Powerscribe - JA_Redacted.pdf

Nuance Powerscribe Professional Services Control Number: VA-21-00079712

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 firm-fixed-price delivery order to be issued under the National Aeronautics and Space Administration (NASA) Solutions for Enterprise-Wide Procurement (SEWP) V Government Wide Acquisition Contract (GWAC) for brand name Nuance Powerscribe professional services.

3. Description of the Supplies or Services:

The Department of Veterans Affairs (VA) Office of Electronic Health Record Modernization (OEHRM) has a requirement for professional services to support the conversion and cutover of the existing Nuance Powerscribe Voice Recognition System (VRS) at various VA facilities throughout VISNs 12, 15, 17, 19, 21, 22, and 23 to interface and communicate with Cerner. On June 5, 2017, VA announced its decision to replace their current Electronic Medical Record (EMR) system, Veterans Health Information System Technology Architecture (VistA), with Cerner, referred to as VA’s new EMR. The goal of this initiative is to leverage an existing commercial solution to achieve interoperability within VA, with DoD, and with community care providers. This proposed action supports these VISNs in their efforts to replace the legacy EMR, VistA, with the new electronic health record, Cerner. Currently, VA has Powerscribe radiology voice dictation deployed in more than 130 VA medical facilities across the enterprise.

This effort shall provide for integration, patient identifier conversion and cut-over services required to enable the existing systems to interface and communicate with Cerner. The period of performance for this effort is 36 months consisting of a staggered and rolling schedule per facility

4. Statutory Authority:

Pursuant to Federal Acquisition Regulation (FAR) 16.505(a)(4), the following brand name requirement is being justified and approved as an exception to fair opportunity under the statutory authority of Section 41 U.S.C. 4106(c)(2) as implemented by FAR 16.505(b)(2)(i)(B), entitled “Only one awardee is capable of providing the supplies or services required at the level of quality required because the supplies or services ordered are unique or highly specialized.”

5. Rationale Supporting Use of Authority Cited Above:

Based on market research described in section eight of this justification, it was determined that limited competition is available among resellers for the required brand name Nuance Powerscribe professional services. Only Nuance Powerscribe professional services are capable of meeting VA’s requirements for this effort.

Currently, VA has Powerscribe hardware/software implemented and in use across 130+ plus locations (comprised of VAMCs, Regional Data Centers) and has invested over ten

(10) years of project and implementation time and cost to maintain and expand its Powerscribe VRS to support VHA’s radiology voice dictation requirements. As stated in Section 3, this effort is only for professional services required to enable the existing Powerscribe systems throughout VISNs 12, 15, 17, 19, 21, 22, and 23 to interface and communicate with Cerner in support of VA’s EHR transition. No other source, other than Nuance, is capable of providing the required integration, patient identifier conversion and cut-over services as access to Powerscribe’s proprietary source code is required in order to ensure the services provided to the hardware and software components of the systems are properly configured. Without these professional services required to integrate the existing Powerscribe VRS with Cerner, VHA will be without an integrated radiology voice dictation system for EHRM operations.

Furthermore, replacing the existing Powerscribe VRS would require an extensive and complex redesign, development and integration effort to deploy a new radiology voice dictation system throughout all 130+ locations. The costs associated with replacing the existing VRS is estimated to be in excess of $800K per site thereby totaling over $100M across all 130+ VA medical facilities currently utilizing Powerscribe. This estimate is based on previous acquisition history and market analysis, and would not be recovered through competition. Therefore, only brand name Nuance Powerscribe professional services can meet VA’s requirements for this effort.

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 market research has revealed that competition is available among resellers of the required Nuance professional services.

In accordance with FAR 16.505(a)(4)(iii)(A)(1), this justification will be provided with the solicitation to all appropriate NASA SEWP V GWAC holders. Furthermore, in accordance with FAR 5.301,16.505(b)(2)(ii)(D), and 16.505(a)(4)(iii), the award notice for this action will be synopsized on the Contracting Opportunities Page at beta.sam.gov website and this justification will be made publicly available within 14 days of award.

7. Actions to Increase Competition:

The Government 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 May & August 2021 by reviewing radiology voice dictation systems available from other manufacturers including AFGA talk, Dolbey Fusion, & MModal Fluency for Imaging.

While similar systems exist, the market research confirmed that due to the proprietary nature of the existing Nuance Powerscribe VRS, only Nuance can perform the required professional services on their proprietary systems. Based on this market research, the VA technical experts confirmed that only brand name Nuance professional services can meet VA’s requirements for this effort.

Further market research was conducted in August 2021 by utilizing the NASA SEWP Provider Lookup which revealed multiple NASA SEWP GWAC holders that are resellers of brand name Nuance Powerscribe products and services, including multiple small businesses and Service Disabled Veteran Owned Small Businesses (SDVOSBs).

However, the requirements for this effort include brand name Nuance professional services that must be performed by Nuance personnel due to proprietary constraints as detailed in Section 5. As such, no SDVOSB or small business concern would be able to comply with the limitations on subcontracting requirements if the solicitation were to be issued as an SDVOSB or small business set-aside. As such, and considering the required brand name Nuance professional services are available from multiple resellers on NASA SEWP V such that adequate competition exists on this vehicle, the solicitation will be issued for competition among all NASA SEWP V contract holders in Groups B, C and D under North American Industry Classification System (NAICS) code 541519, and will not be set aside.

9. Other Facts:

None.