REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
February 11, 2025
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Amendment to Agreement with Nuance Communications, Inc. for Clinical Medical Dictation and Voice Recognition Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 3 to Agreement No. 20-70 with Nuance Communications, Inc., for clinical medical dictation and voice recognition services, increasing the contract amount by $378,324 from $3,589,932 to a total contract amount of $3,968,256, and extending the contract period by six months for a total contract period of February 21, 2020, through August 10, 2025.
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). The cost of $378,324 is funded by State Medi-Cal, Federal Medicare, private insurances, and other department revenue. Funding sources may change in the future pending any legislative activity related to the repeal and/or replacement of the Affordable Care Act. Adequate appropriation and revenue have been included in the Arrowhead Regional Medical Center (ARMC) 2024-25 budget and will be included in 2025-26 recommended budget.
BACKGROUND INFORMATION
Amendment No. 3 to Agreement No. 20-70 with Nuance Communications, Inc. (Nuance), will extend the term by six-months and increase the total contract amount to provide ARMC with sufficient time to complete a new competitive process to procure these services. Additional time for the new competitive process is needed due to the ARMC work volume.
Nuance provides medical dictation and voice recognition services utilized daily by practitioners throughout ARMC inpatient and outpatient settings for documentation of patient encounters into a patient’s medical record.
On February 11, 2020 (Item No. 19), the Board of Supervisors (Board) approved Agreement No. 20-70 with Nuance for clinical medical dictation and voice recognition services at ARMC in the amount of $3,589,932, for the period of February 21, 2020 through February 20, 2025.
On June 22, 2021 (Item No. 14), the Board approved Amendment No.1, providing the partial assignment and consent of Agreement No. 20-70 with Nuance Communications, Inc. to retroactively effective March 2, 2021, for health information management transcription services, removing the stated service from Agreement No. 20-70 with Nuance Communications, Inc., and assigning it to DeliverHealth Solutions LLC, with no other changes to the contract terms or contract period of February 21, 2020 through February 20, 2025.
On March 1, 2022 (Item No. 7), the Board approved Amendment No. 2 with Nuance Communications, Inc. to convert clinical medical dictation and voice recognition services to Epic, the new electronic health record at ARMC, with no change to the contract amount of $3,589,932 and no change to the contract period of February 21, 2020 through February 20, 2025.
ARMC recommends approval of this Amendment as these services are necessary to ensure that accurate clinical medical dictation into a patient's electronic health record.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Bonnie Uphold, Supervising Deputy County Counsel, 387-5455) on January 14, 2025; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on January 17, 2025; Finance (Jenny Yang, Administrative Analyst, 387-4884) on January 24, 2025; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on January 24, 2025.