SOLICITATION NOTICE
Q -- Emergency, After-hours Teleradiology Services (Boston, Bedford, Togus,Manchester)
- Notice Date
- 7/22/2009
- Notice Type
- Presolicitation
- NAICS
- 621512
— Diagnostic Imaging Centers
- Contracting Office
- Department of Veterans Affairs;VA Boston Healthcare System;Contracting Officer (90C);940 Belmont Street;Brockton MA 02301
- ZIP Code
- 02301
- Solicitation Number
- VA-241-09-RQ-0372
- Archive Date
- 8/6/2009
- Point of Contact
- Cheri K. WicksEmail only; no telephone calls accepted.<br />
- E-Mail Address
-
contracting Officer's email
(cheri.wicks@va.gov)
- Small Business Set-Aside
- N/A
- Description
- JUSTIFICATION FOR OTHER THAN FULL AND OPEN COMPETITION 1.Identification of the agency and the contracting activity. VA Boston Healthcare System, Radiology Service, West Roxbury, MA 02132 2.Nature and/or description of the action being approved. Sole Source procurement of : Contractor to provide preliminary interpretations for selected radiologic studies (CT, MRI, and ultrasound) transmitted by VHABHS (or VAMC Bedford, Manchester, and Togus) between the hours of 6:00 p.m. to 8:00 a.m. business days, and 6:00 p.m. Fridays to 8:00 a.m. Mondays, including all holidays. Holiday coverage will be between 6:00 p.m. the day before the holiday to 8:00 a.m. the day following the holiday. 3.Description of the supplies or services required to meet the agency's needs (including the estimated value) Transaction # 523-09-4-7928-0050 with an estimated cost of $200,000. Contractor shall provide preliminary interpretations for selected radiologic studies (CT, MRI, and ultrasound) transmitted by VHABHS (or VAMC Togus and Bedford) between the hours of 6:00 p.m. to 8:00 a.m. business days, and 6:00 p.m. Fridays to 8:00 a.m. Mondays, including all holidays. Holiday coverage will be between 6:00 p.m. the day before the holiday to 8:00 a.m. the day following the holiday. Contractor shall provide telephonic consultative services during the hours of service; consultations will generally be limited to the selection and protocolling of imaging studies, but may include occasional consultations by referring clinicians related to the interpretations provided. Contractor shall access VABHS's PACS images and the requisitions for the examinations, either via the VA's VPN system or another electronic link mutually agreed upon. In the event of a system malfunction, a backup process shall be in place, involving sending of images on CD by taxi cab to the Contractor for preliminary interpretation. Contractor shall fax a preliminary interpretation to the VABHS ordering location and to a VABHS central fax within 60 minutes (30 minutes for images of operative fields and for specifically designated "Critical Tests") of the availability of the image. Interpretations with critical findings will additionally be reported by telephone to the ordering practitioner. Contractor shall provide these diagnostic services within the specified turnaround times for all images transmitted by VABHS except during times of unexpectedly high workload (at least a doubling of the number of images transmitted by VABHS) or severe unanticipated technical or staffing problems. Contractor shall bear the telecommunications cost of communicating the radiology reports and findings back to the VABHS as well as all telecommunications costs relating to transmission of the diagnostic images. Contractor shall enter into a Business Associate Agreement (BAA) with VA Boston Healthcare System in order to facilitate HIPAA-compliant exchange of Protected Health Information (PHI), and to assure appropriate information security in compliance with VA policies. Contractor shall be responsible for installing and maintaining any hardware and software needed to receive images at the reading location, and will adhere to applicable federal regulations protecting confidentiality of patient medical data. Subcontractors shall not be used unless approved in advance by VA, and studies and reports shall not be forwarded to third parties. No patient information shall ever be sent outside of the territorial borders of the United States and territories. Contractor shall provide medical services under this agreement by physicians who are board-certified in radiology, duly licensed and in good standing under the laws of a US state or territory. Contractor shall provide radiologists whose practice primarily or exclusively in the subspecialty of emergency radiology. Contractor shall ensure that all of the physicians providing medical services have medical staff appointments and clinical privileges to practice at the VABHS. No physician shall provide medical services unless he or she maintains such privileges. Contractor shall ensure that all physicians providing services are covered by professional liability insurance in the amount of $1,000,000 per claim and $3,000,000 in the annual aggregate. Contractor shall use reasonable efforts to report any deficiencies in image quality back to VABHS in a timely manner. Contractor shall provide occasional (monthly or by other mutually acceptable schedule) on-site didactic lectures and interactive teaching conferences to VABHS housestaff. Contractor must be within a 25 mile radius of the West Roxbury campus of VABHS so that images on CD can be sent by taxi cab in the event of a power outage or other inability to utilize the PACS. 3.Identification of the statutory authority permitting other than full and open competition. 