Audiocare - Justification and Approval_Redacted.pdf

Control Number VA-21-00066418

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JUSTIFICATION

FOR AN EXCEPTION TO FAIR OPPORTUNITY

1. Contracting Activity: Department of Veterans Affairs (VA)

Office of Procurement, Acquisition, and Logistics Technology Acquisition Center 23 Christopher Way Eatontown, NJ 07724

2. Description of Action: The proposed action is for a non-competitive firm-fixed price (FFP) task order to be issued under General Services Administration (GSA) Information Technology (IT) 70 Federal Supply Schedule (FSS) Contract number GS-35F-0821M to AudioCare Systems for Server/System Replacement Support.

3. Description of the Supplies or Services: VA, Office of Information and Technology, Enterprise Program Management Office, Enterprise Project Management Division, requires for the Contractor to install, configure, and implement their application software on 150 VA-provided virtual servers for existing AudioCare Automated Communication System (AudioCare) software in accordance with the approved AudioCare Win7 to Virtual Machine Migration/Transition Plan to work with VoIP. The AudioCare software provides automated communications capability between Veterans and VA healthcare facilities throughout the United States, Puerto Rico, and the Philippines.

The AudioCare system is operational at 140 VA Medical Centers (VAMC) spanning 22 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). This action is for services only. No additional hardware or software will be procured as a result of this action. The period of performance shall be from July 1, 2021 through August 31, 2022. The total estimated value of this action is

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

AudioCare Automated Communication Legacy Server/System Replacement Support Control Number VA-21-00066418 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 AudioCare Systems Incorporated (formerly Massachusetts Utility Multi- Programming System (MUMPS) Audio), 744 West Lancaster Avenue, Suite 250, Wayne, Pennsylvania, 19087. Based on the extensive market research, as described in section 8 of this justification, it was determined that competition is not viable for the performance to install, configure, and implement their application software on the new VA-provided virtual servers in accordance with the approved AudioCare Win7 to Virtual Machine Migration/Transition Plan to work with VoIP. AudioCare does not allow any other resellers to distribute its license or to perform hardware maintenance, software maintenance, help desk support, training, or other services as the aforementioned services are proprietary. Additionally, Audiocare, due the proprietary nature of their software, is the only company capable of providing the necessary support to migrate their system to the VA virtual servers. Access to the proprietary source code is required to ensure that migration can occur and there is a seamless transfer to the VA virtual servers. VA cannot experience a break in its automated communications system service with the current contract due to its impact on critical patient care.

Furthermore, AudioCare is the only software 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. The required aforementioned 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. Based on market research, only the AudioCare software is capable of interfacing with VA’s Veterans Health Information Systems and Technology Architecture (VistA) system (a database that holds VA patient information in multiple applications) without a break in service. This is a critical technical requirement that VA requires for any automated communication system.

Specifically, the VistA applications that interface with the AudioCare systems are pharmacy, scheduling, and clinical patient record system (CPRS). This interface is accomplished through the use of MUMPS language. VistA is coded in MUMPS language. MUMPS/AudioCare (formerly AudioFAX) 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 VistA and allow the system to remain operational.

AudioCare is uniquely connected to VistA Pharmacy and VistA Scheduling through MUMPS using broker calls to VistA. AudioCare systems and its tight 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 other 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 which would cause a break in service and cause a tremendous negative impact on Veteran care as they would not be able to refill medications by phone or web, schedule appointments or receive physician/patient communications such as lab results and other important medical automated communications. No other solution is capable of immediately interfacing with VistA in order to provide the necessary medical communications to our nation’s Veterans. Failure to procure the required Server/System Replacement Support from AudioCare Systems would lead to a break in service. Any break in service would have a detrimental effect on Veterans who are dependent on the current AudioCare system. Specifically, there would be increased risks of Veterans missing their appointments, not receiving timely care, negative impacts to pharmacy services that provide Veterans important updates related to clinic closures and Corona Virus Disease response.

6. Efforts to Obtain Competition: Market research was conducted, details of which are in the market research section of this document. This effort did not yield any additional sources that can provide the required licenses to meet the Government’s requirements.

