Industry Questions Answers_Neuromonitoring W81K0026QA061.pdf
PDF 70 KB Posted
- Attached to
- Intraoperative Neuromonitoring
- Solicitation number
- W81K0026QA061
- Issued by
-
Department of the Army Medical Command
About this file
This is a Questions and Answers (Q&A) document for a neuromonitoring services contract at Brooke Army Medical Center (BAMC). The document addresses 24 numbered questions and clarifications regarding the Performance Work Statement (PWS) and contract structure, with responses from the government agency.
The contract is structured as a case-based engagement rather than an indefinite-quantity (IDIQ) contract with full-time equivalent (FTE) staffing requirements. Key service requirements include intraoperative neuromonitoring (IONM) for routine and emergency surgical procedures with 24/7/365 on-call coverage, requiring technical staff availability within 45 minutes of order placement for unscheduled emergencies. The facility requires proficiency across multiple monitoring modalities including SSEP, MEP, triggered EMG, phase reversal, direct cortical stimulation mapping with electrocorticography, and EEG recordings. Special qualifications required include certified personnel with successful experience within the past year performing each modality. The per-case pricing includes disposables, with no separate cancellation fees CLIN included. Emergency cases primarily involve spine decompression and fusion procedures for spinal cord injury, acute myelopathy, cauda equina syndrome, conus medullaris syndrome, and unstable spine fractures. Elective block time occurs Monday through Friday with frequent urgent/emergent cases requiring monitoring on nights and weekends, with up to four simultaneous surgeons based on historical experience. The contractor must provide quarterly reports analyzing aggregated IONM data with metrics including signal changes, technical issues, false positives, and false negatives, and demonstrate technical expertise in complex diagnostics and equipment troubleshooting.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Neuromonitoring Questions:
1. How many specialty items are outside the scope of routine IONM?
Answer: Routine is being ready for all the modalities listed in in PWS 5.2.11.
1.1 What were the items and costs for the last 60 months for each item?
Answer: There are no items or costs associated with this requirement. This requirement is for Cases only.
2. There is no CLIN regarding cancellation fees.
Answer: Correct, there will not be a cancellation CLIN on this contract.
2.1 How many cases were cancelled within 2 hours of notifying the IONM provider for the last 60 months?
Answer: Please see #2
2.2 How many cases were scheduled cases were cancelled for the last 60 months?
Answer: Please see #2
2.3 For all scheduled cases, what was the average cancellation notification time over the last 60 months? Please see #2
3. How many routine cases were scheduled during weekends, evenings, and holidays for the last 60 months?
Answer: This requirement is now structured to track cases only; therefore, there is no historical data available.
4. How many routine cases went over 5 hours for the last 60 months?
Answer: There is no historical data available.
5. How many emergency cases went over 5 hours for the last 60 months?
Answer: There is no historical data available.
6. The requirements require remote monitoring by a physician. Can the medical center provide the DHA requirements?
Answer: Guidance will be provided to the awardee as needed.
6.1 Can you provide guidance on obtaining clearance and usage?
Answer: Guidance will be provided to the awardee as needed.
6.2 Is the contractor allowed to use the medical center's public or secure internet signal?
Answer: Guidance will be provided to the awardee as needed.
6.3 Can the IONM provider use its Wi-Fi booster?
Answer: Guidance will be provided to the awardee as needed.
6.4 What is the current policy regarding remote monitoring?
Answer: Guidance will be provided to the awardee as needed.
7. This is an IDIQ, which guarantees only the minimum amount of dollars. It does not guarantee workload and a steady staffing level (hours per day/week/daily). According to FAR Part 16.504, an indefinite-quantity contract provides an indefinite quantity, within stated limits, of supplies or services during a fixed period. It is order-driven, not staffing level-driven. The RFQ and contract document request FTEE quantity; however, the solicitation does not specify the number of hours per day/week/year required to work.
