Frequently Asked Questions

• Submission and Eligibility
• Webinar
• Topics
• Collaboration
• Pilots and Field Tests
• Process
• Awards and Funding

• Ideas
• Questions about the BAA
• Maternity Continuity of Care
• Redesign of the PTSD Treatment Experience
• Mobile Applications for eBenefits
• Innovations in Prevention and Treatment of Pressure Ulcers
• Miscellaneous

General questions about VAi2

Q: What is VAi2?

A: The program is designed to tap expertise both inside and outside government to improve access to services, lower costs, improve quality, and enhance the performance of VA operations. Check out the About page for more details.

Q: If VAi2 received nearly 10,000 submissions for the first two competitions, why were only 36 innovations selected for funding?

A: There is simply a greater number of worthy proposals than there are VAi2 dollars to fund them and people to manage them. As we establish a track record of results that improve access, enhance performance, increase quality, and lower costs, we hope that VAi2 grows to fund even greater numbers of innovations that serve Veterans. Until then, we select only the very top submissions with the limited budget resources we have.

Q: Your webinar slide mentioned there were 20,000 ideas and 135 innovations. How do these numbers relate to the industry competition?

A: As of April 10, 2012, VAi2 has received 20,000 employee ideas and nearly 600 industry submissions, and has selected 135 of those innovations for funding or potential award.

Q: When will the 2011 industry winners be posted on the website? Doesn't seem like they are listed, and I would like to learn more about those results.

A: Winners will be posted on the VAi2 website when contract awards have been made and projects are underway.

Submission and Eligibility

Q: Who can submit proposals for the Industry-IC?

A: VAi2 is committed to broadening our engagement with the private sector and to encouraging entrepreneurs and companies of all sizes to consider making innovative proposals that serve the needs of Veterans. While VAi2 encourages all proposals, in order to conduct business with the Government, contractors must be registered in the Central Contractor Registration (CCR) database.

Q: Are past VAi2 winners allowed to submit?

A: Yes, past participation in a VAi2 competition has no impact on your ability to participate in 2012.

Q: Is this open to organizations not having federal exemption (501c3), or is federal exemption a must?

A: In accordance with PL 98-369, entitled "The Competition in Contracting Act of 1984" and FAR Part 35.016, this BAA is for full and open competition. There are no exclusions of sources or set-asides.

Q: Do you accept international entries into your competition, or is it only for US citizens and companies?

Q: Are there any limitations on university teams participating in the competition?

A: No, there are no limitations. Academic institutions are encouraged to participate. Please note that in order to do business with the Government, offerors must be registered in the Central Contractor Registration (CCR) database prior to award of a contract.

Q: How do I register with the Central Contract Registry?

A: Registration in www.ccr.gov is performed by the contractor, which may take anywhere from 2 weeks to 2 months to process. Please see the CCR User's guide for registration information.

Q: What is required for ORCA certification?

A: Written confirmation is required. The Government will follow up confirmations during proposal evaluations.

Q: Are companies allowed to submit more than one proposal/concept?

A: Yes, however, each proposal should be a genuinely separate idea. Do not submit the same concept for multiple topics. If you think your concept could be applicable across multiple topics, please submit it only for the one topic where you think it will have the greatest impact and list which other topics it might address in the submission.

Q: How difficult is it for an early stage company to get an award?

A: For the VAi2 Industry competition, it is not difficult for early stage companies to receive awards, and you are not required to partner with anyone. A full spectrum of business types has received VAi2 awards in the past. In fact, some of those entities were created specifically for the VAi2 program. Focus on the proposal and your technical qualifications and plan.

Q: How many applications do you expect to receive?

A: In 2011, we received 260 concept papers, from which we invited 69 offerors to submit full proposals. We expect participation in 2012 to be comparable.

Q: Where can I find out more about the "Areas of Interest" and how to submit a proposal?

A: Please review the Broad Agency Announcement sponsored by VAi2. The solicitation number is VA11812R0253 and can be found here. VAi2 also hosted an online Industry Day on April 10, 2012, in the form of a webinar. This provided an opportunity for interested vendors to ask questions and hear from VA experts in each field related to the new competition.

Q: Will there be any priority consideration given to Veteran-owned small businesses?

A: No, for the purpose of these awards, there is no Veterans preference. The awards will be based on the merits of the proposal.

Webinar

Q: May we presume that copies of all slides used in the webinar will be made available after this session?

A: Yes, copies will be made available on the Industry Innovation Competition page and at FebBizOpps.

Q: Will you make the list of attendees on these sessions available to other attendees, to facilitate collaboration?

A: Yes, the list of attendees will be posted on the Industry Innovation Competition page.

Topics

Q: Can I submit more than one concept paper within the same topic area?

A: You can, but they have to be distinct concepts.

Q: If we have an interest/expertise in more than one of the disciplines discussed today, are we permitted to submit multiple concept papers covering the different areas, or should they be covered in a single submission?

A: You are welcome to submit under multiple topics or make multiple submissions for a single topic, but each submission should be a separate idea/concept. If you think your concept could be applicable across multiple topics, please submit it only once for the topic where you think it will have the greatest impact.

Q: Is there potential for more than one award to be made for a given topic?