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: In order to remove or overcome barriers to competition in future acquisitions for this requirement, the program office will conduct additional market research and investigate whether any future actions (cloud solutions or other solutions) are technically and functionally capable of being competed in a timely manner in order to transition seamlessly to a new system without impacting the care to our nation’s Veterans. In addition, if VA determines a future action can be competed, VA will coordinate with all required stakeholders and allow time for preparation for a newly competed action as well as any transition time and/or redundancy, as required.

8. Market Research: The Government's technical experts conducted market research via web based research in May 2021, to ascertain if there were other sources capable of meeting the Governments requirements. The Government technical experts researched alternative software and services from alternative vendors including those from Reminder Call, Data Systems Corp., Intrado Televox Solutions, Capterra Appointment reminder Software and Apptoto.

While there are similar software solutions and services provided by alternative vendors, only Audiocare has access to the the proprietary source code necessary to provide the required migration of existing AudioCare software to the VA virtual servers. In June 2021 the Contract Specialist contacted AudioCare Systems and confirmed that they do not have any resellers and are the only source for AudioCare products and services.

Additionally, in August 2020, the Government’s technical experts conducted market research by posting a Request of Information (RFI) to the Contracting Opportunities webpage. The RFI contained a list of the Government’s minimum functional requirements and a performance work statement. 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 three responses received from Carasoft, Blue Water Thinking (BWT) and Enterprise Resource Performance, Incorporated (ERPi). None of the RFI responses could meet the current VA functional requirements for an automated communication system integrated with VistA. In fact, all three RFI respondents suggested an alternative cloud-based solution. No other solution other than cloud-based solutions were proposed. The Government anticipates a minimum transition time of 12 to 18 months to seamlessly migrate to a new solution and this timeline does not take into acoount the initial research necessary to determine if a cloud based solution is a viable alternative. A new vendor or new proposed solution would require a complete discovery and plan before implementing its solution onto VA’s network. In addition, the Government anticipates that any new cloud solution would be required to meet the FedRAMP certification prior to being able to go live due to the use of PII/PHI; map to each function and the appropriate data flows using APIs; any Virtual Agent would need to be trained to dialog with Veterans; and would take extensive topic modeling for any artificial intelligence implementation. In addition, it is anticipated that VA’s, Human Centered Design would be required to build communication approaches which would require more time and coordination. Furthermore even in the event it is possible to transition to any of the proposed solutions, the Government will still be required to maintain the currently fielded Audiocare system while a new solution is implemented and tested

In summation, the review of the RFI responses by VA technical experts found only AudioCare is capable of configuring, installing, and implementing their application software on VA provided virtual servers to meet all of the Government’s requirements without a break in the currently fielded automated communications system. VA cannot experience a break in service with the current contract due to critical patient care.

Based on the above, it has been determined that only the AudioCare Systems meets all of VA’s requirements and that AudioCare Systems is currently the only responsible source for this brand name item.

9. Other Facts: None.

10. Technical and Requirements Certification: I certify that the supporting data under my cognizance, which are included in this justification, are accurate and complete to the best of my knowledge and belief.

Dyanna L. Brent Date: ________________________________

Project Manager Signature: ____________________________

11. Fair and Reasonable Cost Determination: I hereby determine that the anticipated price to the Government for this contract action will be fair and reasonable based on General Services Administration Information Technology 70 Federal Supply Schedule which was already determined to be fair and reasonable. Furthermore, additional discounts will be sought.

John M. Adamitis Date: ________________________________

Procuring Contracting Officer Signature: ____________________________

12. Procuring Contracting Officer Certification: I certify that this justification is accurate and complete to the best of my knowledge and belief.

John M. Adamitis Date: ________________________________

Procuring Contracting Officer Signature: ____________________________

Approval

In my role as procuring activity Advocate for Competition, based on the foregoing justification, I hereby approve the acquisition of Server/System Replacement Support with AudioCare Systems on an other than fair opportunity basis pursuant to the authority cited in Section 4 above, subject to availability of funds, and provided that the services herein described have otherwise been authorized for acquisition.

Date: ____________ Signature: _________________________________ Philip Weckesser Advocate for Competition Technology Acquisition Center Office of Procurement, Acquisition, and Logistics