Mendocino Coast District Hospital Special Board Meeting June 21 2017

MCDH Board postpones EHR approval awaiting independent feasibility study

Editorial by Marianne McGee, MA/ABS

While the primary agenda item for the Mendocino Coast District Hospital (MCDH) Board of Directors at the June 21 meeting was to approve the contract to spend 4 million dollars on a new Electronic Health Records (EHR), they exercised fiduciary responsibility by delaying that decision until financing is secured.

Staff had selected MEDITECH as their new EHR software provider, although that company was only willing to finance 1.8 million dollars of the 4 million dollar project.  No other lenders are interested in loaning MCDH money because Cal-Mortgage is the first payee on its current debt, so there are no other assets for new lenders to attach.

Cal-Mortgage, which is a Division of the Office of Statewide Health Planning and Development (OSHPD), carries most of MCDH’s debt and would still collect monies even if the hospital closed.

Tonight the MCDH Board, upon CFO Wade Sturgeon’s recommendation, decided to postpone contracting with MEDITECH and voted to allocate funds of $40,000-70,000 for staff to initiate an independent feasibility study to proceed with another loan from Cal-Mortgage to cover the entire upgrade expense.  Should MCDH provide to be a financial risk that even Cal-Mortgage won’t fund, this project is at risk and the community should wake up to the hospital financial issues.

Dr. Peter Glusker, citing a number of MEDITECH concerns, wanted a competitive bid from one of the other top selling providers and CFO Sturgeon expressed concern about the resources that would be spent on this.  Sturgeon was also adamant that this purchase is mandatory because the current ACA (American Care Act) regulations will require this upgrade to meet federal regulations for reimbursements, those may change rapidly given the current volatile political climate.

Many staff involved with the selection of the EHR program were present tonight and advocated for proceeding with the MEDITECH purchase, as this study further negatively impacts the timeline for implementation. Since the current system primarily utilizes the MEDITECH technology, staff clearly preferred this provider over the other two top selling competitors. My experience is that most medical staff hates dealing with computers and EHR system, so nobody will truly be happy with any change, although it may make the transition smoother.

It was acknowledged that initially there were some very negative aspects to the MEDITECH contract and attorney John Ruprecht had negotiated such significant changes, which benefited MCDH, that those elements will be added to their boiler plate language. Although the new MEDITECH contract, without the financing considerations, will be entirely different, they will contain those enhancements. So, the tremendous amounts of time Mr. Ruprecht spent negotiating not be wasted.

President Steve Lund jokingly told staff he would blame them if purchasing this system, the most expensive decision this board has had to face, if it fails, I piped up that I would be holding the MCDH Board members to be accountable for any bad decisions!

CEO Bob Edwards announced that for the rest of the calendar year, monthly MCDH Board of Director meetings will be held at the Fort Bragg Town Hall.  While this does change does have positive aspects, at a cost of $60 per month, I remarked that in spite of the $300,000 remodel of that facility two years ago, it has the most uncomfortable and dirty folding chairs imaginable. Perhaps, Councilman Will Lee, who is also a MCDH employee, can advocate for the $3000 it would take to rectify this situation.

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