38 U.S.C. 8153(a)(3)(A) provides: "If the health-care resource required is a commercial service, the use of medical equipment or space, or research, and is to be acquired from an institution affiliated with the Department in accordance with section 7302 of this title, including medical practice groups and other entities associated with affiliated institutions, blood banks, organ banks, or research centers, the Secretary may make arrangements for acquisition of the resource without regard to any law or regulation (including any Executive order, circular, or other administrative policy) that would otherwise require the use of competitive procedures for acquiring the resource." 48 CFR 873.104(a) provides: "Without regard to FAR Part 6, if the health-care resource required is a commercial service, the use of medical equipment or space, or research, and is to be acquired from an institution affiliated with the Department in accordance with section 7302 of title 38 U.S.C., including medical practice groups and other approved entities associated with affiliated institutions (entities will be approved if determined legally to be associated with affiliated institutions), or from blood banks, organ banks, or research centers, the resource may be acquired on a sole source basis." FAR 6.302-5, Authorized or Required by Statute "Additionally, VA Directive 1663, Health Care Resources Contracting-Buying, further implements provisions of Public Law 104-262, The Veterans Health Care Eligibility Reform Act of 1996. This law significantly expanded VA's health care resources sharing authority. The implementing Directive specifically states "Sole-source awards with affiliates must be considered the preferred option whenever education and supervision of graduate medical trainees is required (in the area of services contracted). The emergency radiologist at Brigham and Women's Hospital (BWH), are faculty members of Harvard Medical School, and will provide educational, academic-quality lectures to VA Radiology and VABHS Radiology housestaff. 5. Demonstration that the proposed contractor's unique qualifications or the nature of the acquisition requires use of the authority cited. Brigham and Women's Hospital, a Harvard Medical School facility, is one of the two major academic affiliates for VA Boston Healthcare System. Teleradiology services are provided through a subsidiary program of BWH, known as NightWatch. The other major affiliate, Boston Medical Center/Boston University School of Medicine, does not offer after-hours teleradiology. As an academic affiliate, BWH has several distinct advantages over other teleradiology services: "There is a long history of close relations between BWH Radiology and VA Boston Radiology. "BWH radiologists are well known to some VA Boston staff and residents (many of the VA residents are from BWH), and thus have existing professional relationships which would facilitate trust and communication of emergency imaging findings. "As faculty at a teaching institution, BWH radiologists provide an added benefit to VA clinical housestaff during consultations for imaging indications, utilization and other information such as need for interventional radiologic services. "Although teleradiology services will primarily involve cross-sectional imaging modalities, occasional supervision and backup may be needed for VABHS radiology residents regarding plain film interpretation, as VABHS residents will continue to provide preliminary plain film services. "As experienced faculty members, BWH radiologists will be able to provide academic-quality lectures to VA Radiology and VABHS Radiology housestaff. "A continuing association with BWH provides the potential to develop future research protocols with VA Radiology, Emergency Department and other areas of VABHS 6.Description of efforts made to ensure that offers are solicited from as many potential sources as is practicable, including whether a Federal Business Opportunities notice was or will be publicized as required by subpart 5.2 (copy attached) and, if not, which exception under 5.202 applies. A sources sought notice was posted in FBO on April 22, 2009 and stated a response date of May 11, 2009. Seven (7) potential sources responded. Three (3) large businesses, two (2) SDVOSB's, one (1) individual physician, and one (1) vendor whose size status could not be determined. 7.Determination by the contracting officer that the anticipated cost to the government will be fair and reasonable. A price analysis will be made prior to award to determine if the price is fair and reasonable. Additionally, price negotiations may be conducted if the CO determines this is necessary. 