Health Care Delivery Solutions (MHS GENESIS)- System Integration- Notice of Intent

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Contract Opportunity

DHA contracting, on behalf of PEO DHMS, is issuing this notice of intent to award a sole source contract and is not a request for competitive quotes. A sole source justification in accordance with FAR Part 6 is being processed for this requirement and will be posted when the approval process is accomplished.

Please note for clarity, the services described below are only applicable to portions of the requirement that we are contemplating sole sourcing. We anticipate posting two additional RFI’s for the competitive actions shortly.

MHS GENESIS was implemented as the first all-in-one record electronic health record (EHR) system for the entire Department of Defense. In addition to DOD, the MHS GENESIS solution is also used by the U.S. Coast Guard (USCG), the Reserve Components (RCs), the United States Military Entrance Processing Command (US MEPCOM), and National Oceanic and Atmospheric Agency (NOAA) with deployment to the National Security Agency (NSA) in progress.

MHS GENESIS plays a vital role in ensuring health, increasing readiness, and improving the safety of care. By standardizing clinical and business processes, MHS GENESIS enables beneficiaries to fully engage in their health care, and focuses on quality, safety, and patient outcomes that will ensure the Military Health System (MHS) can provide high-quality and reliable care globally.

MHS GENESIS is comprised of inpatient and outpatient software solutions from Oracle Health (formerly Cerner), a dental solution from Henry Schein, an enterprise service bus, a suite of revenue cycle management capabilities, and interfaces to external systems that enhance capability delivery. MHS GENESIS is supported by uniquely configured and integrated third-party clinical content, functional baseline content (such as workflows, roles, training, and reports), local site “builds” (including formularies, device locations, and clinic information), solution-unique hardware, infrastructure, clinical application services, and turn-key operational management services in a contractor-provided “enclave.” The core of MHS GENESIS is interfaced with additional commercial off-the-shelf (COTS) solutions, including virtual and behavioral health capabilities from Converge, Conversa, and Silvercloud, virtual health delivery from Phillips eCare, and population health management and analytics from HealtheIntent.

MHS GENESIS provides patients with a single record of care. It integrates inpatient, outpatient, and dental records, and improves communication between patients, military hospitals and clinics, the Department of Veterans Affairs (VA), and civilian health providers. Patients utilize a portal for seamless, secure messaging with providers and access to their medical history.

MHS GENESIS was fully deployed (see DoDI 5000.75) in March 2024. Maintaining the current on-premises enclave has been challenging due to the sheer size of the system, the continued need to expand the hardware and software footprint to stay ahead of database growth, long lead times to procure expansion hardware, the need for duplicative hardware to support Continuity of Operations/Disaster Recovery (COOP/DR), and the need for touch labor required to physically execute updates. Modernization of the MHS GENESIS architecture, that is, moving from an on-premises solution to a cloud solution, has become necessary to maintain the system within the current contractual performance parameters, keep ahead of the database growth, and provide improved scalability, resilience, reliability, and cyber security. The previous 9 years have shown that these are commonly experienced problems with IT solutions across a wide variety of domains, both in the commercial and public sectors. These factors informed the Government’s decision to move forward with planning for the migration of the on-premises solution to the cloud, and authorization for the COTS vendors to begin the process of ensuring their solutions are “cloud ready.”

In preparation for conducting a fair and open competition at the completion of the current contract, the Defense Healthcare Management System Modernization (DHMSM) Program Management Office (PMO) engaged industry and conducted extensive market research looking to inform its acquisition strategy starting in early 2023 through mid-2024. Industry’s responses underscored the PMO’s concerns about the high-risk nature of transitioning the systems integrator role to a different contractor immediately following full deployment that informed the Acquisition Strategy. Furthermore, industry noted the importance of complete documentation in order to be able to successfully compete the role of systems integrator. In February 2024, the Change Healthcare (CHC-OPTUM) ransomware attack caused the Government to review the state of its documentation amid new security and operational vulnerability concerns.

