COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

July 6, 2005

BOARD MEETING DATE:

July 26, 2005

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Nancy J. Steiger, Chief Executive Officer, San Mateo Medical Center

SUBJECT:

Third Amendment to the Agreement with MedQuist
Transcriptions, Ltd.

RECOMMENDATION:

Adopt a resolution:

A.

Waiving the Request for Proposal (RFP) process

B.

Authorizing the President of the Board to execute an Amendment to the Agreement with MedQuist Transcriptions, Ltd. to provide medical transcription services, increasing the amount by $1,400,000 and bringing the total obligation to $5,254,622; extending the term by one year; and replacing Schedule B.

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all.

Goals 5: Residents have access to healthcare and preventive care.

This agreement provides timely access to health information which is critical to patient care and safety.

Performance Measure(s):

Measure

FY 2004-05
Actual

FY 2005-06
Projected

Percent of time that transcribed reports are available throughout SMMC

98%

98%

The agreement provides mandated transcription services making transcribed reports, accurate procedure reports and health information available for physicians, in a timely manner, regardless of the site of the patient’s previous visit.

BACKGROUND:

The medical record serves as the primary communication tool between providers and is a legal document attesting to clinical services provided. Dictated reports support the safe delivery of care. In addition, State and Federal regulatory agencies, including the Joint Commission Accreditation of Healthcare Organizations (JCAHO) and the Licensing and Certification Division of the State Department of Health Services (DHS) regulate health information documentation. SMMC has encouraged increased dictation of patient encounters to increase communication across our system. This includes using dictation and transcription for all admissions and summaries of hospital inpatient stays, same day surgeries, outpatient clinic visits including the satellite clinics, emergency department visits, and ancillary tests through a contractor. Excluded from this service is pathology and radiology dictation, which are under separate contract. The contractor includes the equipment needed for dictating and equipment maintenance services.

After a Request for Proposal (RFP) process in January 2001, MedQuist was selected from five providers because they were the lowest bidder and had the best qualification. The term of the agreement was May 1, 2001 to April 30, 2004 with a maximum amount of $1,439,622. Your Board subsequently approved two amendments to the agreement. The first Amendment extended the term of the agreement through April 30, 2005 and increased the maximum amount to $2,654,622. The second Amendment allowed a Mitigation Period while MedQuist was switching from DOS to Windows, decreased the rate per line by 10% in the current agreement, included services to Burlingame Long Term Care, as well as to three new clinics: Ron Robinson Senior Center, Fair Oaks Pediatric Clinic and the Infusion Clinic, and increased the maximum amount to $3,854,622.

DISCUSSION:

Transcribed reports allow the availability of health information throughout San Mateo Medical Center for continuation and quality of patient care. A health care provider can review transcribed reports from anywhere in the Medical Center and Clinics. Patients coming to the San Mateo Medical Center emergency room can have the benefit of their prior health information available for emergency treatment. In addition, the transcribed medical record contains the most accurate record of medications a patient is receiving and is crucial for Medication Reconciliation, a National patient Safety Goal.

This amendment will allow continued services for an additional year while an RFP for future services is completed. MedQuist has provided good service at excellent rates during this time period and will compete for future services.

The Medical Records Department has aggressively considered other options to decrease the cost of transcription and the processing of the transcribed documents, including, voice recognition; building templates specific for disciplines and electronic signature which will enable physicians to authenticate (sign) documents at their computer terminals. A RFP is being developed and will be completed by December 2005.

County Counsel and Risk Management have both reviewed and approved this Amendment.

FISCAL IMPACT:

This Amendment increases the maximum amount of the Agreement by $1,400,000, from $3,854,622 to $5,254,622, and extends the term of the Agreement by one year, making the new term of the Agreement May 1, 2001 to April 30, 2006. Funds are included in SMMC’s FY2004-05 Adopted Budget and in the Recommended Budget for FY2005-06.