Description
TRM Plus and TEDP-Tier 3 software licenses Control Number TAC-19-50948 6 of 6 Control Number: TAC-19-50948 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, New Jersey 07724 2. Description of Action: The proposed action is for a firm-fixed price delivery order issued under the National Aeronautics and Space Administration (NASA) Solutions for Enterprise-Wide Procurement (SEWP) V Governmentwide Acquisition Contract (GWAC) for seven brand name DSS, Inc.(DSS) TeleCare Record Manager (TRM) Plus and DSS Triage Expert Dual Purpose Tier 3 (TEDP-Tier 3) software licenses and support renewals for Veterans Integrated Service Network (VISN) 21. 3. Description of the Supplies or Services: The proposed software renewal will provide VISN 21 with continued use of its existing TRM Plus and TEDP-Tier 3 software licenses and support, which are highly specialized software applications used by VISN 21 Telecare staff to provide telephone triage and informational services to Veterans, thereby allowing VA to comply with Veterans Health Administration (VHA) Directive 2007-033 for 24/7 access to medical advice. TRM Plus is a complete telephone liaison care management software solution that provides access to telephone treatment protocols to update and organize information from different categories of patient calls. TEDP-Tier 3 is a clinical software application used by nurses who provide telephone triage services to Veterans. TEDP-Tier 3 supports nurse clinical decision making by systematically assessing a Veteran's symptoms through the use of electronic algorithms with branching clinical logic, while providing reference health education information via a clinical library during the process. TEDP-Tier 3 allows the nursing triage staff to identify emergencies, and reduces unnecessary clinic visits. This information is then integrated with the patient s actual health record. Additionally, the telephone triage system provides the support described and also includes a series of VA designed business rules which vary by clinical department and are applied during each triage encounter. There are also national business rules incorporated into the TRM Plus Software. Business rules are developed nationally for the telephone triage product and apply to all VA medical facilities. After beta testing several years ago, it was determined that these products would be used nationally by VHA medical facilities. VHA has integrated this software into both its computer hardware and clinical software environments. Both Vista and Computerized Patient Record System (CPRS) reside on the currently fielded triage systems. Documentation is automatically created in the background during the triage process and saved as a triage encounter record. The proposed effort shall also provide support for TRM Plus and TEDP-Tier 3 during the 12-month period of performance to ensure the software remains operational. This support includes patches, bug fixes and maintenance that will require a source to have access to both brands of software. The required software licenses and support are sold exclusively through DSS, or one of its authorized resellers. The total estimated price of this proposed action is $. The period of performance is from October 1, 2018 through September 30, 2019 with two 12-month option periods. 4. Statutory Authority: The statutory authority permitting an exception to fair opportunity is 41 U.S.C. 4106(c)(2) as implemented by Federal Acquisition Regulation (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 upon continued market research, as described in section 8 of this document, it is determined that limited competition is available among authorized resellers of TRM Plus and TEDP Tier 3 software license and support renewals. TRM Plus and TEDP Tier 3 software has been used within VISN 21 since 2008. The TRM Plus and TEPD-Tier 3 software are the only software applications that meets all of VA s interoperability and compatibility requirements. Specifically, both TRM Plus and TEDP-Tier 3 software are enhanced base-line commercial-off-the-shelf software products that VA information technology staff and VHA clinical staff have used to provide a custom VHA nursing telephone liaison care management system commonly referred to in the VHA as VHA Clinical Nursing Telephone Triage System. This VHA Clinical Nursing Telephone Triage System is installed at the VISN level and serves seven Health Care Systems within VISN 21: Palo Alto, San Francisco, Central Califonia (Fresno), Northern California (Sacramento), Sierra Nevada (Reno), Pacific Islands (Honolulu) and Southern Nevada (Las Vegas). TRM Plus and TEDP-Tier 3 software permits the user to access administrative and clinical information in the Veteran medical record known as the CPRS while launching the TEDP-Tier 3 application should clinical algorithms be needed to evaluate the Veteran caller. TRM Plus and TEDP-Tier 3 software are the only clinical software applications that have the ability to interface with both VistA and CPRS and meet VA s interoperability and compatibility requirements. VistA and CPRS are currently only coded to work with TRM Plus and TEDP-Tier 3 software which are embedded together. Use of any other software would result in duplicated efforts to recode and reconfigure the existing triage systems that use VistA and CPRS. This would result in extensive delivery delays of at least two years and duplicative costs of at least $1M that could not be recuperated through competition. These estimates are based on both similar efforts and failed attempts by other sources to provide an interface with both VistA