Based on the above, the DHMSM PEO decided that, before being able to openly compete the role of systems integrator, it is necessary to migrate to the cloud and to create documentation with respect to its processes and procedures and system internal configurations to adequately address and resolve potential vulnerabilities. Thus, the scope of this sole source will include the services associated with migrating to the cloud in addition to the services at a scale and complexity described below which are required to support the MHS GENESIS solution into the continuous support phase as a defense business system. The follow-on contract will also include deliverables for system documentation of its processes and procedures and system internal configurations as well as a requirement to cooperate with a third-party contractor the Government will engage to ensure the creation of understandable and complete documentation.

The incumbent, Leidos Inc., is the only known source with the unique MHS GENESIS development, integration, and sustainment knowledge necessary to seamlessly migrate integration and sustainment responsibilities to the cloud and ensure unfettered support of MHS GENESIS during the migration period.

Scale and Complexity:

MHS GENESIS is a system of systems, meaning that it contains interfaced EHR COTS product components from multiple different sources (e.g., Oracle Health, Henry Schein, etc.).

MHS GENESIS has an enormous scale and level of complexity. The solution is comprised of 12 major subsystems, utilizes 81 DOD, joint, or commercial interfaces across more than 1,000 end points, and processes at least 20 million messages daily. MHS GENESIS has more than 975 workflows and more than 200 user roles, and it serves 194,000 users and 9.6 million beneficiaries across 137 commands globally. MHS GENESIS contains 255 TB of Millenium data growing at 100 TB annually. The DOD spent 7 years, 2017-2024, migrating data from legacy sites into MHS GENESIS. Additional data is stored across MHS GENESIS’s 12 major subsystem footprints.

MHS GENESIS is comprised of ~26,000 hardware and software assets to deliver capabilities which need to be scanned every 48 hours for cyber vulnerabilities (and remediated as necessary). During deployment, each of the 26 waves averaged more than 7,500 end points.

Services:

The Defense Health Agency (DHA), Contracting Division – Defense Healthcare Management Systems (CD-DHMS), on behalf of PEO DHMS, intends to award a Firm Fixed-Price IDIQ Contract to Leidos (CAGE: 5UTE2) for providing the following services at a 99% average system availability:

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  • Software licensing: The contractor shall be responsible for the procurement and management of software licenses for the suite of COTS products that comprise the MHS GENESIS system of systems on premises and in the cloud. The contractor manages the acquisition of these licenses and monitors usage by the DOD and its federal partners to ensure the Government has the appropriate number of licenses and terms for its user base. As part of the migration from an on-premises hosting solution to a cloud-based hosting solution, the contractor shall ensure continued licensing and terms for all COTS products, which are anticipated to change to Software as a Service (SaaS). Note: Because the current contract requires that the licenses are transferable to the Government but does not require transferability to a new prime contractor, interested companies must address their ability to manage the negotiation and transfer of more than 100 software licenses without interruption.
  
  
  
  

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  • Hosting: The contractor is responsible for providing all the hosting services. The MHS GENESIS solution uses primarily on-premises hosting and leverages the DOD Information Technology networks, as well as DHA infrastructure to enable communications between the MHS GENESIS solution and the Military Treatment Facilities (MTFs) worldwide. This effort also includes cloud migration for the MHS GENESIS solution.
  
  
  
  

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  • System Integration: The contractor is responsible for connecting and maintaining all software products that comprise MHS GENESIS to ensure smooth interaction and data flow. Duties include system/sustainment engineering, testing, cybersecurity/accreditation, system/database administration, and optimization efforts (technical and functional) of the current DHMSM portfolio of products and hardware refresh for solution specific proprietary hardware. The contractor will be required to deliver documentation of its processes and procedures and system internal configurations, among other deliverables, and cooperate with another contractor to develop documentation understandable to a third party. The contractor shall be required to create deliverables addressing processes and procedures and system internal configurations, as well as how it will cooperative with another contractor to develop documentation understandable to a third party.
  