A: Yes. Because the Industry Innovation Competition uses a Broad Agency Announcement instead of a traditional RFP, proposals are not judged against one another but rather against selection criteria. VAi2 could make as many awards as there are promising ideas and for which funds are available.

Q: Just to confirm, the only proposals you will consider are limited to these four topics?

A: Yes, VA will only consider proposals for the topics identified in the active BAA.

Q: If a proposal addresses more than one topic area, should the concept be submitted twice or as a combined concept paper?

A: Proposals should be submitted under the topic area where they will have the greatest impact. The topic should be clearly identified within the Transmittal Letter. More than one proposal can be submitted as long as each proposal pertains to the BAA topics.

Q: Which, if any, of the topic areas are related to the T-21 Initiatives?

A: In a sense we could say that all of the areas fall under T-21 because VAi2 was created as a means of accomplishing the transformation objectives established by Secretary Shinseki. That said, the four topics in the 2012 Industry Innovation Competition are all important areas of interest that have been selected by leadership for their relevance to VA priorities.

Q: Can additional topics be added to this BAA?

A: We do not plan to add additional topics to this BAA.

Collaboration

Q: Can a multi-member group of start-up private companies and academic or public companies apply together?

A: Absolutely. You may find it easiest to pick one party to serve as the prime contractor with other parties serving as sub-contractors.

Q: If the project is a collaboration, are all parties required to be registered in the Central Contractor Registration (CCR) database?

A: Not necessarily. If one party is the prime contactor that will be awarded the contract by VA, and that party sub-contracts portions of the work to others, only the prime needs to be registered in the CCR.

Q: Are joint-venture proposals allowed under the BAA? Are joint ventures with DoD allowed?

A: Yes.

Q: Is payment to the VA personnel involved with the testing allowed?

A: VA clinicians or staff may not legally participate in concept paper or proposal preparation, per 18 U.S.C. § 203 and 205. However, a concept paper or proposal for the implementation of a process by VA doctors in a VA facility or a pilot program at a specific VA facility is acceptable. Do not include the costs for VA salary support in the Rough Order of Magnitude (ROM) or cost proposal.

Q: Is it appropriate or proper for current VA employees to serve as unpaid consultants on the proposal?

A: VA clinicians or staff may not legally participate in concept paper or proposal preparation, per 18 U.S.C. § 203 and 205. However, a concept paper or proposal for the implementation of a process by VA doctors in a VA facility or a pilot program at a specific VA facility is acceptable. Do not include the costs for VA salary support in the Rough Order of Magnitude (ROM) or cost proposal.

Q: How does the awardee compensate established VA partners for the pilot or field test, and via what mechanism (e.g., sub-award)?

A: It is not necessary to include VA salary support for VA partners. The VA has an internal mechanism for compensation of VA partners for pilot or field tests.

Q: Although VA employees are not allowed to participate in preparing the concept paper, is a letter of support from the VA facility expected?

A: Letters of support are neither expected nor required, but may be included in concept papers and/or full proposals. Please note that letters will count against the page limit.

Q: Did I hear that a VA employee cannot be a collaborator (consultant) on the project? Or, can a VA employee only not help to develop the concept paper?

A: VA employees may not participate in concept paper or proposal preparation.

Q: Does the ban on VA employees from contributing to the concept paper apply to uncompensated VA employees?

A: Yes, this ban also applies to uncompensated VA employees.

Q: Is there an advantage to having a relationship with, or a commitment to participate from, a specific VA location or VISN before submitting a proposal?

A: There is no need to have a relationship with specific VA personnel or a VA facility before submitting a proposal. Include in your proposal as much detail as you know or feel is relevant (for example, if you wanted to test deployment in a rural vs. urban area, you should specify that), and as part of the evaluation process we will match up your proposal with potential VA people and facilities. If you happen to know of particular individuals that you think would be particularly helpful to your effort, feel free to identify them. There is no guarantee that VA can secure participation from specific individuals, but our goal is to make the proposals that we choose as successful as possible.

Q: Are there any previous awards that these efforts will work with?

A: No.

Pilots and Field Tests

Q: Is there a certain number of Veterans that should be reached for pilot deployment?

A: No, there is no specific number of Veterans that should be targeted for a pilot program. The size of any pilot should be driven by what the offeror believes is a reasonable number to achieve the expected results.

Q: Must all patients evaluated in the project be VA patients?

A: No, all patients evaluated in the project do not have to be VA patients. Since VAi2 is designed to allow VA to evaluate the impact that new solutions might have on VA services, we are, of course, interested in evaluating how a new solution will impact the Veteran population. However, it may not be necessary for a project to include only VA patients to accomplish this.

Q: Can our model be tested in a non-VA environment but then be readily replicable at the VA?

A: VAi2 is designed to allow VA to evaluate the impact that new solutions might have on VA services. Testing new solutions in a VA environment usually supports an effective pilot evaluation. However, it is possible to demonstrate the viability of a new solution in a non-VA environment, and proposals may be submitted to that effect. Clinical trials in particular may be best conducted in an external environment. Offerors may want to consider adding an additional phase for a VA environment field test, if appropriate.

Q: Is VA clinic involvement for the pilots required? Can the testing be a validation of functionality, or are you looking for field-testing of clinical efficacy?

