Scvhhs MHD Electronic Health Record Enclosure 3 PDF

Dedicated to the Health
Of the Whole Community
Mental Health Department
Mental Health Services Act

Capital Facilities and Technological Needs
Electronic Health Record

Enclosure 3
April 2, 2009
Santa Clara County MHSA Capital Facilities and Technological Needs
Mental Health Services Act

Capital Facilities and Technological Needs
Electronic Health Record - Enclosure 3
Guide to Packet Contents:
Project Proposal Exhibit 1

Face Sheet

Executive Summary
Technological Needs Project Proposal Description
Appendix A Project Risk Assessment
Project Plan

Budget Summary

Stakeholder Participation
Electronic Health Record (EHR) Executive Summary
Project Type: EHR System Project
Purpose: To provide a comprehensive electronic medical record for consumers that can
be shared in a secure and integrated environment across service providers.
This project will:

Overview:
Reduce paper medical charts and provide an electronic mechanism to
securely share critical client treatment data with all providers in the
network;
Improve coordination of care between providers of services through
integration of data;
Provide opportunities to reduce costs by streamlining and automation of
clinic operations;
Produce better treatment outcomes because of better coordination of care
and integrated treatment protocols.
Once completed, the EHR project will provide an integrated system for all
administrative and clinical consumer information. Treatment plans,
assessments and progress notes will be recorded and securely maintained
electronically. Appointment scheduling, lab orders and medication
prescribing will be done online. Client registration and all forms normally
completed during intake, including medical histories, will be attached to the
electronic medical record and will facilitate coordinated treatment.
The full EHR will support a secure, web based Personal Health Record
(PHR) for consumers and their families with web-enabled interface for
appointment scheduling and clinician communication.
Need: The EHR is mandated by Federal, State and Local initiatives. The Federal
Executive Order requires everyone to have an electronic health record by 2014.
The Governor of California has backed this deadline with an Executive Order.
SCVHHS has set a goal of switching to EHRs by 2013.
The EHR will reduce paperwork and eliminate paper patient charts. This
initiative will promote administrative efficiency and has been shown to be cost
effective through national studies. EHRs improve patient safety and promote
coordination of care amongst multiple providers.
EHR Exhibit 3 Page 1

Project The EHR is a complex project and Independent Project Manager (IPO) will be
Management: selected to oversee the implementation of the EHR. In addition, a Project
Manager will be designated internally to guide the project.
The Project Manager will oversee a thorough project planning process that will
result in a Project Charter, Project Organization Chart and Project Work plan.
The organization process will also establish a communication plan, a risk
management plan and an issue management plan. Appropriate advisory and
governance boards will be defined with representatives from across the
organization and provider network.
The Project Manager will be accountable to the Projects Executive Sponsor,

IPO and Project Director(s). The Project Manager will be responsible for
delegating responsibility
Resources: Staff: SCVHHS existing resources will lead the project and form the project
team. Supplemental staff consisting of selected vendor, contracted staff, IPO
project management oversight, and additional development, interface,
implementation, testing, user acceptance testing, documentation, migration,
report development, training and associated technical and support resources
will be required and are documented in the budget.
Equipment: Dedicated hardware will be required which will include servers,
storage devices and other associated hardware. Provider needs for additional
PCs and printers will be analyzed and incorporated into the project during the
planning and design phases of the project.
Software: Off-the-shelf commercially available (COTS) software will be utilized
when ever possible for the EHR.
Technical Technical support will be provided by SCVHHS IS and vendor(s) resources, as

Considerations: appropriate, and will conform to SCVHHS IS standards. Security
administration will be centralized within SCVHHS IS and adhere to their
existing standards.
Timeline: September 2008 December 2014
Estimated Cost: $13.6 million

Enclosure 3
Exhibit 3
Technological Needs Project Proposal Description
County Santa Date: 03/26/09
Name: Clara
Project Name: Electronic Health Record
Check at Least One Box from Each Group that Describes this MHSA Technological Needs
Project
New System.
Extend the Number of Users of an Existing System.
Extend the Functionality of an Existing System.
Supports Goal of Modernization / Transformation.
Support Goal of Client and Family Empowerment.
Indicate the Type of MHSA Technological Needs Project
> Electronic Health Record (EHR) System Projects (Check All that Apply)
Infrastructure, Security, Privacy.

Practice Management.
Clinical Data Management.
Computerized Provider Order Entry.
Full Electronic Health Record (EHR) with Interoperability Components
(Example: Standard Data Exchanges with Other Counties, Contract
Providers, Labs, Pharmacies).
> Client and Family Empowerment Projects
Client / Family Access to Computing Resources Projects.

Personal Health Record (PHR) System Projects
Online Information Resource Projects (Expansion / Leveraging Information-Sharing
Services)
> Other Technological Needs Projects that support MHSA Operations
Telemedicine and Other Rural / Underserved Service Access Methods.

Pilot Projects to Monitor New Programs and Service Outcome Improvement.
Data Warehousing Projects I Decision Support.
Imaging / Paper Conversion Projects.
Other.

> Indicate the Technological Needs Project Implementation Approach
Custom Application
Name of Consultant or Vendor (if applicable):
Commercial Off-The -Shelf (COTS) System Name of Vendor:
The EHR will be a COTS system that is capable of meeting the CA DMH Medi-Cal and MHSA
reporting systems.
Product Installation
Name of Consultant or Vendor (if applicable):
To be determined during the planning and design phase of the project.
Software Installation
Name of Vendor:
To be determined during the planning and design phase of the project.

Full Electronic Health Record (EHR) Project
Introduction to Santa Clara County Organization and

Its Acronyms
The Santa Clara Valley Health and Hospital System (SCVHHS) is the Santa Clara
County organization that manages, operates and directs all healthcare services within
the County. It is an umbrella organization comprised of the following organizations:
The Valley Medical Center (VMC)
Public Health Department (PH)
Department of Alcohol and Drug Services (DADS)
Mental Health Department (MHD)
Childrens Shelter and Custody Health Services (CSCHS)
Valley Health Plan (VHP)
Community Outreach Programs
o School-Linked Services System (SLS)
o Valley Childrens Health Initiative (Valley CHI)
o Community Health Services (CHS)
SCVHHS has a centralized Information Systems Department (SCVHHS IS) that

supports its organizations. In addition, Santa Clara County has a centralized Information
Systems Department (ISD) that provides network and computing services to all County
agencies.
Project Management Overview

The Electronic Health Record (EHR) Project is an integral part of the MHD strategic plan
to modernize and transform clinical and administrative systems to ensure quality of care,
parity and operational efficiency and effectiveness. A fully interoperable EHR with
Personal Health Records (PHR) must be in place by 2014 to achieve compliance with
both Federal and State requirements.
This project will entail selecting and implementing a commercially available off the shelf
software (COTS) product that will give SCVHHS an EHR for all of it MH clients.
SCVHHS has an internal goal to complete this by 2013.
MHD is currently assessing their Uni/Care system to determine if it can continue to meet
its needs in the future and meet the federal, state and local mandates for EHR
implementation. MHD is not using all of the available functionality that Uni/Care
provides. The assessment is part of this project. The outcome of the assessment is not
known at this time, but should MHD decide that another existing product would better
meet their future needs, MHD will issue an RFP for a replacement system. The RFP will
be developed and issued in accordance with Santa Clara County procurement rules.

