The Department of Veterans Affairs (VA) Veterans Health Administration (VHA) has a continuing requirement for National Teleradiology Program (NTP) PACS (Picture Archive & Communications System).

VHA National Teleradiology Program (NTP) is VA’s in-house teleradiology service and has been providing 24 hours/day x 7days/week (24×7) service to VA facilities for over a decade. NTP is currently supporting 125 sites across all Veterans Integrated Services Networks (VISNs) and is projected to interpret between 1.0 and 1.5 million studies annually. NTP presently has reading centers located in the following cities: Durham, North Carolina (NC); New York, New York (NY); Dallas, Texas (TX); San Bruno, California (CA); Menlo Park, CA; Sacramento, CA; Los Angeles, CA; Portland, Oregon (OR); and Honolulu, Hawaii (HI) and has approximately 100 Radiologists working remotely via home Picture Archiving and Communication System (PACS) workstations with VA Virtual Private Network (VPN) connections.

NTP requires a best in breed, next generation PACS that is designed, deployed, and optimized for NTP’s teleradiology workflow and reading environment. The system must also have the capability to serve as a replacement PACS for VISNs as they transition off their existing contracts. Additionally, the system shall incorporate the capability to facilitate cross-site image viewing and sharing for Radiology images with linkage to VA’s two Electronic Medical Records (EMRs), VistA Computerized Patient Record System (CPRS) and Cerner.

NextGen PACS will incorporate two major phases into the overall project: 1) full NTP PACS deployment and implementation and 2) expansion of the NTP PACS to support VISNs to include migration, integration etc.

In November 2018, VA issued the Cloud First Policy mandating that all new and existing IT solutions be assessed to determine suitability to be offered as an enterprise cloud computing service. The VA Enterprise Cloud (VAEC) was established by the Enterprise Cloud Solutions Office (ECSO) in 2017, to host cloud computing solutions. As an IT-related medical system, NextGen PACS will follow this policy.

The central PACS servers, associated application servers and Vendor Neutral Archive (VNA) shall be hosted in VAEC via Amazon Web Services (AWS) or Microsoft Azure. VA shall be responsible for providing the VAEC resources, while the Contractor shall be responsible for all application and OS management and provision of all software and licenses beyond the OS.

Deployment with final validation of the NTP NextGen PACS must be completed no later than November 30, 2023, with the optional task for VISN PACS to be available later in FY24.

Post NTP NextGen PACS deployment, VISNs may elect to exercise optional Tasks in Phase 2 to utilize the NextGen PACS with a separate organizational structure for their internal VISN PACS.

Note that for the purposes of this PWS, PACS and NextGen PACS are the umbrella designations for all components and systems that are required to deliver the full suite of specified capabilities: VNA, workflow, diagnostic review, voice recognition, AI, etc.

• VHA NTP is VA’s in-house teleradiology service and has been providing 24×7 service to VA facilities for the past decade. NTP is currently supporting over 120 sites across all VISNs and is projected to interpret 1.4 million studies annually. NTP presently has small reading centers located in the following cities: Durham, NC; New York, NY; Dallas, TX; Menlo Park, CA; Sacramento, CA; Los Angeles, CA; Portland OR; and Honolulu, HI and has approximately 150 Radiologists working remotely.  Seventy-five percent of the NTP workload is STAT with a 1-hour turn-around time, so every component of the NextGen PACS must integrate seamlessly with a common goal of optimizing workflow, improving quality and minimizing turn-around time.  The vendor must be committed to initial and ongoing software development to customize their application to meet the evolving needs of NTP
• NTP is currently surveying industry to identify potential components of a best in breed, next generation modular PACS that is currently being deployed in the VA Enterprise Cloud (VAEC).  The system must incorporate at a minimum the following features:
  • Workflow/assignment engine for subspecialty assignment, image routing and turn-around time optimization
  • Real-time productivity tracking for each Radiologist
  • Workflow tools such as integrated ad-hoc and assigned peer review
  • Tech/image quality feedback, critical result notification/callback
  • NTP PACS Assistant image intake portal for pre-read QC (optional)
  • HL7 integration to all instances from VistA and Cerner
  • The system must be scalable such that VISNs could elect to deploy the system and would have their worklist, user database, and workflow tools separate and distinct from NTP