A: Submissions should include plans that demonstrate the suitability of the innovation for use by VA. In many cases, this will involve a pilot test or trial that may (but does not have to) involve deployment to a limited set of Veterans, clinicians, or others as appropriate. If the viability of an innovation can be established by lab testing or a non-production proof of concept then it is not necessary to include a pilot or trial program.

Q: Is there a specific period of performance for field tests?

A: Proposals should demonstrate a clear benefit to Veterans with a prototype or field test ideally within one year, and in no more than two years, of the award date.

Q: What if a pilot cannot be completed in 1-2 years?

A: Projects must demonstrate the viability of the innovation within 1-2 years. A demonstration of viability may be different for different innovations; for example, a proof of concept for a completely new solution may be appropriate, while a field trial may be appropriate for an innovation that is new to VA but based on existing technology.

Q: I recently visited a VA Medical Center and wrote a preliminary draft of a randomized trial for our technology; does this innovations competition have to be a clinical trial? What sort of "testing" is the committee looking for? This would obviously impact how we target the study in terms of outcomes.

A: The Industry Innovation Competition is open to both Development and Field Test proposals, depending on the nature of the solution being proposed. The goal is to reach an end deliverable of a prototype that can be evaluated, or a set of field test results that can be evaluated. In both cases, the evaluation is to determine the potential benefit of broad VA deployment. For clinical solutions, a clinical trial may be the best way to achieve this evaluation. For IT solutions, a pilot deployment may be best. For devices, a prototype test may be best. Your proposal should include whichever method you think will best produce results that clearly demonstrate the value of the solution to VA.

Q: Would VAi2 help facilitate access to Veterans for the evaluation?

A: Yes, if your submission requires the involvement of Veterans, clinicians, or other VA employees, the VAi2 team will facilitate access.

Q: Does Veterans' participation in a field test need to be included in our budget?

A: The cost for Veteran participation in a clinical trial should not be included in the contract cost.

Process

Q: How will proposals be evaluated?

A: In the Broad Agency Announcement, VAi2 states explicitly the criteria by which innovations are evaluated. Proposals are reviewed by VAi2 staff and evaluated by subject matter experts in each area of interest in the competitions. Experts come mostly from within the Federal government, but VAi2 also invites experts from industry to participate in these evaluations. These individuals are prohibited from submitting proposals to a competition topic for which they are serving as a reviewer. Proposals submitted under the Industry Innovation Competitions are evaluated on their own merit and will not necessarily compete against other proposals in their area of interest for funding.

Q: Will you provide responses on whether a concept paper or full proposal is accepted?

A: The Government will notify every contractor whether the concept paper or full proposal is or is not accepted.

Q: Will there be any feedback after the concept stage or just a go/no-go?

A: During the concept paper evaluation process, you may receive an email if we have specific issues/questions regarding your concept paper. Otherwise, all offerors will be notified via the Virtual Office of Acquisition (VOA) if they are invited to submit a full proposal or if the concept paper has not been selected for continuation into Stage 2. We will provide you with a brief explanation as to why your concept paper was not selected.

Q: If a proposal is accepted, what additional Federal Acquisition Regulations will companies be subject to?

A: If a proposal is accepted, a follow-on solicitation containing the appropriate clauses and regulation guidelines will be provided to the contractor.

Q: If proposal is not selected, will we be allowed to resubmit a modified proposal?

A: Given the timeline for the Industry Innovation Competition, offerors will not be able to submit modified proposals. Because this competition is conducted using the BAA format, VA will not provide feedback or debriefings for proposals that are not selected for award.

Q: Will a critique of a proposal be given if rejected? Not a comparison, but where the proposal fell short?

A: Unfortunately, due to the number of proposals we receive for these competitions, critiques and/or feedback will not be given.

Q: Will the final procurement be through the T4 contract vehicle or through the VHA acquisition process?

A: The contracts awarded from this BAA have no association with the T4 contract vehicle or any other existing contract vehicle. If a proposal is selected for award, the Contracting Officer will provide solicitation documents containing the terms and conditions of the proposed contract, and will commence negotiations with the contractor.

Q: Will there be a way to find out which proposals were awarded under the BAA?

A: Funded projects will be listed on the Funded Innovations page.

Q: Once a contract has been awarded, I'm assuming there is a lot of back and forth feedback with VA? Can we have ongoing contact with the SMEs to maximize the success of the project?

A: Yes, offerors whose proposals are selected will work closely with VA subject matter experts, both prior to award and during project execution.

Q: Have there been provisions for continuation of projects in the past?

A: When a project completes, we evaluate its success and decide how we would like to move forward. This may involve broader deployment, further development and testing, or documentation of lessons learned.

Q: If a concept paper is chosen, what is the long-term timeline for submission of the full proposal and awarding of the grant?

A: If we select your concept paper, you can expect to be notified in late June. You will then have approximately one month to submit a full proposal. Should your proposal also be selected, we will likely contact you in September. It typically takes another 3–6 months after that to award a contract. Note that this is not a grant program.

Q: How extensive is the IRB process? Would submissions be reviewed by VA, DoD, or both?

A: If an IRB is required for a field test involving VA patients, VA will conduct the review with input from the contractor. The process may take several months.

Awards and Funding

Q: Within VAi2, is there a target amount of funding set aside for each topic area?

