operation sales models. How does your company manage and bill ongoing support? VA expects support to be managed through a single party.

12. Describe how your system tracks examinations referred to the community and expedites retrieval once completed. Describe the process to ensure that images and reports are matched and returned simultaneously.

13. A 24/7/365 help desk, technical support and system monitoring of critical servers and services is required to ensure 99.99% uptime. How is this accomplished? Is the system status data periodically transmitted back to the vendor? What data is in the message? Note that the message cannot include patient identifiers.

14. Describe all tools available for monitoring and notifying via electronic means when there are system failures with image ingest.

15. List all file formats your system can ingest, store and display.

16. Describe how your company can import PDF documents from remote systems outside of DICOM.

17. Describe how your system handles electronic exchange of images and reports to systems outside of VA.

18. What is the minimum and recommended bandwidth for LAN and WAN end to end?

19. All system software updates, and full version upgrades and professional services shall be included and provided by the vendor at no additional cost for the duration of any contract. In addition, all hardware upgrades associated with an update/upgrade will be solely the responsibility of the vendor. If the vendor takes exception to the above, please explain in your response.

a. How are upgrades handled? What are the steps?

20. Provide a DICOM conformance statement.

21. What specific technical capabilities best position your company for success with such a large, complex deployment?

22. What are your company’s strategic development plans for your technology?

23. Please provide a high-level contracting plan to include all subcontractors.

24. Please provide a high-level timeline for implementation.

25. Please provide a high-level workflow and network topology.

26. What additional information will you need from VHA to create a system design and subsequent formal RFP response?

27. Detail end user training delivery methods.

28. Describe how administrative and end user training is delivered.

29. Describe what a VHA ongoing support and administration team would look like. FTE projections are expected.

30. All study exceptions should be presented in an administrative graphical user interface by site and specialty. Describe how your company manages this process so responsibility can be shared across a system administration team.

31. Describe how your company can maintain and administer the entire system using a managed service model.

32. Describe your solution’s capability with HL7 FHIR standards and any advanced interoperability protocols that will ensure seamless integration with the federal EHR and community partners.

33. Detail the security measures and data privacy safeguards your system uses to protect patient information across multi-site and multi-modality exchanges.

34. Are there additional features and functionality not mentioned in this RFI, that your company feels are essential for a multi-VISN, consolidated National Imaging and Report Exchange System?

Contractor Business Questions:

1. What contract vehicle do you recommend for this requirement?

2. What pricing structure do you recommend?

3. Does your organization have an existing GSA, or other Federal schedule available for this type of requirement?

4. What NAICS codes would your company recommend for this action?

5. What key questions do you need to see answered in a future PWS/SOW before you decide to respond to the solicitation?

6. In what format and what kind of supporting documents would be most helpful to include as exhibits in a future PWS/SOW?

7. What do you foresee as the biggest risks in performing the tasks in the draft documentation to meet VA requirements?

RFI: 36C10B26Q0076