Title
a. Authorize the Purchasing Manager for Natividad Medical Center (NMC) to execute the Wolters Kluwer Health Inc. (ProVation Order Sets Software License and Maintenance) Agreement and the Wolters Kluwer Health Inc. Third Party Product Service Agreement for Provation Order Sets Software Licensing & Installation, Professional and Maintenance Services at NMC in an amount not to exceed $458,365 for the period April 15, 2013 to April 15, 2021; and
b. Authorize a contingency (not to exceed 10% of the contract amount or $45,835) to provide funding for maintenance charge increases after April 15, 2016.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
- Authorize the Purchasing Manager for Natividad Medical Center (NMC) to execute the Wolters Kluwer Health Inc. (ProVation Order Sets Software License and Maintenance) Agreement and the Wolters Kluwer Health Inc. Third Party Product Service Agreement for Provation Order Sets Software Licensing & Installation, Professional and Maintenance Services at NMC in an amount not to exceed $458,365 for the period April 15, 2013 to April 15, 2021; and
- Authorize a contingency (not to exceed 10% of the contract amount or $45,835) to provide funding for maintenance charge increases after April 15, 2016.
SUMMARY/DISCUSSION:
ProVation Order Sets is a software system (building tool) that ultimately allows for Physician's electronic entry of patient care orders, in turn, the order set allows hospital staff to follow the Dr's Orders for care of a patient, i.e. medication(s), diet, activity, physical therapy, laboratory and/or radiology testing needed, etc. The ProVation Order Set Software is the foundation to the order set build or a component of the ultimate goal of a fully implemented Electronic Health Record (EHR) System. It should also be stated that all ProVation Order Sets Software interfaces with MediTech (NMC's current system for a fully operational EHR).
Order Set Software is essential to building what will ultimately be used for NMC's Computerized Physician Order Entry (CPOE). Please see Attachment A for a detailed explanation of Order Sets Software and CPOE.
There are two primary order sets software products on the market, ProVation and Zynx. Currently, NMC is using Zynx and is nearing the end of a 5 year contract; ending in October 2013. ProVation order sets did not exist in 2008 when the decision to purchase Zynx was made. Since Provation came into the market, they have quickly become the leader for Order Sets and many hospitals have abandoned Zynx and have replaced it with ProVation. Mayo Clinic, Duke University and Scripps University are examples of recent ProVation adopters. Zynx has not kept up with market demands regarding web-based usability and functionality.
Although Zynx is now an inferior product during the term of the Zynx agreement 90-100 Nursing Care Plans were created and will be integrated into the new MediTech EHR along with the new ProVation Order Sets
It is NMC's recommendation that ProVation Order Sets Software is the superior product based on other hospital reviews, research including The Advisory Board Report: Clinical Content Vendors (Attachment C) and web demonstrations. Outlined below are several reasons that support NMC's recommendation:
- Cost: Provation is less expensive - Provation ($55,700 annually) vs. Zynx ($96,000 annually)
- Provation's clinical evidence web-based research tool (Up To Date) is currently already utilized by most physicians nation-wide including NMC.
- Provation's build management module is more efficient and user friendly.
- Provation's order set knowledge management following the order set build is superior secondary to the ease of update. This decreases the number of human resources needed for post implementation support regarding order set changes that will become necessary as clinical evidence evolves.
Costs for the ProVation Order Sets Software and the Wolters Kluwer Health Inc. Third Party Product Service agreements are described in detail on Attachment B; ProVation Order Sets Software and Maintenance Charges.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed the Agreements as to legal form. The Auditor-Controller has reviewed and approved the Agreements as to fiscal provisions. The Agreements have also been reviewed and approved by Natividad Medical Center's Board of Trustees.
FINANCING:
The cost for these two Agreements including the 10% Contingency is $504,200. $240,686 is included in the Fiscal Year 2012/2013 Adopted Budget. Amounts for remaining years of the Agreement will be included in those budgets as appropriate. There is no impact to the General Fund.
Prepared by: Jim Fenstermaker, NMC Information Technology, 783-2559
Approved by: Harry Weis, Chief Executive Officer, 783-2553
Attachments: Agreements, Attachments A, B and C
Attachments on file with the Clerk to the Boards Office