Memorandum

Lawrence-Douglas County

Fire Medical

TO:	David Corliss, City Manager Diane Stoddard, Assistant City Manager Cynthia Boecker, Assistant City Manager
FROM:	Mark Bradford, Fire Chief
Date:	February 23, 2009
RE:	Mobile Fire Inspection Program and Computer Tablets

INTRODUCTION/DESCRIPTION

As a result of our internal efficiency review of department operations during the Agency Accreditation process, we found that we were extremely inefficient in the way we are managing our patient care record/billing process and fire/target hazard inspection reporting. Most of the inefficiencies identified are inherent in a paper-based system.  Our current manual paper system is antiquated, redundant, expensive and extremely labor intensive. 

PROJECT TEAM

A project team was formed in March 2007 to evaluate project solutions.  The team make-up consisted of 13 members from our department (nine line personnel, three chiefs and one administrative billing clerk). In addition to the department staff, members from the City and County IT departments were also consultants to the project team.  The objective of the team was to review various software and hardware applications and recommend complete electronic patient care reporting (ePCR) and fire mobile inspection solutions.

2006 – 2009 AGENCY ACCREIDTATION RECOMMENDATIONS

Specific Recommendation #3

The Department should incorporate an electronic means of documenting the field inspections. Currently, a paper form is printed, manually completed, and then the information collected is re-entered into the Records Management System (RMS). Adopting a “store and load” electronic system which is also compatible with the existing RMS will reduce this duplication of tasks (5B.7)

2008 Update

Software (Firehouse-Mobile, one license) has been purchased that will enable the department to electronically record inspections, and field beta testing is being performed by the Prevention Division and Operations.

Specific Recommendation #4

The Department should consider the implementation of a computerized EMS report and quality assurance tracking system. Computerized reporting will enhance the gathering of patient information and outcomes as well as make the EMS billing process more efficient. Special emphasis should be given to capturing quality assurance review information. Critical evaluation should be given to assure user-friendly software (5G.5)

2008 Update

In late 2008, the department officially went “live” with electronic Patient Care Report (ePCR) writing. The City, County and the department put considerable time, resources and money into this project to achieve a roll out that was as smooth as possible.  As a result of our internal efficiency review of department operations as part of our agency accreditation process, we found that we were extremely inefficient in the way we were managing our patient care record/billing process. Most of the inefficiencies identified are inherent in a paper-based system. We found our manual paper system was antiquated, redundant and extremely labor intensive.  With this new technology, the ePCR system creates and maintains electronic medical records beginning at the patient’s bedside up to, and including, medical claim submittal. This system also provides an effective reporting tool utilized for Quality Assurance Management and provided an ease of integration with current systems being used by the department. Additionally, multiple methods of data input into the ePCR can be achieved either from the desktop in the stations or the handheld computer tablets utilized in the field.

PROGRAM EFFICIENCY

Electronic Patient Care Reporting (Douglas County Cost) - An ePCR system creates and maintains electronic medical records beginning at the patient’s bedside up to and including medical claim submittal.  ESO Solutions^TM was selected as the vendor for the following reasons based on annual call volumes and the number of mobile devices necessary to meet the mission of the department:

· Quality product at an affordable price

· Customized reporting capabilities

· Data is available from any internet connection anywhere

· State required data automatically captured and submitted electronically

· Increased billing efficiency, revenue and productivity

· Effective reporting tools utilized for Quality Assurance Management

· NEMSIS Gold Compliant (see attached for compliance explanation and policy)

· Ease of integration with current systems being used by the department:

o Computer Aided Dispatch (CAD) Interface

o Ortivus Sweet^TM  Billing Software Interface

o Firehouse^TM  Fire Records Management Interface

o Lifepak^TM 12- Cardiac Monitor Interface

· Multiple methods of data input into the ePCR, either from the desktop in the station or the handheld table computers in the field.

