The vendor is required to provide to offer and implement a comprehensive electronic health records (EHR) application
- The possible replacement of two existing EHR systems within different service areas with a more modern and streamlined EHR system, either as one integrated system for the county behavioral health services (BHS) area, public health services (PHS) area and correctional health services (CHS) area or two separate systems – one that serves the BHS and PHS area and the other that serves the CHS area, with the ability to integrate and interoperate for the purposes of data sharing and coordination of care.
- The new EHR application must:
• Improve patient care quality through better access to accurate and complete health records.
• Enable efficient documentation, order entry, and workflow automation for clinicians and operations staff.
• Provide robust reporting and analytics for clinical and operational decision-making as well reporting to the state.
• Ensure interoperability with existing internal systems, external health care providers, and regulatory bodies for mandated data exchange and reporting.
• Enhance patient engagement through portals and communication tools.
• Maintain compliance with healthcare regulations
• Support compliance with all billing claims functions for all payers including but not limited to agencies.
- Functional requirements
1. Patient and client management
• Demographics and registration: capture and maintain all necessary patient and client information and payer details. 
• Appointment scheduling: advanced scheduling tools with multi-provider and multi-location support, appointment reminders and rescheduling options. 
• May include self-scheduling by patients and client via online portal and the ability to track and report timely access data per CMS medical final rule requirements.
• check-in and check-out workflow: digital check-in, self-pay collection, and automated follow-up scheduling. 
• Patient photographs: for use in better identifying consumers and patients.
2. Clinical documentation and treatment planning
• Charting and templates: intuitive and customizable templates for clinical notes, progress notes, psychiatric evaluations, therapy session notes, crisis intervention records and discharge summaries.
• Care plans: tools for creating, updating, and tracking individualized care plans.
• Clinical decision support (CDS): alerts for drug interactions, allergy warnings, and evidence-based guidelines for all clinical content.
• Voice recognition: speech-to-text capabilities for efficient documentation.
• Role-based access: enable and support strong role-based access based on internal policies and state and federal requirements.
• Dsm-5 and icd-10 integration – supports accurate coding for mental health diagnoses and can be readily updated as diagnostics standard change or are updated.
• Structured and unstructured notes – allows both template-based and free-text documentation.
• Collaborative treatment plans – supports interdisciplinary teams, goal setting, and progress tracking. 3. Order entry and results management
• CPOE (computerized provider order entry): electronic ordering of labs, imaging, prescriptions, and referrals. 
• Results tracking: integration for lab and imaging results with notification alerts for critical findings. 
• E-prescribing: electronic transmission of prescriptions, including controlled substances, to pharmacies.
4. Integrated care coordination
• Multi-disciplinary team support – enables collaboration between internal and external psychiatrists, therapists, case managers, and primary care providers; as well as collaboration with current and state initiatives.
• Electronic referrals and care transitions – facilitates seamless coordination with external healthcare providers and social services. 
• Behavioral and physical health integration – supports whole-person care by linking mental health with primary care and other specialties.
5. Medication management & e-prescribing 
• Electronic prescribing of controlled substances (EPCS) – supports prescribing of psychiatric medications, including controlled substances. 
• Medication reconciliation – tracks medication history and prevents adverse drug interactions. 
• Medical decision support (MDS) – alerts for drug interactions, duplicate therapy, and contraindications.
6. Crisis management and risk assessments 
• Suicide risk and crisis intervention tools – standardized assessments like Columbia suicide severity rating scale (C-SSRS). 
• Behavioral health screening tools – phq-9, gad-7, cage-aid, and other mental health and substance use screening tools, either available externally or to build and deploy our own. 
• Safety plans and crisis notes – quick access to patient crisis plans and emergency contacts, as well as psychiatric advance directives stored in an external system.
7. Patient engagement and portal 
• Access to health records: patients/clients can view test results, medications, immunizations, and visit summaries. 
• Communication: secure HIPAA-compliant messaging with providers and appointment requests. 
• Telehealth integration: support for virtual visits, including scheduling and video conferencing with tracking and auditing capability for reporting purposes 
• Languages: availability in multiple threshold languages for county
8. Billing and revenue cycle management 
• Insurance verification: real-time eligibility checks and claims management for medical and medicare. 
• Avaibity to upload state MMEFs and real-time look up in CalSAWS. 
• Coding support: integrated support for current procedural terminology (CPT), international classification of diseases (icd-10), healthcare common procedure coding system (HCPCS)
codes with auto-suggestions, and all behavioral health-specific billing codes for therapy sessions, psychiatric evaluations, and substance use disorders. 
• Claims submission: automation of claims processing, status tracking, and denial management that support both public and behavioral health services, with particular emphasis on mental health services act and behavioral health services act, SUD and CALAIM requirements, including but not limited to enhanced care management/community support 
• Financial reporting: comprehensive reports for revenue, payments, and outstanding claims for different stakeholders within the county and state. 
• Support for updates: ensure updates for codes to reflect annual changes mandated by CMS (centers for medicare and Medicaid services) and state medical including billing rates. 
