Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Rich Bailey, Chief Information Officer, San Mateo County Health
Subject: Amendment No. 8 to the Agreement with NextGen Healthcare Inc. to Extend the Mirth Connect Interface Engine & Mirth Appliances
RECOMMENDATION:
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Adopt a resolution authorizing Amendment No. 8 to the agreement with NextGen Healthcare Inc. to extend the Mirth Connect Interface Engine & Mirth Appliances, by extending the agreement one year and increasing the amount of the agreement by $49,400 to an amount not to exceed $5,233,510.
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BACKGROUND:
In 2014, San Mateo County Health (SMCH) addressed client security issues related to the accessibility of patient information at the point of service. The Health Information Technology (HIT) division issued a Request for Proposals (RFP) for Health Information Exchange services in October 2015 and selected NextGen Healthcare Inc. to provide the services.
On December 13, 2022, this Board approved an agreement with Epic Systems Corporation (Epic) to provide the Electronic Health Record (EHR) system for SMCH. With the implementation of the new EHR system, SMCH must contract directly for a third-party interface engine - an interface that connects third-party applications to Epic. Currently, NexGen Healthcare’s “Mirth Connect” application provides this service.
In July 2025, the HIT division issued an RFP for an interface engine application. Evaluations were conducted, and the most qualified vendor was elevated into contract negotiations, which are underway. During the process, the County discovered that the EHR System requires a 12-month integration period for a new interface engine, which would exceed the current vendor agreement's expiration.
DISCUSSION:
SMCH is now requesting this Board’s approval for a one-year extension and to waive the RFP process for extending NextGen’s Mirth Connect Interface Engine & Mirth Appliances. This extension will ensure continuity of interface engine services while SMCH finalizes contract negotiations and deploys the new interface engine.
The County Procurement Department has approved the waiver to extend the agreement.
The amendment and resolution have been reviewed and approved by the County Attorney as to form.
The Technology Services Department has reviewed and approved the IT component of this agreement.
The resolution contains the County’s standard provisions allowing amendment of the County’s fiscal obligations by a maximum of $25,000 (in aggregate).
It is anticipated that by continuing to contract with NextGen, EHR communication will be available to all systems and platforms for patients/clients 100% of the time.
PERFORMANCE MEASURE:
|
Measure |
FY 2026-27 Projected |
FY 2027-28 Projected |
|
Percentage of time EHR communication is available to all systems and platforms for patient/client. |
100% |
N/A* |
*N/A The extension is only for one year.
COMMUNITY IMPACT:
By serving as a central hub for data integration, the interface engine enables disparate systems, such as EHRs, labs, imaging centers, pharmacies, and billing systems, to securely and accurately exchange critical health information. An interface engine ensures that providers across different care settings receive timely and consistent patient data. This seamless data flow reduces information silos, leading to better-coordinated care, reduced medical errors, and improved patient outcomes. Demographically, since November 2024, of the specialty care patients at San Mateo Medical Center - the largest user of the interface engine - half were female, half were male, 58% were Hispanic or Latino, and 48% were primarily Spanish-speaking.
FISCAL IMPACT:
The term of this amended agreement is from March 28, 2017, through June 30, 2027. This amendment increases the amount of the agreement by $49,400 to an amount not to exceed $5,233,510.
Funds in the amount of $49,400 are included in SMCH’s FY 2026-27 Recommended Budget and funds. Future costs will be covered by proportional contributions from all SMCH divisions, which may include some net County cost, depending on the composition of each division’s contribution.