Download Agreement/Amendment Printout

County of Santa Clara
Santa Clara Valley Health & Hospital System
Agency Administration
Information Services
80213 A
DATE:
March 22, 2016
TO:
Board of Supervisors
FROM:
Sue Clements, Interim Chief Healthcare Technology Officer
SUBJECT: HealthLink Wave 3 Amendments for Epic Systems Corporation
RECOMMENDED ACTION
Consider recommendations relating to Amendments to Agreement with Epic Systems
Corporation for Enterprise Systems services.
Possible action:
a. Approve Fifteenth Amendment to Agreement with Epic Systems Corporation relating to
terminating the Outgoing Electronic Script Orders Interface and adding the Incoming
Ancillary Results and Orders Interface, with no change to the maximum contract amount
of $64,161,975, and no change to the term of the Agreement, that has been reviewed and
approved by County Counsel as to form and legality.
b. Approve Sixteenth Amendment to Agreement with Epic Systems Corporation relating to
providing licensing and implementation services for Blood Product Administration
Module, increasing the maximum contract amount by $31,600 from $64,161,975 to
$64,193,575, with no change to the term of the Agreement, that has been reviewed and
approved by County Counsel as to form and legality.
c. Approve Seventeenth Amendment to Agreement with Epic Systems Corporation
relating to providing subscription services for Care Everywhere - Carequality Exchange,
with no change to the maximum contract amount of $64,193,575, and no change to the
term of the Agreement, that has been reviewed and approved by County Counsel as to
form and legality.
d. Approve Eighteenth Amendment to Agreement with Epic Systems Corporation relating
to providing licensing and implementation services for EpicCare Wisdom General
Dentistry Module, increasing the maximum contract amount by $327,052 from
$64,193,575 to $64,520,627, with no change to the term of the Agreement, that has been
reviewed and approved by County Counsel as to form and legality.
Board of Supervisors: Mike Wasserman, Cindy Chavez, Dave Cortese, Ken Yeager, S. Joseph Simitian
County Executive: Jeffrey V. Smith
Page 1 of 6
e. Approve Nineteenth Amendment to Agreement with Epic Systems Corporation relating
to providing web services to facilitate communication between Epic and Cisco Call
Center System, increasing the maximum contract amount by $39,000 from $64,520,627
to $64,559,627, with no change to the term of the Agreement, that has been reviewed
and approved by County Counsel as to form and legality.
FISCAL IMPLICATIONS
Approval of the recommended actions would not require modification to the current Boardapproved budget for Santa Clara Valley Medical Center (SCVMC). The funds required to
support the proposed amendments are included in the appropriations fixed assets. The
FY2016 budget for SCVMC includes a one-time appropriation of $12 million dollars for the
implementation of HealthLink Wave 3.
CONTRACT HISTORY
On January 10, 2012, the Board of Supervisors awarded a contract to Epic Systems
Corporation for the license, implementation and support of the Enterprise Core Healthcare
Information Systems for period January 11, 2012 through January 11, 2022. The maximum
financial obligation for the term of the Agreement was $59,000,000.
On May 1, 2012, the Board approved the First Amendment to the Agreement relating to the
acquisition of Clinical Practice Model Content in an amount not to exceed $1,700,000 for
period April 11, 2012 through January 11, 2022. The maximum financial obligation was
revised to not exceed $60,700,000.
On September 11, 2012, the Board approved the Second Amendment to the Agreement
which allowed for the acquisition of Epic’s Tapestry Benefit Enrollment and Maintenance
Interface in an amount not to exceed $51,250 for period September 11, 2012 through January
11, 2022. The maximum financial obligation for the term of the Agreement was revised to
not exceed $60,751,250.
On February 26, 2013, the Board approved the Third Amendment to the Agreement with
Epic relating to adding three interfaces for HealthLink in an amount not to exceed $65,000
for period February 26, 2013 through January 11, 2022. The maximum financial obligation
for the term of Agreement was revised to not exceed $60,816,250.