8.Description of the market survey conducted (i.e., names of firms and the date(s) the firms were contacted) and the results or a statement of the reasons a market survey was not conducted. Market research for this requirement began in April, 2009 with a query of GSA; 107 total vendors are under the SIN 621-050, Radiologic Technology, and 63 of these are small businesses. The majority of the vendors listed are primarily involved in supplying technicians or physicians to perform radiologic procedures. In May, 2009 calls to several area hospitals were made and none were able to provide after-hours radiologic services for outside physicians. A search of VetBiz indicated there were numerous SDVOSB and VOSB vendors listed under NAICS code 621512. Due to the emergency nature of after-hours radiology, and the need to mitigate transmission failures or other unanticipated technical or equipment failures, any successful vendor must be within a 25 mile radius of the West Roxbury. Only two (2) vendors were located in Massachusetts; the SDVOSB that responded to the sources sought notice and another SDVOSB vendor that did not respond to the notice. 9.Any other facts supporting the use of other than full and open competition, such as an explanation why technical data packages, specifications, engineering descriptions, statements of work, or purchase descriptions suitable for full and open competition have not been developed or are not available. The mission of the Department of Veterans Affairs is "to care for him who shall have borne the battle, and for his widow and his orphan." In order to best accomplish this goal, it is essential to provide medical service with the highest degrees of skill, experience and compassion available. This is particularly important in the setting of emergency medicine, specifically during those times of the day when the hospital is not fully staffed. Both VA Boston Healthcare System and BWH share the goals of excellence in healthcare, teaching and research. BWH is uniquely qualified to provide nighttime, weekend and holiday teleradiology coverage for VA Boston for a number of reasons. "The BWH radiologists are all either Emergency Radiology fellowship-trained, or are BWH Emergency Radiology faculty. This assures that any radiologist on duty has both experience and expertise in a wide range of emergency pathology, including all pertinent modalities and organ systems, such as body imaging, neuroradiology, musculoskeletal radiology, general radiology and nuclear medicine. The broad range of skills unique to emergency radiologists maximizes safe and expedient radiologic interpretation for those types of pathology occurring during the evening, weekend and holiday hours. "As the closest major teaching facility to VA Boston, a backup plan of using taxicab or automobile transport of imaging media (CD, DVD, etc.) in the case of system failure is easily accomplished; it is not feasible within reasonable time limits with most other teleradiology providers. "In addition to being an academic affiliate (see 5.), BWH has an established, growing, and highly regarded teleradiology program. "Because of the strong emphasis on not only state-of-the-art medical care, but also teaching and research throughout VHA, a close academic affiliate is often in the best position to provide contracted services that address these areas in a comprehensive and integrated way. As described in the VA Radiology Handbook, "services are often procured from a university affiliate on a sole-source basis." "The BWH physicians have expressed a strong interest in VA peer review and feedback "BWH Radiology is known for their strong IT support and have the technical expertise to facilitate integration with VA OI&T services. "The large and well-staffed organization at BWH makes the workload easily scalable as needs change. "The proximity of BWH will facilitate the ease of communication and information transfer. 10.A listing of the sources, if any, that expressed, in writing, an interest in the acquisition. 1.Jackson & Coker Locum Tenens 2.Online Radiology Medical Group Incorporated 3.An Individual Physician 4.Brigham and Women's Hospital 5.PatriotVetIT 6.Heritage Radiology Solutions 7.LocumTenens.com 11.A statement of the actions, if any, the agency may take to remove or overcome any barriers to competition before any subsequent acquisition for the supplies or services required. VA policy is to seek competition in the acquisition of healthcare resources and this is done whenever possible. A review of the VA FY2009 Socioeconomic Program Goals & Accomplishments shows that VISN 1, VA New England Healthcare System, is significantly exceeding the VA-Wide Socioeconomic Goal for Small Business. The VA-Wide goal is 28.7% and as of April 30, 2009, 56% of contracts had gone to small businesses.
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- Record
- SN01884271-W 20090724/090723000327-e35b82e3f36f35d8e873eaf3d6475f57 (fbodaily.com)
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