Choteau Hospital district board picks Omaha software vendor for data storage

Teton Medical Center in Choteau will contract with a Nebraska company to provide and maintain a new computer software system and to establish an offsite location for storing hospital data.

The price tag for the service is nearly $325,000 over five years.

By Nancy Thornton-Acantha reporter

TMC’s governing body, the Teton County Hospital District board, authorized TMC Administrator H. Ray Gibbons to execute a contract with American HealthNet Inc. of Omaha, Neb., for a "software upgrade and conversion to an application service provider protocol" at the board’s Jan. 30 meeting. TMC will pay $5,000 immediately to secure the deal, according to TMC Finance Officer Bryan Chalmers. TMC would then pay in installments not to exceed $65,000 per year for the "phase one components" for the five years of the contract.

Normally, the hospital district is under a requirement for competitive, advertised bidding in purchases over $50,000, that concludes with letting a bid to the lowest responsible bidder.

However, units of local government have a purchasing alternative under certain conditions and TMC took advantage of that process in concluding its deal with the healthcare company.

The hospital board adopted the sole source procurement rule outlined in Montana Code 18-4-306, earlier in the meeting before approving the contract, and upon a motion by board member Dick Van Auken of Fairfield, agreed to go with American HealthNet.

The law states that a contract may be awarded for a supply or service item without competition when, (a) there is only one source for the supply or service item, (b) only one source is acceptable or suitable for the supply or service item, or (c) the supply or service item must be compatible with current supplies or services. The board is required to document the reasons and outcome of its purchase and provide the information to the public, if requested.

The board reviewed the information that Chalmers had gotten from several companies for purchasing new software. After the review, the board awarded a contract to American HealthNet, the same company that provides TMC’s current accounting system.

The company announced this past September that it will stop putting changes or updates into TMC’s current software product at the end of 2008, and TMC sought a new system based on that information.

Chalmers gave an overview of proposals TMC received for the purchase of a software system. He said, however, that after due diligence, TMC has opted to have a service contract with American HealthNet as a sole source provider under an "application service provider" relationship (meaning that it stores all data at its Omaha office and would update and maintain the software at its Omaha office and deliver the information over the Internet).

This would be better, Chalmers added, than to purchase the software and hire information technicians to maintain the system on site in Choteau.

American HealthNet had proposed to sell TMC the system for $371,815, but included a $165,237 incentive discount for a total of $206,578. (The company agreed to hold the cost down to 2007 prices for the new Clarus software purchase prior to TMC’s advertising for proposals.)

Tech-Time Inc. of Billings submitted some numbers last October for its Stat! System, according to the company’s sales manager Jim Moore. His figure totaled $278,300 for software and implementation, hardware and system software and annual support.

Tech Time provides the Stat! integrated software system for the medical centers in Cut Bank, Forsyth and Fort Benton and has recently submitted a quote to Liberty Medical Center in Chester.

In offering an incentive discount, American HealthNet proposed to work jointly with TMC and with Liberty using the Clarus system.

Since TMC opted not to purchase a system after all, the board did not accept either purchase proposal. Instead, the board’s discussion centered on the benefits of continuing to work with American HealthNet through a contract for service as an application service provider, as opposed to purchasing the new software. The board did not formally seek other competitive proposals for the contract-for-service scenario. Chalmers said that after contacting vendors and garnering opinions from other facilities’ employees, American HealthNet was the "best solution for TMC." He called the company’s relationship with TMC as "very strong."

Gibbons said the company is the only vendor that meets all of our needs, today and in the future."

In a follow-up interview, Moore suggested that TMC did not outline an "apples to apples" comparison, but he added that he learned last fall that TMC was happy with American HealthNet and on that basis, Moore said he figured TMC would not want to work with another company.

Chalmers said TMC would go through the budget process this spring and include the cost of installing the new system into the projected expenses for the new fiscal year. He added that the basic system could be installed and the staff trained on using it by October.

TMC is a 12-bed hospital and 34-bed nursing home that operates on a $4 million budget.

Gibbons said the new system would be able to incorporate improvements that would meet compliance standards set by Medicare and Medicaid for electronic medical charting by a 2014 deadline.

On another matter, the hospital board approved several amendments to the Teton County Hospital District board bylaws. The board tightened qualifications for board members to exclude current TMC employees and their immediate family members; and immediate family members of TMC active medical staff.

State law places no exclusions other than that the trustees must be elected from among the registered electors qualified to vote at general elections within the district; however, the Attorney General of Montana rendered an opinion in 1998 that a hospital district employee cannot be a hospital district trustee. Those positions are incompatible because one has the power of removal over the other, among other issues. (The opinion concludes the same argument for city employees who seek a position on the city council.)

The Teton County Hospital District board’s exclusion of immediate family members from trustee positions is a different matter. The AG’s office, when contacted last week, could find no similar opinion regarding exclusion of immediate family members of employees.

Regardless, the current trustee qualifications, which place no exclusions, will apply to this election cycle because the filing period opened before any bylaw change was approved.

The three-year terms of two board members, Marsha Hinch and Justin Lee, expire on May 6, and the incumbents plan to seek re-election, according to board clerk Joyce Lindgren.

Nominating petitions are available at the Teton County Clerk and Recorder’s office in Choteau or at TMC. The deadline for filing is Feb. 21 at 5 p.m.

In other business,

–TMC Chief Nursing Officer Robert Rang resigned to take a position in Alaska. Gibbons said he has staffed the position with a qualified person from the Kalispell Regional Medical Center, and is interviewing four candidates.

–Chalmers reviewed TMC’s financial reports and said that TMC had a $53,428 operating loss in December, but good revenues last July and August enabled TMC to absorb the reduction and post a $255,995 operating profit for the fiscal year to date. He cautioned that TMC has delayed some plant improvements, which are expenses that do not show on the books yet.

–Gibbons reported that the yearly state inspection should happen at any time to include the hospital and the nursing home operations.

–Gibbons said that the boiler replacement project went well with the aid of two Choteau businesses, Howard’s Plumbing and Teton Lumber, that provided the lift truck to hoist the boilers to the roof and down into the physical plant.

–TMC admitted five hospital patients and four nursing home residents in December. Sixty-one people visited the emergency room in December, bringing the total number so far this fiscal year to 484, well above the three-year average of 412 visits. The average daily census in the nursing home is 25.7 residents.

Full Story: http://www.choteauacantha.com/articles/2008/02/07/news/news4.txt