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
David McGrew, Interim Chief Information Officer, San Mateo County Health
Subject: Amendment to the Agreement with Cerner Corporation for the Utilization of the Electronic Medical Record, Applications, and Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Cerner Corporation to provide the utilization of the Cerner Electronic Medical Record, applications, and services, extending the term by one year through December 31, 2025, and increasing the amount by $3,590,810 to an amount not to exceed $67,691,132.
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BACKGROUND:
In September 2003, the Board of Supervisors approved an agreement with Siemens Health Solutions, Inc. (Siemens) for ongoing information technology support and applications at San Mateo Medical Center (SMMC).
In February 2015, Siemens was acquired by Cerner Health Services, Inc. (Cerner) and the agreement was assigned to Cerner.
In June 2022, Cerner was acquired by Oracle and is now Oracle Cerner. The agreement has been amended multiple times since.
In December 2022, this Board approved an agreement with Epic to replace the current Electronic Medical Record (EMR) and other applications and services.
In May 2023, this Board approved an extension of the agreement to December 31, 2024.
DISCUSSION:
During the transition period to Epic, SMMC will continue to use Cerner to access historical clinical and financial data through its applications, primarily Soarian, Invision and Enterprise Document Management. This amendment will provide access to these Cerner applications and services through December 31, 2025, at which time the conversion of all historical clinical information and the close-out of patient billing accounts receivable are expected to be complete.
Cerner Application provides SMMC the ability to serve its patients using existing applications for: patient treatment; lab orders diagnostic imaging, and Rx/e-Prescribing. Cerner is also the main application providing everything SMMC and its Revenue department needs to complete Patient Registration (admitting and discharge) and all financial reports/billing. SMMC will benefit from using the Cerner applications to provide clinical services to its patients with minimal interaction throughout the Epic implementation.
SMMC and San Mateo County Health (SMCH) request this Board to waive the Request for Proposals process to allow Cerner to continue to provide these services and increase the funding through the end of the extended term, while SMCH continues to prepare the Epic implementation to accept the legacy EMR transition process.
The County Contract Compliance Committee has approved a waiver request to extend the agreement.
The County Attorney has reviewed and approved the resolution and agreement as to form.
The resolution contains the County’s standard provisions allowing amendment of the County’s fiscal obligations by a maximum of $25,000 (in aggregate).
The Information Services Department has reviewed and approved the IT components of this agreement.
It is anticipated that the current legacy system Cerner will be 99.99% available for continuity of patient care, clinical treatment and all the hospital operational needs related to this contract.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Actual |
FY 2024-25 Estimated |
|
Percentage of time that current legacy system is available for continuity of patient care, clinical treatment, and all hospital operational needs |
99.99% |
99.99% |
Equity Impact:
The use of an integrated electronic health record system (EHR) supports SMCH’s commitment to advancing health equity. By proactively addressing potential disparities, SMCH can ensure the benefits of an integrated EHR are shared equitably across all populations we serve. This contract amendment provides continuity of access to historical patient demographic and clinical data, allowing for better tracking of health outcomes across different populations and identifying health disparities more effectively. This can lead to enhanced care coordination among healthcare providers, especially for marginalized populations who may have more complex healthcare needs.
FISCAL IMPACT:
The term of this amended agreement is September 23, 2003, through December 31, 2025. The amendment increases the contract amount payable under the agreement by $3,590,810 to an amount not to exceed $67,691,132 for the 22-year and 3-month term. Funds in the amount of $3,590,810 are included in the SMMC FY 2024-25 Adopted Budget. Similar arrangements will be made for future years.
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.