Special Notice / Hearing: None
Vote Required: Majority
To: Honorable Board of Supervisors
From: Michael P. Callagy, County Executive
Louise F. Rogers, Chief, San Mateo County Health
Roberto Manchia, County Chief Financial Officer
Subject: Approval of Creation of Electronic Health Record Budget Unit (8420B)
RECOMMENDATION:
title
Adopt a resolution authorizing the approval of the creation of a Budget Unit (8420B) for the budgeting of the Electronic Health Record System for County Health projects.
body
BACKGROUND:
San Mateo County Health (SMCH) is responsible for providing necessary medical care to its medically indigent population. SMCH operates San Mateo Medical Center and its outpatient clinics; Public Health, Policy, and Planning, which includes multiple clinics; Family Health Services; Behavioral Health and Recovery Services; Aging and Adult Services, and Correctional Health Services. These six SMCH divisions utilize multiple, outdated electronic health record (EHR) systems or paper charts to maintain patient information. The fragmentation results in a constant struggle by SMCH providers to obtain a current and comprehensive view of the client record at the point of care. The use of multiple EHRs impedes data sharing and coordination between in-and out-patient care, mental health and substance use disorder treatment, social services, and community partners.
On December 13, 2022, this Board approved an agreement with EPIC Systems Corporation (Epic) to provide: a license to its software to host SMCH associated hardware and data, implementation services, and staff to assist SMCH in building a single, unified EHR system and ensure a successful implementation. Also approved with the Epic agreement was the authority for the Chief of County Health or their designee to approve additional agreements.
In conjunction with the aforementioned agreement on December 13, 2022, this Board approved an Appropriation Transfer Request in the amount of $22,273,248 to fund the project for the remainder of FY 2022-23.
DISCUSSION:
Because implementation of EHR is anticipated to take three years, spanning multiple budget cycles, and relying on one-time funding sources during the 10-year cycle of the project, it is necessary to create a Budget Unit 8420B to appropriate revenues and expenditures. The creation of a new budget unit will allow for greater transparency for this long-term project, as well as provide appropriate spending controls. Due to the complex nature of the agreement and required capitalization to meet accounting standards, this budget unit will be part of Fund Group 4 Countywide capital project funds. This budget unit will be included in the reporting structure for County Health.
The agreement and resolution have been reviewed and approved by the County Attorney as to form.
It is anticipated that 100% of medical clinical information systems users from SMCH divisions will use a single unified EHR system.
PERFORMANCE MEASURE:
|
Measure |
FY 2022-23 Estimate |
FY 2024-25 Projected |
|
Percentage of medical clinical information systems users from SMCH divisions that are using a single unified EHR system |
0% |
100% (1,132 users) |
FISCAL IMPACT:
There is no fiscal impact as a result of creating this budget unit. The FY 2022-23 Approved Budget of $22,273,248 was approved on December 13, 2022. Expenses for subsequent years will be included in future budget requests.