JA_FAR_13.5_(OTFO)_BACH_DICTATION_Redacted.pdf

HNC Control No.: HNC-18-6182

Digitally signed by WREN.PETER.II.1214502670 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USA, cn=WREN.PETER.II.1214502670 Date: 2018.08.02 17:42:20 ‐05'00'

Justification and Approval For

Other Than Full and Open Competition

Requirement: To execute a Sole Source award to procure renewal of the Dictation and Transcription System for Blanchfield Army Community Hospital (BACH), in Fort Campbell, Kentucky.

Authority: Simplified Procedures for Certain Commercial Items, 41 U.S.C. 1901 as implemented by FAR Subpart 13.5

Estimate: $477,643

Prepared By: Phone: 256-722-8951 Name: Hykeem Walker

Signature:

Title: Contract Specialist Date: 3 August 2018

Procuring Contracting Officer: Phone: 256-895-8286 Name: Peter Wren II

Signature:

Title: Contracting Officer Date: 02 Aug 2018

Technical Representative: Phone: 256-895-1091 Name: Jeffrey Cunningham

Signature: CUNNINGHAM.JEFFREY.WAYNE.1104 544173

Digitally signed by CUNNINGHAM.JEFFREY.WAYNE.1104544173 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USA, cn=CUNNINGHAM.JEFFREY.WAYNE.1104544173

Title: Project Manager Date: 8 August 2018 Date: 2018.08.08 14:48:03 ‐05'00'

Requirements Representative: Phone: 256-895 -2503 Name: Kevin Miller

Digitally signed by MILLER.KEVIN.B.1396246542

Signature: DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USA, cn=MILLER.KEVIN.B.1396246542

Title: Program Manager Date: 8 August 2018 Date: 2018.08.08 15:13:21 ‐05'00'

WALKER.HYKEEM.KARI.10209 Digitally signed by cn=WALKER.HYKEEM.KARI.1020925996

25996 Date: 2018.08.03 09:23:58 ‐05'00'

MILLER.KEVIN.B.1396246542

Reviews: I have reviewed this justification and find it adequate to support other than full and open competition.

Program Manager:

Name:

Digitally signed by MILLER.KEVIN.B.1396246542

MILLER.KEVIN.B.139624 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USA, cn=MILLER.KEVIN.B.1396246542

Signature:6542 Date: 2018.08.08 15:16:22 ‐05'00' Date: 8 August 2018

Legal Counsel:

Name:

WEISENBERGER.CH Digitally signed by WEISENBERGER.CHRISTOPHER.C.1367701419 DN: c=US, o=U.S. Government, ou=DoD, RISTOPHER.C.13677 ou=PKI, ou=USA, Signature: 01419 cn=WEISENBERGER.CHRISTOPHER.C.136770141 Date: 2018.08.0616:14:13 ‐05'00' Date: 8 August 2018

Justification and Approval For

Other Than Full and Open Competition

1. CONTRACTING ACTIVITY: United States Army Corps of Engineers, Engineering and Support Center (CEHNC), 4820 University Square, Huntsville, AL 35816-1822.

2. DESCRIPTION OF ACTION: Blanchfield Army Community Hospital (BACH) requests a Firm Fixed Price (FFP) Commercial Sole Source contract using Simplified Acquisition Procedures (SAP) in accordance with 10 U.S.C. 2304(g)(1)(B) to an other than small business, 3M Company.

The Government projects award for August 2018 and fiscal year 2018, Procurement funds will be used. Blanchfield Army Medical Center (BACH) requires the purchase of Dictation and Transcription System as a new solution that is already in place in some Military Treatment Facilities including Dwight D. Eisenhower Army Medical Center (EAMC) which will serve as the hosting center for BACH from 3M Company, 3M Center, Saint Paul, MN, 55144-1001. An acquisition plan is not required because this procurement does not meet the threshold at Defense Federal Acquisition Regulation Supplement 207.103(d)(i)(B).

3. DESCRIPTION OF SUPPLIES OR SERVICES: 3M Secure Enterprise Dictation & Transcription Solution (SEDTS) allows medical professionals the ability to call a toll-free telephone number from landline telephones and mobile telephones, e.g. cell phones, Smart phones, etc. and input voice dictation. The Dictation software product allows for other voice dictation methods, e.g. Personal Computer (PC) dictation. The dictation software product utilizes Back End Speech Recognition (BESR). Commercial and Military Health System (MHS) Return on Investment (ROI) data shows BESR increased transcription efficiency and decreased transcription turn-around times.