In March 2013, SCVHHS executed the Fourth Amendment to the Agreement with Epic
relating to changing the name of the interfaces in the Third Amendment. It was an
administrative amendment and there was no change in the maximum contract amount of
$60,816,250, and no change to the January 11, 2022 end date of the Agreement.
On August 13, 2013, the Board approved the Fifth Amendment relating to providing a patient
abstractor program for HealthLink with no change to the maximum contract amount of
$60,816,250, and no change to the January 11, 2022 end date of the Agreement.
On August 13, 2013, the Board approved the Sixth Amendment to the Agreement with Epic
relating to terminating one interface license and replacing it with a new interface license
required for biomedical device data integration with no change to the maximum contract
amount of $60,816,250, and no change to the January 11, 2022 end date of the Agreement.
Board of Supervisors: Mike Wasserman, Cindy Chavez, Dave Cortese, Ken Yeager, S. Joseph Simitian
County Executive: Jeffrey V. Smith
Agenda Date: March 22, 2016
Page 2 of 6
On September 24, 2013, the Board approved the Seventh Amendment which added two
pharmacy interfaces in an amount not to exceed $77,500 for period September 24, 2013
through January 11, 2022. The maximum financial obligation for the term of the Agreement
was revised to not exceed $60,893,750.
On September 24, 2013, the Board approved the Eighth Amendment to the Agreement with
Epic relating to providing operational support for SCVMC Patient Business Services
Department and implementation support for the Ambulatory Go-Live increasing the
maximum contract amount by $1,120,600 for period September 24, 2013 through January 11,
2022. The maximum financial obligation for the term of the Agreement was revised to not
exceed $62,014,350.
The Ninth Amendment to the Agreement with Epic was drafted, but SCVHHS decided to not
move forward with executing the Amendment. Epic has requested to keep the numbering of
the Ninth Amendment on file to avoid any potential confusion in the future.
On November 26, 2013, the Board approved the Tenth Amendment with Epic relating to
providing outgoing scheduling interface in an amount not to exceed $23,500 for period
November 26, 2013 through January 11, 2022. The maximum financial obligation for the
term of the Agreement was revised to not exceed $62,037,850.
In July 2014, the County Executive executed the Eleventh Amendment with Epic relating to
terminating the Outgoing Clinical Flowsheet Interface and replacing it with the Outgoing
Syndromic Data Interface. There was no change in the maximum contract amount of
$62,037,850, and no change to the January 11, 2022 end date of the Agreement. The Board
of Supervisors ratified the Eleventh Amendment at the next available Board Meeting on
August 5, 2014.
On November 4, 2014, the Board approved the Twelfth Amendment to the Agreement
relating to providing two interface licenses in an amount not to exceed $45,125 for period
November 4, 2014 through January 11, 2022. The maximum financial obligation was
revised to not exceed $62,082,975.
On November 3, 2015, the Board approved the Thirteenth Amendment to the Agreement
with Epic relating to providing implementation services for the Custody Health Services
Electronic Health Record Project, increasing the maximum contract amount by $1,696,000
from $62,082,975 to $63,778,975, with no change to the term of the Agreement.
On November 3, 2015, the Board approved the Fourteenth Amendment with Epic relating to
providing licensing and implementation services for EpicCare Infection Control Module.
The maximum contract amount was increased by $383,000 from $63,778,975 to
$64,161,975, with no change to the January 11, 2022 end date of the Agreement.
REASONS FOR RECOMMENDATION
SCVHHS Information Services’ HealthLink Team is currently active with the
implementation of Wave 3, which will be delivered in two phases. Phase 1 includes OpTime
(Surgery), Anesthesia, Radiant (Radiology), Clinical Case Management, Infection Control,
and Kaleidoscope (Ophthalmology). Each of those modules are in various stages of
implementation, but are on target to all go live in February 2017. Phase 2 includes Nurse
Board of Supervisors: Mike Wasserman, Cindy Chavez, Dave Cortese, Ken Yeager, S. Joseph Simitian
County Executive: Jeffrey V. Smith
Agenda Date: March 22, 2016
Page 3 of 6
Triage and Wisdom (Dental). These two projects have not launched yet and are targeted to
go live in May 2017.