A: There are no target amounts set aside for each topic within this BAA. We will look at proposals of any size. Note that these are not meant to be nationwide system deployments—just pilot projects that we can evaluate prior to any national deployment.

Q: Is funding for contract awards set aside, or is it subject to potential budgetary constraints?

A: Funding for VAi2 is appropriated annually in the President's budget for VA. While that means that funding is budgeted for VAi2 programs—including the Industry Innovation Competition—award amounts are subject to the availability of remaining funds. This tends to favor submissions made earlier in the competition.

Q: If work is to be done at VA sites, will it be funded from this award? Do we factor this into our submitted budget?

A: Do not include the costs for work done by VA employees at VA sites in the proposed costs.

Q: What is the total number of awards for this effort? How many awards might there be per topic area?

A: The number of awards is not predefined. Because this is a BAA, we have the flexibility to review the concept papers and invite as many offerors to submit a full proposal as meet our criteria. We anticipate that a subset of proposals will be selected for award. We hope to receive many submissions that address the BAA topics in interesting and innovative ways.

Q: Historically, what has been the fraction of proposals selected for proposal and the fraction that have been awarded?

A: In 2011, we requested 69 full proposals from 260 concept papers, or roughly 25 percent. Thirteen of those proposals were selected for potential award, which is five percent of the original 260 submissions. In 2010, the number awarded was closer to ten percent.

Q: Are offerors required to use a specific accounting system in order to receive a grant?

A: First, this is not a grant program; the resulting actions will be FAR-based contracts, most of which will be firm-fixed-price. There is no specific accounting system required unless you propose to use a Cost Reimbursement contract type, in which case you will need an approved accounting system in accordance with FAR 16.301-3(a)(1). We can also use other vehicles if necessary.

Q: Are funds awarded at the start of the project?

A: Payment schedules will vary between contracts, but payments are generally associated with milestones and deliverables.

Ideas

Q: How is Intellectual Property (IP) regarded in this competition?

A: Generally, IP issues for any proposal will be a matter for negotiation during the contract formulation, consistent with IAW FAR Subpart 27.4—Rights in Data and Copyrights.

Q: What is a company's commitment to VA if it submits an idea?

A: The submission of a concept paper is merely the first step in determining VA's interest in exploring the potential for an invitation to submit a full proposal and potentially a contract award. As stated in the BAA, an invitation to submit a full proposal does not guarantee a contract award.

Q: Is an idea "made public" by the act of submitting it? Or is it only made public if it is selected?

A: An idea is not made public just by the act of submission. As stated in the BAA, it is the policy of VAi2 to treat all concept papers as privileged information. The BAA provides instructions regarding restrictive marking on proposals.

Q: Will VA consider a solution that employs commercial, fee-based online services?

A: The Government considers the overall impact of the solution and the most cost effective way to procure the innovative idea, in accordance with the procedures set forth in the BAA.

Q: Are you only considering solutions that have never been implemented or tested at VA?

A: The Government is looking for innovative ideas that increase Veteran access to VA services, reduce or control the costs of delivering those services, enhance the performance of VA operations and improve the quality of service that Veterans and their families receive. These ideas can modify existing practices, represent solutions never before implemented, or be proven solutions from other applications that have never been used at VA.

Q: Is there any limit on the amount of development that VA will fund?

A: Development proposals should be able to demonstrate a clear benefit and be ready for broad deployment within 12–24 months.

Q: I thought I heard earlier that this is not a proposal to receive funding, but now I am hearing that VA might fund research. Can you clarify?

A: The VAi2 Industry Innovation Competition seeks innovations that either are already commercially available or can be prototyped and evaluated within 12–24 months. Note that this is not a grant. Selected proposals may be awarded a contract with specific milestones and deliverables.

Q: Is there a constraint on project timelines? Can the contract award cover multiple years? If so, is there a limit?

A: The period of performance may not exceed 24 months.

Q: Is it expected that the efficacy of the new technology solution will be tested within the proposed two years?

A: Yes, proposals should include a field test or prototype evaluation as part of the period of performance.

Q: What do you mean by "scalability"?

A: "Scalability" refers to the ability of the proposed innovation to be deployed VA-wide. While there is no guarantee of any deployment of an innovation beyond the conclusion of the VAi2 project, should VA decide that broad production deployment would be beneficial, the complexity and cost of deployment at scale becomes important. Offerors are not required to submit deployment plans; it is sufficient to provide a discussion (which may be largely qualitative) of how the innovation might be scaled beyond the initial project.

Q: What is an example of an appropriate implementation plan?

A: As described in the BAA, the implementation plan addresses the proposed schedule, milestones, and deliverables for the innovation project, as well as the personnel, facilities, management, and structure of the organization. The implementation plan is a required component of the full proposal.

Questions about the Broad Agency Announcement (BAA)

Q: Is there a required format for the Performance Work Statement?

A: We have removed the requirement to write the technical proposal in a clear and concise Performance Work Statement (PWS). However, the technical proposal will serve as the basis for developing a PWS during the negotiation process. Therefore, please ensure that the technical proposal clearly defines all tasks to be performed.

Q: We were unable to find the required format for submissions (hardcopy, softcopy, PDF, etc.). Would you please respond or alert us to where we can find the answer to our question?

