Redacted LS JA - AudioCare Prefill SW Maint and Lic.pdf

CONTROL NUMBER VA-25-00032662

LIMITED-SOURCES JUSTIFICATION

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 firm-fixed-price task order issued under General Services Administration (GSA), Multiple Award Schedule (MAS) contract number 47QTCA22D00CM, under Category 511210 – Software Licenses to Payton Merger Sub II, LLC doing business as AudioCARE, an Artera Company, for AudioCARE PREFILL software licenses, maintenance, and support to improve pharmacy operations efficiency at the Veterans Integrated Service Networks (VISN) 5 – VA Capitol Health Care Network.

3. Description of the Supplies or Services: The VA, VISN 5 - VA Capitol Health Care Network requires the addition of new AudioCARE pharmacy modules, specifically AudioPREFILL, TM-PREFILL, and ACS-TM-BASE software license products, to provide automated communication capability between Veterans and VISN 5 – VA Capitol Health Care Network facilities. To fulfil this requirement, VA requires a comprehensive solution that includes installing and operating the AudioPREFILL and TM-PREFILL modules, as well as the AudioCARE Base Short Message Service (SMS) software system, which provides an SMS license for up to 120,000 texts per year. The solution must include annual licenses, full software maintenance and support, technical support for the AudioCARE Server, and customer service for all AudioCARE Systems applications placed throughout VISN 5. The contractor is responsible for ensuring a successful interface between AudioPREFILL and the current VA infrastructure, including interoperability and code compatibility with the VA’s Computerized Patient Record System (CPRS) and Veterans Health Information Systems and Technology Architecture (VistA) applications, and will install the software remotely. The need for these modules is required now and must be integrated with VistA/CPRS until VA completes the transition to Oracle/Cerner over the next five years.

VA requires that all software modules communicate with existing AudioCARE systems currently in place at the VISN 5 facilities, that all software modules can notify patients via text messages and audio when their prescriptions need to be refilled (AudioPREFILL and related modules), and that all software patches are provided to keep the AudioCARE applications operational and integrated with VistA/CPRS. The contractor will be in charge of delivering all software licenses, as well as any associated licensing maintenance and/or support, for any development, delivery, integration, operation, and/or maintenance associated with its proposed application(s), software products, software solutions, and/or systems. All services will be conducted remotely. The contractor will provide unlimited telephone support 24 hours a day, 7 days a week for emergency situations. The contractor will provide all products within 90 calendar days or less from the date of award. This effort will also include an optional task Contract Line Item Number for the base and option years, which will allow VISN 5 facilities to order

VISN 5 AudioCARE PREFILL Software Licenses, Maintenance, and Support additional text services if necessary. The period of performance for this action will be a base of 12-months, beginning June 1, 2025 through May 31, 2026, with four 12-month option periods and five optional tasks, if exercised. The total estimated value of this proposed action, including option periods and optional tasks 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(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, 1025 Chapala Street, Santa Barbara, CA 93101-3245.

AudioCARE is the original equipment manufacturer and sole authorized seller of AudioCARE PREFILL software licenses, maintenance, and support products. No other brand name software can function within the existing environment of AudioCARE software and applications developed to interact with the AudioCARE Brand software and the current VA Infrastructure AudioCARE systems without disrupting critical services offered to Veterans. The current VA VISN 5 – VA Capitol Health Care Network infrastructure is based on AudioCARE software, and only AudioCARE can provide AudioCARE software licenses, maintenance and support. AudioCARE’s software coding is proprietary in nature and not available to any other party. Any source must have access to the code to ensure that the services provided are properly configured and that the updates are generated and deployed to the software. Without access to AudioCARE’s proprietary software codes, no other software provider can develop and release software updates, patches, and fixes for the AudioCARE software required to support the existing VISN 5 – VA Capitol Health Care Network AudioCARE infrastructure. AudioCARE’s proprietary software coding and configuration are not publicly available and are protected by intellectual property rights and copyright. Only AudioCARE has access to the necessary source code to deliver updates, patches, and technical support to ensure continued system compatibility and operational reliability.

No other brand name or third-party software solution can integrate with the existing AudioCARE infrastructure without substantial redevelopment, reverse engineering, or risk of disrupting critical Veteran prescription communication services. No other provider or software solution would offer the same capability to provide AudioCARE PREFILL products to notify patients that their prescriptions are about to run out either through phone or text alerts, as well as the ability to request refills and/or renewals of their prescriptions, when needed. The existing infrastructure and configuration rely on proprietary source codes and data formats to function effectively.

Furthermore, AudioCARE software maintenance and support will ensure that all support services are delivered and properly configured to the VA-owned AudioCARE software, which can only be given by individuals with access the proprietary software code.