and CPRS. The TRM Plus and TEDP-Tier 3 software licenses are already fully integrated into the VistA CPRS system utilizing this software. Having software that integrates with VistA and CPRS is critical so clinicians can access and evaluate a patients medical records during the triage process. Failure to access patient records would result in incomplete information with which to advise the patient. VA has many years invested in the customization of the TRM Plus and TEDP-Tier 3 software licenses to meet the current and ongoing architecture needs of VA. To work with another manufacturer s product to achieve the current level of functionality of this software would require extensive rework and high level programing along with system design expertise to customize and retrofit another software product to meet the needs currently met by the existing software products which have been used for many years. To date, VA has not identified any other vendors who can successfully integrate their software with VistA and CPRS. In addition, TRM Plus and TEPD-Tier 3 are proprietary software products owned by DSS. Inc; therefore, support for for these products can only be provided by DSS, or one of their authorized resellers. Only these sources have access to the proprietary code needed to support the TRM Plus and TEDP-Tier 3 software licenses and ensure all services provided are properly configured. 6. Efforts to Obtain Competition: Market research was conducted, details of which are in the market research section of this document. In accordance with FAR 5.301 and 16.505(b)(2)(ii)(D) the resulting contract award will be announced on the Federal Business Opportunities Page and this Justification for an Exception to Fair Opportunity will be made publicly available. In addition, this Justification for an Exception to Fair Opportunity will be posted on the NASA SEWP V website with the solicitation. 7. Actions to Increase Competition: In order to remove or overcome barriers to competition in future acquisitions for this requirement, the Government will continue to perform market research to determine if there are any new products or maintenance services available that will enable future requirements to be competed. 8. Market Research: The Government s technical experts have conducted research using internet searches looking for alternative software products with compatible electronic triage protocols that could be readily integrated with VistA and CPRS. VA s technical experts reviewed similar software from Microsoft to include the product description and previous efforts to try and interface this product with VistA and CPRS, which failed. It was determined, as of June 2018, that the dual products of TRM Plus and TEDP-Tier 3 are the only software products that can meet VA s specified healthcare requirements that permit full and seamless integration with VistA and CPRS without significant development, configuration and associated testing duplicating what VA has already completed and invested in as detailed in Section 5 of this Justification. In July 2018, the Contract Specialist conducted market research to ascertain the extent of limited competition among resellers of the required software licenses and support renewals. Through the use of the Provider Look-up tool on the NASA SEWP V GWAC website, one Service-Disabled Veteran-Owned Small Businesses (SDVOSBs) and two small businesses were identified as resellers of the required Telecare Record Manger license renewals and support. Additionally, the Contract Specialist reached out to DSS, Inc. via phone to confirm there are no other SDVOSB resllers of these DSS products and support. A representative from DSS, confirmed for the Contract Specialist that Minburn Technology was the only SDVOSB reseller of the TRM and TEDP-Tier 3 software and support. Further, DSS, Inc. confirmed that small business resellers GMC Tek and Sword and Shield were resellers of the products as well. Therefore, limited competition is anticipated. 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. Date: _________________________ Senior Implementation Manager Signature: ______________________ 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 anticipated competition. Additionally, NASA SEWP V has already determined the prices on contract to be fair and reasonable. Finally, the successful quote will be compared with the Independent Government Cost Estimate. Date: ______________________ Procuring Contracting Officer Signature: ______________________ 12. Procuring Contracting Officer Certification: I certify that this justification is accurate and complete to the best of my knowledge and belief. Date: ______________________ Procuring Contracting Officer Signature: ______________________ Approval In my role as procuring activity Advocate for Competition, based on the foregoing justification, I hereby approve the acquisition of brand name DSS TRM Plus and DSS TEDP-Tier 3 software licenses and support, on a limited competition basis pursuant to the statutory authority cited in paragraph 4 above, subject to availability of funds, and provided that the property and services herein described have otherwise been authorized for acquisition. Date: ____________ Signature: _________________________________ Advocate for Competition Technology Acquisition Center Office of Procurement, Acquisition and Logistics JUSTIFICATION Justification For An Exception To Fair Opportunity Coordination Matrix Date Concur/Non-Concur Director, Procurement Services F Technology Acquisition Center Office of Procurement, Acquisition and Logistics Department of Veterans Affairs