A: Proposals must be submitted electronically through the Virtual Office of Acquisition (VOA). Please review the VAi2-sponsored Broad Agency Announcement, VA11812R0253, found at this link.

Q: Is it preferred that the responding organization have previous federal contracting history for this announcement?

A: It is not required or preferred by the Government that organizations have a federal contracting history.

Q: Is the official applicant a VA representative or the private company? For instance, I am a faculty member at the SF VA; does that mean that I am the primary applicant, with the companies supplying the devices? Or am I secondary in this case? If I am secondary, what role does the VA staff member play? Does the contract allow for salary support if I am coordinating the clinical trial?

A: The VAi2 Industry Innovation Competition is looking for solutions submitted by industry. Private-sector entrepreneurs and companies of all sizes may submit concept papers. In order to conduct business with the Government, offerors must be registered in the Central Contractor Registration (CCR) database prior to contract award. VA clinicians or staff may not participate in concept paper preparation; however, a concept paper for the implementation of a process by VA doctors in a VA facility or a pilot program at a specific VA facility is acceptable. Do not include the costs for VA salary support in the Rough Order of Magnitude (ROM).

Q: Is there a set standard/expectation or formula that is used to determine the contract value, or is this decided by us based on our opinion/justifications?

A: No, there is no standard to determine the contract value. The value will be based on negotiation and agreement of the final cost/price based on the offeror's cost/price proposal.

Q: What is the "CAGE Code?"

A: A CAGE Code is a five-position code that identifies companies doing or wishing to do business with the Federal Government. The CAGE Code request process is incorporated into the CCR registration. Your company will be assigned a CAGE Code during the processing of your registration. Please see the CCR User's Guide for registration information.

Q: Are hyperlinks permitted in proposals?

A: Hyperlinks are not permitted in proposals or concept papers.

Q: What do "period of performance" and "proposed amount" mean?

A: "Period of performance" means the contract length. The "proposed amount" means the fair and reasonable dollar amount for your innovative idea.

Q: Is there a required format for the concept paper?

A: On page 10 of the BAA, there are specific instructions as to what must be included. Beyond that, the format can be of your choosing as long as you cover all required topics.

Q: What is the format of the one-page summary slide? Is it an actual PowerPoint slide or PDF with the graphics, etc.?

A: VAi2 has provided a PowerPoint template for the summary slide, also available as an attachment on FedBizOpps. Summary slides should follow this template and be submitted as a PDF document (you can save a PowerPoint file as a PDF with the "save as" feature).

Q: How long (pages) should the concept paper and final proposal be?

A: Concept papers may not exceed 8 pages in length, not counting the summary slide and cover page. Full proposals are limited to 50 pages. Please review the BAA for submission guidelines.

Q: Does the page limit for the concept paper include or exclude a reference list?

A: The 8-page limit DOES include the reference list.

Q: When I go into the summary part of the application, can I go into the phase one outcomes that have already been done?

A: Yes, one of the components of the "Proposed Approach" section should be a description of the potential impact and benefits of the proposed innovation. A discussion of previously demonstrated benefits can be included as supporting evidence.

Q: We have a video that we documented from day one to present with testimony. Can this be submitted with the application?

A: At the concept paper stage, your submission is limited to the concept paper, cover sheet, and summary slide. Multimedia attachments and hyperlinks are not permitted.

Maternity Continuity of Care

Q: Will maternity care beyond coordination application be accepted?

A: We want something that does coordinate between the private care and VA, and the solution should be a seamless transition/means of transmission between VA and private.

Q: Should this focus on just Veterans or Veterans and spouses?

A: For now, female Veterans who are pregnant would be the focus. The spouse is still important, and some educational functions could be included and directed to spouses/family (e.g. tools that can target family).

Q: Is there interest in monitoring infant care in the home?

A: Newborn benefits cover all post-delivery newborn care from birth up to the first 7 days of life. It is ideal that the newborn outcomes are tracked. A list of specific newborn outcomes can be developed and tracked (i.e. outcome of delivery, complications).

Q: Would there be a need for simultaneous tracking?

A: We envision this tool to allow for coordination of care across systems between VA and the public provider seamlessly.

Q: What are the different types of providers and other stakeholders that need to have access to the real-time tracking knowledge?

A: VA providers, VA health system leaders, Women Veteran Program Managers, VA Fee Basis/Contract Managers, Maternity care coordinators, and non-VA providers of maternity care. It would also be ideal if there would be access to a de-identified database nationally.

Q: What is the universe of providers outside the VA?

A: Through VA Purchased Care, VA provided maternity benefits for almost 3,000 pregnancies in the last year.

Q: Can you discuss how these must work with existing VA systems? Is there an internal case management system to which integration would be required?

A: Anytime you can leverage existing tools it is good. That said, if something will not work with a system, that should be listed. There are some case management tools available. It would be great if a particular function would sync up with the existing VA systems. But, don't be scared to go outside what the VA currently has in place.

Q: In terms of seamless sharing?

A: VA's electronic health record would exchange information with the private doctor. Maternity/newborn outcomes would be collected in a database that is user-friendly. "Seamless" depends on the proposal and how you plan on exchanging the information. For your concept paper, worry about performance; if chosen, we will begin to look into interfaces. It is not something you need to deal with initially.

