Inter-Departmental Correspondence

Information Services Department



April 19, 2009


May 19, 2009







Honorable Board of Supervisors


Jean S. Fraser, Chief, Health System

Chris Flatmoe, CIO/Director Information Services



Agreement with Michael Aratow, MD, FACEP



Adopt a Resolution

    A. Waiving the Request for Proposal (RFP) Process;

    B. Authorizing the President of the Board to execute an Agreement with Michael Aratow, MD, FACEP for consulting services for the term of May 25, 2009, to April 30, 2010, for a maximum obligation of $160,232; and

    C. 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.



Commitment: Responsive, effective, collaborative government.

Goal 20: Government decisions are based upon careful consideration of future impact, rather than temporary relief or immediate gain.

This Agreement with Dr. Michael Aratow keeps this commitment by ensuring effective planning, preparation and coordination is done in support of Health Information Technology (IT) projects.

Performance Measure(s):


FY 2007-08

FY 2008-09

Percent of medium and large IT projects that are completed on time



Percentage of IT Projects Meeting Original Project Goals





To ensure effective IT decisions were made, a long-range Information Technology Strategic Plan (ITSP) was completed for the San Mateo Medical Center (SMMC). The ITSP recommended the addition of a Chief Medical Information Officer (CMIO) to provide critical physician input in IT decisions. Dr. Aratow, an Attending Physician in the SMMC Emergency Room, was selected by the executive management team at SMMC as well as by ISD to be the CMIO in January 2007. Since assuming the role of CMIO, Dr. Aratow has provided physician IT leadership at SMMC by serving as the primary clinician stakeholder in clinical IT projects, including the Electronic Ambulatory Medical Record (AEMR). In Fiscal Year 2008-09 your Board decided to support the recommendation to unite SMMC and the Health Department into one department, the Health System.



There are opportunities resulting from the scale of the Health System. IT projects can benefit several or all of the operating divisions and support the Health System’s mission of building healthy communities and being an excellent safety net for vulnerable populations. Examples of Health System IT projects are: the implementation of single sign-on (and subsequent work to expand it to Health System transactional systems and eventually to context-sharing), AEMR availability to other Health System divisions, HCIN expansion, and SMMC use of the Behavioral Health and Recovery Services’ Netsmart/Avatar system.

Since assuming the role of CMIO, Dr. Aratow has demonstrated a unique ability to balance the perspective of IT professionals with a clinician’s perspective resulting in significant progress in the area of clinical application development. Now there is the opportunity to expanding his scope of responsibilities to provide clinician leadership for IT projects across the entire Health System.

Waiver of the County’s Request for Proposals process is recommended in consideration of Dr. Aratow’s in-depth knowledge of the IT installations at the Health System and his experience as the CMIO.

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 and approved the Agreement and Resolution as to form.



The term of the Agreement is from May 25, 2009, through April 30, 2010. The total maximum obligation under this Agreement is $160,232. Funding for this Agreement is included in the ISD FY 2008-09 Adopted Budget, and future years’ costs will be included in subsequent years’ recommended budgets. Costs will be billed as applicable to the several budget units within the Health System.