Title
Approve and authorize the Deputy Purchasing Agent for Natividad Medical Center (NMC) to execute Amendment No. 3 to the Agreement (A-12461) with Navin, Haffty & Associates, LLC for Information Technology Project Management Consulting Services at NMC to extend the term and adding $1,111,600 for a revised total Agreement amount not to exceed $4,876,100 in the aggregate Agreement term of July 1, 2013 through June 30, 2016.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors Approve and authorize the Deputy Purchasing Agent for Natividad Medical Center (NMC) to execute Amendment No. 3 to the Agreement (A-12461) with Navin, Haffty & Associates, LLC for Information Technology Project Management Consulting Services at NMC to extend the term and adding $1,111,600 for a revised total Agreement amount not to exceed $4,876,100 in the aggregate Agreement term of July 1, 2013 through June 30, 2016.
SUMMARY/DISCUSSION:
Over the last several years NMC has purchased, and continues to purchase, necessary modules of Meditech in order to systematically build a fully electronic EHR. The implementation of these modules provide for improved services and safety to NMC patients, as well as, meeting the ongoing mandated Medicaid and Medicare Meaningful Use requirements via the HITECH Act legislated by the federal government.
Meditech's Physician Documentation (PDoc) module is an essential component in meeting the requirements of Meaningful Use for an EHR. NMC implemented PDoc meaningful use functionality by October 1, 2014, on time and in order to meet Meaningful Use Stage 2 requirements. PDoc is a Meditech application that is part of two Meditech software modules; Physician Care Manager II (PCM II) and Emergency Department 2 (EDM2). PDoc allows for physicians to electronically document in the electronic health record, including but not limited to subjective histories from patients, physical exams, relevant results, assessments and plans including problem lists. These physician plans also include orders that are then executed via Computerized Physician Order Entry (CPOE) which has been discussed and referenced in earlier board reports.
PDoc is closely coupled with speech recognition software named Dragon which allows the provider to dictate, customize, and document electronically in real time. Dragon has also been discussed in a previous separate board report.
Navin Haffty & Associates has currently been providing consulting clinical, technical and training expertise in coordination with NMC staff for the PDoc/Dragon implementation. NMC is requesting Navin Haffty & Associates provide subject matter expertise for day-to-day post implementation and optimization. Furthermore, there will need to be significant optimization of PDoc/Dragon and CPOE with the implementation of the mandated ICD-10 project which has been referenced in previous board reports. ICD-10 is the International Classification of Diseases, 10th Revision. Initially ICD-10 had been mandated by the Department of Health and Human Services (HHS) and Congress for implementation by Oct 1, 2014 but in March 2014, Congress postponed the mandated implementation until Oct 1, 2015. ICD-10 is critical for accurate coding, billing and subsequent revenue. NMC's system of coding is based on physician documentation (PDoc). There is significant optimization and maintenance of NMC's PDoc/Dragon templates that will have to occur as ICD-10 is implemented at NMC. Without this ICD-10 optimization, NMC revenue could be significantly impacted.
The implementation phase of the PDoc/Dragon project plan began on Sept 1, 2013 and will end as scheduled on or before December 31, 2014. The project will begin transitioning to optimization and support on approximately November 3, 2014. The ICD-10 project is currently in progress and is scheduled to go live at NMC on Oct 1, 2015. Dedicated SME support and optimization time will be required from Navin Haffty & Associates and the NMC PDoc and CPOE teams to support ICD- 10 changes during the ICD- 10 project implementation. Additionally, there is a daily need for ongoing PDoc/Dragon SME optimization and support of physician documentation.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this Amendment No. 3 as to legal form and risk provisions. The Auditor-Controller has reviewed and approved this Amendment No. 3 as to fiscal provisions. This Amendment No. 3 has also been reviewed and approved by Natividad Medical Center's Finance Committee on November 25, 214 and by its Board of Trustees on December 05, 2014.
FINANCING:
The cost for this Amendment No.3 is $1,111,600 for FY2014/15 $539,200 FY 2015/16 $572,400 for a total amount not to exceed $4,876,100. Amounts for remaining years of the Amendment No.3 will be included in those budgets as appropriate. There is no impact to the General Fund.
Prepared by: Dr. Charles Harris, Staff Physician, 783-2785
Approved by: Dr. Kelly O'Keefe, Interim Chief Executive Officer, 783-2553
Attachments: Amendment No.3, Amendment No.2, Amendment No. 1, Original Agreement and Spend Sheet.
Attachments on file with the Clerk to the Board's Office