Q: Is there a need to apply multiple policies to privacy/security?

A: Yes, that should be reflected in your proposal. We have polices to deal with that information, and we expect they will be applied to these programs. Initially, although you need to consider them, we will worry about the actual requirements for privacy/security at time of award. Please see information in the BAA.

Q: Who retains software rights?

A: Depends on when it was developed (under the BAA project, or previously). Specifics will be negotiated at the time of award depending on what we want and what you will offer us.

Q: Could there be a need for both VA and outside providers to provide care simultaneously, such as treating depression or high BP during pregnancy or post-partum for some time? It seems like Dr. Zephyrin is talking more to a transition period rather than simultaneously.

A: Yes, there are cases when VA and non-VA providers see a patient simultaneously. The Veteran may use VA care during pregnancy and in the postpartum period to manage non-pregnancy related diagnoses. Exchange of up-to-date accurate maternity information during that time is critical to ensuring coordinated quality care.

Q: Do the VA Coordinators already exist in the VA health care system?

A: In most sites the Women Veteran Program Manager ensures the Veteran receives needed services during her pregnancy. VA coordinators exist within the VA health care system and function in various roles. At this time, there is not an official national designation for a maternity care coordinator; however, a few sites may have someone functioning in this capacity.

Q: Are solutions preferred to propose the ultimate system, or pieces of that system that can work with other components to reach an ultimate system?

A: Preferred solutions are ones that develop a user-friendly innovation that will allow for real-time tracking of maternity and newborn outcomes (these can be defined), develop a searchable database of these outcomes, and/or allow for exchange of information between the Veteran, VA system and non-VA provider.

Q: The VAi2 materials refer to a "Firm Fixed Price" for the contract. In responding to the maternity tracker portion of the VAi2 BAA, are clinical medical services (pre- and post-partum) expected to be included as part of the fixed-fee cost proposal? If additional medical services emerge from the maternity tracking program (e.g., NICU, Maternal Fetal Medicine, PPD psychiatric support), how are these accounted for, if at all, in the BAA and its associated cost structure?

A: Medical services for maternity care will generally not need to be included in your cost proposal; those services will be provided and paid for by VA. The goal of this BAA topic is to provide an innovative solution for tracking maternities, not to provide medical services.

Q: Is there a standard set of data elements that are required for the maternity outcomes analysis?

A: Standard data elements for maternity/newborn outcomes include the following:

• Antenatal care "outcomes" can include information that is part of standard assessment at prenatal visits (see ACOG's antepartum template and VA/DoD's pregnancy passport template)
• Maternal outcomes, including: pregnancy complications (hypertension, diabetes, preeclampsia, hemorrhage, placenta previa, etc.), type of delivery (cesarean section, vaginal), length of stay, lactation status, etc.
• Newborn outcomes (birth weight, complications, gestational age at birth, apgar scores, length of stay, etc.)

These standard data elements may be defined in categories using CPT codes, ICD-9 codes, and/or DRG codes.

Q: Does all compiled data need to be searchable (discrete data)?

A: Yes.

Q: Is there a need for a user interface for outside providers who do not yet use electronic medical records?

A: There is not currently a user interface for outside providers who do not use electronic medical records. A user interface for outside providers would be beneficial.

Q: Is there a requirement to track all outside care a female Veteran receives during her pregnancy, or should this be limited to just the maternity care?

A: The requirement is to track outside maternity care the female Veteran receives during pregnancy and the immediate postpartum period (up to 3 months postpartum).

Redesign of the PTSD Treatment Experience

Q: What percentage of PTSD members use MyHealtheVet (MHV)?

A: We don't know. We continue to develop that information, but we don't know how many MHV users have PTSD. We would be interested in a tool that would help us track that. You may therefore propose to use it, but MHV is not a requirement. If you know there is information you would like to capture for your proposal, please let us know what those requirements would be, and we will provide feedback on how to implement your plan.

Q: What would you consider a reasonable study size?

A: It's hard to answer that question because so many variables would affect it. We would be particularly interested in proposals that use a large sample size, or a large sample size of different locations of care (MCs, CMOCs, colleges, etc.). We would like a sample size of at least 100, but again, it depends.

Q: It sounds like we can only use VA-offered services at a VA facility. Is this true? Or would you consider proposals for innovative methods offered outside of VA that could be incorporated into a VA environment later?

A: We would certainly like to use outside programs (community resources, clergy, etc.) for this treatment. As a matter of fact, we prefer to see outside programs that can supplement the existing VA systems.

Q: Regarding outcome measures, does VA measure these?

A: Standard is the VA PTSD checklist, if diagnostic interview, then clinician assessment (guided interview). We will certainly consider others with explanations.

Q: Must we involve a VA clinic?

A: No, you may propose a VA pilot site, but you don't have to. If you are not going to collaborate with VA, the therapy will need to be provided by your choice of clinicians, and we must ensure that the site can provide evidence-based PTSD services based on VA regulations.

Q: We are hoping to clarify that it is okay to submit a proposal that would entail redesigning the PTSD experience outside of the VA system.

A: Yes, we are interested in all viable solutions that improve the likelihood that Veterans with PTSD will seek and complete evidence-based treatment.

Q: How many VA members are currently experiencing some degree of PTSD? What percent are diagnosed?