If MHD decides to remain with Uni/Care, they will re-implement the system enabling full
EHR functionality to their clinics and treat it as if it they were implementing a new
system.
The EHR project is considered a high risk project. Determination of requirements,

problem resolution, implementation, testing, determination of workflow changes,
hardware and software changes in a volatile environment all contribute to the challenges
that will be encountered. In addition the project is further complicated by intense training
requirements across the service system and must be performed without diminution of
consumer treatment, care and administration of operational programs. Since these types
of projects can often lose energy and focus, MHD will create a project structure and
methodology that will mitigate the risk.
Independent Project Oversight
The MHD will bring in an independent consultant (IPO) to oversee the project for its
duration. The IPO will review all project documentation and meet at regularly with the
Project Steering Committee. In between meetings the IPO will have weekly contact with
the Project Manager to discuss issues and progress. The IPO will provide a monthly
report containing their assessment of the health and progress and report any areas of
concern related to the project.
The primary responsibility of the IPO will be to see the successful implementation of the
Project. They will be recognized as a project team member who will identify risks and
risk mitigation strategies based on their experience. They will be able to contribute to
problem resolution and be recognized by all participants as an authority on the health of
the project. As such, they must be ready to recommend termination of a failed project
and send up adequate warnings in advance of a potential disaster.
The IPO will be an experienced professional, knowledgeable about the business

operations of a public sector Mental Health organization and experienced in information
technology project management. They will ensure that a standard project management
methodology is utilized and that all documents are completed as requested.
Project Management
The Project Manager assigned to each of these projects will be responsible for
organizing, documenting, communicating and managing the project. They will use a
standard project management methodology and maintain an accurate project plan in
MS-Project. The Project Manager will be responsive to the IPO and work collaboratively
with them. The Project Manager will assign tasks and deadlines to resources as
necessary to ensure success.
The IS Manager and the Project Manager assigned to this project have experience with
EMR implementations. The IS Manager has been involved in the Uni/Care
implementation from the beginning and will continue to be involved in this project. The
Project Manager gained valuable experience with the SCVHHS Ambulatory EMR
project.
The Project Manager will see that, at a minimum, the following will be created and

maintained for each project:
A Project Charter
A Governance Body incorporating appropriate stakeholders
A Project Organization Chart
A Project Plan (including critical path and work breakdown schedule)
A Project Communication Plan
An Issue Management Plan
A Risk Management Plan
A Project Steering Committee
A Project Dashboard Report to be submitted to the Steering Committee monthly
A Monthly Project Status Report
A Quarterly Project Status Report to the State DMH
The Project Manager will be accountable to the Projects Executive Sponsor, IPO and
Project Director(s). The Project Manager will be responsible for delegating responsibility
or directly managing the following aspects of the project:
Project Aspects Tasks
Integration Management Delegated as appropriate

Incorporated into the test plan for each
project
Scope Management Responsibility of the Project Manager
Use Project Plan and Project Charter to
manage
Changes to scope will be addressed in
the Issue Resolution Management
Plan.
IPO will monitor changes
Time Management Responsibility of the Project Manager
Use Project Plan and Project Charter to
manage
IPO will monitor timelines and
deadlines
Cost Management Responsibility of the Project Manager
IPO will require monthly budget reports

Project Aspects Tasks
to monitor
Part of the project dashboard
presented monthly to the Steering
Committee
Quality Management Delegated as appropriate
Governance Board will review and
direct
Indicators will developed and be
incorporated into the test plan and user
acceptance criteria
Human Resource Management Responsibility of the Project Manager
FTEs will be responsible to the Project
Manager for this project and to their
assigned supervisor.
Consultants will be managed by the
Project Manager.
Project Manager will coordinate any
vendor staff.
Communications Management Responsibility of the Project Manager
Delegated as appropriate
Managed using the Communications
Plan prepared during the Planning
Phase of the project
Procurement Management The Project Team, Governance Body
and County procurement officers will
work collaboratively to obtain any
necessary hardware, software or other
resources.
Delegated as appropriate
This project will entail selecting and implementing a COTS software product that will give
SCVHHS an EHR for all of it MH clients. This project includes:
Assessment of the functional components of the current transaction system is

the first step in the project management. SVCHHS MHD must assess the
current functionality and compare it to the new requirements for a full EHR.
The process will require, at a minimum:
Definition of requirements
Identification of compatibility with current system
Definition of hardware and/or software purchases or upgrades
Determination of vendor, staff or other supporting resources needed to

successfully implement, and;

Identification of on-going maintenance staff and resource needs.
Assessment of the functionality of the current system vendor. IS and MHD are
jointly assessing their current system, Uni/Care, and may yield a decision that
the current transaction system and available functionality is not the best choice
for MHD, in which case, the assessment process will require the following:
Development of a procurement RFP
Letting of an RFP for a County approved procurement cycle.
Selection and activation, procurement or purchase of enhancements to the

current transaction system, or selection and contract development for a new
system.
Implementation Planning will be necessary whether additional components are

added to enhance the current transaction system, or a new system is selected.
Planning will need to define a phased in approach to implementation, based on
efforts to maximize integration of the system. Planning will include all aspects
of:
Requirements definition
Hardware and software infrastructure requirements
Hardware and software upgrade or procurement
Testing of hardware and software installations
User acceptance testing
Identification of workflow opportunities offered by the EHR
Training of staff, both Contracted Provider and MHD staff
Phased in staff hiring, contractor staff or other resources to support the

implementation phases and on-going maintenance of the system.
Implementation of a full Electronic Health Record (EHR) that activates functional

components available in the selected transaction system with commercially
available off the shelf (COTS) components based on upgrades available
through the current system, or selection of a new transaction system that
includes full EHR components.
A detailed project plan is attached to this document.

Project Costs
The cost estimates for development of the EHR are documented in the Exhibit 4 Budget
Summary.
Nature of the Project

The extent to which the Project is critical to the accomplishment of the County,
MHSA, and DMH goals and objectives.
The EHR Project is a critical component of the MHD compliance with Federal and State
requirements that a fully interoperable EHR with Personal Health Records (PHR) is in
place by 2014. It is also an integral part of the MHD strategic plan to modernize and
transform clinical and administrative systems to ensure quality of care, parity and
operational efficiency and effectiveness.
SCVHHS has set an internal target goal of 2013 for implementation of a full EHR for the
HHS and MHD. The goals and expected benefits for the EHR include:
Reduce paper medical charts and provide an electronic mechanism to securely

share critical client treatment data with all providers in the network. It is understood
that many consumers received services with multiple providers and participate in
service offerings in different programs across agencies. The EHR is a key
enhancement that will improve treatment and operational efficiency.
Access to EHR information will provide consumer treatment records across the
spectrum of outpatient, inpatient and emergency room services. Information on
services and consumer needs will provide better information on identification of
candidates for FSP programs. The development of effective treatment protocols and
new programs will be an expected outcome of EHR implementation.
Clinic automation and streamlined processes will yield cost savings and enhanced
billing related revenue capture. Revenue enhancement will occur through improved
integration and automation of client services with billing.
The full EHR will support a secure, web based, Personal Health Record (PHR) for
consumers and their families with a web-enabled interface for appointment
scheduling and clinician communication.
Improved exchanges of defined data with other County agencies will improve
coordination of care for at-risk children receiving services from multiple agencies.
Improved opportunities to securely share consumer medical history and treatment

information that will follow the consumer through other agencies, such as probation,
juvenile halls, and jails services. The overarching goal is to provide a mechanism
that provides for a more seamless follow-up of services, when needed and improve
the referral and on-going service process.