Answer: This is not be an IDIQ contract. The RFQ does not request FTEs. This contract will be for cases only.
7.1 How many FTEEs does the medical center require to be on duty daily, which includes weekends, evenings, and holidays as stated in FAR 16.601?
Answer: See #7
7.2 According to FAR Part 16.3, what is the cost-Reimbursement for on-call coverage, daily staff (FTEE) on duty, call-back fees, and overtime?
Answer: See #7
7.3 Can you confirm if this is an FTEE medical sharing contract? If so, please provide the required number of hours per year based on the surgical demand and surgical procedures.
Answer: See #7
8.0 Major Questions: The PWS requirements section 5.2.10 requires CLTM and Doctor of Audiology.
Answer: See updated PWS
8.1 How many cases over the last 60 months required CLTM?
Answer: No historical data is available.
8.2 How many cases requiring CLTM were outside normal business hours?
Answer: The referenced information is not required for RFQ submission. Please see PWS 1.5.4.3.
8.3 How many cases over the last 60 months require an audiologist?
Answer: No historical data is available.
8.4 How many Brain Stem Auditory Evoked Potentials cases have there been over 60 months that required an audiologist?
Answer: No historical data is available.
9.0 Major Question: The PWS requires a neuropsychologist to be available for on-site support for awake craniotomy.
Answer: Awake craniotomy is not currently done at BAMC. See updated PWS.
9.1 How many awake neuropsychologists supported awake craniotomies?
Answer: See #9
9.2 Who is the incumbent contractor providing neuropsychologists' services?
Answer: See #9
9.3 How many awake craniotomies were completed over 60 months?
Answer: See #9
10. On page 40, PWS 1.3 Scope, the contractor shall provide non-personal services on an order/encounter basis. Please explain the order/encounter type and basis? What are the types and basis?
Answer: This requirement is case only. Please see updated PWS.
11. On page 41, PWS 1.4.15, Contractor Travel: What was the cost of travel within or beyond 40 miles for travel services? What are the services provided?
Answer: This requirement does not provide for travel.
12. On Page 68, PWS 5.2.3, On Call Team 24/7/365, The requirement requires a technical representative to be in place at the Military Treatment Facility for emergency unscheduled surgeries within 45 minutes after placement of an order. How many emergency unscheduled surgeries over the 60 months by the on-call team? What are the emergency procedures/cases?
Answer: No historical data. Primarily spine decompression and fusion for spinal cord injury, acute myelopathy, cauda equina syndrome, conus medullaris syndrome, or unstable spine fracture without neurological deficits.
13. On Page 68, PWS 5.2.4, the requirement is requesting a technical expert specializing in complex diagnostics, troubleshooting, and resolving software/hardware issues, providing advanced support to team staff. What is the technical expert's experience, training, and requirements? We are requesting that the Medical Center provide examples of complex diagnostics, troubleshooting, and the resolution of software/hardware issues.
Answer: Neuromonitoring computer not connecting to remote neurologist despite no change in hospital network/wifi function; malfunctioning neuromonitoring equipment such as MEP impulse not reaching the patient or EEG/SSEP/EMG signal not being detected at baseline despite normal preop neurological function; D-wave signals not received or interpretable despite electrodes being positioned correctly; No triggered EMG response detected despite touching an uninjured motor nerve; No EMG response detected despite direct stimulation of uninjured motor cortex; No interpretable phase reversal despite electrode array being positioned over all likely locations of the central sulcus. See updated
PWS.
14. Please explain page 69, PWS 5.2.5., highly staffed and dedicated to proactively adding and making modifications, ensuring continuity and stability for add-ons and changes with minimal disruption. According to the FAR, the government must state the exceptions in all Performance Work Statements within the RFQ. This is not a Statement of Objective solicitation (SOO). What is highly staffed? What is dedicated to proactively managing additional modifications? What is stability for add-ons and changes with minimal disruption?
