Title
Authorize the Purchasing Manager for Natividad Medical Center (NMC) to execute an Agreement with Medical Information Technology, Inc. (MediTech) for Physician Care Manager (PCM) Phase II, Software Implementation Services at NMC in an amount not to exceed $156,000 for the period August 27, 2013 to June 30, 2015.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors authorize the Purchasing Manager for Natividad Medical Center (NMC) to execute an Agreement with Medical Information Technology, Inc. (MediTech) for Physician Care Manager (PCM) Phase II, Software Implementation Services at NMC in an amount not to exceed $156,000 for the period August 27, 2013 to June 30, 2015.
SUMMARY/DISCUSSION:
In July of 2004 this Board approved and NMC initiated its Health Care Information System Software (Electronic Medical Record) system with Medical Information Technology (Meditech). Since that time NMC has added and continues to add additional modules to the Meditech system.
This new Agreement provides required, essential and ongoing licensure/software support and updates to the Meditech applications utilized by Natividad Medical Center.
As part of NMC's ongoing Electronic Health Record (EHR) strategy NMC must implement Inpatient Computerized Physician Order Entry (CPOE) as required by Centers of Medicaid and Medicare Services (CMS) and by the HITECH Act of 2009.
The Meditech PCM Phase II software module is comprised of two major functional components: CPOE and PDOC (Physician Documentation). CPOE functionality allows physicians to electronically generate all patient orders, including medications, diet, therapies to be rendered, IVs, and lab tests. Physician Documentation (PDOC) functionality (also required by Meaningful Use), allows for the electronic documentation of the physician note; the patients history, objective findings and, the physician's assessment and plan. This will be achieved with the use of an electronic dictation software product named Nuance Dragon (medical speech recognition software).
Meeting the Meaningful Use and the HITECH Act of 2009 requirements for CPOE will be resource intensive. NMC will be submitting additional requests for agreements with Provation (Order Set build software), Beacon Partners consulting services who will provide two subject matter expert (SME's) consultants (Nurses) and Navin Haffty & Associates consulting services who will provide ten subject matter expert (SME's) consultants of varying clinical disciplines including Project Management, Pharmacy Technicians, Nursing, and a Physician necessary for Order Set building, implementation and its subsequent integration into Meditech's CPOE and PDOC functional modules.
The overall project plan timeframe which includes the PCM II installation, Provation Order Set creation, CPOE and PDOC functionality/workflow implementation and testing, is slated to start once approved and has estimated go-live dates in April (CPOE) and July (PDOC) of 2014.
In December 2010, there was an initial payment made to Meditech for the software purchase and delivery (implementation) of the PCM Phase II module but due to resource constraints and other competing priorities, the implementation was deferred given that it was not yet required for meaningful use. Meaningful use requirements now dictate we implement so we must move forward to meet deadlines. Since our initial purchase (which included an implementation fee of $51,690), Meditech has increased their fees to $207,690 for the implementation of the PCM Phase II module required an additional payment of $156,000 (minus the credit of the previous payment of $51,690) to schedule and implement the module (see Attachment A). The increase in pricing is due to the module now having additional functionality including being updated to be Meaningful Use Stage II compliant. Once this module is implemented we will then be able to build NMC's CPOE.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this Agreement as to legal form and risk provisions. Auditor-Controller has reviewed and approved this Agreement as to fiscal provisions. The Agreement has also been reviewed and approved by Natividad Medical Center's Board of Trustees.
FINANCING:
The cost for this Agreement is $156,000 and is included in the Fiscal Year 2013/2014 Adopted Budget. There is no impact to the General Fund.
Prepared by: Jim Fenstermaker, Interim Chief Information Officer, 783-2559
Approved by: Harry Weis, Chief Executive Officer, 783-2553
Attachments: Agreement, Attachment A
Attachments on file with the Clerk to the Board's Office