The development and implementation of standard data sets with contracted

providers and other agencies and the State will reduce costs and ensure
improvements in data exchange capabilities.
MHD clinical staff model with full EHR implementation includes the following
components as presented in the graphic that follows.
EHR Clinical Staff Model 2014
The degree of centralization or decentralization required for this activity.
All publicly-funded Santa Clara Valley County Mental Health services are administered
centrally. This includes billing, claims processing, FFS Medi-Cal, financial services,
contract administration, QM, Compliance, IS and provider network management.
Service delivery is de-centralized through a network of County operated facilities and
Contract Providers.
MHD has a dedicated group of IS staff to support their applications including, All other
Network, WAN, & LAN services are centralized and provided by SCVHHS IS.

The EHR Project is a centralized process in the activation of enhanced or currently

available components within the current transaction system or, selection and
implementation of other EHR solutions. SCVHHS IS will house and maintain the
systems that support an EHR.
The data communication requirements associated with the activity and;
The characteristics of the data to be collected and processed, i.e., source, volume,
volatility, distribution, and security or confidentiality.
The EHR will integrate internal and external data currently captured by MHD and provide
opportunities to capture additional data identified in new project proposals.
For example, internal data sources include:
Hospital/Inpatient providers
Ambulatory and Outpatient services
Department of Alcohol and Drug Services (DADS)
Custody Health programs
County Mental Health Clinics
Contract providers, including FFS providers
Pharmacy
Labs
Enterprise Data Warehouse (future, planned)
External data sources include:
County administrative systems

State and other eligibility systems
State claims processing
Federal block grant
Criminal Justice programs
Juvenile Justice programs
Other County agencies
MH courts
MHSA outcomes reporting.
The EHR current and future components will integrate data from MHD as an
administrator and provider of services and their contract providers.
Some of the internal and external data exchange partners are include in those described
in the following graphical representation as well as an overview of the characteristics.
This represents the future state model for MHD of functionality and the users of the
functionality.


During the Project Planning phase of the project, MHD will determine the volume and
establish a growth factor in order to obtain the appropriate amount of hardware and
infrastructure upgrades. SCVHHS IS understands that sizing and planning are critical to
the success of this initiative. Our current client base is:
Clients served: 23,000
Claims processed: 500,000
County end-users, including clinicians: 806
Contract Providers: 71
The data captured in the full EHR will contain PHI and will be maintained in a manner
required for HIPAA compliance and DMH, State, Federal, and other required
security/confidentiality procedures.
SCVHHS has established policies and procedures for its current systems that comply
with the all standards for HIPAA on the appropriate/secure and confidential maintenance
of PHI. Additional information of the security mechanisms proposed for the EHR is
provided in the Security Process section of this Exhibit.
The degree to which the technology can be integrated with other parts of a system in
achieving the Integrated Information Systems Infrastructure.
The EHR Project and the Enterprise Data Warehouse (EDW) Project are integral
components of the IISI. These two projects will enable SCVHHS to achieve secure,
real-time system interoperability within the provider network and with all of its business
partners. It will provide timely reporting and service information to managers, clinicians,
and ultimately consumers.
The EHR Project will provide an integrated tool to support all the day-to-day business
operations of MHD administrators and providers.
The EDW Project will provide comprehensive data and information tools to support
decision making, outcome reporting and quality management initiatives.
The County will comply with all State requirements. All COTS software will be selected
to fit into the State DMH IISI and Santa Clara County standards established by SCVHHS
IS.

Hardware Considerations
Compatibility with existing hardware, including telecommunications equipment.
SCVHHS IS has a broad set of well defined technology standards in place today.
The EHR will be constructed of standard hardware and will utilize existing software and
telecommunication standards to the highest extent possible.
Further, because MHD systems are hosted in the County's data center several system
components, including networking, power, temperature control, security, and other
components will leverage existing County systems and facility features wherever
possible.
A copy of SCVHHS IS Technology Standards and Network Management policies are

included in Appendix B of Exhibit 2.
Physical space requirements necessary for proper operation of the equipment.
Mental Health Department (MHD) systems are currently hosted in a data center
operated by the SCVHHS IS.
This data center is a state of the art facility that hosts systems for several County
Departments other than Mental Health. An evaluation of the data center determined that
adequate space currently exists to accommodate the proposed EHR.
It is known that there will be additional electrical power capacity needs and upgraded air
conditioning in the current facility. These costs have been included as part of the budget
included for the EHR.
Hardware maintenance.
The SCVHHS IS currently manages the networking equipment, all servers, power, and
temperature controls. Currently the Countys policy is to own, not lease, hardware
equipment and refresh equipment on a 5 year cycle.
Part of the proposed EHR implementation plan includes the hiring of additional technical
staff to assist existing staff with systems administration and hardware management over
time as capacity grows. While we anticipate that existing staff will be able to install and
maintain hardware initially, it is likely that as system utilization grows over time that
additional staff will be required.
A copy of the Network Management and the Table of Contents for a confidential policy
related to Business Continuity Plan are included in Appendix B of Exhibit 2.

Backup processing capability.
The EHR will, to the extent possible, utilize existing hardware and processes so as to
conform with existing backup processing practices and the County's Disaster Recovery
Plan. Because the current backup processing capability planning process is designed
for existing systems, it is likely that additional capacity will be required with the
development and operation of the EHR. As such, provision has been made in the
planning process and budget estimates for additional backup servers, backup
application licenses, tapes, and other necessary supplies. Further, part of the planning
process also includes provision for staff to manage and take responsibility for the backup
process in general and compliance with all regulatory requirements and existing County
standards.
A copy of the Data Backup policy is included in Appendix B of Exhibit 2.
Existing capability, immediate required capacity and future capacity.
Expanding current capacity to meet future needs and added functionality will be
considered during the project planning and design phases of this project. MHD currently
purchases hardware at contracted cost through the SCVHHS IS contract. Because this
project involves a capability that does not exist today, expansion of the servers,
networking equipment, backup equipment, and other associated hardware will be
required and is included in the budget assumptions.
A key underlying assumption throughout the hardware budget is that SCVHHS IS will
leverage existing purchase agreements and negotiated pricing wherever possible to
procure hardware at the lowest possible cost.
A secondary assumption throughout the hardware budget is that where possible MHD
will utilize servers of a consistent type and build for ease of administration and
configuration.
SCVHHS has a well defined Technology Standards policy that defines hardware and
platform requirements. The Technology Standards policy is included in Appendix B of
Exhibit 2.

