Justification and Approval Audiocare.pdf

Control Number VA-20-00038271

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 be issued under General Services Administration (GSA) Information Technology (IT) 70 Federal Supply Schedule (FSS) Contract number GS-35F-0821M to AudioCare Systems for the renewal of brand name AudioCare Automated Communication system (AudioCare system) license renewals, hardware maintenance, software maintenance, help desk support, and training.

3. Description of the Supplies or Services: VA, Office of Information and Technology, Enterprise Program Management Office, Enterprise Project Management Division, requires renewal of 2,176 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. In addition, this action will include training for clinics at VA facilities that are added during the period of performance. 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). The software maintenance required consists of patching of the software modules by AudioCare to keep the system operational. Hardware maintenance support is required to supply labor, parts and technical support for all installed hardware. The base period of performance shall be from October 1, 2020 through September 30, 2021, plus two, 12-month option periods. This effort will also include optional tasks for, server/system replacement support and outgoing transition which is required as the current equipment is Win7 hardware and its associated support is at end of life. When Win7 hardware is at end of life, VA shall phase off currently fielded Win7 machines to the new Virtual Server (maintained by VA) and voice over internet protocol solution.

AudioCare Automated Communication System Control Number: VA-20-00038271

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 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 renewal of the existing AudioCare licenses or the performance of the hardware maintenance, software maintenance, help desk support, training, and server/system replacement support and outgoing transition. 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. The AudioCare license renewals, hardware maintenance, software maintenance, help desk support, and training are required for the system to remain operational. In the event the AudioCare licenses are not renewed, the critical services it currently provides 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, AudioCare 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. The required aforementioned 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. Based on market research, no other software was proposed and 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 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. Any break in service would have a detrimental effect on Veterans who are dependent on the current AudioCare system. There is a risk of Veterans missing their appointments or not getting timely care. It would also impact pharmacy as they would need to provide extra staff to answer the telephone inquiries and refill requests. VA is also using these services to call and text Veterans in order to provide important updates related to clinic closures and Corona Virus Disease response.

The Government’s market research efforts did not yield any alternate software solutions. In the event there was another software solution proposed, the Government anticipates it would take approximately 12-18 months for a new software solution to be customized to interface with VistA and provide the necessary medical communications to our nations Veterans. The Government’s market research indicated possible alternative cloud-based solutions. The Government was not aware of possible alternative cloud-based solutions until it conducted its market research. As a result, the Government 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 the event a future action can be competed, the Government anticipates a minimum transition time of 12 to 18 months from contract award to seamlessly migrate to a new solution as per the timeline indicated by vendor’s in response to the Government’s market research. Furthermore, this timeline does not take into account the initial research necessary to determine if a cloud-based solution or other solution is a viable alternative.

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. As such, this contract will provide up to three years of support consisting of a 12-month base period and two, 12-month option periods. The anticipated period of performance will enable the Government to conduct its additional market research and investigate whether any future actions are capable of being competed in order to transition seamlessly to a new system without negatively impacting the care to our nation’s Veterans. In addition, if VA determines a future action can be competed, this period of performance will allow VA to 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 proposed source for this action is AudioCare Systems Incorporated, 744 West Lancaster Avenue, Suite 250, Wayne, Pennsylvania, 19087.

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.

BWT, Carahsoft, and ERPi each offer a new cloud-based method for automated communications that may be a viable solution in the future and one the VA will investigate. However, any transition from the legacy automated communications system in place today to a cloud based automated communication system would require there be no disruption of the critical services the AudioCare system currently provides to our Veterans. In the event that a future action (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, the Government anticipates a minimum transition time of 12 to 18 months from contract award to seamlessly migrate to a new solution and this timeline does not take into account the initial research necessary to determine if a cloud based solution or other solution is a viable alternative. A new vendor or new proposed solution (cloud solution or other 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. The time it would take to perform a viable discovery to collect all the capabilities and requirements mapping to capabilities cannot be completed before October 1, 2020. 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 the AudioCare license renewals, hardware maintenance, software maintenance, help desk support, and training from AudioCare Systems can meet all of the Government’s requirements without a break in the currently fielded automated communications system. None of the respondents are able to maintain the current system with an alternative product or are able to provide the AudioCare license renewals, hardware maintenance, software maintenance, help desk support, and training on the legacy systems by the required date of October 1, 2020. 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.