Justification AudioCare Contract Migration Bridge.pdf

Control Number VA-23-00031470

LIMITED SOURCES JUSTIFICATION

1. Contracting Activity: Department of Veterans Affairs (VA) Office of Procurement, Acquisition, and Logistics

Technology Acquisition Center 23 Christopher Way Eatontown, New Jersey 07724

2. Description of Action: The proposed action is for a non-competitive firm-fixed price (FFP) task order (TO) to be issued under General Services Administration (GSA) Multiple Award Schedule (MAS) Contract number 47QTCA22D00CM to Payton Merger SUB II LLC (doing business as AudioCare, an Artera Company) for the renewal of brand name AudioCare Automated Communication system license renewals, software maintenance, hardware maintenance, help desk support, and training. This new Office of Information and Technology TO will serve as a bridge maintaining the vital VA services to our Veterans until a new competitive award is completed by Veterans Health Administration (VHA). VHA is targeting to release the new solicitation for the competitive award in first quarter of Fiscal year 2024.

3. Description of the Supplies or Services: VA, Office of Information and Technology, Software Product Management, Health Services Portfolio, requires renewal of 2,195 term software licenses, and maintenance for existing AudioCare Automated Communication System (AudioCare) software and hardware that provides automated communications capability between Veterans and VA Healthcare facilities throughout the United States, Puerto Rico, and the Philippines. The software maintenance required consists of patching of the software modules by AudioCare to keep the system operational. In addition, this action will include training for clinics at VA facilities that are added during the period of performance. Lastly, this action will include help desk support. The AudioCare system is operational at 143 VA Medical Centers (VAMC) spanning over 18 Veterans Integrated Service Networks (VISNs). The system allows Veterans to receive medical appointments and pharmacy information from their specific VAMC via a toll-free number. Specifically, the AudioCare system performs the following functionalities: prescription inquiry and refill order processing, prescription specific medication information for patients, prescription renewal requests and pick-up reminders, appointment scheduling and reminders, preventive health messages, customized patient surveys, secure physician/patient communications (i.e. lab results, pre-examination questionnaires, immunization information and screening results), staff emergency notifications, and patient initiated balance inquiries. Any such automated communication system has to interface and be integrated with Veterans Health Information Systems and Technology Architecture (VistA). Currently, this interface is accomplished through the use of Massachusetts Utility Multi-Programming System (MUMPS) language. Specifically, the VistA applications that interface with the AudioCare systems are Pharmacy, Scheduling, and Clinical Patient Record System (CPRS). The base period of performance shall be from October 1, 2023, through June 30, 2024, plus one, 6-month option period.

4. Statutory Authority: This acquisition is conducted under the authority of the Multiple- Award Schedule Program. The specific authority providing for a limited source award is Federal Acquisition Regulation (FAR) Part 8.405-6(a)(1)(i)(B), “Only one source is https://vaww.ecms.va.gov/FORCE/#/requirements/requirement/3845569

AudioCare Automated Communication System Control Number: VA-23-00031470 capable of providing the supplies or services required at the level of quality required because the supplies or services are unique or highly specialized.”

5. Rationale Supporting Use of Authority Cited Above: The proposed source for this action is Payton Merger (formerly AudioCare Systems), 744 West Lancaster Avenue, Suite 250, Wayne, Pennsylvania, 19087. In Fiscal Year (FY) 2021, Veterans Health Administration (VHA) Office of Veterans Access to Care (OVAC) embarked on a modernization effort for an Interactive Voice Response (IVR) system, which would replace the brand name AudioCare Automated Communication system license renewals, software maintenance, hardware maintenance, help desk support, and training contained in this acquisition. Phase 0 of this IVR modernization effort began in October of 2021 and was scheduled to end December 31st, 2021. Unfortunately, the Phase 0 effort lasted much longer than anticipated and therefore was not completed until late summer of 2022. The completion of Phase 0 was to approve selected Office of Electronic Health Record Modernization vendors to start Phase 1 of the implementation work. VHA/OIT/Chief Technology Officer/OEHRM leadership met in June of 2022 in Austin, TX to discuss the Oracle Health – Cerner Phase 0 IVR solution. It was determined that the Oracle Health-Cerner solution and cost did not align and that VHA- OVAC would need to seek a different IVR system solution. In July of 2022 OVAC was informed that this IVR modernization effort would not be approved and that the effort to select a solution would need to be restarted. In July of 2022 VHA-OVAC started to work on the new IVR solution with Unified Communication Infrastructure group. However, in January of 2023 it was determined that a sole source award for this work could not be supported and that a new market study would need to be completed. In Spring of 2023 the new RFI/Market study was sent out and completed.

This has put the IVR modernization effort nearly a year behind the original schedule and has forced the Government to enter into a new procurement to re-compete the IVR services. The current Task Order with Payton Merger ends on September 30, 2023.

Even with all efforts being put forth to engage in a new competition for an IVR system, there is a high risk that the award may not be finalized in a timely manner or may get delayed due to factors outside the control of the Government team currently engaged.

An absence of a bridge task order with Payton Merger for AudioCare license renewals, software maintenance, hardware maintenance, help desk support, and training would result in immediate loss of services currently being provided to Veteran patients and will severely impact patient care. VA cannot experience a break in service with the current contract due to critical patient care needs.

