Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Amendment to the Agreement with DeliverHealth Solutions LLC to Provide Transcription Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with DeliverHealth Solutions LLC to provide transcription services, extending the term of the agreement through August 31, 2025 and increasing the amount of the agreement by $100,000 to an amount not to exceed $790,000.
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BACKGROUND:
Transcribing medical reports makes patient information available throughout San Mateo Medical Center (SMMC). Transcription supports information continuity and providers are encouraged to dictate patient reports to increase communication across the Health Department. SMMC completed a Request for Proposals (RFP) for medical transcription services in August 2018.
In January 2019, SMMC entered into an agreement with Nuance Communications Inc. for medical transcription services for the term of September 1, 2018 through August 31, 2021 in an amount not to exceed $675,000.
There have been several amendments which reassigned the agreement from Nuance Communications, Inc. to DeliverHealth Solutions LLC (DeliverHealth), extended the term through December 31, 2024, and increased the agreement amount by $15,000 to an amount not to exceed $690,000.
DISCUSSION:
This amendment will extend the term of the agreement by eight months through August 31, 2025 and increase the amount of the agreement by $100,000 to an amount not to exceed to $790,000. This extension is a temporary solution, and the long-term plan is to transition to a speech-to-text technology that is better integrated with Epic. SMMC’s Executive Management Team recently made the decision to extend the contract with DeliverHealth through August 31, 2025, to allow providers using dictation services today to continue using the same platform until Epic is implemented. SMMC plans to do evaluations in late 2024 or early 2025 to better understand what various speech-to-text technologies are available in the market. SMMC plans to conduct an RFP for that long-term solution after Epic is implemented. This plan would avoid introducing more potential vendors into Epic implementation at a critical time when Epic-facilitated contracts are being finalized and build testing commences. Therefore, in accordance with Administrative Memo B-1 Section IV. subsection F., it is in the best interests of the County to waive the request for proposals process and amend the agreement to continue speech-to-text dictation and transcription via DeliverHealth’s existing software platform through August 31, 2025.
County Attorney has reviewed and approved the resolution and amendment as to form. The resolution contains the County’s standard provisions allowing amendment of the County fiscal obligations by a maximum of $25,000 (in aggregate).
The Information Services Department has reviewed and approved the IT component of this agreement. The County’s Contract Compliance Committee has approved a waiver request for a seven-year term for this agreement.
It is anticipated that transcribed reports are available 99% of the time within the expected turnaround times as listed below:
• Stat Reports - 3 hours
• H&P and Pre-op reports - 12 hours
• All other reports - 24 hours
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Estimated |
FY 2024-25 Projected |
|
Percentage of time that transcribed reports are available within expected turnaround times |
99% |
99% |
FISCAL IMPACT:
The term of the amended agreement is September 1, 2018 through August 31, 2025. The amendment increases the amount payable under the agreement by $100,000 to an amount not to exceed $790,000 for the seven-year term. Funds in the amount of $100,000 are included in the SMMC FY 2024-25 Recommended Budget.
Expenses at SMMC are covered by fees for services or third-party payors whenever possible. The portion of expenses for services provided to the medically indigent or to those covered by programs that do not meet the full costs of care is covered by the County’s General Fund contribution to SMMC and is within the existing annual appropriation.