Software Considerations
Compatibility of computer languages with existing and planned activities.
The EHR as proposed will utilize existing County and Mental Health Department
standards with respect to the compatibility of computer languages, software, and all
other aspects.
The Technology Standards policy for software is included in Appendix B of Exhibit 2.
Maintenance of the proposed software, e.g. vendor-supplied.
The EHR will utilize Commercial Off the Shelf (COTS) software components. The
vendor will provide software updates, software development, and other functions to
update and maintain the core software that it produces.
The EHR software deployed onsite in Santa Clara will be maintained and administered
by existing or future SCVHHS IS staff. SCVHHS IS staff assigned to MHD currently
maintain a wide variety of COTS software, including the current transaction system
installation. SCVHHS IS currently has appropriate contractual Service Level
Agreements (SLAs) for vendor supported software utilized and will add or expand
agreements as needed for the development of the EHR.
SCVHHS IS also maintains networking software. The County will remain current on
releases of software.
Provision has been made in the projected budget for vendor support and licensing
agreements as well as some interaction with contracted staff who would provide
SCVHHS with specialized skill sets at critical junctures in the development and
operational phases of the project.
Availability of complete documentation of software capabilities.
The EHR vendor will be expected, via contract provisions, to provide documentation for
the EHR product. Vendor supplied documentation will be adapted, printed, as needed
and distributed to users and system maintenance staff resources.
The County will need to develop some documentation that reflects specific processes in
place that are unique to Santa Clara County and therefore not included in the standard
set of vendor documentation. For example, data exchange documentation for
partners/contracted vendors, backup and recovery documentation, internal systems
management functions, and other such activities could require significant effort. MHD
and IS will develop supplemental documentation. The attached budget summary
includes provision of MHSA funds to develop documentation to support operations.

Availability of necessary security features as defined in DMH standards noted in

Appendix B.
The Mental Health Department (MHD) has a wide ranging set of security responsibilities
that it currently is required to meet with existing systems. These responsibilities include
County, State, and Federal as well as other legislated security measures and
mechanisms. After reviewing the security features as defined in California DMH
standards as noted in Appendix B, we believe that the security features of the EHR will
exceed DMH standards and meet all applicable County, State, Federal, and other
security requirements.
To ensure compliance with California DMH and other standards, we have planned for an
annual security evaluation to be conducted to evaluate the extent to which the EHR
meets current and future security standards. This evaluation, as planned, would be
conducted by an expert and impartial third party.
An abbreviated version of the IT Security policy for SCVHHS is included in Appendix B

of Exhibit 2.
Ability of the software to meet current technology standards or be modified to meet

them in the future.
SCVHHS IS has a defined and mature set of current technology standards. These
standards were designed with the goal of future growth and in anticipation of
technological changes over time. Further, to support these standards, SCVHHS IS has
established relationships with a number of vendors and has negotiated pricing and
upgrade terms to reflect future growth and change.
The current practice management system conforms to all County technology standards.
The vendor has a business relationship with Microsoft and utilizes Microsoft
development tools. Should MHD seek a replacement EHR it will require the new COTS
software package to conform to County technology standards and easily fit into its
technical environment.
The Technology Standards are defined in a SCVHHS IS policy included in Appendix B of

Exhibit 2.

Interagency Considerations
Describe the Countys interfaces with contract service providers and state and local
agencies. Consideration must be given to compatibility of communications and
sharing of data. The information technology needs of contract service providers
must be considered in the local planning process.
MHD exchanges consumer treatment and service information with a number of other
agencies. The agencies include, but are not limited to the following:
Contracted providers, including FFS providers

State and other eligibility systems
State claims processing
Other County agencies including:
DADS
Public Guardian
Custody Health Services
SCVHHS
FSP Programs
MH courts (Future, planned)
Contract Providers are currently entering in consumer treatment information directly into
MHDs Uni/Care system. Some of the providers also do direct data entry of service
information while others submit the service data via a proprietary EDI function. In the
future, all Contract Provider agencies will be encouraged to submit their data via secure
EDI using standard transaction sets. Planning, funding and transition planning will be
developed during the planning and design phases of the project.
MHD recognizes the complexity related to the sharing of information internally and
across agencies. The SCVHHS IS currently maintains a robust WAN and exchanges
data with State and local entities. The development of a set of electronic data exchange
transactions that utilize industry-standard formats is imperative and will be a key driver of
all planning. It is the intent of MHD to emphasis standard data set development and
implementation as one of the goals for the EHR. This will include adopting the relevant
HIPAA / ANSI transaction standards and HL-7 standards for other consumer health data.
In addition, MHD will stay current with changes to standards and adopt the behavioral
health data standards that are currently under development.
MHD recognizes that contracted providers and consumers are valued partners and
collaborators in this process. MHD has actively included providers and consumers in
planning about the EHR strategy and its advantages for the entire service system. The
MHD currently conducts regular meetings with providers and during the development
and implementation of the EHR it is expected that contracted providers, especially, will
actively participate in review of data and implementation decisions.
We recognize that providers will need be to included in the EHR requirements process,
will need clear support and lead time on any changes in transactions and will require
training and technological support to facilitate implementation. The conversion of
contracted provider strategy will be a key milestone in the planning process for EHR
implementation.

Training and Implementation
Describe the current status of workflow and the proposed process for assessment,
implementation and training of new technology being considered.
Training and implementation are two different activities, but both require careful
development, sufficient resources and active project management in order to achieve
successful results.
Implementation of the EHR will require:
Clear understanding of the objectives

o Define the data needed
o Tie objectives to the best data sources
o Establish business rules
o Define users, applications, data load frequency and other issues
Establishment of a migration path
Procure or build software for migration, loads of data, user testing
Development user acceptance test scenarios and process
Development of policies and procedures that support the EHR
Expansion of security, confidentiality, back-up and other procedures to maintain
the systems
Procurement, installation, set-up and tuning of hardware and software.
In addition, prior to implementation, a business and operational assessment will

be completed to identify and document:
o Current workflows processes
o New workflow opportunities that can/should be implemented to maximize
the advantages of the new functionality
o Documentation of processes that can be used for system configuration
decision-making
o Development of modified policies and procedures.
Training of business users will be completed via collaborative meetings with end-
users, software vendors and project team members and encompass, a minimum,
the following:
Identification of key users that will access the EHR components

Implementation of appropriate security
Scheduling of training that aligns with workload and service needs
Identification of long term updates and maintenance of training information, and
on-going training processes
Identification of other basic computer skills training that may be required for end-
users that may, now with the EHR, need to utilize the systems.
See Appendix B of Exhibit 2 for SCVHHS training guidelines that will be considered
during the project planning phase and incorporated into the EHR training plan.
MHD is fully aware that the process to ensure the successful rollout and subsequent

utilization of the potential of the EHR and reporting capabilities, training and
implementation are key success factors. The budget documented in the Budget
Summary includes line items for staff training and implementation costs are factored
throughout.

Security Strategy
Describe the Countys policies and procedures related to Privacy and Security for the
Project as they may differ from general Privacy and Security processes.
Because the data to be contained in and exchanged with the EHR involves PHI, it is
recognized by SCVHHS that it is necessary to ensure that any proposed solution is fully
compliant with all relevant regulatory and legal requirements. In addition to these
regulations, compliance with all DMH standards will be part of the development and
operations of the EHR.
For any selected vendor(s) for COTS software SCVHHS IS will ensure that the vendor(s)
pre-certify their product as being compliant with HIPAA and all other Federal, State, and
Local legal requirements.
To ensure system and data security the County ISD performs an annual security
evaluation and test of all applications containing PHI.
The SCVHHS IS Security policy in an abbreviated form is included in Appendix B of

Exhibit 2.
Protecting data security and privacy.
Data security and privacy will be built in to the project from day one and be enforced by
the stringent and fully compliant SCVHHS IS policies with Federal, State and Local
regulations on security and privacy. All PHI is encrypted.
Compliance with relevant security requirements is evaluated on an annual basis by the

County ISD.
The SCVHHS IS Security policy in an abbreviated form is included in Appendix B of

Exhibit 2.
Operational Recovery Planning.
MHD currently ensures operational recovery planning through the existing County Wide
Business Continuity Planning (BCP) process. The EHR will conform to existing
requirements and be part of the County-wide planning, documentation, and testing
procedures. The details for the Operational Recovery for the EHR will be incorporated
into the BCP during the planning process.
The Table of Contents for the confidential Business Continuity Plan has been included in
Appendix B of Exhibit 2.
Business Continuity Planning.

