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COUNTY OF SAN MATEO
Inter-Departmental Correspondence
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Information Services Department
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DATE:
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February 19, 2009
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BOARD MEETING DATE:
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March 17, 2009
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SPECIAL NOTICE/HEARING:
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None
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VOTE REQUIRED:
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Majority
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TO:
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Honorable Board of Supervisors
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FROM:
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Chris Flatmoe, CIO/ Director of Information Services
Sang-ick Chang, M.D., CEO/San Mateo Medical Center
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SUBJECT:
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Amendment No. 1 to the Agreement with eClinicalWorks
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RECOMMENDATION:
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Adopt a Resolution:
1) Authorizing the President of the Board to execute Amendment No. 1 to the Agreement with eClinicalWorks to increase the number of licenses under the Agreement, thereby increasing the contract amount by up to $700,000 for a new total maximum fiscal obligation of no more than $2,500,000; and
2) Authorizing the Chief Information Officer or his designee to execute contract amendments which modify the Agreement’s terms and/or the services provided under the Agreement so long as the modified Agreement remains within the Agreement’s fiscal provisions, including the not-to-exceed amount.
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VISION ALIGNMENT:
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Commitment: To ensure basic health and safety for all County residents.
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Goal 5 and 7: Provide residents access to healthcare and preventive care; and maintain and enhance public safety of all residents and visitors.
This Amendment 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 transcription costs. In addition, the e-RX functionality will provide safer and more efficient medication management.
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Performance Measure(s):
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Measure
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FY 2008-09
Projected
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Reduce outpatient clinic dictation volume
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50%
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Reduction of Emergency Dept. visits and hospitalizations for patients with asthma and diabetes
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10%
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Reduce storage space required for medical records in the outpatient clinics
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20%
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BACKGROUND:
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On January 8, 2008, the Board approved Resolution Number 069209, which authorized a seven year Agreement with eClinicalWorks to install and maintain an Ambulatory Electronic Medical Record (AEMR) system at San Mateo Medical Center (SMMC).
eClinicalWorks was selected through the Request for Proposal Process (RFP) due to their compliance with the RFP functional requirements and proven experience with similar or larger projects. This Amendment is an extension of the original Agreement resulting from the RFP. Implementation of the AEMR is currently underway.
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DISCUSSION:
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As part of the AEMR implementation process SMMC performed a detailed review of the number of care providers (physicians, nurse practitioners, physicians’ assistants, optometrists, physical therapists, psychologists, dentists, hygienists, midwives, nutritionists, podiatrists, licensed social workers, counselors, and audiologists) that will be using the AEMR and therefore require a license from eClinicalWorks. This review confirmed the need for an additional 28 FTE (Full Time Equivalent) licenses. Additionally, 26 licenses for residents and 18 for dentists were also identified as required. Without these additional licenses the AEMR implementation cannot be completed. The increased fiscal obligation amount takes into account all costs associated with the additional licenses, including annual cost adjustment provisions in the Agreement.
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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. Risk Management has reviewed and approved Contractor’s insurance and County Counsel has reviewed and approved these documents as to form.
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FISCAL IMPACT:
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The new total maximum fiscal obligation under this Agreement is $2,500,000. The increased cost is for the additional licenses, including ongoing maintenance and support. Funding for this increase is from grants and results in no net County cost. Ongoing maintenance and support will be included in future ISD Recommended Budgets and funded through service charges to Health System departments.
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