SEDTS includes transcription software allowing: transcriptionists to review and edit Back End Speech Recognition (BESR) generated notes, and for special situations, the separate capability to transcribe dictated notes without BESR. The Dictation software allows for both of the above processes to work securely and remotely on laptop and personal computers from geographically separated locations. Dictation has transcription electronic signature capability, which allows dictating professionals to review, edit and sign transcribed documents electronically, and Patient Administration personnel the capability to audit when the transcription is signed; in addition, the electronic signature capability accommodates medical residents’ and medical students’ dictation and electronic signature workflows. The dictation software product has dictation and transcription management and reporting tools allowing detailed analysis of electronically signed documents, rapid dictation and transcription turnaround times, and lines of transcription produced by the transcription service provider that include sufficient detail to validate invoicing from the transcription service provider. Dictation software provides audit trail capabilities to record changes to the dictated and transcribed notes and can be configured to include an electronic document upload interface with the capability to interface with the Defense Health

Agency’s inpatient Electronic Health Record (EHR) Commercial off the Shelf (COTS) product Essentris. The dictation software includes a dictation & transcription software platform with the capability to receive an electronic Admissions, Discharge and Transfer (ADT) demographic data feed from the Composite Health Care System (CHCS). The Dictation software also has all of this capability with the Military Health System’s new EHR, Genesis.

The SEDTS product by 3M has passed the Army’s Risk Management Framework (RMF).

SEDTS also has a Business-to-Business (B2B) connection from the Defense Information Systems Agency (DISA) to 3M’s secure hosted data center in Austin, TX. B2B allows medical dictations (HIPAA Data) to securely return to the MTF. The 3M SEDTS product includes agile software modification and development capability, which (1) allows a variety of commercial dictation input devices to function with the bundled dictation and transcription solution, and (2) meets both the Army Medical Department’s (AMEDD’s) and local security requirements, e.g.

foot pedals, and microphone input.

The duration of this contract is anticipated to span from 3 August 2018 to 2 August 2023, and will consist of a one-year base period, and four, one-year option periods. The estimated value of this acquisition is $477,643 which is comprised of $275,050 for the base period, $48,212 for option year one, $48,975 for option year two, $55,698 for option year 3, and $49,708 for option year four.

4. AUTHORITY CITED: Simplified Procedures for Certain Commercial Items, 41 U.S.C.

1901 as implemented by FAR Subpart 13.5:

Exclusive Licensing Agreements

5. REASON FOR AUTHORITY CITED: The unique 3M SEDTS dictation solution includes 3M’s copyrighted software which is not compatible with dictation software from other manufacturers. Dictation software from other manufacturers will not allow WBAMC to take advantage of the existing enterprise solution. 3M is the only source available from which to acquire this unique solution. Pursuant to FAR 13.5, 3M demonstrates a unique capability to provide the particular software solution required. The unique product (SEDTS) is available only from 3M, which holds all the rights in data, copyrights and secret processes in accordance with FAR Subpart 13.5.

The Army has invested in 3M’s SEDTS solution to satisfy its dictation needs in Army Military Treatment Facilities (MTFs). By utilizing it in three (3) MTFs that will serve as regional hubs, they are able to share the solution with other satellite locations. Taking advantage of the resource sharing capabilities of this solution can only be done through the use of 3M’s software.

Having no resellers of their software makes 3M the only provider of this solution. The hubs purchased the hardware to support the service saving the satellite MTFs in that region from having to purchase any additional hardware allowing for significant cost-savings. This enterprise solution by 3M allows for resource sharing of transcriptionists saving the costs of purchasing redundant solutions and equipment for each MTF.

a0oc9ccw Highlight

The regions are broken down into the Pacific, Central and Atlantic regions. Evans Army Community Hospital (EACH) located on Fort Carson in Colorado servers as the hub for the central region. EACH is the hub for Blanchfield Army Community Hospital (BACH). With EACH already having purchased the equipment, BACH will only have to tie in to it which requires no hardware providing an immediate cost saving of roughly $200,000. The enterprise solution is developed so that EACH, serving as the regional hub, can share their Dictation services with each of the MTFs in the region. This cost savings will re-introduce itself with each lifecycle of the hardware for the MTF’s which do not serve as hubs such as BACH. The United States Army Medical Command (MEDCOM) is so invested into this solution that they are funding BACH with the initial funding of $275,050.

6. EFFORTS TO OBTAIN COMPETITION: 3M’s SEDTS solution is not compatible with any other dictation software. 3M has no distributors or resellers of SEDTS.

7. ACTIONS TO INCREASE COMPETITION: The dictation software product industry is expanding and it is possible that more companies in the future will start offering these types of products. While alternative dictation software products built to these specifications, organizations with DIARMF, and with products specifically tailored to MTFs are not available today, it is likely that a full and open competition at the end of this contract would result in several capable vendors being able to compete. Over the next five years the Department of Defense is deploying a new clinical electronic health record (MHS Genesis) that will be an industry standard product versus the current electronic medical eco system that exists now using multiple systems built or tailored specifically for the DoD. Over this course of time, it will become easier to find vendors meeting the common criteria described in this document.

8. MARKET RESEARCH: Market research included looking at Digital Speech Systems, Genesis Government Solutions (not affiliated with MHS Genesis EHR), and Nuance. All vendors were met via onsite meetings. All were found to be lacking in quality Natural Language Processing (NLP) as well as Backend Speech Recognition (BESR), none had an Information Assurance certification and none had a direct interface from their products to a government electronic health information system. Some were not viable due to their need to house personal health information in databases not certified or at least managed by the Department of Defense. None provided the granular access to the data required in order to ensure only authorized clinical personnel have the ability to see personal health information.

