Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Stephen Dean, Chief Information Officer, San Mateo County Health
Subject: Amendment to the Agreement with NextGen Healthcare Inc. to Provide Healthcare Data Interoperability Consulting and Technology Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with NextGen Healthcare Inc. to provide healthcare data interoperability consulting and technology services, extending the term through June 30, 2025, and increasing the maximum amount by $701,453 to an amount not to exceed $4,267,282.
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BACKGROUND:
Since 2014, San Mateo County Health (SMCH) has been working to address client safety issues related to the accessibility of patient information at the point of service. SMCH outlined a path to improve the exchange of health information beyond the primary Electronic Health Record (EHR) that County Health providers utilizes. The Health Information Technology (HIT) division issued a Request for Proposals (RFP) for Health Information Exchange (HIE) services in October 2015 and selected Quality Systems, Inc. to provide the services.
In March 2017, this Board approved an agreement with Quality Systems, Inc. to provide HIE services to SMCH for the term of March 28, 2017, through March 27, 2022, in an amount not to exceed $3,070,644.
In February 2019, the Chief Information Officer (CIO) of SMCH approved an amendment to change Contractor’s name from Quality Systems, Inc. to NextGen Healthcare Inc. (NextGen) effective September 6, 2018 and acquire perpetual licenses and support for NextGen’s Mirth Connect applications. The agreement was subsequently amended to update payment terms, add Disentanglement terms to the agreement, extend support and services through June 30, 2023, and increase the maximum amount to $3,565,829.
DISCUSSION:
SMCH’s requirements for Health Data Interoperability will shift significantly with the new Integration Engine requirements for the Epic EHR system (Epic) in late 2024. SMCH also expects requirements to change with the new California Data Sharing Framework and new federal data sharing regulations. To prepare for this, SMCH will be separating the Health Data Interoperability requests into Interface Engine (data exchange) requirements and HIE user interface requirements.
This amendment contains two components, a two-year extension, and a one-year extension. The proposed two-year extension for NextGen’s Integration Engine software (Mirth Connect) and services will support Epic’s requirement for a consistent and stable Interface Engine starting in October 2023 and continuing through a post-go-live stabilization period. Work for an Interface Engine RFP is planned to start in June 2024, with implementation by June 2025.
The proposed one-year extension for NextGen’s HIE User Interface software (Mirth Results) and services allows sufficient time for SMCH to prepare the HIE user interface RFP, which is planned for release in early FY2023-24 with implementation by June 30, 2024. This will address current HIE user interface functionality, the California Data Sharing Framework requirements, and updated federal data sharing regulations.
County Health requests this Board to waive the Request for Proposals process to allow NextGen to continue to provide its proprietary services, prepare for the RFPs described above, and increase the funding through the end of the extended term.
The amendment and resolution have been reviewed and approved by County Attorney as to form.
The County’s Contract Compliance Committee has approved a waiver request to extend the agreement to a nine-year term.
The Information 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 information will continually be available to all members of patient/client’s records of healthcare providers in the HIE 100% of the time.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Estimated |
FY 2024-2025 Projected |
|
Percentage of time EHR information is continually available to all members of patient/client records of healthcare providers in the HIE |
100% |
100% |
FISCAL IMPACT:
The term of this agreement is from March 28, 2017, through June 30, 2025. The amendment increases the contract amount by $701,453 to an amount not to exceed $4,267,282 for the 93-month term.
Funds in the amount of $657,252 are included in County Health’s FY 2023-24 Recommended Budget and funds in the amount of $44,200 are included in County Health’s FY 2024-25 Recommended Budget. Future year 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.