D--NIC-10-02696_Clinic-in-hand

On September 27, 2011, the Technology Acquisition Center awarded contract VA118-11-P-0113 to Agilex Technologies, Inc., 5155 Parkstone Drive, Chantilly, Virginia, 20151-3812 on a sole-source basis. This effort is to provide fully disabled Veterans, and Veteran caregivers, with mobile devices that include custom health care applications for data display and patient interaction. These applications are intended to improve communication and the flow of medical data for fully disabled Veterans and Veteran caregivers, while relieving them of the difficult task of transportation to and from VA facilities. The period of performance for this effort is 12-months, in the total value of $4,970,279.23. The Justification and Approval is below. JUSTIFICATION AND APPROVAL FOR OTHER THAN FULL AND OPEN COMPETITION 1. Contracting Activity: Department of Veterans Affairs (VA) Office of Acquisition and Logistics Technology Acquisition Center 260 Industrial Way West Eatontown, NJ 07724 2. Description of Action: This proposed action is for a firm-fixed price contract with a one (1) year period of performance for development services and hardware required to support the "Clinic-in-Hand" effort. 3. Description of Supplies or Services: This proposed action is intended to establish VA's first patient-facing mobile health application that is integrated with the Veterans Health Information Systems and Technology Architecture (VistA) systems Electronic Health Record. To establish this application, VA requires development services and hardware to ensure the application will work. The goal of this pilot is to place veterans and veteran caregivers at the center of their health care through the use of mobile technology. Should the project be successful, the need to transport these fully disabled veterans to VA medical centers or clinics for treatment or evaluation will be significantly reduced. The "Clinic-in-Hand" effort will build on the iHealth Adapter capability which facilitates the extraction of health data from VistA systems. "Clinic-in-Hand" applications will extract key medical information from VistA systems via the iHealth Adapter and disseminate that information to homebound veterans and their caregivers through applications built to run on mobile devices. The "Clinic-in-Hand" effort will expand the iHealth Adapter data interfaces beyond the current patient record extracts currently under development, create mobile health care applications, procure mobile devices for data display and patient interaction, populate those devices with extracted health data, and provide the customized devices to the initial test population of fully disabled veterans and veteran caregivers. These applications are intended to improve communication and the flow of medical data for fully disabled veterans and veteran caregivers, while relieving them of the difficult task of transportation to and from VA facilities. The total estimated price of the proposed action is $4,995,572.80. 4. Statutory Authority: The statutory authority permitting other than full and open competition is 41 U.S.C.253(c)(1) as implemented by the Federal Acquisition Regulation (FAR) Subpart 6.302-1 entitled, "Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements." 5. Rationale Supporting Use of Authority Cited Above: The proposed source for this action is Agilex Technologies, Inc. (Agilex), 5155 Parkstone Drive, Chantilly, Virginia 20151-3812. Agilex is in the process of developing and testing a unique and innovative concept called the iHealth Adapter, which is an open source, scalable, standards-based framework for mobile healthcare computing and multitasking focused on VA clinical data services and secure mobile devices. The iHealth Adapter is a unique and innovative concept in that it provides a set of common services to interact with VistA systems, and provides information to mobile devices for use at point-of-care. Currently the healthcare data exchange between VistA systems and a mobile device has only been accomplished utilizing the iHealth Adapter. This was accomplished under a Broad Agency Announcement with Agilex. The iHealth Adapter is currently in development and testing under the existing Agilex contract, therefore the source code has not yet been finalized and accepted by the Government. No other vendor has the required source code and knowledge of the iHealth Adapter to make the necessary modifications and extended applications required to meet the timeframe defined by VA for expanded support of fully disabled veterans. This assessment is based on responses to a Request for Information (RFI). Any other source other than Agilex would be required to modify or build a new interface to VistA systems for communication with mobile devices. Modification of the iHealth Adapter without access to the source code is not possible. This would result in extensive delivery delays and duplication of cost that would not be recovered through competition. Specifically, the Veterans Health Administration Chief Information Technology Architect has analyzed existing and past interface development efforts and determined that the development cycle required would take between six (6) months and three (3) years for similar efforts. Once that work is complete, the vendor would then have to build the more complex data retrieval and write the source code into the VistA system that this proposed effort requires. Certification and Accreditation (C&A) would then be required for these programs and would require an additional six (6) months of elapsed time. These extensive delivery delays do not address the VA priority of immediately improving remote healthcare support to fully disabled veterans. There are currently approximately 3,000 fully disabled veterans in the VA patient base, and significantly more seriously disabled veterans. The capability to assist these veterans remotely is a critical and significant improvement not only to the discomfort and logistics of transportation to and from medical facilities, but to the immediacy of response to their healthcare issues. In summary, given Agilex's expertise in developing and deploying the iHealth Adapter, it is the only source capable of expanding upon this work. It would not be possible for another vendor to make enhancements to the iHealth Adapter since Agilex is the creator, and the source code has yet to be accepted by the Government. No other vendor has the knowledge or expertise with the iHealth Adapter required to perform this work. Given the Government's estimate that it would take between one (1) to three (3) years for another source to develop and obtain the aforementioned C&A for a new interface to the VistA system for mobile devices, no other source is capable of performing this effort in the critical timeframe needed. Failure to provide this capability as soon as possible would significantly impact the ability of VA medical support to provide critically needed health care to fully disabled veterans. 6. Efforts to Obtain Competition: Market research was conducted, details of which are in the market research section of this document. This effort did not yield any additional sources that can meet the Government's requirements. There is no competition anticipated for this acquisition. Additionally, the proposed action will be synopsized on the Federal Business Opportunities Page (FBO) in accordance with FAR 5.201. Any proposals that are received shall be evaluated. Furthermore, this Justification and Approval will be made publicly available on the FBO Page. 7. Actions to Increase Competition: Given an initial successful implementation of the "Clinic-in-Hand" effort, the VA would then plan to roll out this capability to the large numbers of injured or ailing veterans who could benefit from this form of remote medical support. Subsequent development and roll-out of "Clinic-in-Hand" applications can be competed since the iHealth Adapter source code will be available to all developers at that point. The Government anticipates accepting the iHealth Adapter source code in January 2012. Once the iHealth Adapter source code is accepted from Agilex, and this sole source effort is completed, VA will have all of the documentation necessary to compete all future iHealth Adapter related work. All future applications to be included in this program will be competed by utilizing the aforementioned source code. 8. Market Research: Redacted. 9. Other Facts: None