Firehouse^TM Mobile Fire Inspection Reporting (City Cost) - An electronic mobile fire inspection reporting system creates and maintains electronic inspection reports beginning in the business and including printing documentation at the site.  Our Firehouse^TM reporting management system was selected in part as the vendor for the following reasons to meet the mission and strategic plan of the department:

· Ease of integration with current systems being used by the department:

o Firehouse^TM  Fire Records Management Interface

o ESO Solutions^TM Patient Care Reporting

· Customized field reporting capabilities

· Data is available from any internet connection anywhere

· State required data automatically captured and submitted electronically

· Effective reporting tools utilized to eliminate redundancy in data entry and mailings (reduce postage cost)

Program Costs for ePCR (Douglas County Purchased in FY 2007)

There are three types of costs associated with ePCR:  a one-time set up fee, monthly charges, and annual maintenance costs.

There is a one-time set up cost of $85,600.  This includes:

· Software

o Annual subscription to ESO Solutions^TM                                $11,595

o Licenses (10 x $695)                                                 $  6,950

o On-site Training                                                        $  3,885

o CAD Interface                                                          $  3,995

o Ortivus Sweet^TM  Billing Interface                                   $  1,995

o Firehouse^TM Interface                                                 $  3,995

o Lifepak^TM 12- Cardiac Monitor Interface  (16 x $585)        $  9,360

o Cardiac Monitor Interface                                            $  3,995

o Air Cards (10 x $50/month)                                         $     500

Software Subtotal      $46,270

· Hardware

o Tablet Computers (10 x $3,828)                                  $38,280

o Standard Carry Cases (10 x $105)                                $  1,050

                                                                   Hardware Subtotal     $39,330

                                                                   Grand Total             $85,600

Initial startup cost include the first month’s air card cost and the first year of annual software maintenance  For each of the following months, a mobile connection cost would be $500 month.  In addition, the annual software maintenance/subscription fee to ESO Solutions^TM is $11,595.  All of these costs were paid by Douglas County.  As part of this process, the city had agreed to purchase the electronic tablets in the 2007 FY.  This request was deferred in FY2007 to FY 2008 and again in FY2008 to FY2009.  The same tablets would be used for ePCR and for the Firehouse^TM Fire Mobile Fire Inspection reporting system.

Program Costs – Firehouse^TM Mobile Fire Inspection Reporting Program (City Cost)

There are three types of costs associated with mobile fire reporting:  a one-time license fee, monthly charges and annual maintenance costs.

· Software – Firehouse^TM Mobile Fire Inspection Reporting Program

Operations Budget Line Item 001-2200-562.40-04

o Licenses (20 x $885)                                                  $17,700

o Discount for Multiple Licenses (-25%)                           -$  4,425 

o Firehouse^TM Interface to Firehouse^TM  Records Management

System already in place                                              $        0

                                                              Software Subtotal      $13,275

· Software – Firehouse^TM Mobile Fire Inspection Update/Support

Operations Budget Line Item 001-2200-562.26-05                         

o Software Updates and Support (20 x $110)                    $  2,200

Support Subtotal       $  2,200

· Software –Microsoft ^TM Office Professional Software

Operations Budget Line Item 001-2200-562.26-05

o Microsoft ^TM License and update (10 x $497)                            $  4,970

                                                                   Software Subtotal      $  4,970       

· Hardware – Dell Computer Tablet

Capital Request Line Item 001-2200-562.60-80

o Tablet Computers (10 x $3,980)                                  $39,800

o Air Cards (10 x $43/month) 001-2200-562.34-01             Monthly

                                                                   Hardware Subtotal     $39,800

                                                                    Project Grand Total   $60,245

FUNDING

The software costs are budgeted in the FY 2009 Operating Budget (line item 001-2200-562.40-04 and 001-2200-562.26-05) with hardware costs budgeted in the FY 2009 Capital Requests (line item 001-2200-562.60-80).

RECOMMENDATION
The Department is requesting to proceed with the purchase, connectivity and maintenance/subscription agreements for ePCR (County cost) and Firehouse^TM Mobile Fire Inspection software and required hardware available through government purchasing contracts in order to achieve the most cost effective pricing in an amount not to exceed:

Firehouse^TM Mobile Inspection Module Software & Support           $15,475

     (The Firehouse^TM Software is a sole-source purchase as a companion

to our current software suite).

Microsoft ^TM Office Professional Software                                  $  4,970

(Microsoft Software is purchased on the State of KS Contract #07359

with Software House International)

          Dell Computers, Electronic Tables                                            $39,800

     (The Dell hardware is being purchased via State of KS Contract# 07979)

                                                                    Total Request           $60,245