MHD currently ensures business continuity planning through the existing County Wide
requirements and be part of the County-wide BCP planning, documentation, and testing
procedures.
Emergency Response Planning.
MHD currently ensures emergency response planning through the existing County Wide
requirements and be part of the County-wide BCP planning, documentation, and testing
procedures.
HIPAA Compliance.
The inclusion of PHI and other data in the EHR will require MHD to ensure compliance
with the Health Insurance Portability and Accountability Act (HIPAA). HIPAA will be one
of many sets of regulatory compliance that will require planning and operational practice
over time. Where possible, the EHR will leverage existing stringent security
mechanisms employed by other MHD or County systems.
Compliance with HIPAA and other relevant security requirements will be evaluated on a
yearly basis by a third party.
SCVHHS maintains HIPAA required Business Associate Agreements and ensures

compliance with all employees, providers and contractors required training, legal
agreements regarding confidentiality, protection and privacy requirements for HIPAA
covered paper and electronic records.
A copy of the required Business Associate Agreement can be found in Appendix B of

Exhibit 2.
SCVHHS already has both a Security Officer or HIPAA Compliance Officer responsible
for all data and operations within any of the SCVHHS agencies.
State and Federal laws and regulations.
In addition to HIPAA and DMH security requirements there will be a number of State and
Federal laws and regulations that will require additional security mechanisms to be
considered, implemented, and practiced. Where possible, the EHR will leverage existing
security mechanisms employed by other MHD or County systems.
Compliance with State, Federal, and other relevant security requirements will be
evaluated on a yearly basis by a third party.

Project Sponsor(s)
Commitments
Sponsor(s) Name(s) and Title(s)
Identify the Project Sponsor name and title. If multiple Sponsors, identify each
separately.
The co-sponsors for the Electronic Health Record project are:
Nancy Pena, Ph.D., SCVHHS Mental Health Department Director

Dennis Kotecki, SCVHHS Chief Information Officer
Commitment
Describe each sponsor(s) commitment to the success of the Project, identifying

resource and management commitment.
The Project Sponsor agrees to provide direction and leadership for this Project and will:
Provide Executive leadership and bidirectional communication on the EHR
project.
Accepts visible departmental ownership for EHR project.
Set strategic direction and goals for projects.
Has final approval on all project deliverables.
Serves as the ultimate decision-maker on issues that cannot be resolved at a
lower level.
Is accountable for the Projects success and will hold all team members
responsible for their contributions and assignments to the project.
Approvals/Contacts
Please include separate signoff sheet with the names, titles, phone, e-mail,
signatures and dates for: Individual(s) responsible for preparation of this Exhibit,
such as the Project Lead or Project Sponsor(s).
Approval / Contact sign-off sheet is attached.

APPENDIX A - PROJECT RISK ASSESSMENT
Electronic Health Record
Category Factor Rating Score
Estimated Cost of Project Over $5 million 6
Over $ 3 million 4 6
Over $500,000 2
Under $500,000 1
Project Manager Experience
Like Projects completed in a "key staff" role None 3
One 2 2
Two or more 1
Team Experience
Like Projects completed by at least 75% of None 3
Key Staff One 2 2
Two or more 1
Elements of Project Type
Local Desktop /Server 1
1
New Install Distributed/Enterprise Server 3
Local Desktop /Server 1
2
Update/Upgrade Distributed/Enterprise Server 2
Hardware
Local Network/Cabling 1
Distributed Network 2
Infrastructure 3
Data Center/Network
Operations Center 3
Custom Development - 5
Application Service Provider 1 3
COTS* Installation "Off-the-Shelf" 1

Software Modified COTS 3
Number of Users Over 1,000 5
Over 100 3
3
Over 20 2
Under 20 1
Architecture Browser/thin client based 1
Two- Tier (client / server 2
*Commercial
Multi-tier (client & web, 3
Off-The Shelf database, application, etc.
Software servers) 3
Total
Score 25
Total Score Project Risk Rating
25 - 31 High
16 - 24 Medium
8 - 15 Low
Appendix A Template Project Risk Assessment Word 2003 version