Fifteenth Amendment – Incoming Ancillary Results and Orders Interface
The Fifteenth Amendment to Agreement with Epic Systems Corporation will delete an
interface that was part of the Enterprise Agreement that was not implemented and replace it
with an Incoming Ancillary Results and Orders Interface required for the implementation of
Radiant (Radiology).
Sixteenth Amendment – Blood Product Administration Module
The Sixteenth Amendment is for the licensing and implementation services for Blood
Product Administration Module. As of March 2014, Epic is offering a streamlined blood
administration workflow with the Blood Product Administration Module. This module helps
the clinician match the blood product dispensed from the blood bank with the blood order a
physician has placed for the patient in HealthLink. The module, through use of barcode
technology, would also assist healthcare professionals in positive patient identification using
system-controlled logic that can require a positive match of the patient, the blood product to
be administered, and information received from the external blood bank system.
Seventeenth Amendment – Carequality Exchange
The Seventeenth Amendment is in relation to the subscription services for Care Everywhere
to include the Carequality Exchange. Since 2013, SCVMC has utilized Epic’s Care
Everywhere for Clinical Information Exchange. Care Everywhere provides a secure
framework for interoperability so that wherever the patient goes, the clinicians providing care
can have the information they need. When an Epic system is on both sides of the exchange, a
richer data set is exchanged and additional connectivity options, such as cross-organization
referral management, are available. Since going live with Care Everywhere, SCVMC has
exchanged more than 1.6 million records. The Carequality Exchange would enable
SCVHHS to expand its interoperability by adopting the Carequality framework with Epic.
Carequality is like Care Everywhere, however it unites multiple networks and multiple
vendor systems, beyond Epic. Carequality is a national, public-private initiative to unite
interoperability vendors, under a single governance structure with the goal of providing
interoperability across networks. Convened by the Sequoia Project, this is the largest
national initiative to unite healthcare stakeholders, regardless of platform. Through
Carequality, every Epic organization can connect to every other Carequality Connected
organization, no matter which networks they participate in or which electronic health record
vendor they use.
Eighteenth Amendment – Wisdom General Dentistry
The Eighteenth Amendment to Agreement with Epic Systems Corporation is for the licensing
and implementation services for EpicCare Wisdom General Dentistry module. The Wisdom
Dentistry module is fully integrated with the medical chart allowing dental professionals with
access to patients’ histories, problem lists, allergies, and medications, as well as Chart
Review where they can review patients’ medical visits. Dental practices also have a unique
set of workflows for diagnosis, treatment, and billing. EpicCare Ambulatory includes some
Board of Supervisors: Mike Wasserman, Cindy Chavez, Dave Cortese, Ken Yeager, S. Joseph Simitian
County Executive: Jeffrey V. Smith
Agenda Date: March 22, 2016
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content for dental professionals, including notes and charting tools, however Wisdom has
several key features that are not available in EpicCare Ambulatory, including tooth charting,
periodontal charting, dental treatment plans and preventative care. Additionally, Wisdom
integrates with Resolute Professional Billing using a dental billing module that helps dental
professionals with preauthorization and claim workflows unique to dentistry. Wisdom also
integrates with Cadence scheduling to accommodate unique dental scheduling needs.
Medical providers will also have access to the patient’s dental chart for continuity of care.
Wisdom will be implemented for all dental practitioners in both Custody Health Services and
SCVMC. It will be going live in May 2017, which is the same time that Custody Health
Services for Adult Custody will be going live.
