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Health Commission signs off on budget initiatives including $20M annual IT investment, seeks ROI and staffing details
Summary
The Commission approved DPH budget initiatives and received an IT briefing that requested $20 million in ongoing operational funding for an EHR program and identified a one-time implementation need (estimated ~$123M); commissioners asked for FTE projections, adoption/training plans and a business-case showing revenue and cost impacts.
The San Francisco Health Commission on Wednesday reviewed and approved a set of budget initiatives from the Department of Public Health that together leave roughly $19.7 million available to program toward the department—s unified electronic health record (EHR) initiative.
Greg Wagner, the department—s chief financial officer, presented the proposed FY2015-16 budget of approximately $1.98 billion, with $1.3 billion in projected revenues and the balance in general-fund support (about $625 million). Wagner described revenue-neutral and emerging-need initiatives including staffing for general-medicine clinics, bringing food and nutrition services in-house, and expansions funded by the Mental Health Services Act (MHSA).
Bill Kim (DPH IT leadership) briefed the Commission on the department—s unified EHR plans: DPH requested an additional $20 million in ongoing IT operational funding (a roughly 26% increase over the current IT base) to right-size IT, hire and retain roughly 89 IT positions, build informatics/help-desk capacity, and prepare for a FY2018 go-live. Kim said the department is also estimating a one-time implementation cost of approximately $123 million and is pursuing a variety of funding strategies including debt, fundraising and reallocation of surplus. He described active vendor discussions (Epic via UCSF and Cerner) and early discussions with other counties about a consortium to obtain lower pricing.
Commissioners focused on adoption and return-on-investment. They asked for a clearer FTE chart and a business-case analysis showing revenue-cycle gains and cost avoidance that would justify embedding $20 million in DPH—s base budget. Wagner and Kim agreed to provide projected FTE counts, a timeline for hiring and training, and an ROI estimate based on peer institutions (UCSF was cited as a potential model). Kim emphasized that a major purpose for hiring now is to retain institutional knowledge after vendor-led implementation teams depart.
The Commission approved the budget initiatives on the spreadsheet in the meeting packet and authorized staff to proceed with mayoral/budget-office processes while returning with additional detail for the Commission prior to the mayor—s final submission.
