COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Information Services Department

DATE:

December 24, 2007

BOARD MEETING DATE:

January 8, 2008

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Sang-ick Chang, M.D., CEO/San Mateo Medical Center

Chris Flatmoe, CIO/ Director of Information Services

SUBJECT:

An Agreement with eClinicalWorks

RECOMMENDATION:

Adopt a resolution:

A. Authorizing the President of the Board to execute an Agreement with eClinicalWorks to install and maintain an Ambulatory Electronic Medical Record (AEMR) at San Mateo Medical Center (SMMC) for the term of seven (7) years, commencing upon the date of the Board of Supervisors’ approval, in an amount not to exceed $1,800,000 over the term of the Agreement; and

B. Authorizing the Chief Information Officer or his designee to execute contract amendments which modify the County’s maximum fiscal obligation by no more than $25,000 (in aggregate), and/or modify the contract term and/or services so long as the modified term or services is/are within the current or revised fiscal provisions.

VISION ALIGNMENT:

Commitment: To ensure basic health and safety for all County residents and a responsive, effective and collaborative government.

Goal 5 and 7: Provide residents access to healthcare and preventive care; and maintain and enhance public safety of all residents and visitors.

This Agreement contributes to these goals because eClinicalWorks introduces automation that will replace manual and paper-based systems resulting in improved patient care as well as reduced costs. As a result of implementing the AEMR, the following Performance Measures will be achieved:

Performance Measure(s):

Measure

FY 2008-09
Projected

Reduce outpatient clinic dictation volume

50%

Reduction of Emergency Dept. visits and hospitalizations for patients with asthma and diabetes

10%

Reduce storage space required for medical records in the outpatient clinics

20%

BACKGROUND:

Currently, clinical care in the outpatient clinics is based largely on manual and paper-based methods. This contributes to overhead for file storage, staff time to locate paper charts, and difficulty in reading different styles of handwriting.

In January 2005, the AEMR selection committee composed of SMMC and ISD personnel sent a Request for Proposal (RFP) to AEMR system vendors. Responses were received from 5 vendors, with 3 considered as finalists (Exhibit A). eClinicalWorks was ultimately selected due to their proposed solution for SMMC’s operating needs, their compliance with the RFP functional requirements, and their proven experience with similar or larger projects.

DISCUSSION:

A critical component of SMMC’s Information Technology Strategic Plan, the AEMR will interface with SMMC’s Hospital Information System. In addition, a new methodology for preventive care of patients with chronic diseases, known as the Chronic Care Model, is being incorporated into the outpatient practices at SMMC and requires the use of specialized databases of information called Registries.

The AEMR will provide better and more uniform clinical documentation and support resulting in more efficient clinic workflow. The new AEMR will also replace the non-integrated Electronic Disease Registries resulting in a more flexible and easier to use solution than the current systems.

The Agreement has been reviewed and approved by County Counsel. 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.

The County Manager approved a waiver allowing the negotiation of a seven year Agreement with eClinicalWorks.

FISCAL IMPACT:

The term of the Agreement is seven (7) years and would start upon the Board of Supervisors’ execution of this Agreement. The total obligation under this Agreement is not to exceed $1,800,000. Funding for this Agreement is entirely through grants and gifts from the SMMC Foundation. Future years’ maintenance will be included in the ISD Recommended Budget and cost applied to SMMC, while a permanent position for ongoing administration of the AEMR will be included in the Recommended SMMC Budget after the first year.

1.

General Description of RFP

Project to Acquire Ambulatory Electronic Medical Record and Scheduling System

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) End user evaluations from Vendor fair (4) Vendor’s proven and successful previous experience with similar projects (5) Cost of the proposed solution(s) (6) 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 vendors

10

6.

Number of proposals received

5

7.

Who evaluated the proposals

Michael Aratow, Chief Medical Information Officer

Cheryl Dellafemina, Analyst, ISD

Stuart Holcomb, Consultant

Chester Kunnappilly, VP Quality

Mary Ellen Reed, Relationship Manager, ISD

Geoffrey Rutledge, Former Chief Medical Information Officer

Peter Weil, Consultant

8.

In alphabetical order, names of finalists and location

Allscripts, Mr. Jay Peterson, Sales Executive - Clinical Solutions Group

222 Merchandise Mart Chicago, IL 60654

eClinicalWorks, Mr. Girish Kumar Navani, President
Westborough Executive Park,
112 Turnpike Road (Route 9),
Westborough, MA 01581

Nextgen/Siemens Medical Solutions USA, James M. Bilich, Clinical Solutions Executive

6700 Koll Center Parkway

Suite 220, Pleasanton, CA 94566