Title
a. Approve and authorize the Contracts/Purchasing Officer or Contracts/Purchasing Supervisor to execute Amendment No. 1 to the Service Agreement with Robinson and Associates Consulting, LLC. to increase Agreement amount by $288,220 for a total Agreement amount not to exceed of $387,820 and extend Agreement for the revised term of May 1, 2015 through December 31, 2017, for the provision of consulting and evaluation services to develop requirements in support of the issuance of a Request for Proposal (RFP) for the consideration, identification, and selection of a unified Electronic Health Record (EHR) solution for the Health Department and Natividad Medical Center (NMC); and
b. Authorize the Contracts and Purchasing Officer or Contracts/Purchasing Supervisor to sign up to three future amendments to this agreement where the amendments do not exceed 10% of the approved Amendment No.1 amount ($38,782) and does not significantly change the scope of work. (REVISED VIA SUPPLEMENTAL AGENDA)
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and authorize the Contracts/Purchasing Officer or Contracts/Purchasing Supervisor to execute Amendment No. 1 to the Service Agreement to increase Agreement amount by $288,220 for a total Agreement amount not to exceed of $387,820 and extend Agreement for the revised term of May 1, 2015 through December 31, 2017, for the provision of consulting and evaluation services to develop requirements in support of the issuance of a Request for Proposal (RFP) for the consideration, identification, and selection of a unified Electronic Health Record (EHR) solution for the Health Department and Natividad Medical Center (NMC); and
b. Authorize the Contracts and Purchasing Officer or Contracts/Purchasing Supervisor to sign up to three future amendments to this agreement where the amendments do not exceed 10% of the approved Amendment No.1 amount ($38,782) and does not significantly change the scope of work.
SUMMARY/DISCUSSION
The proposed Amendment #1 to the Agreement with Robinson & Associates, LLC. (R&A) is to incorporate NMC into the EHR evaluation/assessment project. Robinson and Associates, LLC is comprised of subject matter experts in the health information technology field representing clinical, technical experience with EHR systems deployed in the industry, and will support the County’s efforts to implement interoperability across all health domains. The approval of this recommended action will meet the goal of developing an RFP with comprehensive stakeholder input towards an enterprise EHR solution with a short term health information exchange solution recommendation as a project of this scope requires a thorough RFP process with a comprehensive implementation plan. Robinson and Associates, LLC will not be a respondent to the RFP but will develop the scoring tool, participate in the review process, and properly transition County from evaluation, assessment, and solution selection to implementation.
The Health Department's 2011-2015 Strategic Plan has a focus on prevention that advocates Health in All Policies which require prevention and early intervention, direct clinical and behavioral health service delivery, and the measurement of outcomes that all require data sharing both internal and external to the programs, Health Bureaus, County departments, and community partners to better monitor outcomes. Data sharing is critical for the provision of continuity of care and services for the unserved and underserved in our community touching multiple agencies. Bridging data siloes will also help to bridge service siloes while protecting confidentiality to empower our clients within the community.
Natividad Medical Center and fellow County department, is a collaborative partner of the Health Department that serves the same cross section of the community with the focus beyond inpatient care and immediate service provision. Natividad Medical Center promotes and supports healthcare access and efforts to reduce health disparities, prevention services with population health management approach, and understands the need to bridge the data siloes. Collectively, both departments provide a full spectrum of care to the residents of this County.
The Health Department currently utilizes two major EHR systems. The Clinic Services Bureau utilizes EPIC hosted by Oregon Community Health Information Network (OCHIN) and the Behavioral Health Bureau utilizes Avatar hosted by Netsmart Technologies, Inc. In addition to the two major EHR systems, the Health Department utilizes other proprietary applications and static data sets. NMC currently utilizes Meditech as the EHR along with other proprietary applications all of which are disparate systems. This fragmentation contributes to disconnected and siloed client care although both departments provide services to the same cross section of the community.
It is the intent of the Director of Health and the Chief Executive Officer of NMC to collectively provide an update to the Board on the activities, the intent, and the recommendation relative to data exchange collaboration. Health Department and NMC will be taking a phased approach with parallel activities that are individually meeting the departmental objectives but collectively meeting County objectives that will facilitate secure data sharing first within and between the County departments.
The approval of this recommended action either directly supports or better prepares Health to meet the Monterey County Health Department 2011-2015 Strategic Plan initiatives: 1) Empower the community to improve health through programs, policies, and activities; and 2) Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services. The proposed Amendment #1 to the Agreement with R&A supports the following essential public health services: 1) Monitor health status to identify and solve community health problems; 2) Diagnose and investigate health problems and health hazards in the community; 3) Inform, educate, and empower people about health issues; 4) Mobilize community partnerships and action to identify and solve health problems; 5) Link people to needed personal health services and assure the provision of health care when otherwise unavailable; and 6) Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
OTHER AGENCY INVOLVEMENT:
County Information Technology Department has been apprised of this project and concurs with the recommendation. County Counsel has reviewed and approves as to legal form. The original Agreement and Amendment #1 to the Agreement as proposed, is on file with the Clerk of the Board.
FINANCING:
Funding for the services relative to Health Department's EHR evaluation/assessment Amendment #1 to the Agreement is included in the Health Department FY 2015-16 Adopted Budget proportionally for Clinic Services (001-4000-HEA007-8096), Behavioral Health (001-4000-HEA012-8410), and Public Health (001-4000-HEA003-8124) in the amount of $75,000. The Health Department will include $24,600 into its FY 2016-17 Requested Budget. Funding for the services relative to NMC's EHR evaluation/assessment is included in the NMC FY 2015-16 Adopted Budget (451-9600-NMC001-8142) in the amount of $211,338 and will be included in its Recommended Budget for FY 2016-2017 in the amount of $76,882 for the cumulative Agreement total of $387,820. Should funding be reduced and/or terminated, the County may terminate this agreement by giving thirty (30) days written notice of such action.
Prepared by: Sarah House, Departmental Information Systems Manager, 755-4531
Approved by: Ray Bullick, Director of Health, 755-4526
Gary R. Gray, DO, Chief Executive Officer of NMC, 783-2504
Attachments:
Original Agreement on file with the Clerk of the Board
Amendment #1 on file with the Clerk of the Board