Based on the market research, as described in Section 8 of this justification, it was determined that a bridge contract with Payton Merger would be necessary to avoid a break in service for patient care while a new competitive action is pursued. Payton Merger does not allow any other resellers to distribute its software licenses or to perform software maintenance, hardware maintenance, help desk support, training, or other services as the aforementioned services are proprietary. The AudioCare license renewals, software maintenance, hardware maintenance, help desk support, and training are required for the system to remain operational. In the event the AudioCare licenses are not renewed, and there is a break in service, the critical services currently being provided to our nation’s Veterans will no longer be operational (i.e. prescription inquiry and refill order processing, prescription specific medication information for patients, prescription renewal requests and pick-up reminders, appointment scheduling and reminders, preventive health messages, customized patient surveys, secure physician/patient communications (i.e. lab results, pre-examination questionnaires, immunization information and screening results), staff emergency notifications, and patient initiated balance inquiries).

Furthermore, Payton Merger is the only source that can meet all of VA’s functional requirements and provide a system compatible with VA’s existing infrastructure without a disruption of critical services to our nation’s Veterans while a full competition is conducted to select a vendor and completely integrate the selected solution with current VA systems. The required licenses and services are not available through resellers and no other solution exists that can allow VA to seamlessly transition to another product without a break in critical services provided by the AudioCare system for Veterans within the current timeframe. The ability of an IVR solution to integrate with current VA systems such as pharmacy, scheduling, and CPRS is a technical requirement that VA requires for any automated communication system. This interface is accomplished through the use of MUMPS language. VistA is coded in MUMPS language. Payton Merger developed a single interface connection to VistA that can pull information for all the different AudioCare modules. Currently, there is no other source that can provide the required functionality to seamlessly interface with all VistA systems and allow the infrastructure to remain operational without requiring an integration effort to be undertaken by another selected vendor which could not be completed within the current timeframe. AudioCare is uniquely connected to VistA Pharmacy and VistA Scheduling through MUMPS using broker calls to VistA. AudioCare systems and its integration between VistA and AudioCare is what provides an end-to-end solution for automated communication to our nation’s Veterans regarding scheduling and prescription refills. In order for Veterans to continue receiving medical information, the automated communication system must interface with VistA. Any solution other than the AudioCare System would not be able to immediately communicate with patient data in the VistA applications such as pharmacy, scheduling, and CPRS across all the VistA systems in place at VA which would cause a break in service and cause a tremendous negative impact on Veteran care as described above, ultimately resulting in Veterans not being able to receive timely medical care. No other solution is capable of immediately interfacing with all VistA systems through the existing AudioCare Automated Communication System without launching an integration effort in order to provide the necessary medical communications to our nation’s Veterans. It would also impact pharmacy as additional staff would be needed to answer the telephone inquiries and refill requests. VA is also using the AudioCare System to call and text Veterans to provide important updates related to clinical, facilities and administrative information.

AudioCare also provides text only capabilities for Pharmacy -PREFILL; Scheduling - Reminder, Cancel, and Recall - Reminder; Clinical -communicator. The TO with the current vendor ends at the end of FY2023. While competition does exist for selection of a new product, the timeline for such a competition and subsequent award introduces substantial risk to continued availability of current services to Veteran patients. For this reason, a bridge TO is needed with the current vendor while competition is pursued to select a solution that can provide services, as described in Section 3 and this section, needed by Veteran patients.

In the event competition yields a new software solution that meets the Government requirements, the Government anticipates it could take up to 24 months for a new software solution to be customized to interface with VistA and provide the necessary medical communications to our nations Veterans. The option period of this proposed action will only be exercised in the event the new proposed solution from the ongoing re-compete is not fully integrated and tested.

6. Efforts to Obtain Competition: Market research was conducted, details of which are in Section 8 of this document. This effort did not yield any additional sources that can provide current AudioCare licenses. There is no competition anticipated for this acquisition. In accordance with FAR 5.301 and 8.405-6(a)(2), a copy of this Justification will be posted, along with a synopsis of the award notice, to the Contracting Opportunities website within 14 days of award. In accordance with FAR 8.405-6(a)(2), this justification will be posted on the GSA Advantage website to notify all interested parties.

7. Actions to Increase Competition: No barriers to future competition are anticipated. A competitive contract is anticipated to be awarded by January 2024.

The anticipated period of performance of this action will enable the Government to conduct open competition to select a solution that meets VA’s needs and allows for a seamless transition without negatively impacting the care to our nation’s Veterans.

8. Market Research: In April 2023 a Request of Information (RFI) was posted to the Contracting Opportunities webpage. The RFI contained a list of the Government’s minimum functional requirements and a PWS. In the RFI, the Government requested capability statements from vendors to demonstrate their ability to provide a comprehensive automated communication system that meets all of the Government’s immediate functional requirements and the anticipated length of time for transition to a new solution. A brand name was not specified. There were four responses received from Cisco, Four Points Technology, TTEC Government Solutions and Artera System. Review of the responses indicates presence of solutions in the industry capable of meeting the Government’s needs as outlined in the RFI. Artera System acquired AudioCare and proposed the AudioCare solution.

Cisco, Four Points Technology, and TTEC Government Solutions all offer automated communications systems that may be a viable solution in the future and potential sources for the anticipated re-compete effort. However, any transition from the legacy automated communications system in place today to a cloud based automated communication system would require that there be no disruption to our Veterans of the critical services to the AudioCare system currently in place.

The Government anticipates that to seamlessly transition to a solution selected from a new competition could take up to 24 months from contract award and start of integration work. This bridge with the current vendor is required to ensure there is no break in the services from currently fielded automated communications systems while the Government team engages in a new competition for an appropriate solution choice and integration of the new software solution with the current VA systems. The bridge TO enables the Government time to properly compete this requirement and then to integrate the selected solution with VA systems.

9. Other Facts: None