Inter-Departmental Correspondence

Information Services Department



October 20, 2009


November 10, 2009







Honorable Board of Supervisors


Chris Flatmoe, CIO/Director, Information Services

Jean S. Fraser, Chief, Health Systems

Susan Ehrlich, MD, MPP, CEO/San Mateo Medical Center



Amendment No. 3 to the Agreement with Picis, Inc.



Adopt a Resolution authorizing the President of the Board to execute Amendment No. 3 to the Agreement with Picis, Inc. to provide support and maintenance for an Emergency Department Information System (EDIS) at the San Mateo Medical Center (SMMC), increasing the contract amount by up to $192,501 for a new total maximum fiscal obligation of $845,001 and extending the term through June 30, 2012.



On December 6, 2005, your Board approved Resolution Number 067671, which authorized a four-year Agreement with Picis, Inc. to install and maintain an EDIS at SMMC. Implementation of the EDIS has been completed. Picis, Inc. was selected through the Request for Proposal process. During implementation of the Picis EDIS, three essential features were identified as modules that SMMC would need in the future but were not included in the original Agreement. Amendment #1 was approved by your Board on August 6, 2006, which included these features 1) addition of Admissions-Discharge-Transfer (ADT) Interface, 2) bilingual discharge instructions and 3) additional staff training. On June 22, 2007, Amendment #2 was approved by the Chief Information Officer to authorize removal of certain line items that were not implemented, giving the County a credit of $13,392.



This current Amendment remedies contractual inconsistencies, synchronizes contract terms with the County’s fiscal cycle, increases the term of the contract to a total of 6.5 years and modifies the not to exceed amount.


We recommend the contract term be extended because the Picis EDIS has been a dependable system and the vendor has been very responsive and supportive of the County. The Picis EDIS has extensive interfaces with other hospital systems and has been customized for use at SMMC. Significant time, effort, training and expertise would be required to convert the existing EDIS to another vendor. It is for these reasons we feel it is in the best interest of the County to extend this contract an additional 2.5 years. A waiver request extending the contract beyond three years is on file in the County Manager’s Office.


The Amendment with Picis, Inc. assures 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.


Approval of this agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by continuing to support the automated EDIS, improve production, supply enhanced functionality and provide efficient patient care. It is expected that there will be a significant reduction in dictation of chart notes, resulting in more timely and accurate patient charts.


Performance Measure(s):



FY 2009-10

Reduce ED Dictation Volume



Percent of Time EDIS Application is Available (Uptime)





The term of this Agreement is from December 6, 2005 through June 30, 2012. This Amendment increases the not to exceed amount to the Agreement by $192,501. The new total fiscal obligation of the Picis Agreement is not to exceed $845,001. $77,000 is included in the 2009-10 SMMC Adopted Budget. Expenses at SMMC are covered by fees for services or by third-party payors whenever possible. The portion of expenses for services provided to the medically indigent, or to those covered by programs that do not meet the full costs of care are covered by the County's General Fund contribution to SMMC.