Furthermore, no other software products could meet VA’s interoperability and compatibility requirements, necessitating a total replacement of the current AudioCARE infrastructure without breaking any the of the current codes. It will be an astronomical estimated duplicated cost to the Government to replace the current AudioCARE system in the amount of over $100 million. The $100 million estimate is based on completely replacing the current AudioCARE software and related modules in order to complete the data analysis and reporting automation codes for the non-AudioCARE system with a new non-AudioCARE reporting automation language. Furthermore, it includes the replacement of the current infrastructure throughout the entire VA; the development, integration, and testing of a new system; the migration of historical data; the creation of custom interfaces with CPRS and VistA; and compliance with federal security certifications such as Federal Information Security Modernization Act and Federal Risk and Authorization Management Program, as well as VA Authorization to Operate within the VA’s environment due to the use of Personally Identifiable Information and/or Protected Health Information. It also includes project management, training, and continuous support throughout the system’s lifecycle. This transition would also require an estimated four to five years to complete, including development, testing, certification, and deployment across VA to include VISN 5. During this time, the current AudioCARE system would need to be maintained in parallel to avoid interruptions in patient care.

AudioCare is the only solution that currently provides a solution that is fully integrated with VistA/CPRS until the transition to Oracle/Cerner is complete within the next five years. With the expedited implementation timeframe, we have now for Oracle/Cerner, it is unrealistic that another vendor will dedicate the time and resources to develop a similar product that can meet the VA requirements. Vista/CPRS knowing that electronic health record will only be around about next 5 years.

Because of the proprietary design of AudioCARE, no other provider can provide immediate compatibility with the VA’s existing systems. Any alternative would require significant redevelopment to achieve even baseline functionality and would not be able to seamlessly exchange information with CPRS and VistA. AudioCARE software language was written and designed to interface with a single connection to VistA that can pull information from all the AudioCARE modules. AudioCARE systems, as well as the close connection between VistA and AudioCARE provide an end-to-end solution for automatic medication refill communication to our nation’s Veterans. As a result, VA would face substantial costs and delays, risking disruptions in prescription notifications and pharmacy related communication to Veterans. These estimates are based on previous similar efforts. Due to functionality resulting from proprietary source codes, system configuration, and integration with VA legacy systems, only one provider has provided the AudioCARE software solution, which is a VA enterprise-wide software solution. Currently, no other providers or software solutions can offer an alternate or compatible solution for operating within the existing VA infrastructure. If we use another provider or software solution, we risk having interoperable issues, significant cost duplication that is unlikely to be recovered through competition, technical risks associated with reengineering interfaces with CPRS and VistA, and service disruptions during transition periods that impact patient care and the continuous delivery of critical pharmacy services. Only AudioCARE can provide the integrated, proprietary functionality necessary to meet VA’s current operational and technical requirements without interruption or unacceptable duplication of cost and 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. According to market research, AudioCARE is the sole distributor or provider of AudioCARE software licenses, maintenance and support.

In accordance with (IAW) FAR 8.405-6(b)(3), the ordering activity will post the justification and the Request for Quotation to GSA eBuy. In addition, IAW FAR 5.301 and 8.405-6(a)(2), this action will be synopsized on the Contract Opportunities website at the time of award, and the justification will be made publicly available within 14 days.

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. Specifically, the Government will continue to monitor the marketplace to determine whether other software solutions could integrate into VA's existing infrastructure.

8. Market Research: The Government’s technical experts conducted market research in October 2024 through March 2025. The market research examined similar software packages and associated software maintenance and support, such as McKesson EnterpriseRX and PrimeRX, to determine whether these software products can meet the Government’s requirements. Neither of these two software providers offer interoperability and code compatibility with the current VA infrastructure without substantial duplication of time and costs as outlined above. The Government’s technical experts also researched online websites and web-based forums such as GSA Advantage!, GSA eLibrary, and Federal Procurement Data System for performance mainframe software solutions that could meet the Government’s requirements.

According to the market research, no other provider is capable of performing the services due to the proprietary source code required to issue updates, and AudioCARE is the only source capable of providing the necessary maintenance and upgrades for AudioCARE software. No other company has the ability to create and distribute software updates and fixes for AudioCARE software required to meet existing VISN 5 – VA Capitol Health Care Network requirements. AudioCARE manufactures and distributes its own products, as well as the maintenance and support services that go with them. All of AudioCARE’s systems and applications are proprietary, and no resellers, dealers, or other third-party firms can sell, service, or support AudioCARE products. Based on this market research, the Government’s technical experts determined that only AudioCARE can meet all of the Government’s requirements. At the time of writing, there were no new entrants into the marketplace capable of providing these services.

In February 2025, the Contract Specialist contacted AudioCARE via email and obtained a sole source letter, dated February 25, 2025, confirming that it is the sole distributor or provider of AudioCARE software licenses, maintenance and support, as a small business under its GSA MAS contract. The AudioCARE representative also stated that software maintenance and support are only available through their GSA MAS contract.

9. Other Facts: None.