COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Information Services Department

DATE:

November 11, 2005

BOARD MEETING DATE:

December 6, 2005

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Chris Flatmoe, CIO/Director of Information Services

SUBJECT:

Agreement with Picis, Inc. for Emergency Department Information System

RECOMMENDATION:

Adopt a Resolution:

A. Authorizing the execution of an Agreement with Picis, Inc. to install and maintain an Emergency Department Information System (EDIS) at San Mateo Medical Center (SMMC) for the period of December 6, 2005 to December 6, 2009, in an amount not to exceed $600,000; and

B. Authorizing the Chief Information Officer to execute subsequent amendments and minor modifications in an amount not to exceed $25,000.

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all County residents.

Goals 5 and 7: Residents have access to healthcare and preventive care; and maintain and enhance the public safety of all residents and visitors.

This Agreement contributes to these goals because Picis, Inc. provides a computer application that will automate and improve Emergency Department (ED) patient care.

PERFORMANCE MEASURES:

Measure

FY 2005-06
Projected

Reduce ED dictation volume

50%

Reduction of ED cycle time

30 minutes

BACKGROUND:

SMMC has recently completed an Information Technology Strategic Plan (ITSP) process. The ITSP recommends the acquisition of a dedicated EDIS that is interfaced with Siemens Invision Healthcare Information System (HIS).

SMMC utilizes Siemens Invision HIS and has been a Siemens customer since 1999. The ED uses Invision and manual processes for patient registration, orders, results, and charge entry. Additionally, SMMC ED operations are supported by several computing systems, including SpaceLabs ED discharge instruction system.

Currently, clinical care in the ED is based largely on manual and paper-based methods. Triage notes are recorded on paper, and the paper chart is used to record nursing notes and physician and physician-assistant orders.

DISCUSSION:

A new EDIS system will replace the out-dated, non-integrated SpaceLabs discharge instruction Emergency Department module that is currently installed.

An updated ED system will improve patient care by providing the ability to identify and report on patients who meet arbitrary diagnostics, evaluation, or treatment criteria. A new system will provide better clinical documentation, patient discharge instructions, and support for a more efficient ED workflow. Financially, the system delivers accurate and improved billing for hospital services and supplies through the use of an automated analysis. This analysis validates whether or not the required elements of clinical documentation are present for the level of physician billing.

In August 2005, the EDIS selection committee solicited RFPs from six vendors, and received five proposals as listed in Exhibit A. Picis, Inc. was selected due to the “best overall fit” of their proposed solution to SMMC’s operating needs, their compliance with the RFP functional requirements, and their proven experience with similar projects.

This Agreement with Picis, Inc. differs from the County’s standard agreement in several significant respects. The terms of the sub-licensors’ agreements do not indemnify the County, include provisions for the payment of attorneys’ fees in the event of a dispute, and one of the sublicensor’s agreements dictates that the trial of any dispute be venued in Illinois. The sub-licensors in this case supply programmed content intended to be used in the application of care in the ED. It is common for such content providers to require these provisions. County Counsel has reviewed the Agreement and advised SMMC/ISD of the risks and potential liabilities of entering into the Agreement.

A waiver request extending the contract beyond three years in on file in the County Manager’s Office.

FISCAL IMPACT:

The term of this Agreement is from December 6, 2005 to December 6, 2009. The total obligation under this Agreement is not to exceed $600,000. Funding for this Agreement is included in the SMMC Budget. Future year maintenance will be included in the Information Service Department’s Recommended Budget and cost applied to SMMC.

1.

General Description of RFP

Project to Acquire Emergency Department Information System (EDIS)

2.

List key evaluation criteria

(1)"Best overall fit" of vendor's proposed technical solution to SMMC’s operating requirements (2) Technical compliance with the RFP functional requirements (3) Vendor’s proven and successful previous experience with similar projects (4) Cost of the proposed solution(s) (5) Vendor’s general financial strength and stability in the industry

3.

Where advertised

N/A

4.

In addition to any advertisement, list others to whom RFP was sent

List of Names in #8

5.

Total number sent to prospective proposers

6

6.

Number of proposals received

5

7.

Who evaluated the proposals

Albert P. David, ISD Relationship Manager

Julie Griffiths; Charge Nurse, ED

Lisa Lee, Charge Nurse

James Lonergan; Director of Critical Care Services

Edward Lipton, Staff Physician

Isela Montenegro, Patient Access Manager

Edgar Pierluissi, VP & Medical Director, Quality

Kathi Palange, VP Patient Care Services

Ana Rivera, Training Specialist

Geoff Rutledge, Chief Medical Information Officer

Cathy Shiner, Patient Supervisor

Robert Spencer, Supervising Physician

Celeste Symonette, Quality Dept

Linda Wallach, Quality Manager

Dawn Yaley, Registered Nurse

8.

In alphabetical order, names of proposers (or finalists, if applicable) and location

Amelior Inc.

Mr. Jeff Powell, Regional Vice President

32 Journey, Suite 250, Aliso Viejo, CA 92656

Cerner/Vitalworks Inc., Mr. Cameron Miller
2800 Rockcreek Parkway, Kansas City, MO 64117

Emergisoft Inc, RFP Response Team

proposals@emergisoft.com

Emergisoft Plaza
524 E. Lamar Blvd. Suite 100, Arlington, Texas 76011

PICIS (Ibex) Inc., Ms. Rebecca Forristall

5600 N River Road

Suite 150, Rosemount, IL 60018

Siemens Medical Solutions USA, Mr. Stephen C. Miller

6700 Koll Center Parkway

Suite 220, Pleasanton, CA 94566

Wellsoft Inc., Ms. Lisa Nazzaro & Ms Mary Jane Martin

Account Executives

605 Franklin Blvd, Somerset, NJ 08873