Question: I am currently trying to obtain new HFA3’s for our CBOCs however I am being told that another bid came in the was substantially lower for the Haag-Streit Octopus 900 and unless I am able to state “specific technical deficiencies” with the Octopus 900, that will be what we have to purchase instead. Has anyone else come across this issue and if so what “specific technical deficiencies” were you able to state for why you needed a HVF?

Answers: (17 responses, highlights compiled below)

Summary: The main points were that if you need/want a specific brand you need to do a “sole source” request. Those then have a number of different required documents that need to be filled out for justification. If you don’t do a sole source then the bid goes public and any company can come in and say we can provide the same thing for cheaper and the VA has to go with whatever the cheapest option is. Ideally, I would say that anyone putting in a request should just work very closely with their contracting officer to make sure they explain what they need and why and that person will be able to guide them in the process.

  • In the past, I pointed out that the results would not be compatible with the HFA.
    • Can’t readily compare single fields. More importantly, if you are doing a progression analysis, not compatible at all. So, it is best to use the same instrument. This was accepted by my station in the past.
    • If you are planning on getting FORUM, you would lose the ability to integrate the VF and OCT data.
  • We had the same issue come up recently. The company selling the Octopus instrument is certainly pushing hard for their instruments.
    • Assuming you also currently have HFAs in your clinic, this is what we noted to our VA that allowed us to get the HFA3s:  Although, the Haag-Streit Octopus visual field can analyze the Zeiss Humphrey Field Analyzer ‘s data it does not appear to have the Glaucoma Progression Analysis (GPA) software that we currently use in the other clinics. The Glaucoma Progression Analysis software allows us to use previous data from the older Zeiss visual field instruments to track changes. The Zeiss Humphrey Field Analyzer 3 also has the liquid lens technology, which reduces the amount of setup time and technician error to provide more reliable results. The liquid lens technology is not available for the Octopus instrument. In addition, our biomed department has experience with networking the Zeiss HFA visual field instruments to allow sharing of the test results between the different clinics. The Octopus visual field has never been networked at VAPAHCS before and the difficulty with networking a new instrument that is not in the system could delay and impact patient care for months.
  • Purchasing will always try to low bid. So you have to come up with justification.
    • No doubt you have used Humphrey visual fields for years and so your database is Humphrey which is based on gold standard algorithms. Going to octopus means that you likely have to re- establish baseline data on every single patient.
    • Is your current one out or are you adding one? If adding one you must go with Humphrey if that is what you have. You can’t test back and forth between the two. No matter what the vendor says…. It does the same strategy or what- ever, you can’t do change analysis on patients because that is propriety software to the instrument vendor.
  • You need to do sole source
    • State standard of care – literature related to glaucoma studies almost always reference HVF
    • Do you have Zeiss Forum? If so, need to be able to transfer images
    • Standardization of equipment: if you have HVF already, then it’s appropriate to get the same instrumentation for comparison, ease of repair, stocking of bulbs, etc.
    • Liquid lens is of value in my opinion – avoids technical errors (wrong trial lens used)
  • There are a couple of possibilities:
    • Do you already have HFAs in your clinic? If so, your salient characteristics can state that any new purchase MUST be able to fully integrate previous data
    • Do you have the ZEISS Forum Software platform? If so, your salient characteristics can state that any new purchase MUST be able to integrate into the Glaucoma Workplace module of ZEISS Forum.