  
  
  

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  • Enable New Capabilities: The contractor shall be responsible for enabling new capabilities that are part of the existing MHS GENESIS solution that align with a functional requirement once approved by the EHR configuration steering board (CSB). Following CSB approval of new capabilities that are not part of the current MHS GENESIS solution the contractor shall enable the system integration/system interface for a seamless interaction/data flow. These capabilities may be identified through non-traditional contract mechanisms (e.g., other transactions) or in accordance with the requirements of the Federal Acquisition Regulation. The contract strategy for the specific functional requirement will consider how to leverage competition.
  
  
  
  

The period of performance for this follow-on contract is dependent upon the completion of the cloud migration, the availability of comprehensible documentation, and time for the Government to properly compete the requirement. The Government intends to leverage an IDIQ in the form of a base year plus option years in order to tailor the period of performance to the shortest time-period needed to satisfy these conditions and then compete the subsequent contract. The Government will also include an individual option contract line item on the IDIQ that will give the Government the unilateral option to extend the period of performance up to nine months, which will allow the Government to retain the incumbent for transition activities should a new prime contractor be selected as a result of full and open competition. Task orders similarly may be issued with a combination of base and option terms to tailor the periods of performance to facilitate competition at the earliest date possible. For planning purposes, the Government is estimating a three-year total effort for a dollar value of $1.131B with a transition option for an additional nine months and $263.34M.

In the best interest of the Government, Leidos, Inc, the incumbent of the current contract, will be afforded the opportunity to continue to provide above mentioned support services. The Government intends to award the contract no later than July 28, 2025.

Be advised that the aforementioned information is anticipatory in nature and is not binding. This notice is not a request for competitive proposals; however, any firm believing it can fulfill the requirement of providing these services may be considered by the Agency. Interested parties shall identify their interest and capabilities in response to this synopsis within 14 calendar days of publication.

The response must clearly demonstrate an ability to successfully fulfill the above requirements without duplicating the investment already made. Specifically address as part of the response the following:

1. Experience and capability to deliver services similar to those described above, i.e., in support of an EHR or other critical defense business system, of similar scale and complexity, including the interested company’s approach to transitioning to a new system integrator with limited documentation on processes and procedures and system internal configurations.


2. Experience and capability to manage cloud migration of a similar EHR or critical defense business system without degradation to the system from an on-premises hosting solution where the migration has already started under the management of the prior systems integrator. As part of your response, explain your approach to maintaining prior systems integrator’s migration schedule and describe the efforts your company would undertake to mitigate delay and risk associated with migrating a system of similar size and complexity with limited documentation on processes and procedures and system internal configurations. Assume that MHS GENESIS is 12 months into a transition from on-premises hosting to cloud hosting with the total transition taking 30 months.


3. Explanation of approach to managing overall risk given a change in systems integrators at the same time as the migration to the cloud.


4. Ability to manage the negotiation and transfer of more than 100 software licenses without interruption.

The Government’s assessment is that responses must elaborate on all of the four enumerated paragraphs above. If a company disagrees with that assessment, please respond by explaining how the Government may otherwise meet the requirements listed in this notice. While there is no maximum page limit, the Government is only interested in responses relevant to this notice. The Government will not review individual resumes or general marketing materials. While there is no mandatory format for responses, the Government requests that responses in excess of five pages include a table of contents, page numbers and corresponding headers.

The Government reserves the right not to respond to any expression of interest received. Any comments, questions, or concerns regarding this notice may be submitted IN WRITING via email to Sonya Edom (sonya.m.edom.civ@health.mil). No telephone responses will be accepted.

Submissions will NOT be reimbursed by the Government and the entire cost of any submission will be at the sole expense of the source submitting the information. A determination by the Government not to compete this proposed contract action based upon responses to this notice is solely within the discretion of the Government.

Information received will be considered solely for the purpose to determining whether to conduct a competitive procurement. This synopsis is for informational purposes only. Any Justification and Approval resulting from a decision to award the proposed sole source action will be posted on this website.

All information received in response to this notice that is marked Proprietary will be handled accordingly. The Government shall not be liable for or suffer any consequential damages for any proprietary information not properly identified. Proprietary information will be safeguarded in accordance with the applicable Government regulations. Submissions will not be returned, nor will the Government confirm receipt of submissions.

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