JA - Vocera - Fully signed____Redacted.pdf

Control Number TAC-23-00000836

LIMITED-SOURCES JUSTIFICATION

1. Contracting Activity: Department of Veterans Affairs 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 firm-fixed-price delivery order to be issued under the General Service Administration (GSA) Federal Supply Schedule (FSS) Category 511210, entitled “Software Licenses Includes both term and perpetual software licenses and maintenance”, for the purchase of the perpetual Vocera Enterprise License for 200 users and the renewal of software maintenance and technical support for the brand name Vocera Communications System Service, Maintenance and Integration for James A. Haley Veterans’ Hospital (JAHVAH).

3. Description of Supplies or Services: The Department of Veterans Affairs (VA), JAHVAH currently utilizes the brand name Vocera Communication System for instant, wireless voice communication at two locations, the Main Campus of the JAHVAH (13000 Bruce B. Downs Blvd. Tampa, FL 33612) and the Primary Care Annex (PCA) (13515 Lake Terrace Lane Tampa, FL 33637). The VA JAHVAH currently owns perpetual Vocera Enterprise Licenses for 700 users, therefore these two locations require Vocera Premier Software Maintenance and Support and Premier Plus Support for existing Vocera Communications Systems.

Vocera Premier Software Maintenance and Support includes standard phone & email support during business hours and Emergency 24 x 7 phone technical assistance for severe issues, Software hotfixes and releases, Annual system health reporting and online training. Vocera Premier Plus Support includes an on-site Vocera System Administrator, maintenance of vocera databases and call flows, management of vocera badges and ancillary equipment, system health analysis every 6 months, deployment optimization, end user training, issue escalation and management, end user report management, and increased end user satisfaction by utilization of formal feedback methods. Higher level support is required to ensure high availability of Just-in-time communication for safe and timely delivery of patient care for our Veterans.

In addition, JAHVAH has a need to expand the Vocera Communication solution in order to integrate with New Port Richey (NPR) VA Clinic, (7900 Little Road, New Port Richey, FL 34654-3419). Therefore, in the base period the NPR requires the purchase of the perpetual Vocera Enterprise License for 200 users, in addition the integration, implementation and training. Once the Vocera communication system is fully integrated at NPR, NPR will have the need for Vocera Premier Software Maintenance and Support and Premier Plus Support.

In 2006 the VA JAHVAH purchased the Vocera communication system. The Vocera communication system is a Just-in-time communication and proper clinical alarm notification with escalations that are vital elements for safe and timely delivery of patient care for our veterans. The Vocera Communications software is used with Vocera hands-free communication badges and integrates into our land-line phone systems. The platform has grown across service sections and now integrates varying clinical solutions. Notable processes relying on Vocera include STAT/NOW order notification, PRN evaluation reminders, EarlySense monitoring, GetWellNetwork room cleanliness, and communication between staff members.

Vocera Incident Command roles and broadcast groups are developed and available as part of larger facility emergency preparedness plan. Vocera solutions are in high demand and are expected to continue to scale up and expand facility-wide rapidly.

Just-in-time communication and proper clinical alarm notification and escalations are vital elements for safe and timely delivery of patient care for our Veterans.

The period of performance shall be one (1) 12-month base period, two (2) 12-month option periods and one optional task, if exercised. The Optional Task is for Vocera Premier Software Maintenance and Support for the NPR VA Clinic. This optional task will be exercised once the Vocera Communications System is fully integrated at the NPR VA Clinic and there is a need for Premier Software Maintenance and Support. The Optional Task may be exercised one time during the base period, up to 8 months. The total estimated value of the proposed action is .

4. 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) 8.405-6(b), “Items peculiar to one manufacturer. An item peculiar to one manufacturer can be a particular brand name, product, or a feature of a product, peculiar to one manufacturer. A brand name item, whether available on one or more schedule contracts, is an item peculiar to one manufacturer.”