Nineteenth Amendment – Web Services
The Nineteenth Amendment is for web services to facilitate communication between Epic
and Cisco Unified Contact Center Enterprise. In August 2015, SCVMC launched a project to
replace its current Call Center system to the Cisco platform. The Cisco Automated Call
Distribution (ACD) system will be the sole gateway to the SCVMC Valley Connections call
center and will provide information to patients, make appointments and register patients for
various primary care services at eight clinic locations with a volume exceeding over a million
calls annually. The system will also provide an Interactive Voice Response System (IVR)
which will be integrated to HealthLink. In order to integrate the new Cisco Unified Contact
Center Enterprise to HealthLink, these standard web services are required. The web services
would facilitate communication between the Cisco IVR and HealthLink for patient’s
appointment information and demographics. This will streamline management of Custody
patients already identified in Epic and route calls to customer service for assistance, ensure
data integrity and security by prompting patients to confirm mailing address and other
pertinent information and identify new and existing patients so appropriate appointment slots
are given.
Approval of the Amendments with Epic Systems Corporation would enable the HealthLink
Team to move forward with the implementation of Wave 3 modules as planned. The
Fifteenth through Nineteenth Amendments align with SCVHHS’s Strategic Road Map as it
relates to the Triple Aim Plus Objective by improving system integration and delivering
coordinated/integrated personalized care which will lead to improved patient experience and
health outcomes.
CHILD IMPACT
The recommended action will have no/neutral impact on children and youth.
SENIOR IMPACT
The recommended action will have no/neutral impact on seniors.
SUSTAINABILITY IMPLICATIONS
The recommended action will have no/neutral sustainability implications.
BACKGROUND
HealthLink Implementation Timeline:
Board of Supervisors: Mike Wasserman, Cindy Chavez, Dave Cortese, Ken Yeager, S. Joseph Simitian
County Executive: Jeffrey V. Smith
Agenda Date: March 22, 2016
Page 5 of 6
1/10/2012
Board of Supervisors awarded a contract to Epic for HealthLink
5/4/2013 and 5/7/2013
HealthLink go-live at SCVMC, hospital outpatient departments
and two primary care clinics (Bascom and Moorpark)
8/20/2013 and 10/15/2013
Ambulatory go-live
2/24/2014
Wave 1 completed with implementation of Beacon for
Oncology and Infusion Center
6/3/2014
Initial Healthy Planet go-live to facilitate population health
management and patient engagement
7/12/2014
Major upgrade completed to Epic version 2014
7/25/2015
Wave 2 go-live of Beaker for Laboratory and Willow
Ambulatory for pharmacy
November 2016
Epic 2015 upgrade completed; Custody Health Services Juvenile Hall go-live
February 2017
Wave 3, Phase 1 go-live for OpTime, Anesthesia, Radiant,
Clinical Case Management, Infection Control, and Kaleidoscope
May 2017
Wave 3, Phase 2 go-live for Nurse Triage and Wisdom; Custody
Health Services – Adult Custody and Behavioral Health
Services go-live
CONSEQUENCES OF NEGATIVE ACTION
Failure to approve the recommended actions may impact the ability to meet strict timelines
for HealthLink implementation for Wave 3 modules.
STEPS FOLLOWING APPROVAL
Please send notification of completed processing to SCVHHS Information Services, 2325
Enborg Lane, Suite 260, San Jose, CA 95128, Attn: Susan Quillinan.
ATTACHMENTS:
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Epic Fifteenth Amendment - redacted (PDF)
Epic Sixteenth Amendment - redacted (PDF)
Epic Seventeenth Amendment - redacted
(PDF)
Epic Eighteenth Amendment - redacted
(PDF)
Epic Nineteenth Amendment - redacted
(PDF)
Board of Supervisors: Mike Wasserman, Cindy Chavez, Dave Cortese, Ken Yeager, S. Joseph Simitian
County Executive: Jeffrey V. Smith
Agenda Date: March 22, 2016
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