• Funding source management – supports grant-based billing, state funding, and per member per month, capitation and fee-for-service models. 
• Rules: billing rules to verify and enforce requirements established by payer organizations. compliance rules to ensure compliance of any local, state and federal laws
9. Immunization management 
• Automated immunization records – tracks vaccination history, schedules, and reminders for patients. 
• Bi-directional state immunization registry integration – enables automatic reporting and retrieval of immunization data. 
• Mass vaccination event support – streamlines data entry during public health emergencies like pandemics or flu outbreaks
10. Communicable disease tracking & reporting 
• Electronic case reporting (ECR) – automates disease reporting to public health authorities. 
• Contact tracing & investigation tools – supports real-time tracking and follow-up for infectious disease outbreaks. 
• Syndromic surveillance integration – helps identify emerging public health threats in collaboration with hospitals and emergency departments.
11. Maternal, child, and family health services 
• prenatal and postnatal care documentation – supports assessments, screenings, and interventions for pregnant individuals and newborns.
• WIC and nutrition program integration – supports referrals and coordination with state WIC programs. 
• Early intervention & developmental screening – tracks milestones and risk factors for children.
12. Public health reporting 
• Support automated public health reporting for billing and service tracking of communicable diseases as required by state mandates.
13. Population health management 
• Risk stratification: tools for identifying high-risk patient populations. 
• Care coordination: case management tools for chronic disease management. 
• Data analytics: aggregation of clinical data for population health initiatives and ability to upload state population health datafiles.
14. Laboratory information system
• Must support
o Lab orders
o Results management
o Interfaces with external partners and systems
o Reports and trends tracking
o Standard and customizable order sets
16. Health information management (him) 
• Support for a compliant system functional component that is able to acquire, manage, analyze and protect EHR data.
16. Core public health documentation and case management 
• Customizable clinical templates – supports a variety of public health services, including immunizations, maternal and child health, STI/HIV screenings, environmental health, and communicable disease tracking.
• Epidemiological and surveillance tools – tracks outbreaks, disease trends, and community health metrics.
• Chronic disease management – supports long-term tracking and management of diseases like diabetes, hypertension, and asthma.
17. Analytics and reporting 
• Operational dashboards: real-time customizable insights into patient volume, resource utilization, and key performance indicators (KPIs). 
• Clinical reporting: support for all regulatory reporting including state interfaces and report submissions, and other quality reporting requirements. 
• Custom reports: user-defined reports with export options to common formats. 
• Quality measures tracking – supports behavioral health outcomes reporting using variously available data and formats. 
• Population health & predictive analytics – identifies trends in patient conditions and treatment effectiveness with options for customizations to support needs.
18. Interoperability 
• Data standards: support for hl7, FHIR APIs, DICOM, and CCD/CCR standards. 
• External systems integration: interfaces with labs, pharmacies, imaging systems, CDC, state and federal registries, health departments, and health information exchanges (hies). 
• Internal data integration: interfaces and/or direct data exchange with internal data warehouse and data lakes using common links such as client information, billing claim numbers, etc. 
• Data exchange: secure sharing of patient data with external providers and facilities using published national standards such as the 21st century cures act. 
• laboratory and diagnostic data exchange – interfaces with public and private labs for communicable disease testing and reporting
19. Interfaces 
• Medical devices: support for a variety of medical devices in labs and clinics using appropriate technical standards including wearable devices.
20. Compliance and security 
• Regulatory compliance - federal: HIPAA, 42 cfr part 2, Hitech, SAMHSA and other relevant mandates adherence.
• Regulatory compliance – state: all current and evolving requirements from state including support for CALAIM, ab133 DXF, BHQIP, etc. 
• This includes behavioral and public health services. 
• Access controls: role-based user permissions and two-factor authentication. 
• Audit trails: detailed logs of access, edits, and data sharing to support all state and federal regulations. • Data encryption: end-to-end encryption for data at rest and in transit. 
• single sign on: support agency single sign on protocols. 
• Emergency access: support emergency access procedures (break-glass mechanisms) for critical situations. 
• Cloud based platform: application must be cloud based on a compliant platform with all necessary technical and administrative safeguards and disaster recovery and business continuity support
21. Mobile and remote access 
• mobile apps: provider and patient access through mobile devices. 
• Offline access: limited functionality during connectivity disruptions with automatic synchronization.
22. User interface design 
• Intuitive navigation: design a user-friendly interface with clear menus and easy data entry mechanisms. 
• Context-aware display: display relevant information based on the user's role and current clinical context. 
• Customizable workflows: allow users to tailor workflows to their specific practice needs.
23. System architecture: 
• Cloud-based deployment: leverage cloud infrastructure for scalability, reliability, and accessibility. 
• Microservices architecture: design modular components for easier maintenance and updates. 
• Service-oriented architecture (SOA): enable communication between different system components through well-defined services.
- Questions/Inquires Deadline: June 19, 2025