5. Rational Supporting Use of Authority Cited Above: Based on market research as described in Section 8 of this justification, it was determined that limited competition is viable among resellers of Vocera products and services. The Vocera communications system is currently installed and operational at the Tampa VAMC, which includes the Main Campus of the JAHVAH and the Primary Care. Vocera software is a proprietary product. Therefore, only Vocera or its resellers can provide maintenance and support on its software product. The proprietary code is required to ensure all Vocera software updates and patches are properly pushed through the fielded software and to ensure the software is properly configured. Access to this code is also required to ensure all services provided on the Vocera software is properly configured. Only Vocera and its authorized resellers can provide the associated support services for Vocera Premier Software Maintenance and Support and Premier Plus Support for the Vocera Communication System solution as both require access to required proprietary code and technical data.

JAHVAH has a need to expand the Vocera Communication solution in order to integrate with the NPR VA Clinic. The use of another brand name solution for voice-to-voice communications at the NPR VA Clinic would hinder seamless communication between current Vocera system users and NPR users. For example, there are multiple services at NPR, such as Primary Care, Mental Health, Laboratory, Physical Therapy, Respiratory and Xray Department, that require voice-to-voice communication with services located at the main campus of JAHVAH. Also the NPR clinic would be included in Vocera Incident Command roles and broadcast groups as part of organization’s emergency preparedness plan. For example, in the event of a disaster, such as a hurricane, by having the same voice-to-voice communications at all locations, the staff at all three locations will be able to communicate directly with other Vocera system users included in Incident Command Roles such as medical supplies, outpatient, red, yellow, green and black teams. In addition, only the Vocera Professional Services can provide the integration, implementation and training on the existing infrastructure due to proprietary software and firmware source code.

Due to these proprietary constraints, the use of any other brand name solution for voice-to-voice communications would require a complete replacement of the existing Vocera communication system due to the proprietary nature of the Vocera infrastructure. Replacement would include, but is not limited to, security approval for attributes such as voice-to-voice communication, voice to text communication, Computer Patient Record System (CPRS) integration, Barcode Medication Administration (BCMA) integration, reimplementation of technical solution/architecture, replacement of equipment and hardware, existing perpetual software licensing, and retraining of 1,500 end users. This would represent a significant investment in time that staff would be without Just-in-time communication and proper clinical alarm notification and escalations that are vital elements for safe and timely delivery of patient care for our Veterans. In addition implementation of another brand name solution for voice-to-voice communication would require a significant redundancy in cost as the Department of Veterans Affairs (VA), JAHVAH has invested over $1.3 million in the current Vocera Communication system for equipment and additional integrations since 2020. This investment does not include man-hours/labor cost for Biomed, OI&T and Nursing Informatics staff. Use of another brand name solution for voice-to-voice communications would result in a substantial duplication of cost that would not be recovered through competition.

Failure to continue software maintenance and technical support for brand name Vocera Communication System software licenses, server maintenance, and Premier Plus Support Services, will impact Tampa’s VAMC’s Vocera Communication System, which will continue to degrade until it is virtually unusable. Tampa VAMC would continue to face difficulties in its ability to maintain acceptable levels of communication and patient care and vital patient information would be further compromised due to human error and delays. Additionally, the lack of a wearable, hands-free, and voice activated communication badge would increase risk of contamination within the hospital and response times to medical emergencies such as cardiopulmonary arrest, inclement weather, bomb threats, or active shooter scenarios will be delayed causing unnecessary loss of life.

6. Efforts to Obtain Competition: Market research was conducted, details of which are in section 8 of this justification. This effort did not yield any additional sources that can meet the government’s requirements. However, the undersigned VA technical representative determined that limited competition is available among authorized resellers for software maintenance and technical support for brand name Vocera

Communication System software licenses, server maintenance, and Premier Plus Support Services and integration. In accordance with FAR 8.405-6(a)(2) this justification will be made publicly available within 14 days of award. Furthermore, in accordance with FAR 8.405-6(b)(3) this justification will be posted with the Request For Quotation.

