LSJ_20190603_Redacted.pdf

Control No: CEHNC-FY-1295 Contractor: Education Management Solutions, LLC

Program/Equipment: MO&T Initial

Version – March 2017 FOR OFFICIAL USE ONLY

JUSTIFICATION REVIEW DOCUMENT

FAR 8.405-6 LIMITED SOURCES JUSTIFICATION

UNDER THE GENERAL SERVICES ADMINISTRATION

FEDERAL SUPPLY PROGRAM

Program/Equipment: The customer is Madigan Army Medical Center, procurement is for Education Management Solutions (EMS) simulation management system.

Authority: Title III of the Federal Property and Administrative Services Act of 1949 (41U.S.C. 251, et. Seq) and Title 40 U.S.C 501, Services for Executive Agencies, as implemented by FAR 8.405-6.

Amount:

Prepared by: Brian Bezilla Phone: 256-895-1849 MO&T Project Manager Date: 16 Apr 19 Email: brian.e.bezilla@usace.army.mil

Contracting Officer: Jeffrey Roberts Phone: 256-895-1350

Contracting Officer Date: 17 Apr 19 Email: jeffrey.c.roberts@usace.army.mil

Technical: Brian Bezilla Phone: 256-895-1849 MO&T Project Manager Date: 16 Apr 19 Email: brian.e.bezilla@usace.army.mil

Requirements: JR Teer Phone: 256-895-1255 MO&T Program Manager Date: 17 Apr 19 Email: edward.g.teer@usace.army.mil

Reviews: I have reviewed this justification and find it adequate to support limiting competition.

Program Manager: Signature:

Typed Name: JR Teer Phone: 256-895-1255

Legal Counsel:

Typed Name: Margaret Simmons Signature:

Phone: 256-895-1101

Program/Equipment: MO&T Initial

Version – March 2017 FOR OFFICIAL USE ONLY

FAR 8.405-6 Limited Sources Justification Under the General Services Administration

Federal Supply Schedule Program

1. Contracting Activity: U.S. Army Engineering & Support Center, Huntsville (CEHNC), Medical Outfitting and Transition (MO&T) Program, Huntsville, AL

2. Description of Action: Madigan Army Medical Center requests a delivery order, under the General Services Administration (GSA) Federal Supply Schedule (FSS) Program with Education Management Solutions (EMS), LLC, Exton PA. The Government will execute this action against GSA contract GS-35F-227BA. Projected award is May 2019 and fiscal year 2019 Other Procurement, Army funds will be used.

An acquisition plan is not required because this procurement does not meet the threshold at Defense Federal Acquisition Regulation Supplement 207.103(d)(i)(B).

(Insert approval authority title approved an acquisition plan in accordance with DFARS 207.103(d)(i)(B) on (insert date).

The required acquisition plan in accordance with DFARS 207.103(d)(i)(B) is currently awaiting (insert approval authority title) approval.

3. Description of Supplies/Services: This order will provide a complete and usable solution for a simulation management system for the Graduate Medical Education (GME) Andersen Simulation Center at Madigan Army Medical Center, Joint Base Lewis- McChord, WA. The system integrates software and digital audio-video recording to schedule, train and evaluate simulation activities on patient manikins and live actors.

All products required are included under GSA contract GS-35F-227BA. Installation services are included under GSA contract GS-35F-227BA and are ancillary to the products required. The schedule details of GS-35F-227BA were verified and the products and services to be provided are within the scope of the GSA Contract.

Period of Performance: 1 May 2019 to 31 December 2019 Total Value:

4. Authority Cited: Title III of the Federal Property and Administrative Services Act of 1949 (41U.S.C. 251, et. Seq) and Title 40 U.S.C 501, Services for Executive Agencies, as implemented by FAR 8.405-6 and substantiated by the following:

FAR 8.405-6(a)(1)(i)(A). An urgent and compelling need exists, and following the procedures would result in unacceptable delays.

FAR 8.405-6(a)(1)(i)(B). Only one source is capable of providing the supplies or services required at the level of quality required because the supplies or services are unique or highly specialized.

FAR 8.405-6(a)(1)(i)(C). In the interest of economy and efficiency, the new work is a logical follow-on to an original Federal Supply Schedule order provided that the original

Andersen Simulation Center at Madigan Army Medical Center, Joint Base Lewis- McChord, WA. The system integrates software and digital audio-video recording to h d l t i d l t i l ti ti iti ti t iki d li t

Program/Equipment: MO&T Initial

Version – March 2017 FOR OFFICIAL USE ONLY order was placed in accordance with applicable Federal Supply Schedule ordering procedures. The original order or BPA was not previously issued under a sole-source or limited-sources procedures.

FAR 8.405-6(b)(1). Items peculiar to one manufacturer. An item peculiar to one manufacturer can be a particular brand name, product, or a feature of a product, peculiar to one manufacturer. A brand name item, whether available on one or more schedule contracts, is an item peculiar to one manufacturer.