EHR Project DRAFT 090127 svs
ID Task Name Duration Start Finish Predecessors
1 EHR Project 1393 days? Wed 10/1/08 Wed 2/5/14
2 1.0 Determine EHR Strategy for MHD (Uni/Care or other product) 105 days Wed 10/1/08 Fri 2/27/09
3 Perform Current State IT Assessment 33 days Wed 10/1/08 Fri 11/14/08
7 Conduct EHR Readiness Survey 63 days Wed 10/1/08 Tue 12/30/08
12 Perform Gap Analysis 47 days Wed 10/1/08 Fri 12/5/08
17 Conduct meetings with Uni/Care to discuss future plans 9 days Wed 10/1/08 Mon 10/13/08
20 Conduct Market Study Research of other vendors 39 days Wed 10/1/08 Mon 11/24/08
25 Present Findings and Facilitate Discussion 21 days Mon 12/8/08 Wed 1/7/09 20,19,12
29 Identify MHD/ IT team to review other systems 2 days Thu 1/8/09 Fri 1/9/09 25
32 Review existing BH EMRs in use 11 days Wed 1/14/09 Wed 1/28/09 29
36 Discuss Findings 6 days Thu 1/29/09 Thu 2/5/09 32
39 Develop recommendation to the MH Executives 16 days Fri 2/6/09 Fri 2/27/09 36
43
44 2.0 Develop Contract Provider Strategy 105 days Wed 10/1/08 Fri 2/27/09
45 Perform Current State Assessment 33 days Wed 10/1/08 Fri 11/14/08
49 Identify Possible Contract Provider Models 30 days Mon 11/17/08 Tue 12/30/08 45
53 Conduct Contract Provider Needs Assessment and Input Meeting 13 days Wed 12/31/08 Mon 1/19/09 49
56 Determine Feasible Strategies 7 days Tue 1/20/09 Wed 1/28/09 53
60 Develop Position Paper 6 days Thu 1/29/09 Thu 2/5/09 59
63 Present to Contract Providers for Review 13 days Fri 2/6/09 Tue 2/24/09 60
66 Obtain approval of Contract Provider Stategy 3 days Wed 2/25/09 Fri 2/27/09 63
69
70 3.0 Develop EHR Project Organizational Strategy and Structure 40 days Mon 2/2/09 Fri 3/27/09
71 Establish Project Structrure 11 days Mon 2/2/09 Mon 2/16/09
77 Establish Centralized Project Files 6 days Tue 2/17/09 Tue 2/24/09
82 Establish Project Charter 4 days Mon 3/2/09 Thu 3/5/09
86 Establish Project Communication Plan 4 days Fri 3/6/09 Wed 3/11/09 82
90 Establish Project Management Processes 12 days Thu 3/12/09 Fri 3/27/09 86
103 Determine External Resource Needs for the project 6 days Tue 2/17/09 Tue 2/24/09
108
109 4.0 Develop RFP for New System, if needed 86 days Mon 3/2/09 Mon 6/29/09 2
110 Procure External Resource to Support RFP Development, if Needed 40 days Mon 3/2/09 Fri 4/24/09 105
132 Determine review and approval process for RPF 10 days Mon 3/2/09 Fri 3/13/09 71
133 Develop RFP for New System 46 days Mon 4/27/09 Mon 6/29/09 110
157
158 5.0 Complete a Workflow Analysis 92 days Mon 2/23/09 Tue 6/30/09
159 Procure External Resource to Support Workflow Analysis 40 days Mon 2/23/09 Fri 4/17/09 106
181 Identify Internal Resources to Support Workflow Analysis 20 days Mon 3/2/09 Fri 3/27/09
184 Gather Any Existing Workflow Documents 10 days Mon 3/30/09 Fri 4/10/09 183
187 Develop Workflow Workgroup Teams (Subject Matter Experts and IT) 18 days Mon 3/30/09 Wed 4/22/09 181
201 Convene Meeting #1 - Review and Validate Existing Workflows 2 days Wed 5/6/09 Thu 5/7/09 187
207 Complete Meeting #1 Post Meeting Activities: Update Workflows and Redistribute
6 days Fri 5/8/09 Fri 5/15/09 201
210 Convene Meeting #2: Develop Missing Workflows 1 day Fri 5/22/09 Fri 5/22/09 207
212 Complete Meeting #2 Post Meeting Activities: Develop Workflows and Distribute6 days Mon 5/25/09 Mon 6/1/09 210
215 Convene Meeting #3 - Analyze Workflows 1 day Mon 6/8/09 Mon 6/8/09 212
Page 1
221 Complete Meeting #3 Post Meeting Activities: Update Workflows and Redistribute
5 days Tue 6/9/09 Mon 6/15/09 215
223 Validate All Updated Workflows 11 days Tue 6/16/09 Tue 6/30/09 221
227
228 6.0 Procure new system / services (or, contract with Uni/Care) 304 days Tue 6/30/09 Fri 8/27/10 109
229 Develop Vendor Proposal Evaluation Methodology 81 days Tue 6/30/09 Tue 10/20/09
246 Select a Vendor 150 days Tue 8/11/09 Mon 3/8/10
295 Develop Proposed Agreement, SOW and Exhibits 75 days Tue 3/9/10 Mon 6/21/10
304 Negotiate Contract 49 days Tue 6/22/10 Fri 8/27/10 301
322
323 7.0 Develop Implementation Plan for System Implementation 504 days Mon 3/30/09 Thu 3/3/11
324 Establish External Project Leadership and Support Needs 56 days Mon 3/30/09 Mon 6/15/09 70
350 Establish Project Oversight Strategy 64 days Tue 6/16/09 Fri 9/11/09
376 Develop Preliminary Implementation Strategy 14 days Tue 6/16/09 Fri 7/3/09 2,44,70,324
385 Evaluate Vendor Implementation Strategy 8 days Mon 8/30/10 Wed 9/8/10 228
389 Finalize Implementation Strategy and Timeline 26 days Thu 9/9/10 Thu 10/14/10
400 Identify Temporary Staffing and Provider Needs 100 days Fri 10/15/10 Thu 3/3/11
414 Identify Super Users to Assist with Configuration, Training and Ongoing Support
12 days Fri 10/15/10 Mon 11/1/10
419
420 8.0 Develop a Training Strategy and Plan 74 days? Fri 10/15/10 Wed 1/26/11
421 Determine Training Needs (for Practice Mgmt, ePrescribing, EHR, Portals, PHR)10 days Fri 10/15/10 Thu 10/28/10 389
425 Determine Training Approach 5 days Fri 10/29/10 Thu 11/4/10 421
430 Develop Training Material 41 days? Fri 11/5/10 Fri 12/31/10 425
443 Design Training Sessions 10 days Mon 1/3/11 Fri 1/14/11 430
447 Schedule Training 3 days Mon 1/17/11 Wed 1/19/11 443
468 Conduct Training (Super User/ End User Training inc in Phase Detail) 5 days Thu 1/20/11 Wed 1/26/11 447
470
471 9.0 Upgrade Hardware / Network Infrastructure 41 days Mon 8/30/10 Mon 10/25/10
472 Determine Hardware Needs 5 days Mon 8/30/10 Fri 9/3/10 228
477 Procure Hardware and Network Components 26 days Mon 9/6/10 Mon 10/11/10 472
481 Install and Test Upgraded Hardware and Network Infrastructure Components 10 days Tue 10/12/10 Mon 10/25/10
484
485 10.0 Implement the Practice Management System/EHR Lite 200 days Mon 9/27/10 Fri 7/1/11
486 Install and Configure Practice Management System Software 98 days Tue 10/26/10 Thu 3/10/11
524 Test Practice Management System 34 days Fri 3/11/11 Wed 4/27/11
535 Convert Data 168 days Mon 9/27/10 Wed 5/18/11
567 Pilot Practice Management at One Site 180 days Fri 10/15/10 Thu 6/23/11
574 Train Staff on Practice Management System 5 days Fri 6/24/11 Thu 6/30/11 567
575 Go-Live on Practice Management System/EHR Lite 1 day Fri 7/1/11 Fri 7/1/11 574
576
577 11.0 Implement ePrescribing 294 days Mon 10/18/10 Thu 12/1/11
578 Install and Configure ePrescribing 43 days Mon 7/4/11 Wed 8/31/11
588 Test ePrescribing 33 days Thu 9/1/11 Mon 10/17/11
598 Accept System Software 1 day Tue 10/18/11 Tue 10/18/11 593
599 Pilot ePrescribing 288 days Mon 10/18/10 Wed 11/23/11
606 Train Staff on ePrescribing 5 days Thu 11/24/11 Wed 11/30/11 599
Page 2
607 Go-Live on ePrescribing 1 day Thu 12/1/11 Thu 12/1/11 606
608
609 12.0 Implement EHR (Lab Interfaces, Provider EDI) 426 days Fri 10/15/10 Fri 6/1/12
610 Install and Configure EHR Components 64 days Fri 12/2/11 Wed 2/29/12 577
620 Test EHR Components 33 days Thu 3/1/12 Mon 4/16/12
630 Accept System Software 1 day Tue 4/17/12 Tue 4/17/12 625
631 Pilot EHR Components 420 days Fri 10/15/10 Thu 5/24/12
638 Train Staff on EHR Components 5 days Fri 5/25/12 Thu 5/31/12 631
639 Go-Live on EHR Components 1 day Fri 6/1/12 Fri 6/1/12 638
640
641 13.0 Implement Provider Portal 535 days Fri 10/15/10 Thu 11/1/12
642 Install and Configure Portal 47 days Mon 6/4/12 Tue 8/7/12
652 Test Portal 28 days Wed 8/8/12 Fri 9/14/12
662 Accept System Software 1 day Mon 9/17/12 Mon 9/17/12 657
663 Pilot Portal 529 days Fri 10/15/10 Wed 10/24/12
670 Train Staff on Portal 5 days Thu 10/25/12 Wed 10/31/12 663
671 Go-Live on Provider Portal 1 day Thu 11/1/12 Thu 11/1/12 670
672
673 14.0 Implement Client Portal 661 days Fri 10/15/10 Fri 4/26/13
674 Install and Configure Portal 47 days Fri 11/2/12 Mon 1/7/13
684 Test Portal 28 days Tue 1/8/13 Thu 2/14/13
694 Accept System Software 1 day Fri 2/15/13 Fri 2/15/13 689
695 Pilot Portal 636 days Fri 10/15/10 Fri 3/22/13
702 Train Staff on Portal 5 days Mon 3/25/13 Fri 3/29/13 695
703 Perform Outreach to Educate Clients on Portal 20 days Mon 4/1/13 Fri 4/26/13 702
704 Go-Live on Client Portal 1 day Mon 4/1/13 Mon 4/1/13 702
705
706 15.0 Implement PHR 792 days Fri 10/15/10 Mon 10/28/13
707 Install and Configure PHR 52 days Mon 4/29/13 Tue 7/9/13
717 Test PHR 28 days Wed 7/10/13 Fri 8/16/13
727 Accept System Software 1 day Mon 8/19/13 Mon 8/19/13 722
728 Pilot PHR 767 days Fri 10/15/10 Mon 9/23/13
735 Train Staff on PHR 5 days Tue 9/24/13 Mon 9/30/13 728
736 Perform Outreach to Educate Clients on PHR 20 days Tue 10/1/13 Mon 10/28/13 735
737 Go-Live on PHR 1 day Tue 10/1/13 Tue 10/1/13 735
738
739 16.0 Post Implementation Review 618 days Mon 9/26/11 Wed 2/5/14
740 Review Implementation of Practice Mangement System 31 days Mon 9/26/11 Mon 11/7/11 575FS+60 days
746 Review Implementation of ePrescribing 31 days Fri 2/24/12 Fri 4/6/12 607FS+60 days
752 Review Implementation of EHR Components 10 days Mon 8/27/12 Fri 9/7/12 639FS+60 days
758 Review Implementation of Provider Portal 31 days Fri 1/25/13 Fri 3/8/13 671FS+60 days
764 Review Implementation of Client Portal 31 days Tue 6/25/13 Tue 8/6/13 704FS+60 days
770 Review Implementation of PHR 31 days Wed 12/25/13 Wed 2/5/14 737FS+60 days
Page 3
California Department of Mental Health MHSA Capital Facilities and Technological Needs
Enclosure 3
Exhibit 4
Budget Summary
For Technological Needs Project Proposal
County Name: Santa Clara
Project Name: Electronic Health Record (EHR)
(List Dollars in Thousands)