A: We do not have definitive data on how many Veterans in VA are "experiencing some degree of PTSD" or what percent are diagnosed. What we can say is that in fiscal year 2011, 476,515 Veterans received at least two outpatient mental health visits or one inpatient bed day of care related to a primary or secondary diagnosis of PTSD.

Q: Of those diagnosed, what percent receive SSRI/SSNRI or Benzodiazepine Rx treatment alone? What percent receive Cognitive Behavioral Therapy treatment alone? What percent receive both Rx and Cognitive Behavioral Therapy treatment?

A: We do not have data broken down in exactly that way. We refer the interested party to a recent article that may have information of close relevance:

Bernardy, N., Lund, B., Alexander, B., and Friedman, M. (2012). Prescribing trends in Veterans with Post-Traumatic Stress Disorder. Journal of Clinical Psychiatry, 73(3), 297-303.

Q: Approximately how many patients use the My HealtheVet member portal?

A: As of March 31, 2012, there were over 1.6 million registered users of My HealtheVet. Of those, over 600,000 had authenticated their accounts in person, which is required in order to use certain features.

Q: How involved does your team intend/desire to be in data organization and analysis process? Do you have an informatics/analytics team for these kinds of situations, or would you prefer that we partner with a research institution to provide the bulk of the data analysis and outcomes reporting?

A: The VA Office of Mental Health Services has a very small team working on Mental Health Informatics and Analytics that would be able to provide a limited amount of consultation at the beginning of the project. However, they would not have the resources to be involved in the "data organization and analysis process" throughout the project. Proposing to work with a research institution for data analysis and outcome reporting would be very appropriate.

Mobile Applications for eBenefits

Q: Since we use iOS devices, is there a preferred OS?

A: Target iOS and Android. Portability between those operating systems would work best.

Q: Can we get information on VA's IT infrastructure?

A: Look at standard web service interfaces. Talk about how you would leverage standards and what your requirements will be. Also, many of these systems are still evolving toward a particular infrastructure. Don't get too hung up on interfaces/architecture; focus on what you are providing us, why we need it, and what resources you would need in order to perform. If your paper is invited back for a full proposal, we will work with you to determine the specific technical interface requirements.

Q: How does eBenefits link into MyHealtheVet, Blue Button, and DOD systems?

A: There is a current program working to link eBenefits with MyHealtheVet. It should be up around April. That said, for this proposal, worry less about the sign-on web interfaces and more about how you would make use of the systems to help make the app work. We will work with you to determine how best to make that connection. Vendors can assume that we will determine sign-in.

Q: How frequently do these systems/requirements change so that the mobile front would change?

A: Be prepared for the fact that things do change in this domain. More valuable than any particular function would be the ability to add/delete functions from the mobile front end. We are in a process of transformation, and new processes/technologies will be utilized within VBA. It is important that the app be able to evolve to meet those changes.

Q: What about Section 508 requirements?

A: They are applicable to the mobile apps.

Q: What about the current eBenefits mobile?

A: It is continuing. We would like to advance and develop this further, so proposals should be used to further the eBenefits functionality.

Q: Do systems that we propose need to be behind the VA firewall?

A: Functionally, either way would work, but we have found that there are many systems that have the information behind the firewall, and you will be required to interface with some of them. That said, don't let your proposal suffer for worrying about these interfaces. Worry about functionality first and foremost.

Q: Eligibility on mobile app?

A: That is tricky. We are not there yet, and would rather focus on the backbone functions and worry about the more advanced functions in the future.

Q: Are these services in eBenefits accessible via web services?

A: Yes, eBenefits uses web service to fetch data from the back-end data sources.

Q: Whom do we contact for current system information?

A: Please contact Carol Newcomb (Carol.Newcomb@va.gov), Contracting Officer, who will refer your question to the appropriate subject matter expert.

Q: Is there a preferred call routing technology? (e.g. Siebel, Microsoft, etc.)

A: This question is a bit unclear. Would the vendor please elaborate?

Q: What happened to the current eBenefits mobile portal? Any challenges with the current mobile portal that you can share?

A: There are no challenges to report with the mobile portal at this time.

Q: How could we gain additional details on what back-end systems and APIs are available? Do you have public APIs that are available for accessing data using enterprise data access services?

A: Not every API is publically available. Specific details on the APIs can be made available as needed. Please contact Carol Newcomb (Carol.Newcomb@va.gov), Contracting Officer, who will refer your question to the appropriate subject matter expert. Please specify which back-end systems and include the details you are looking for.

Q: iPhone and iPad both run iOS. Did you misspeak in saying Mac OS?

A: Yes. iOS is the preferred mobile platform. Android should follow quickly thereafter.

Q: Are you looking to enhance eBenefits or have a new application that supplements the current eBenefits application?

A: eBenefits is in a constant state of development as we update the site with new features and services.

Innovations in Prevention and Treatment of Pressure Ulcers

Q: How is VA currently tracking wound data?

A: Tracking wound data is done in a variety of ways. Some have developed templates, but it's not universal. It's different at each VA location, but it is usually added to the EHR as notes no matter how it was initially tracked at the local level.

Q: Does VA currently use any equipment that stops pressure ulcers?

