Vue PACS MSC JA_Final_Redacted.pdf

Vue PACS Managed Services VA-23-00067705

JUSTIFICATION

FOR AN EXCEPTION TO FAIR OPPORTUNITY

1. Contracting Activity: Department of Veterans Affairs (VA)

Office of Procurement, Acquisition, and Logistics Technology Acquisition Center 23 Christopher Way Eatontown, NJ 07724

2. Description of Action: This proposed action is for the award of a firm-fixed-price delivery order (DO) issued under the National Aeronautics and Space Administration (NASA) Solutions for Enterprise-Wide Procurement (SEWP) V Governmentwide Acquisition Contract (GWAC) on a sole source basis to Four Points Technology, LLC (Four Points) located at 14900 Conference Center Drive, Suite 100 Chantilly, VA 20151 for brand name Philips managed services support, including hardware and software upgrades, replacement of end-of-life hardware, hardware and software maintenance, training, integration and customization, and system monitoring, and modification of the current environment for the existing and deployed brand name Philips Vue Picture Archive and Communication System (PACS) currently in use by the Veterans Integrated Services Network (VISN) 16 South Central VA Healthcare Network.

3. Description of the Supplies or Services: The proposed action is for managed service support of the existing VISN 16 Vue PACS system. The Contractor shall perform an analysis of the existing infrastructure, prepare a plan to modify the current environment and then execute the update of said environment at VA direction to ensure 99.99% uptime. As part of this requirement, the contractor shall furnish and maintain all server and storage hardware, maintain software licensing and upgrades, and provide technical support services for the hardware and software upgrades and hardware environment, which is required to maintain the complete VISN 16 Vue PACS system. The managed service requirements include the following services: Server and storage hardware maintenance and repair; modification of the current environment to meet required Service Level Agreement (SLA) specifications; upgrade of existing perpetual software licensing to latest version(s) for the following software: Vue PACS Server; Vue PACS Client, Vue PACS Enterprise, Global Vue Motion, Vue Reporting, Orthoview, Vue Beyond, and CD Direct; maintenance and security patching of software; integration and customization services; and training for the brand name Philips Vue PACS system currently in use by the VISN 16 South Central VA Healthcare Network. This action will ensure that Radiology Imaging services of that network are available for patient care with minimal service interruption and prompt corrective action to restore those services in the event of unavoidable interruptions. Additionally, the Contractor shall provide active system monitoring with in-house support desk 24x7x365 and for repair/replacement hardware be provided within 4-hours. Any hardware procured under this effort shall have a life expectancy that meets or exceeds the period of this proposed action. Finally, the Contractor shall provide training to VA staff on the solution and disaster recovery support.

The Period of Performance shall be a 12-month base period with four 12-month Option Periods. Further, three Optional Tasks shall be included to allow for the integration of another voice recognition and structure reporting software (one time exercise);

additional PACS Administration Training (one training session); and additional PACS Application Support Training (up to two sessions). These Optional Tasks may be exercised during any performance period of the resultant Delivery Order. Four 12-month option periods have been included to continue performance of these services. The total estimated value of the proposed action is , inclusive of all Option Periods and Optional Tasks.

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 was determined that only Philips or its authorized reseller, Four Points, can provide the managed services support, and all the services that comprise it. Only Philips or Four Points has the required access to the Philips source code to provide the managed services support and can furnish the required brand name Philips replacement products and services that are interoperable with the existing environment.

The VISN 16 Vue PACS system was originally competed and implemented in fiscal year (FY) 2018. Additional items, namely Vue Reporting and a vendor neutral archive expansion, were awarded and implemented in FY 2019 and FY 2020. The VISN 16 Vue PACS system as a whole has been designated as a Food and Drug Administration (FDA) Medical Device. This requirement supports the underlying information and technology component of that medical device. The brand name Philips PACS system acquired by VISN 16 replaced the previous VistA Radiology PACS provided by the VA Office of Information Technology (OIT), which has been completely shut down VA-wide.

As such, the entire VISN 16 PACS infrastructure, applicable to hundreds of providers, thousands of Veteran patients, and millions of diagnostic images is dependent upon this brand Philips Vue PACS system. The source code and software licensing for Vue PACS is proprietary to Philips, and therefore is restricted to Philips or its authorized reseller.

VA’s requirement is to obtain a managed service that will ensure 99.99% uptime for the entire system.

In order to accomplish this, the main components, specifically the hardware and the software components must be upgraded to obtain the system uptime requirement of 99.99%. More precisely, the existing software must be upgraded to the latest iteration to ensure that it will work with the modified environment. The modification of this environment is critical to obtain this uptime metric. The current infrastructure is comprised of servers and hardware that were previously provided by Philips in the initial procurement and are now at end of life. This hardware hosted the brand name software components. As such, and as part of the managed service, the environment, including the hardware, software, and firmware, must be modified to ensure the required uptime.

Given the proprietary nature of the software, and the operating baseline requirements to ensure that it runs optimally, the storage component of the Vue PACS environment must be developed and implemented by Philips. This modification would include replacement of end-of-life hardware, specifically at failover sites. No other source has access to the Philips proprietary hardware/operating system and specifications, nor would another source have the access to the proprietary code to properly configure the environment to meet this requirement.