7. Action to Increase Competition: In order to remove or overcome barriers to competition in future acquisitions for the requirements described herein, the Government’s technical experts will continue to conduct market research to ascertain if there are changes in the marketplace that would enable future actions to be competed.

8. Market Research: The Government’s technical experts conducted Market research in June 2022. Strategies included review of industry websites including Cisco and Voalte Platform, email and voice communications with the manufacturer, and conferencing with other VA facilities that have mobile, hands free voice-to-voice communication services. The Government technical experts confirmed that as the source code required to issue the updates is proprietary, therefore, Vocera or an authorized reseller, is the only source capable of providing the required Vocera licenses, integration, maintenance and technical support. The use of any other vendor solution is capable of avoiding the duplication of cost and time as outlined in Section 5 of this justification.

On June 6, 2022, the Contract Specialist emailed Vocera asking for a list of authorized resellers. On June 6, 2022, Vocera provided a list of its authorized resellers in the Federal Market; Government Marketing and Procurement (GMP) and Alvarez & Associates LLC (Alvarez). Both Alvarez and GMP are Service-Disabled Veteran-Owned Small Businesses (SDVOSB) contract holders under GSA FSS Category 511210 titled “Software Licenses Includes both term and perpetual software licenses and maintenance”. As a result of the aforementioned market research, a Request for Quotation (RFQ) was released on September 9, 2022 as a SDVOSB set-aside to contract holders under GSA FSS Category 511210.

On September 8, 2022 a GSA contract holder submitted a question pertaining to VAAR 852.219-77 VA Notice of Limitations on Subcontracting, which is a required clause due to the SDVOSB set-aside acquisition strategy. Under the services portion of the clause, it requires the Contractor to certify that “the Contractor will not pay more than 50 percent of the amount paid by the government to it to firms that are not VIP-listed SDVOSBs as set forth in VAAR 852.219-10 or VOSBs as set forth in VAAR 852.219-11. Any work that a similarly situated VIP-listed subcontractor further subcontracts will count towards the 50% subcontract amount that cannot be exceeded. Other direct costs may be excluded to the extent they are not the principal purpose of the acquisition and small business concerns do not provide the service as set forth in 13 C.F.R. 125.6.” The GSA contract holder who submitted the question indicated the services related to this requirement were completed by the original equipment manufacturer (OEM), Vocera and that no Vocera authorized resellers would be able to certify VAAR clause 852.219- 77.

On September 9, 2022, the Contracting Officer contacted Vocera to confirm whether Offerors would be able to certify VAAR 852.219-77 considering the requirements in the RFQ. On September 9, 2022, a Vocera representative confirmed Offerors would not be able to certify this clause because most of the services related to the requirements in the RFQ are completed solely by Vocera and cannot be performed by an SDVOSB, VOSB or any other small business reseller and that proprietary services are only performed by the Vocera Professional Services team.

In light of the information received by the OEM, and in conjunction with the prior market research conducted, the acquisition strategy for this effort was reassessed.

There is no longer a reasonable expectation that competition exists on GSA amongst two or more SDVOSB/VOSB/Small Business concerns that can meet the Limitations in Subcontracting requirements for this effort. SDVOSBs or VOSBs would not be able to meet the requirements of an SDVOSB or VOSB set-aside requiring the Contractor not pay more than 50% of the amount paid by the government to it to firms that are not VIP-listed SDVOSBs as set forth in VAAR 852.219-10 or VOSBs as set forth in VAAR 852.219-11 and in accordance with 13 C.F.R. § 125.6 and VAAR 852.219-77. As such, this effort shall not be set aside.

Therefore, in order to maximize competition, the RFQ will be resolicited amongst all GSA contract holders FSS Category 511210.

9. Other Facts: None