REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
August 22, 2023
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Amendments to Contracts for Professional Clinical Informatics Staffing and Consulting Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1 to the following contracts for clinical informatics staffing and consulting services, increasing the not-to-exceed aggregate amount by $8,000,000, from $10,000,000 to $18,000,000, with no change to the term of December 1, 2022 through November 30, 2027:
1. Optimum Healthcare IT LLC, Contract No. 22-1098
2. 314e Corporation, Contract No. 22-1099
3. Eight Eleven Group, LLC dba Medasource, Contract No. 22-1100
4. Tegria Services Group - US, Inc., Contract No. 22-1101
5. Nordic Consulting Partners, Inc., Contract No. 22-1102
(Presenter: William L. Gilbert, Director, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
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) as the total additional cost of $8,000,000 is 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) 2023-24 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
Approval of the Amendments will allow ARMC to continue utilizing Epic implementation and training staffing and consulting services, while recruitment for equivalent permanent positions concludes. ARMC has hired 20 permanent positions to date and anticipates hiring 26 more permanent positions, to conclude the recruitment of the permanent positions.
ARMC has experienced challenges in recruiting and hiring of permanent staff for the vacant positions needed to work with Epic. Due to this need, more hours than anticipated were expended during the contract period; the Amendments will add additional funding and extend the contracts to support the needed staffing at ARMC. Epic is the electronic health record system that is utilized at ARMC. The consultants hired through the existing contracts will continue to provide support and training to ARMC and support a smooth transition/hand off once all permanent positions are filled.
Current consultants include physicians, pharmacists, credentialed trainers, and Epic analysts that have specialized technical skills specific to Epic application development, support, training, and onboarding new staff hired at ARMC. These consultants have both clinical and technical skills that are specific to the patient delivery system in a large hospital setting that has a robust electronic health record.
Consultant staffing will facilitate ARMC’s progression toward process improvement, implementation of new best practices, and use of industry-leading technology. With value-based services becoming the new norm in healthcare, ARMC continues to align itself with a structure that will allow for quality services at appropriate costs. ARMC will leverage the expertise of these consultants to enhance the current experience of county citizens through the analysis of current structures and the implementation of best demonstrated practices.
On November 15, 2022 (Item No. 10), the Board of Supervisors approved the contracts listed in the Recommendation on an as-needed, fee-for-service basis for clinical informatics staffing and consulting services in the not-to-exceed aggregate amount of $10,000,000 for the five-year period of December 1, 2022 through November 30, 2027.
ARMC recommends approval of the Amendments to the contracts as they will provide the technical expertise and experience to ARMC in application development and maintenance services, program management, clinical application development and support, analysis, programming, architecture, data management, reporting, quality assurance, optimization services, workflow design and optimization, and project management.
PROCUREMENT
The Amendments are based on competitively procured contracts resulting from Request for Proposal No. ARMC123-ARMC-4683 for Clinical Informatics Consultant Staffing released on August 8, 2022. The Purchasing Department continues to approve this procurement based on the formal, competitive solicitation referenced above.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Deputy County Counsel, 387-5455) on July 26, 2023; Purchasing (Ariel Gill, Buyer, 777-0722) on July 28, 2023; Human Resources (Gina King, Assistant Director, 387-5571) on August 3, 2023; ARMC Finance (Chen Wu, Finance Budget Officer, 580-3165) on August 3, 2023; Finance (Jenny Yang, Administrative Analyst, 387-4884) on August 3, 2023; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on August 4, 2023.