COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

January 6, 2006

BOARD MEETING DATE:

January 31, 2006

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Nancy Steiger, CEO/ San Mateo Medical Center

Chris Flatmoe, CIO/Director of Information Services

SUBJECT:

Agreement with Dictaphone Corporation

RECOMMENDATION:

Adopt a Resolution:

A)

Waiving the Request for Proposal (RFP) process

B)

Authorizing the execution of an Agreement with Dictaphone Corporation to install and maintain a radiology transcription and dictation information system at San Mateo Medical Center (SMMC) for the period of February 1, 2006 through January 31, 2009, in an amount not to exceed $233,100; and

C)

Authorizing the Chief Executive Officer of SMMC 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 Dictaphone’s Powersribe system provides a speech recognition radiology dictation system that will further automate the transcription process and improve patient care. Currently, there is a 24 hour turn around time from dictation, to transcription, to physician for signature. The Dictaphone/Powerscribe system provides a reduction in time for the signature process, and radiology reports are immediately available to the physician. These performance targets reflect projected improvement from the current fiscal year.

PERFORMANCE MEASURES:

Measure

Current Year 2006

Projected Year 2007

Projected Year 2008

% of Radiologists using voice dictation

95%

100%

100%

System Uptime

95%

99%

99%

Turn Around Time (TAT)

95% 4 hr. TAT

99% 2 hr. TAT

99% 2 hr. TAT

BACKGROUND:

Since 1999 the provider of transcription services for Radiology has been The Electric Company. The Electric Company has notified SMMC that they intend to terminate their contract with SMMC effective March 31, 2006. Radiology currently transcribes approximately 4000 radiology reports per month.

In response to the Electric Company’s intention to terminate their current contract, a small group was assembled to survey the radiology transcription industry for vendors of automated radiology transcription systems. This selection panel, consisted of the Director of Imaging, a Project Manager from Information Services Department (ISD), two Information Technology Analysts, two Radiologists, the Chief Medical Information Officer, and the Vice President of Ancillary and Support Services . Requirements for the proposed solution were that the software system must automate transcription of physician dictations and enable physician editing and electronic signoff, integrate with our Siemens Radiology Information System (RIS) version 27, be proven in the marketplace and supported by a stable vendor.

DISCUSSION:

The selection panel examined the dictation solutions that are listed on SMMC’s MDbuyline service and selected three vendors for detailed consideration. The panel then evaluated input from a Siemens User Group to evaluate the compatibility of existing interfaces between Siemens RIS version 27 and the vendor’s solution, the functionality of the proposed solution and cost. The evaluation process included detailed review of functionality and usability with onsite presentations and demonstrations, plus additional demonstrations of software via teleconferencing. Radiologist members of the selection panel, who would be users of the systems, tested the physician training and setup features of each system.

The selection panel recommends Dictaphone Corporation as the chosen vendor for several reasons. Dictaphone/Powerscribe has successful interfaces in production use between Siemens RIS version 27 and Dictaphone/Powerscribe. The other vendors would have to build a custom interface which would require longer time for implementation and greater professional fees. SMMC radiologists are familiar with the Dictaphone/Powerscribe system since they are using the Dictaphone/Powerscribe system at other hospital sites where they practice and this familiarity reduces the training costs and lessens the risk of failure of physician adoption. Also, the timeline for implementation of the Dictaphone system is shorter. Additionally, the price from Dictaphone/Powerscribe was the lowest compared to the other vendors surveyed. Based on the results of an informal RFP and our immediate need for a replacement of the current radiology transcription service, we feel it is in the best interest of the County to waive the RFP process. The Information Services Department and County Counsel has reviewed and approved the Resolution and Agreement as to form. County Manager’s Office has approved the waiver request for Equal Benefits.

FISCAL IMPACT:

The term of this Agreement is from February 1, 2006 through January 31, 2009. The total obligation under this Agreement is not to exceed $233,100. Funding for this Agreement is included in the SMMC Budget and the FY 2005-06 ISD Adopted Budget.