Community Project Funding/Congressionally Directed Spending - Non-Construction - Address: 222 W. 39th Avenue, San Mateo, CA 94403 Project Director's Name: Stephen Dean Contact Phone number: 628-239-0695 email: sdean@smcgov.org San Mateo County Health seeks to implement an enterprise-wide electronic health record “EHR 2.0” for several thousand health care providers and other users and approximately 70,000 low income and publicly insured San Mateo County residents to replace antiquated information systems that will no longer be supported after 2024. County Health overall serves more than 100,000 residents through a broad array of medical, behavioral health, correctional health, public health, family health and aging and adult services. The EHR 2.0 will be initially launched in San Mateo Medical Center, the County hospital and affiliated clinics, the provider functions within Correctional Health and Public Health, Policy and Planning, and then will be extended to other parts of the system. San Mateo Medical Center currently serves 69,166 patients annually through multiple levels of care. The population served is diverse with 57% of its patients reporting a Hispanic, Latinx or Spanish origin and over 83% of our patients reporting a preferred language other than English. San Mateo Medical Center provides care to 15,594 children 17 and younger, with 19% living in neighborhoods in the lowest quartile of census tracts with respect to health outcomes. The annual volumes of care provided include 40,852 medical emergency department visits, 3,262 visits to psychiatric emergency services, 13,316 patient days on the inpatient medical surgical unit, 10,238 inpatient psychiatric days, 11,046 skilled nursing unit days, more than 17,000 dental visits and 254,272 ambulatory clinic visits. These visits are documented in one of three separate electronic health records that will be replaced with a single new system. A readiness assessment and exhaustive review of the requirements for EHR 2.0 were conducted, leading to an RFP and identification of the vendor most able to meet those requirements. We have studied the experience of other public systems and hospitals and developed realistic estimates of the personnel and other resources needed to support the implementation. We have identified $80 million in one-time funds from County Health sources to support approximately $105 million in implementation costs and seek the balance of $25 million from other sources. This request is for $1 million targeted to the first phase of the project for EHR licensing, project team development, and EHR system build activities. EHR 2.0 will, over time, provide an integrated view of all client/patient information, and enable providers and case managers to collaborate efficiently and effectively in supporting an outcome for every client. This will enable more equitable outcomes for all patients who rely on us as their system of care and will be particularly helpful as we respond across the County to people experiencing homelessness and as we provide emergency services. Due to the complexity and transient nature of our patients who experience homelessness, many have received medical or psychiatric care at other local healthcare systems. Our current technology comprised of multiple systems makes accessing external medical records for these patients very challenging. This undermines our efforts to engage and serve them effectively in routine primary care services and contributes to our difficulties coordinating their care. Case managers and providers are challenged to easily identify the patients/clients that have missed appointments. EHR 2.0 will include case management tools, dashboards, and reports that will aggregate data across our divisions within County Health where our patients often receive care or services. EHR 2.0 will provide tools that assist provider teams to align preventative care activities, resources, follow up appointments, and referrals for patients efficiently and reliably.
