Title
Authorize the Deputy Purchasing Agent for Natividad Medical Center (NMC) or his designee to execute Amendment No. 2 to the agreement with Himagine Solutions, Inc. for remote retrospective abstraction, data collection and entry of trauma patients into NMC’s Trauma One Database, adding $250,000 for a revised total agreement amount not to exceed $449,999 with an agreement term of July 1, 2016 through June 30, 2018.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
Authorize the Deputy Purchasing Agent for Natividad Medical Center (NMC) or his designee to execute amendment No. 2 to the agreement with Himagine Solutions, Inc. for remote retrospective abstraction, data collection and entry of trauma patients into NMC’s Trauma One Database, adding $250,000 for a revised total agreement amount not to exceed $449,999 with an agreement term of July 1, 2016 through June 30, 2018.
SUMMARY/DISCUSSION:
Improvement in trauma care depends on the establishment of functioning trauma care systems, of which a trauma registry is a crucial component. According to the American College of Surgeons (ACS), trauma registries should be concurrent at a minimum, where 80% of cases must be entered within 60 days of discharge as per Centers for Medicare & Medicaid Services Qualified Health Plan (QHP) Application Chapter 16 (CD 16-6). ACS recommends that one full-time dedicated trauma registrar captures the National Trauma Data Standard (NTDS) data set for 500-750 admitted patients annually (CD 15-9).
Natividad Medical Center has surpassed the volume recommendation and requires assistance due to the high volume of patients treated at the trauma center. A total of 1375 trauma patients were seen in 2015 and the volume increased to 1522 patients seen in 2016. Himagine Solutions, Inc. provides experienced, certified registrars to perform retrospective abstracting, data collection and entry of trauma patients into NMC’s Trauma One Database, via a secured and remote access, as needed and within the required time period set by ACS.
On June 6, 2017, the Board approved amendment No. 1 to the agreement with Himagine to extend the services through June 30, 2018 and to add an additional $100,000 to the agreement. NMC had only requested $100,000 because we were planning on utilizing less of Himagine’s services. However due to unanticipated circumstances, NMC had to continue using Himagine to keep NMC’s registry concurrent. On a quarterly basis, NMC is required to submit data from the registry to the ACS National Trauma Data Bank (NTDB)/Trauma Quality Improvement Program (TQIP). In April 2017, multiple coding errors were discovered preventing NMC from sending the data from January 2017 through March 2017 to the NTDB. At that time, NMC did not realize the magnitude of the problem and that it had extended back to the 2016 data. One of NMC’s in-house registrars was assigned to fix this issue so NMC could map successfully to the NTDB. It took NMC’s in-house registrar almost 2 months to fix the errors that were created in a 3-month abstraction period which also resulted in utilizing more of Himagine’s services to maintain regulatory compliance.
Although NMC recently hired a full time employee to assist current staff with fulfilling the requirements of ACS, NMC will continue requiring the services of Himagine until after the new employee has been established and is up-to-date with NMC’s current processes and procedures and able to meet the required abstraction demands based on the trauma center’s current volume. NMC is anticipating the need for Himagine to continue providing services through June 30, 2018; however, this is dependent on the monthly trauma patient census which will determine the need for further services.
$11,772 of the $250,000 increase currently requested is slated to pay the invoices received for services that were provided in June 2017 with the remaining $238,228 slated for this current FY17-18. The previous amendment amount of $100,000 has proven to be too low in meeting the current demand for entering data in NMC’s Trauma One Database. By increasing the contract amount with Himagine, NMC will be able to evaluate the future needs of increasing permanent staff levels to accommodate the census should it continue to increase and to cover any additional unforeseen incidents requiring an increase of Himagine’s services while maintaining a concurrent registry and meeting the ACS requirements.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this amendment No. 2 as to legal form and risk provisions, and the Auditor-Controller has reviewed and approved as to payment provisions. This amendment No. 2 has also been reviewed and approved by NMC’s Finance Committee on July 27, 2017 and by its Board of Trustees on August 4, 2017.
FINANCING:
The cost for this amendment No. 2 is $250,000 all of which is included in the Adopted Budget for Fiscal Year 2017-18. Should NMC seek extensions of the original agreement, amounts for any extensions will be included in those budgets as appropriate. There is no impact to the General Fund.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
This agreement is for trauma registry services which are a crucial component of a functioning trauma center. These services ensure regulatory compliance and have enabled NMC to operate its trauma center efficiently and effectively regardless of volumes. Maintaining a trauma registry is an ACS requirement. Remaining compliant ensures that NMC is able to continue to provide trauma care to patients in need, measure outcomes of care and benchmark with other trauma centers to ensure the best practices of care are provided.
__ Economic Development
X Administration
X Health and Human Services
__ Infrastructure
__ Public Safety
Prepared by: Julie Ramirez, Trauma Program Manager, 772-7350
Approved by: Gary R. Gray, DO, Chief Executive Officer, 783-2504
Attachments:
Himagine Solutions Inc Amendment 2
Himagine Solutions Inc Amendment 1
Himagine Solutions Inc Agreement
Himagine Solutions Inc Spend Sheet
Attachments on file with the Clerk of the Board