REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
January 14, 2025
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Agreement with Symago, LLC. for a Pharmacy Interactive Voice Response System
End
RECOMMENDATION(S)
Recommendation
Approve Agreement, including non-standard terms, with Symago, LLC., for the implementation of a pharmacy interactive voice response system, for purchase amounts as authorized by County Policy, for the contract period beginning January 14, 2025 through January 13, 2028, renewing annually thereafter until terminated by either party.
(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 implementation cost and future purchases, are funded by State Medi-Cal, Federal Medicare, private insurances, and other departmental 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 future recommended budgets.
BACKGROUND INFORMATION
The Agreement will enable Symago, LLC. (Symago) to implement a pharmacy interactive voice response (IVR) system that can streamline call handling processes, reduce wait times and improve the efficiency of patient interactions with clinical staff. ARMC currently utilizes OmniSYS, LLC’s (OmniSYS) IVR interface with Foundation System Inc. ARMC is replacing this system with Epic Willow Ambulatory, which includes the interfaces with the hospital’s electronic health record (EHR). The new IVR system with Symago can be integrated in the Epic Willow Ambulatory module, and will improve pharmacy messaging communication with patients.
The Agreement is Symago’s standard commercial contract, which includes terms that differ from the standard County contract and omits certain County standard contract terms. While the parties negotiated certain contract terms to County standard terms, Symago would not agree to all County standard terms. The non-standard and missing terms include the following:
1. Symago’s maximum liability to the County is limited to two times the amount paid by the County, excluding indemnified claims, breach of confidentiality under the Business Associate Agreement, and claims arising from Symago’s gross negligence, willful misconduct, or violation of law.
• The County standard contract does not include a limitation of liability.
• Potential Impact: Claims could exceed the liability cap and the Agreement amount leaving the County financially liable for the excess.
ARMC recommends approval of the Agreement, including the non-standard terms, to provide for the safety, health and safety service needs of county residents by ensuring efficient and effective communication with patients regarding their pharmacy prescriptions.
PROCUREMENT
The Purchasing Department supports this competitive procurement as ARMC Pharmacy Department requested quotes from three companies: OmniSYS, LLC, Lumistry, Inc. and Symago. OmniSYS was not able to complete an Information Technology (IT) Risk Assessment for the new interface with the electronic health record, and Lumistry, Inc. only has a stand-alone IVR system that does not interface with ARMC’s EHR. Therefore, Symago was selected by the department as they were the only vendor that could both interface with the EHR and complete the IT risk assessment to ensure the integrity of ARMC’s IT systems are not compromised by the IVR application.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Bonnie Uphold, Supervising Deputy County Counsel, 387-5455) on December 16, 2024; Purchasing (Veronica Pedace, Buyer III, 387-2464) on December 16, 2024; Risk Management (Greg Ustaszewski, Staff Analyst II, 386-9039) on December 17, 2024; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on December 17, 2024; Finance (Jenny Yang, Administrative Analyst, 387-4884) on December 19, 2024; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on December 19, 2024.