COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

December 22, 2006

BOARD MEETING DATE:

January 23, 2007

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

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

SUBJECT:

Amendment to the Agreement with WebMedx

RECOMMENDATION:

Adopt a Resolution authorizing the execution of an Amendment to the Agreement with WebMedx and the County of San Mateo to add to the scope of services under the Agreement installation and maintenance of an Electronic Signature Authentication (ESA) system at San Mateo Medical Center (SMMC), and to increase the maximum amount payable under the Agreement by $80,000 to a total of $4,030,000.

VISION ALIGNMENT:

Commitment: To Ensure Basic Health and Safety for All and a Responsive, effective and collaborative government.

Goal 5 and 20: Provide residents access to healthcare and preventive care and Government decisions are based on careful consideration of future impact, rather than temporary relief or immediate gain.

Performance Measure(s):

Measure

FY 2005-06
Actual

FY 2006-07
Projected

Reduce Chart delinquencies

30%

30%

Reduction of FTE needed to follow-up on unsigned charts

1-2 FTE dedicated to chart follow up

1-2 FTE dedicated to chart follow up

WebMedx provides medical transcription services to SMMC and all facilities. Replacing the physical signature process currently in use at SMMC with an Electronic Signature Authentication (ESA) system will reduce the potential to negatively affect patient care and will improve SMMC revenue.

BACKGROUND:

Currently all medical transcriptions generated at SMMC are physically printed, sent to the dictating physician for review and signature, and then filed in the corresponding patient paper chart. This process is labor intensive, and often results in incomplete charts. Incomplete charts can impact and affect the quality of patient care and result in a backlog of unrealized SMMC revenue.

There will be a reduction in workload for medical records staff as a result of a successful ESA implementation. More important, SMMC should realize a significant reduction in chart delinquencies as a result of easier access to, and a higher compliance with signing transcriptions. Physician satisfaction will increase as a result of a simpler process for performing the task of signing documents.

DISCUSSION:

The SMMC Medical Records Department is aggressively seeking options to improve the processing of transcribed documents, by implementing an electronic signature capability which will enable physicians to authenticate and electronically sign documents. This system will be electronically linked to the Chart deficiency system used to monitor signature compliance.

In June, 2006, SMMC conducted a Request for Proposal for an Electronic Signature Software to replace the physical signature process that is currently in use at SMMC. Four proposals were received and evaluated.

Two vendors were selected for further evaluation based on quality, pricing, experience, and references. Selection criteria included turnaround time, performance parameters, training, technical support and quality assurance. Webmedx was selected, as they met SMMC’s standard for quality and proposed the best price.

It is recommended that the SMMC implement Webmedex’s Electronic Signature Authentication software. This software will replace physical signature process that is currently in use.

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, Risk Management, and Information Services Department have reviewed and approved this Agreement.

FISCAL IMPACT:

The term of the Agreement with WebMedx is presently February 1, 2006 to January 31, 2009, with a maximum amount of $3,950,000. The Amendment increases the maximum amount payable under the Agreement by $80,000 to a total maximum obligation of $4,030,000. Funds are included in SMMC’s FY06-07 Adopted Budget and will be included in future year Budget Requests.