(1) (2) (3) (4) (5) (6)
Category 08/09 09/10 10/11 Future Years Total One-time Estimated

Costs Annual Ongoing
(1+2+3+4) Costs*
Personnel 889 889 3,112 4,890 889
Total Staff (Salaries and Benefits) 889 889 3,112 889 889
Hardware 150 150 300 600 16

From Exhibit 2
Total Hardware 150 150 300 600 16
Software 1,300 1,300 500 3,100 90

From Exhibit 2
Total Software 1,300 1,300 500 3,100 90
Contract Services (list services to be

675 850 1,000 2,525 30
provided)
NOTE: See below for description
Total Contract Services 675 850 1,000 2,525 30

Administrative Overhead 175 75 36 286 8
Other Expenses (Describe) 1,000 1,000 1,000 3,000 8
NOTE: See below for description
Total Costs (A) 4,189 4,264 5,948 14,401 1,041

Total Offsetting Revenues (B) ** 100 250 450 800
MHSA Funding Requirements (A-B) 4,089 4,014 5,498 13,601 1,041
* Annual Costs are the ongoing costs required to maintain the technology infrastructure after the one-time implementation.
** For Projects providing services to Multiple-Program Clients (e.g., Mental Health and Alcohol and Drug Program clients),
Attach a Description of Estimated Benefits and Project Costs allocated to Each Program.
Project Proposal, Enclosure 3, Exhibit 4 - Budget Summary Page 1 of 2 10/29/2008

Notes:
Personnel Costs Include the following FTEs to support the application:
Technical Resources: Interface Support Analyst; Database Administrator; Systems Administrator
Operational Resources: MH Training Support Resource; Financial Analyst; Administrative Support Resource
Contract Services to be provided include staff augmentation, subject matter experts (SMEs), project management assistance,
and project oversight. Specifically considered:
Workflow Analysis Facilitation; System Configuration / Set-up Specialist (Year 1 only)
Temporary Resources (backfill on Admin. & Clinical staff); Project Lead Support (Year 1 & 2)
Data Entry / Conversion Specialists; Programmers for Conversion; Performance Tuning Specialists (Year 2 only)
Independent Project Oversight; Vendor Support (Over life of project)
Hardware costs include:

Servers; SAN; PC's; Network equipment
Other expenses include:

Training
Documentation
Miscellaneous expenses not categorized elsewhere
Contract Provider Transition Support ($2 million)
Offsetting revenues will come from DADS, other County funds, and Contract Providers.
Project Proposal, Enclosure 3, Exhibit 4 - Budget Summary Page 2 of 2 10/29/2008

Enclosure 3
Exhibit 5
Stakeholder Participation
For Technological Needs Project Proposal
County Name: Santa Clara
Project Name: Electronic Health Record
Counties are to provide a short summary of their Community Planning Process (for Projects), to include
identifying stakeholder entities involved and the nature of the planning process; for example,
description of the use of focus groups, planning meetings, teleconferences, electronic communication,
and/or use of regional partnerships.
Stakeholder Type Meeting Type Meeting

(e.g. Contract Provider, Client, Family (e.g. Public Teleconferences)
Member, Clinician)
Date
MHSA IT Fund Planning Meeting for Original multidisciplinary Committee of MH Staff,
Administrative, Technology and IT staff and contractor IT staff to do CFTN Needs 4/08/2008
Clinical Stakeholders Assessment Planning

Comprehensive, structured interviews with IT staff

MH Staff / Mangers 6/17/2008
to discuss structure, vision, priorities and needs.
All County and Contractor CFTN Kick-Off meeting and Presentation of IT
6/18/2008
Stakeholders Assessment Plan by Outlook Associates
MHSA Stakeholder and Leadership Official update on CFTN activities to overall MHSA
6/20/2008
Committee Meeting (SLC) governing body (SLC)
Comprehensive, structured interviews with

staff/managers and clinicians from various service
MH Staff/Managers/Clinicians areas. Interviews included: Adult Services, 7/08/2008
Clerical, Older Adult Services, Eligibility and
Benefits, Unicare Coordination.


Learning Partnership/Decision Support,
MH Staff/Managers/Clinicians Contracted providers, General Planning regarding 7/09/2008
MHSA and Housing needs and a Mental Health
Clinic.
Enclosure 3, Exhibit 5, Stakeholder Participation For TN Project Proposals page 1of 5

Member, Clinician)
Date
Comprehensive, structured interviews with a
Staff/Managers/Clinicians/Other
Mental Health Clinic and another supporting 7/15/2008
Agencies
agency - SSA.
Staff/Managers/Clinicians/Other Finance, Billing and Claims, MHSA Programs,
7/16/2008
Agencies Quality Improvement and Drug and Alcohol
Services (DADS).
Staff/Managers/Clinicians/Contracted contracted provider business solution (ABS),
Provider Billing Service and Managed Care Program and Consumer and 7/17/2008
Consumers and Families Family interview at a County sponsored Peer
Support Program.
Staff/Managers/Contracted Providers
Contracted Providers, Contract Services, Clinical, 7/18/2008
Group/Clinicians
Physician and Pharmacy Services.
MH Executives/Clinicians Discussion on vision and contractor strategy. 07/21/2008
Comprehensive, structured conference call

interview regarding the Call Center, Claims and
Staff/Managers/Contracted Provider 7/24/2008
Authorization services and Contracted provider
(e.g.Symed).
Telephone conference call with NAMI

Consumer Advocate 7/28/2008
representative.