A: It depends on the facility, but at the Memphis VA we had 100 percent Integrated Air Services on each bed. Each VAMC may use different technology. The fact that there isn't a nationalized standard would definitely be an area that innovators should target.

Q: What percent of ulcers happen at hospitals versus the home?

A: We need to check the exact numbers, but we do know that the national statistic for hospital ulcers is 1 percent to 5 percent. For home care, it depends on whether it's palliative, in which case pain management is the most important goal. It seems as though there is a higher percentage of acute hospital care cases.

Q: Do we know how VA pressure ulcer healing compares to the general population?

A: No, there is no way to obtain that information at this point.

Q: Do you have a best practice for care of ulcers? Or are you looking for this innovation to drive that practice?

A: The latter. We have a lot best practices, but they are not realized and they are not shared consistently. In some facilities, we are using some methods that are not as evidence-based as we would like.

Q: To clarify, there is not a standard patient assessment instrument used across the VA?

A: There is a standardized template for admission and one for reassessment, and the reassessment is done daily. Those are the data we are collecting universally now. If it is not conducted in a timely manner, or consistently, the data are inaccurate, and we cannot use them. That is the current issue with the process. There will be some wound care standards coming out soon, but we do not have them yet, nor do we know how sophisticated they will be. We would like an IT application that can be expanded to look at all types of wound healing. For ulcers, we need applications to verify the baseline data.

Q: Does the VA know how long wounds progress from Stage 1 to 4? Would it help to know this information?

A: Yes, we would definitely like to know that information. We do not have access to it yet, and the current information available must be maintained on a patient-by-patient basis and tracked by hand.

Q: How do you currently measure the effectiveness of the interventions?

A: Basically, we measure by determining if the wound heals. On a case-by-case basis, we monitor our patients' healing and we modify treatment if we do not see improvement.

Q: Would an organization's ability to fix all wounds help here?

A: No, this group is specifically looking at pressure ulcer care. Possibly on future efforts, though.

Q: Do we have any estimate of the costs that are currently associated with pressure ulcer care?

A: No, we do not have that information at this time. What we do have is the cost of a day of care, which varies depending on where you are. The best way to look at it is if we can prevent the more serious ulcers, we can save a lot of money. It is difficult to track exactly how much we spend per person across VA, though. Medicare figures have been used, but that information is only partially helpful.

Q: On the cost question, is it possible to segregate by stage?

A: There has been some literature on that, but it is all over the place. It is therefore difficult to state accurate costs, since they vary depending on what you are looking at and what it comprises (e.g. legal costs, how long did it take to heal, etc.)

Q: Also, are there sources for current best practices in healing by type?

A: Yes there are several resources for best practices for different types of wounds (e.g. pressure ulcers, diabetic ulcers, venous stasis ulcers). Here are a few we have used:

1. Guideline for Prevention and Management of Pressure Ulcers. Wound, Ostomy and Continence Nurses Society. Retrieved from https://wocn.site-ym.com/store/default.asp
2. Guideline for Management of Wounds in Patients with Lower-Extremity Venous Disease. Wound, Ostomy and Continence Nurses Society. Retrieved from https://wocn.site-ym.com/store/default.asp
3. Agency for Healthcare Research and Quality. Preventing Pressure Ulcers in Hospitals: A Toolkit for Improving Quality of Care. Retrieved from http://www.ahrq.gov/research/ltc/pressureulcertoolkit/
4. National Pressure Ulcer Advisory Panel. Pressure Ulcer Treatment. Retrieved from http://npuap.org/Final_Quick_Treatment_for_web_2010.pdf

Q: How is the patient's ulcer data entered into the MyHealtheVet portal? Is the patient able see his/her medical records as they relate to his/her ulcer?

A: To our knowledge, the patient's ulcer data may be entered into the electronic medical record by templates or progress notes, but not into the MyHealtheVet portal. The portal is for communication with the physician/provider on the patient's status, to make appointments, and to refill prescriptions. There is not access to progress notes at this time.

Miscellaneous

Q: Can you provide an example of a technology that was selected as a result of last year's program?

A: Funded innovations from the 2010 industry competition are available on the Funded Innovations page.

Q: Can you expand upon how the 2011 VHA innovations on the VAi2 website are linked to the 2012 BAA? Are they linked only under the "Innovation Initiative?"

A: VAi2 runs separate competitions to solicit innovative ideas from employees and the private sector. The VHA innovations were generated by VA employees through an internal competition, while the 2012 industry competition is open to the private sector only. VAi2 funds and administers both competitions, but they are not directly associated.

Q: Is there any piece of advice or something I should remember as I decide to turn in my application?

A: We encourage you to review these FAQs and the webinar presentations for additional information that may be of help.

Q: What is VA policy on taking photographs?

A: The VAi2 team will work with offerors on a case-by-case basis if photographs are required. For example, photographs of VA facilities or equipment to be used in project planning during the execution phase of an innovation project may be allowed; photographs of Veterans, patients, or employees may not be allowed under some circumstances.

Q: What does "implementation" mean?

A: It depends on the context. We often use the term "implementation" in the context of an innovation project to refer to a pilot or field test, where the technology or solution is evaluated in a live VA setting. We may also speak of "implementation" following the pilot or field test, when a successful innovation is transitioned to a more permanent deployment at VA.