IBM and Nuance are working to acquire these capabilities but thus far are not at the level of 3M. More specifically, there are significant financial benefits to have a system with NLP and BESR capabilities. These automated capabilities can significantly reduce or eliminate the need for additional transcription staff which will otherwise complete these tasks manually.

Furthermore, this will reduce the duplication of effort that providers currently do by eliminating copying and pasting medical notes. These efficiency gains go hand in hand with MHS Quadruple AIM efforts to reduce costs and improve efficiency. Being able to dictate clinical notes that are then automatically placed into the electronic health record means that provider notes will be available much sooner for nursing staff and other providers to read and use in their care of the patients. In addition to this the licensing of the 3M product by the numbers of dictated lines of texts versus the current process of named licenses will ensure that the service is

Date: 2018.08.08 15:16:51 ‐05'00' available to most of the clinical providers within the facility, thus improving access to the service. It will also prevent the waste that can occur when named licenses are not used or are shelved for long periods of time when providers are on leave or deployed. 3M SEDTS is the only product that meets DoD cybersecurity requirements. 3M is the only product that contains approved interfaces between existing Clinical Documentation Systems (CHCS, MHS Genesis, and Essentris).

9. INTERESTED SOURCES: To date, no other sources have written to express an interest.

10. OTHER FACTS: This is not a previously acquired contract; however, the Army is already invested into the Dictation Enterprise System for other hospitals and MEDCOM has provided funding for each hospital to take part in order to maximize the investment value already in place.

Alternatives: (1) Award to another vendor or manufacturer of medical transcription systems.

Ramifications include: (1) the lead time for another contractor to develop an alternative solution that meets the Government’s minimum needs (which includes successfully passing the Government’s DoD Information Assurance Certification and Accreditation Process (DIACAP)) is estimated to be a minimum of 12 months; (2) the cost of development (which includes revisions to the documentation and testing, and the cost of maintaining this version of the COTS product(s) with the government modifications) would be borne by the government; and (3) the costs for testing for IA certification, as well as subsequent IA actions to address changes needed for COTS product(s), would also be borne by the government.

11. TECHNICAL CERTIFICATION: “I certify that the supporting data under my cognizance, which is included in the justification, is accurate and complete to the best of my knowledge and belief.”

Name: Jeffrey W. Cunningham Date: 8 August 2018

Title: Project Manager Signature:

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

Name: Kevin B. Miller Date: 8 August 2018

Digitally signed by MILLER.KEVIN.B.1396246542 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USA, Title: Program Manager Signature:96246542 cn=MILLER.KEVIN.B.1396246542

13. Fair and Reasonable Cost Determination: I hereby determine that the anticipated cost to the Government for this contract action will be fair and reasonable based on the extensive research conducted by the customer.

CUNNINGHAM.JEFFRE

Y.WAYNE.1104544173

Digitally signed by CUNNINGHAM.JEFFREY.WAYNE.1104544173 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USA, cn=CUNNINGHAM.JEFFREY.WAYNE.1104544173 Date: 2018.08.08 15:04:00 ‐05'00'

MILLER.KEVIN.B.13

The capabilities of other Dictation providers with similar products will be reviewed and used as a competitive price comparison. Historical prices from two (2) previously awarded contracts (W81K00-17-P-0431 & W912DY-17-P-0280) for the 3M SEDTS at other military hospitals (Dwight D. Eisenhower Army Medical Center & Darnall Army Medical Center) will also be used to determine price fair and reasonableness.

Name: Peter Wren, II Date: 8 AUG 18

Title: Contracting Officer Signature:

Digitally signed by WREN.PETER.II.1214502670 ou=USA, cn=WREN.PETER.II.1214502670 Date: 2018.08.08 18:02:09 ‐05'00'

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

UG 18

Digitally signed by WREN.PETER.II.1214502670 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USA, cn=WREN.PETER.II.1214502670

Date: 2018.08.08 18:03:39 ‐05'00'

APPROVAL

Based on the foregoing justification, I hereby approve the procurement of BACH 3M Dictation on an other than full and open competition basis pursuant to the authority of 10 U.S.C. 2304(g)(1)(B) as implemented by FAR Subpart 13.5(a)— Simplified Procedures for Certain Commercial Items” subject to availability of funds, and provided that the services and property herein described have otherwise been authorized for acquisition.

Digitally signed by

WREN.PETER.II.1214502670

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USA, cn=WREN.PETER.II.1214502670

Date: 2018.08.02 17:45:16 ‐05'00' 3 August 2018 Peter Wren II date Contracting Officer

Reviews: I have reviewed this justification and find it adequate to support other than full and open competition.

Program Manager: Name: Kevin B. Miller

Digitally signed by MILLER.KEVIN.B.1396246542 ou=USA, cn=MILLER.KEVIN.B.1396246542

Signature: 1396246542 Date: 2018.08.09 08:36:50 ‐05'00' Date: 9 August 2018

Name: Peter Wren, II Date: 8 A

Title:

Contracting Officer

Signature:

MILLER.KEVIN.B.