Comprehensive, structure interviews with

Staff/Managers/Consumer
Consumer Affairs, Custody and Court Services 8/13/2008
Affairs/Clinicians
and Family and Children Services.
Comprehensive, structured interviews with the

Staff/Managers/Other Agencies Public Guardian agency, Decision Support and 8/14/2008
MH IT.
Capital Facilities and Technology Needs Steering

Country Interdepartmental
Committee (Became CFTN Leadership 8/15/2008
Stakeholders
Committee)
MH and IT Management and Core Presentation Mental Health Services Act CFTN
9/9/2008
Team Component IT Visions and Project List
MH and IT Management and Core Presentation of assessment of Current State of 9/18/2008

Member, Clinician)
Date
Team SCC County Mental IT by Outlook Associates

Consumers & Family Consumer Focus Groups 9/26/2008
Contract Service Providers Technology Needs Town Hall Meeting 9/26/2008
9/26/2008

10/17/2008
Ethnic Communities (ECCAC) Task MHSA CFTN presentation and receiving input
10/22/2008
Force from ethnic group representatives on MHSA CFTN
Presentation and receiving input from Older Adults

Older Adults Services Focus Group 10/28/2008
Committee representative on MHSA CFTN
Mental Health Managers and Contractor

Leadership group to review combined Capital,
CFTN Leadership Committee 11/13/2008
Facilities and Technology Needs plans prior to
submitting to SLC
Multidisciplinary Committee of MH Staff, IT staff

MHSA IT Fund Planning Meeting and contractor IT staff to do initial CFTN Needs 11/14/2008
Assessment Planning

MHSA Stakeholder and Leadership CFTN Component Proposal Approval by overall

11/17/2008
Committee Meeting (SLC) MHSA governing body (SLC)
Special session for Mental Health, IS Californian Behavioral Health IT System Market
11/24/2008
and Contractor key stakeholders. Analysis by Outlook Associates
Health And Hospital Committee Status Report on Mental Health Services Act
12/10/2008
(HHC) of Board of Supervisors (Proposition 63) Component Proposals

Member, Clinician)
Date
12/19/2008
Public Hearing on CFTN Component Mental Health Board (Reports to Board of

1/6/2009
Proposal Supervisors)
Presentation by Outlook Associates of Gap

MH and IT Management and Core
Analysis and Future State of IT for SCC Mental 1/7/2009
Team
Health

Mental Health Internal Clinical View the Clinical Features and Functions of Pro-
1/14/2009
Stakeholder event Filer EHR product from Unicare
Visited Kern County Mental Health System of

Mental Health and IT staff Site Visit
Care to learn about their EHR implementation 1/21/2009
to Kern County
experience.
1/23/2009
Committee Meeting (SLC) governing body
MHSA Technical Needs Strategy and Decision

Mental Health Dept. Ops Meeting 2/4/2009
Making
Town Hall Meeting for north Santa Open Session for all stakeholders during Public
2/11/2009
Clara County residents Comment Period on CFTN Project Proposal
Mental Health and IS Internal Presentation of Proposal for Enterprise Data

2/12/2009
Stakeholder Review Warehouse Project (Enclosure 3)
Town Hall Meeting for central Open Session for all stakeholders during Public
2/12/2009
Santa Clara County residents Comment Period on CFTN Project Proposal
MH Executives / Clinicians / IS staff Presentation, discussion & review of project. 2/13/2009
Mental Health and IS Internal Presentation of Proposal for Electronic Health

2/13/2009
Stakeholder Review Record System Project (Enclosure 3)
Town Hall Meeting for south Santa Open Session for all stakeholders during Public
2/14/2009
Clara County residents Comment Period on CFTN Project Proposal
2/20/2009

Member, Clinician)
Date
Guests at California AVATAR Spring 2009 User
Users Group Meeting attended by
Group Meeting to learn about EHR product 3/3/2009
MH and IT staff
functions and features
MHSA Comparison Study of EHR

Special session of MHSA Coordination Meeting 3/9/2009
products
3/20/2009
MHSA Stakeholder and Leadership Technology Needs Project Proposal Approval by

4/17/2009
Committee Meeting (SLC) overall MHSA governing body (SLC)
Contract Service Providers Special Session to discuss Contractor Strategy for

5/14/2009
Stakeholders use of EHR system use by Contract Agencies
Public Hearing on CFTN Enclosure 3 Mental Health Board (Reports to Board of

5/18/2009
Project Proposals Supervisors)
MHSA Stakeholder and Leadership Technology Needs Project Proposal Budget

5/21/2009
Committee Meeting (SLC) Approval by overall MHSA governing body (SLC)

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Dedicated to the Health

Of the Whole Community

Mental Health Department

Mental Health Services Act

Electronic Health Record

Mental Health Services Act

Electronic Health Record - Enclosure 3

Guide to Packet Contents:

Project Proposal Exhibit 1

Project Proposal Exhibit 3

Project Proposal Exhibit 4

Project Proposal Exhibit 5

Electronic Health Record (EHR) Executive Summary

Project Type: EHR System Project

This project will:

EHR Exhibit 3 Page 1

The Project Manager will be accountable to the Projects Executive Sponsor,

Technical Technical support will be provided by SCVHHS IS and vendor(s) resources, as

Timeline: September 2008 December 2014

Estimated Cost: $13.6 million

EHR Exhibit 3 Page 2

Project Name: Electronic Health Record

Indicate the Type of MHSA Technological Needs Project

Infrastructure, Security, Privacy.

> Client and Family Empowerment Projects

Client / Family Access to Computing Resources Projects.

> Other Technological Needs Projects that support MHSA Operations

Telemedicine and Other Rural / Underserved Service Access Methods.

EHR Exhibit 3 Page 3

> Indicate the Technological Needs Project Implementation Approach

Commercial Off-The -Shelf (COTS) System Name of Vendor:

To be determined during the planning and design phase of the project.

To be determined during the planning and design phase of the project.

EHR Exhibit 3 Page 4

Full Electronic Health Record (EHR) Project

Introduction to Santa Clara County Organization and

SCVHHS has a centralized Information Systems Department (SCVHHS IS) that

Project Management Overview

EHR Exhibit 3 Page 5

The EHR project is considered a high risk project. Determination of requirements,

Independent Project Oversight

The IPO will be an experienced professional, knowledgeable about the business

EHR Exhibit 3 Page 6

maintained for each project:

A Governance Body incorporating appropriate stakeholders

A Project Organization Chart

A Project Plan (including critical path and work breakdown schedule)

A Project Communication Plan

An Issue Management Plan

A Risk Management Plan

A Project Steering Committee

A Project Dashboard Report to be submitted to the Steering Committee monthly

A Monthly Project Status Report

A Quarterly Project Status Report to the State DMH

Project Aspects Tasks

Integration Management Delegated as appropriate

EHR Exhibit 3 Page 7

Project Aspects Tasks

Assessment of the functional components of the current transaction system is

Identification of compatibility with current system

Definition of hardware and/or software purchases or upgrades

Determination of vendor, staff or other supporting resources needed to

EHR Exhibit 3 Page 8