Specifically, the required maintenance (both hardware and software) and additional support services (e.g., training and integration) can only be provided by Philips or its authorized reseller due to the proprietary nature of the VISN 16 Vue PACS system. The required maintenance services will include development of upgrades, fixes and patches to proprietary software/firmware, and must seamlessly interoperate with the existing structure. In order to develop this code, a capable source must have access to the proprietary source code. As stated above, no source, other than the original software developer or its reseller, would have the necessary access. Therefore, patches or changes to the software provided by any other source could render the entire solution useless and vulnerable to security threats. Further, access to the proprietary code is critical for requirements such as testing and analysis of patches prior to deployment, full system monitoring and also performing root cause analysis for any issue that were raised. No other source would be able to correctly identify root issues and correct the issue in real time without the access to the proprietary code. The maintenance of the existing system is critical to support the high volume of Veteran health and related documents processed by VA.

Additionally, hardware maintenance can only be provided by Philips or its authorized reseller. Specifically, any components provided must meet not only the general performance and form/fit/function requirements, but also those set by the FDA. No other components can meet those requirements. Specifically, part of that requirement is that all parts shall perform identically to the OEM specifications, so as to not invalidate the FDA certification of the solution. Therefore, these services and components must be provided by Philips as the OEM of the solution, or its authorized reseller. Further, the required trainings are tied to the brand name Philips application, and therefore a source would need intimate understanding and knowledge of the Philips product and its features to satisfy the required training. As noted in the Market Research section, no other source has this requisite knowledge and understanding. Therefore, only Philips, or its authorized reseller would be able to satisfy this requirement.

The only way for another source to provide the required services would be to replace the existing system with an entirely new PACS vendor. This would create significant duplication of cost and effort, which VA estimates upfront costs to be approximately $1.3M. This cost is attributable to migration of data, and includes costs attributable to training, productivity loss due to the learning curve, and reproduction of end user customized builds for hanging protocols and report templates. This does not include the cost of procuring a new system. Based on historical efforts, VA estimates that it would take a minimum of five years to complete the necessary testing, training, clinical use and acceptance, security scans/approvals and especially data migration necessary to implement the new system to the full functionality provided today. During this time, VA would have to continue to maintain and upgrade aspects of the existing Philips Vue PACS system until such time that a new solution would be in place. VA estimates that this would be an additional $8.8M in costs for the maintenance and upgrade of the system. This estimate is based on engineering estimates of the VA Technical Subject Matter Experts. As such, it would be wholly inefficient to run two PACS systems, especially given the additional significant limitations of space, power, and cooling requirements at any of the locations. Further, even if a new solution could be competed, the required upgrades of the existing system would need to occur as hardware components have become end of life.

Failure to award this effort as proposed will significantly impede the ability of VA to provide care to the Veteran. Specifically, hundreds of providers, thousands of Veteran patients, and millions of diagnostic images are dependent upon the Vue PACS. Without comprehensive on-going monitoring, support, and upgrades, the system will fail to perform leading to delayed reporting and/or loss of information needed to make often critical and life-saving decisions for Veteran patients. Any reporting delays and irretrievable data has direct impact on patient care.

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, even among resellers. 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 Federal Contract Opportunities website and this justification will be made publicly available within 14 days after award.

7. Actions to Increase Competition: 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: The Government’s technical experts have been conducting market research since August 2021 and most recently in July 2023, which was comprised of reviewing similar PACS systems from alternative manufacturers including AGVA, McKesson, MIPACS, and Fuji. While other software systems provide general imaging capabilities and general training and support services, none of these sources have the required access to the Philips source code to provide the managed services support, nor would their products be interoperable with the existing environment. As such, without total replacement of the environment, they cannot meet the functional requirements identified in Section 5 of this justification. Thus, the only way to support VISN 16 other than through this limited competition, would be to do full scale replacement of Vue PACS system, which would result in the detrimental consequences to patient care described in Section 5.

Further Market Research was conducted via release of a concurrent Request for Information (RFI), 36C10B23Q0337_1 under NASA SEWP V GWAC and to the Contracting Opportunity page under SAM.gov on June 28, 2023. Two responses were received from Four Points and HurtVet, however only Four Points was considered to be capable because it proposed the entire required imaging system. The contracting officer notified the parties who responded to the RFI the results and intended strategy. There has been no additional response from HurtVet after they were notified that they were deemed unable to meet our requirements. To clearly demonstrate the relevant and crucial authorizations and partnerships, Philips is the original equipment manufacturer and an authorized seller of brand name Philips managed services support. In an email dated July 19, 2023, Philips notified VA that it would exclusively partner with Four Points for this effort. As such, there not an expectation of competition, even in a limited capacity and the solicitation will be released under NASA SEWP V GWAC directly to Four Points.

9. Other Facts: None.

10. Technical and 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 comparison of proposed price to historical data for the same or similar items, the proposed pricing for to the published catalogue and published price indices under NASA SEWP V and comparison of the proposed price to the Independent Government Cost Estimate.

12. Procuring Contracting Officer Certification: 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 managed services support for the existing and deployed brand name Philips Vue PACS system currently in use by the VISN 16 South Central VA Healthcare Network 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.