5. Reason for Authority Cited:

The supplies and services being acquired are available on the Education Management Solutions, LLC GSA Federal Supply Schedule. In accordance with FAR 8.002, the use of Federal Supply Schedules satisfies the requirements for obtaining supplies and services at a higher priority than the use of commercial sources.

The Andersen Simulation Center, as the Headquarters of the Army Central Simulation Committee, facilitates Army Medical Command (MEDCOM) Graduate Medical Education (GME) resident learning by placing them in simulated hospital and field care environments, performing simulated patient care on manikins and live patient actors.

The Center has spaces that replicate typical Exam Rooms, Emergency Room treatment bays, Labor and Delivery Rooms and Operating Rooms. The live actors and sensor-driven manikins provide real time feedback on how well students follow proper treatment protocols and treatment Concepts of Operation. This feedback guides both individual adjustments and improvement and provides the GME program with valuable data that informs ongoing adjustments and improvements to training processes and curricula.

Key to the simulation process is data collection, retrieval, analysis, and debriefing.

Andersen is part of an Army MEDCOM network of twelve locations that are currently in the process of fielding a solution of like simulation management systems. Automating the data recording and debriefing tasks reduces the inefficiency and inaccuracy of manual effort and maximizes the amount of time instructors can spend with the more than 429,000 personnel that have been trained since 2007. By using EMS SimulationiQ at Andersen and across Army facilities, MEDCOM would eliminate compatibility concerns and custom requirements. This approach provides for uniformity of design and a single point of responsibility for any defects, compatibility issues and maintenance. A single source reduces costs by streamlining contract oversight. A single product-line inventory is also expected to reduce warehouse stock and space required for system product parts and pieces.

Based on market research conducted by the IT Manager for the Army’s Central Simulation Committee, industry simulation management system providers include CAE Health Care and EMS. Industry audiovisual manufacturers include Laerdal, B-Line Medical, KbPort, EMS and CAE Health Care. Laerdal, CAE Health Care and Gaumard are primarily manikin manufacturers. They are capable of training recording and data recall; but only for their products. Their systems have some video capture and debriefing capability but cannot integrate with manikins of other manufacturers.

Program/Equipment: MO&T Initial

Version – March 2017 FOR OFFICIAL USE ONLY

Laerdal uses the SimView or SimManager online tools for video recording and debriefing. SimManager employs cloud based computing, but servers are located in Norway. The Army cannot used foreign based cloud services. Laerdal partnered with B- Line to access a similar online tool called SimCapture which avoids use of foreign country cloud servers. SimCapture offers scheduling, video recording, debriefing and assessment. Both EMS SimulationiQ and CAE LearningSpace provide automated scheduling, video and audio recording, debriefing and assessment.

There are several key features of the EMS system required by the Army which CAE LearningSpace does not provide:

a. EMS SimulationiQ is the only system that has Army IT Manager, Central Simulation Committee submission/endorsement for Federal Risk and Authorization Management Program (FedRAMP) approval. FedRAMP is a Government-wide approach to standardizing assessments in security, authorization and continuous monitoring practices related to cloud computing products and services. Any cloud-based systems must first be FedRAMP compliant, then must secure Defense Information Systems Agency (DISA) certification.

b. SimulationiQ provides Sim Check-in. This allows users to automate attendance capture and tracking of learners based on profession and Department. This data capture generates reports to higher command to demonstrate Operational Readiness in conjunction with recently established MEDCOM/Defense Health Agency (DHA) Individual Critical Task List (ICTL) requirements. ICTLs will be the measurement of a healthcare provider’s wartime clinical readiness to support battlefield medicine.

c. Resource/Inventory Management. SimulationiQ tracks Class VIII supplies for training events and simulator wear-and-tear per use. Asset tracking identifies where equipment is located, as equipment is frequently loaned out to different locations. The supply use and equipment location data EMS tracks reduces the manpower hours needed to conduct inventory by hand. The simulator wear data it collects eliminates human error in overlooking required maintenance. Maintenance oversight can occur due to lack of manpower or during periods of heightened activity and usage at the simulation center. Keeping simulators maintained and operational optimizes training time and learner throughput.

d. Standardized Patient Management. Through use of Sim Check-in, SimulationiQ allows automated tracking of workflow by Standardized Patients (actors). This allows actors to get paid faster and reduces manpower needed to track hours and process payments.

e. Key Performance Indicator (KPI) Dashboard. This feature allows educators to tailor indicators to learning objectives and see how their learners are executing those indicators. If an emphasis in a specialization changes, the KPI Dashboard can accommodate those changes and quickly implement them into the training.

