Title
a. Authorize the Deputy Purchasing Agent for Natividad Medical Center (NMC) or his designee to execute an agreement with Nextgate Solutions, Inc. for Enterprise Master Person Index System services for an amount not to exceed $1,387,049 with an agreement term of November 6, 2018 through November 5, 2023.
b. Approve the NMC Chief Executive Officer’s recommendation to accept non-standard indemnification, insurance, limitation on liability, and limitation on damages provisions within the agreement.
c. Authorize the Deputy Purchasing Agent for NMC or his designee to execute up to three (3) future amendments to the agreement which do not significantly alter the scope of work and do not cause an increase of more than ten percent (10%) ($138,705) of the original cost of the agreement.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
a. Authorize the Deputy Purchasing Agent for Natividad Medical Center (NMC) or his designee to execute an agreement with Nextgate Solutions, Inc. for Enterprise Master Person Index System services for an amount not to exceed $1,387,049 with an agreement term of November 6, 2018 through November 5, 2023.
b. Approve the NMC Chief Executive Officer’s recommendation to accept non-standard indemnification, insurance, limitation on liability, and limitation on damages provisions within the agreement.
c. Authorize the Deputy Purchasing Agent for NMC or his designee to execute up to three (3) future amendments to the agreement which do not significantly alter the scope of work and do not cause an increase of more than ten percent (10%) ($138,705) of the original cost of the agreement.
SUMMARY/DISCUSSION:
California’s Section 1115(a) Medicaid Waiver Renewal, entitled Medi-Cal 2020, was approved by the Centers for Medicare and Medicaid Services in late 2015. The goals of the waiver are to transform and improve the quality of care, access, and efficiency of health care services.
Natividad and the Monterey County Health Department (MCHD) are participating in two of the waiver programs:
a) The Public Hospital Redesign and Incentives in Medi-Cal (PRIME) program builds upon the Bridge to Reform 2010-2015 California Waiver’s Delivery System Reform Incentive Payments (DSRIP) program to improve the quality and value of care provided by California’s safety net hospitals and hospital systems.
b) The Whole Person Care (WPC) regional pilots focus on the coordination of health, behavioral health, and social services, as applicable, in a patient-centered manner with the goals of improved beneficiary health and well-being through more efficient and effective use of resources.
For effective care coordination and collaboration to exist, Natividad and MCHD will need to leverage its Electronic Health Record (EHR) system to seamlessly transition patients between inpatient and outpatient clinic facilities. A challenge exists in that both entities operate three disparate EHR systems:
1) Meditech (Hospital Inpatient);
2) EPIC (Clinic Outpatient); and
3) Avatar (Behavioral Health)
This is particularly evident as duplicates and mismatches exist when linking the three systems. This makes identifying each other’s patients difficult at times and complicates the implementation of future population health capabilities that are intended to create a single health record per person.
The solution to this challenge is to put in place an “Enterprise Master Patient Index” (EMPI) solution that will match patients and ensure that their data is correct and consistent between the three EHR systems. Patients will be assigned a unique identifier so they are represented only once across the spectrum of care.
To address this emerging need, the County of Monterey published an open and competitive “Request for Proposal” in September 2017 for an EMPI system. For a proposal to receive consideration, it would need to be scalable and allow for the future onboarding of additional County agencies. The outcome we’re anticipating is to maintain a single shared longitudinal patient identifier.
A committee comprising of Natividad, MCHD and County ITD staff reviewed 9 RFP responses. Four of the proposals were selected and invited to demonstrate their solutions. The Nextgate MatchMetrix EMPI service received the highest score by the committee and was selected to move forward. The decision was based on meeting established criteria, quality of service, cost/value and their experience with County governments. Nextgate’s proposal also met the County’s requirement for a system that did not tax existing resources by offering their EMPI as a vendor hosted and supported “Software as a Service” solution. In this arrangement, Nextgate will fully operate and manage the Matchmatrix system internals in a secure cloud while the County focuses on using the system’s capabilities.
This proposal is a five-year agreement which includes professional implementation services for installation, system integration, deduplication of existing records, travel, training, licensing, hosting and ongoing support.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this agreement as to legal form, and the Auditor-Controller has reviewed and approved as to payment provisions. The agreement has also been reviewed and approved by NMC’s Finance Committee on August 23, 2018 and by its Board of Trustees on September 7, 2018.
FINANCING:
The cost for this agreement is $1,387,049 of which $596,813 is included in the Fiscal Year 2018-19 Adopted Budget. Amounts for remaining years of the agreement will be included in those budgets as appropriate.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
This agreement will support the County strategic initiative for Health and Human Services by supporting the County’s PRIME and Whole Person Care. An EMPI system will help facilitate these efforts by establishing and maintaining a single longitudinal patient identifier across the spectrum of care.
__ Economic Development
__ Administration
X Health and Human Services
__ Infrastructure
__ Public Safety
Prepared by: Ari Entin, Chief Information Officer, 783-2564
Approved by: Gary R. Gray, DO, Chief Executive Officer, 783-2504
Attachments:
Agreement per RFP# 9600-71
Attachments on file with the Clerk of the Board