COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Information Services Department

DATE:

July 5, 2006

BOARD MEETING DATE:

August 1, 2006

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

 

TO:

Honorable Board of Supervisors

FROM:

Chris Flatmoe, CIO/Director of Information Services

SUBJECT:

Amendment #1 with Picis, Inc. for the San Mateo Medical Center (SMMC) Emergency Department Information System (EDIS).

   

RECOMMENDATION:

Adopt a Resolution:

    Authorizing the execution of Amendment #1, adding:

    Supplemental Software and Services Agreement #2 – ADT Software License and Fees,

    Supplemental Software and Services Agreement #3 – Exit-Writer, and

    Supplemental Software and Services Agreement #4 – End User Training with Picis, Inc.

Increasing the not to exceed amount by $52,500 and bringing the total obligation to $652,500.

 

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 by providing 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 developed an Information Technology Strategic Plan (ITSP). The ITSP recommended the acquisition of a dedicated Emergency Department Information System (EDIS) that interfaces with Siemens Invision Healthcare Information System (HIS).

The ED uses Invision and manual processes for patient registration, orders, results, and charge entry. Additionally, SMMC ED operations were supported by several computing systems, which included SpaceLabs ED discharge instruction system. A new EDIS system would replace the out-dated, non-integrated SpaceLabs discharge instruction Emergency Department module. An updated ED system would provide better clinical documentation, patient discharge instructions, and support for a more efficient ED workflow. Finally, the system would deliver improved billing for hospital services and supplies.

On December 6, 2005, after selection of Picis, Inc. as the best overall vendor among six responses to an RFP, your Board approved an Agreement with Picis, Inc. by Resolution #067671 for implementation of the new EDIS. During implementation of the PICIS EDIS, three essential features were identified that were not included in the original Agreement.

 

DISCUSSION:

Detailed implementation work with the PICIS EDIS led to the discovery of the following three unanticipated requirements:

    1) The addition of an outbound Admissions-Discharge-Transfer (ADT) interface would enhance the workflow and speed the delivery of completed clinical charts to the billing system.

    2) The available discharge instruction sets were found to be written in English only, and tailored for patients who have a university education. The licensing of the Exit-Writer content will allow us to provide discharge instructions in English and Spanish that are understandable by the majority of our patients, and

    3) Additional training by Picis for our staff will minimize the disruption to Emergency Department operations that may otherwise occur at the time of go live for this software.

ISD is requesting your Board approve Amendment #1, attaching the above features to the Agreement with Picis, Inc.

The Contractor has assured compliance with the County’s Contractor Employee Jury Service Ordinance, as well as all other contract provisions that are required by County ordinance and administrative memoranda, including but not limited to insurance, hold harmless, non-discrimination and equal benefits.

County Counsel has reviewed the Amendment and advised SMMC/ISD of the risks and potential liabilities.

 

FISCAL IMPACT:

The term of this Agreement is from December 6, 2005 to December 6, 2009. This Amendment increases the not to exceed amount of the Agreement by $52,500. The total obligation under this Agreement will be $652,500. Future year’s maintenance costs will be included in the Information Service Department’s FY2006-07 Recommended Budget and distributed to the appropriate departments within the San Mateo Medical Center through the ISD work authorization process.