Program/Equipment: MO&T Initial

Version – March 2017 FOR OFFICIAL USE ONLY

f. Competency Artificial Intelligence (AI). This feature will be added in a future acquisition and allows for competency fingerprinting, which coupled with the KPI Dashboard, automates the data gathering and analysis of that data. In conjunction with the set KPIs, Competency AI provides automated early warning through machine learning. This provides better training by analyzing the outcomes and learning objectives, to see if the modality is valid or needs adjustments. As learning objectives become more refined through machine learning, changes can happen at a much greater rate, since no person needs to do time consuming data analysis. This should lead to a better trained force that produces better patient outcomes and safety.

Key to the EMS SimulationiQ solution is its capability of integrating multiple manufacturers’ manikins. While Laerdal SimMan manikins represent the majority of the Army’s simulation manikin inventory, manikins by other manufacturers are also used, including CAE Caesar, and Gaumard’s HAL and Victoria patient models. Only SimulationiQ can integrate the data generated from these different manikins into standardized usable report information.

The Army currently uses EMS SimulationiQ at Madigan Army Medical Center’s Just In Time space, which is part of an Andersen Simulation Center satellite at Joint Base Lewis-McChord WA. This LSJ supports the expanded solution required at the JBLM Anderson Simulation Center.

Although CAE LearningSpaces cannot provide the required EMS SimulationiQ features listed above, the IT Manager for the Army’s Central Simulation Committee prepared a comparative analysis for outfitting the MEDCOM simulation portfolio locations with CAE LearningSpaces versus EMS SimulationiQ as an alternative. The analysis pricing is based upon current CAE Health Care pricing on the Defense Logistics Agency (DLA) Troop Support Medical Electronic Catalog (ECAT) online system and actual EMS GSA pricing.

For the four large Medical Treatment Facilities across MEDCOM, he estimated it would cost each at Walter Reed National Military Medical Center and Madigan Army Medical Center, and each at Brooke and Tripler Army Medical Centers to field SimulationiQ. The other six MEDCOM sites would total roughly , for a total SimulationiQ fielding cost of

To field LearningSpaces would require data transfer from existing to new systems.

Internal infrastructure revisions may be required. Downtime for hardware and staff retraining would occur as well as a reduction in training throughput for students.

The IT Manager estimated a new LearningSpaces system would cost , along with costs of installation , data transfer and rebuilding work flows ( and staff training of Full costs to field LearningSpaces would total

, almost twice the cost of fielding SimulationiQ. In addition, the resulting LearningSpaces configuration would not have the capabilities listed above and would not allow for communication with manikins other than Laerdal.

Program/Equipment: MO&T Initial

Version – March 2017 FOR OFFICIAL USE ONLY

6. Actions to Increase Competition: It is anticipated that since current and any future requirements for simulation management systems must integrate with existing software and hardware, opportunities to increase competition may not exist. For other future requirements where this integration is not required, delivery orders will be competed among all eligible General Service Administration (GSA) Federal Supply Schedule (FSS) contractors to the extent possible.

7. Market Research: For this particular procurement, based on the rationale stated above, it is determined to be in the best interest of the Government to utilize items peculiar to one manufacturer, Education Management Solutions, LLC. While systems from Laerdal, B-Line Medical, KbPort and CAE Health Care were investigated, currently Education Management Solutions, LLC is the only contractor capable of providing the full capabilities and features that comply with Army’s requirement for simulation management systems. Further, Education Management Solutions, LLC is a woman-owned small business under the NAICS 541512 in System for Awards Management (SAM) as well as on the GSA schedule.

8. Other Facts:

a. Procurement History Contract: Not applicable to this action.

Contractor: Not applicable to this action.

Award Date: Not applicable to this action.

Competitive Status: Not applicable to this action.

Authority: Not applicable to this action.

9. Technical Certification: I certify that the supporting data under my cognizance which are included in the justification are accurate and complete to the best of my knowledge and belief.

Typed Name: Brian Bezilla Signature:

Title: MO&T Project Manager

10. Requirements Certification: I certify that the supporting data under my cognizance which are included in the justification are accurate and complete to the best of my knowledge and belief.

Typed Name: JR Teer Signature:

Title: MO&T Program Manager

11. Best Value Determination/Fair and Reasonable Cost Determination: I hereby determine that the order represents the best value to the Government in accordance with FAR 8.405-6(c)(2)(v). Additionally, I hereby determine that the anticipated cost or price to the Government for this contract action will be fair and reasonable.

Program/Equipment: MO&T Initial

Version – March 2017 FOR OFFICIAL USE ONLY

This determination will be made using the following: price analysis IGCE other: identify the methodology or combination of methodologies that will be used.

Typed Name: Jeffrey Roberts Signature:

Title: Contracting Officer

12. Contracting Officer Certification: I certify that this justification is accurate and complete to the best of my knowledge and belief.

Typed Name: Jeffrey Roberts Signature:

Title: Contracting Officer