Answer: We are a trauma center with many operating room schedule changes due to urgent/emergent surgeries for patients coming through the emergency department. The company needs to have enough staff to allow us to begin urgent/emergent surgeries requiring neuromonitoring within 45 minutes. The process for scheduling needs to be efficient, and the neuromonitoring staff should initiate communication with the OR desk and surgeons to have current knowledge of the case order. See updated PWS.
15. Please explain page 69, PWS 5.2.7, the ability to produce quarterly reports with a comprehensive analysis of aggregated IONM data to identify significant trends. According to the FAR, the government must state the exceptions in all Performance Work Statements within the RFQ. This is not a Statement of Objective solicitation (SOO). What are the quarterly report requirements, data points, monitoring requirements, and required trends to be observed?
Answer: Number of monitoring cases with each modality as the denominator, number of changes from baseline signals, number of changes due to technical issues (e.g., electrode misplaced or receiver / impulse generator malfunction), changes corrected with anesthesia adjustment, changes corrected with surgical adjustment, number of false positives (e.g., tech reported a signal change that persisted despite troubleshooting and interventions but patient woke up without any corresponding neurological deficit), number of false negatives (e.g., patient woke up with new neurological deficit that was not detected by neuromonitoring such as new myotomal weakness despite MEP remaining at baseline).
See updated PWS.
16. On page 69, PWS 5.2.8, High-tech intraoperative neuromonitoring (IONM) system and supplies complex spinal and cranial procedures, where its robust design and precise signal capture are critical. According to the FAR, the government must state the exceptions in all Performance Work Statements within the RFQ. This is not a Statement of Objective solicitation (SOO). What is the high-tech IONM system required for this solicitation? What are the supplies for complex spinal and cranial procedures? How many high-tech IONM systems are required daily, 24/7/365? How are the estimated supplies and number of surgical procedures are required for complex spinal and cranial procedures annually and the next 5 years?
Answer: Electrodes for SSEP, MEP, EMG, EEG recordings; assorted grids and stripes for phase reversal and electrocorticography; bipolar and monopolar stimulation probes ;
compatible signal processing equipment. See updated PWS.
17. On page 69, PWS 5.2.11, Proficient in any and every modality for any surgery types for 1 through 8. According to the FAR, the government must state the exceptions in all Performance Work Statements within the RFQ. This is not a Statement of Objective solicitation (SOO). What is considered proficient in any and every modality for any surgery? What are proficient measures within the QASP? What is the evidence of the proof of successful use of these modalities by the local neuromonitoring technologists, data points, graphs, and documentations expected by Brooke Army Medical Center?
Answer: The techs must have successful experience within the past year of performing each of the modalities (e.g., SSEP, MEP, triggered EMG, phase reversal, direct cortical stimulation mapping with ECOG for after-discharges, etc. listed in the PWS). The proof will be in the techs’ credentials, work experience history, and quality metrics described in response to Question 15. See updated PWS.
18. On page 68, PWS 5.1.1, Special Qualifications. What are the special qualifications?
Answer: See 5.2.9, 5.2.10, and 5.2.11.
19. Please provide a breakdown of payor mix (commercial vs. government patients)
Answer: Not required for RFQ submission.
20. Please provide days of surgery (block days) during the week
Answer: Elective block time Monday through Friday. Frequent urgent/emergent cases requiring neuromonitoring on nights and weekends.
21. Will there be overlapping surgeons on the same day?
Answer: Yes, multiple times per week, up to four simultaneous surgeons based on historical experience.
22. Are there any cranial surgeries requiring neuromonitoring?
Answer: Yes. See cranial modalities requested in PWS.
23. Does the per-case price include disposables or are they supplied by the facility?
Answer: Includes disposables
24. Does the per-case price include cancellation fees?
Answer: There is no cancellation CLIN in this RFQ.
File details come from the government source that posted it. Updated .