Primary Department: Public Health Services
Primary Department Head/Elected Official: Leah Barton, Executive Director
Managing Department: Public Health Services
Managing Department Head/Elected Official: Leah Barton, Executive Director
Regular or Supplemental RCA: Supplemental RCA
Type of Request: Investment Memo
Investment Memo Type: Final Investment Memo
Project Name: Electronic Medical Records System Replacement
Project ID (if applicable): TBD
Vendor Legal Name (if applicable): N/A
MWBE Contracted Goal (if applicable): N/A
MWBE Current Achievement (if applicable): N/A
Justification for 0% MWDBE Participation Goal: N/A - Goal not applicable to request
Grant Indirect Costs Rate (if applicable):
Justification for 0% Grant Indirect Costs Rate (if applicable): N/A - Not a grant item
Incremental Authorization Requested: $3,685,350
Total Estimated Project Cost: $3,685,350
Request Summary:
title
Request by Public Health Services for approval of a Final Investment Memo for the Electronic Medical Records System Replacement project, in an amount of $3,685,350, and request for approval of commercial paper funding in the amount of $3,690,000.
end
Project Description:
Harris County Public Health seeks to replace its Electronic Medical Records (EMR) system for the clinics and facilities throughout Harris County. The new EMR build will enable holistic medical services to the community through a secure, fault-tolerant, recoverable, and compliant system that adheres to Protected Health Information, Health Insurance Portability and Accountability Act (HIPAA), and Criminal Justice Information Service (CJIS) regulations. The EMR system aims to enhance operational efficiency, financial performance, and the quality of care. The scope includes:
• Replacing the current EpicCare version and adding modules for a fully integrated system that tracks patient progress from entry to exit. Adding available modules:
o Dental Health Services module - Wisdom
o Health Information Exchange - CareEverywhere
o Population Health - HealthyPlanet
o Patient Communication - Cheers
o Care Coordination and Case Management - Compass Rose
o Outpatient Pharmacy and Inventory Tracking - Willow
o Resolute Professional Billing System
o Mobile Platform Access - Rover
o Behavioral Health
o Safety Net Solutions
o Social Care Referrals - FindHelp
• Implementation and Onboarding Plan
o Provide a Work Plan describing a typical/expected implementation/onboarding plan, including durations of activities and artifacts needed at key intervals. Identify the time frame from the executed contract to the Go-Live implementation date.
o Outline implementation roles and responsibilities of vendor, PHS, and any third parties and/or subcontractors. Describe roles and expertise that PHS must make available and when for successful and quick implementation.
Anticipated Project Expenditures and Timeline:
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Project Scope Breakdown |
Initial Fees |
Implementation & Configuration |
Maintenance & Support |
Estimated Completion |
|
|
One-Time |
Annual* |
|
|
Epic Licenses |
$- |
$1,677,000 |
$33,097 |
January 2028 |
|
3rd Party Modules |
$46,000 |
$468,000 |
$83,900 |
January 2028 |
|
Implementation & Support Services |
$- |
$1,358,500 |
$656,250 |
January 2028 |
|
Hardware & Infrastructure |
$- |
$- |
$66,000 |
January 2028 |
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Miscellaneous** |
$135,850 |
$- |
$- |
January 2028 |
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Total |
$181,850 |
$3,503,500 |
$839,247 |
January 2028 |
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Notes |
*Annual costs to be covered by Charity Care **10% of the Implementation & Support Services one-time costs |
Justification & Alternatives:
Harris County Public Health (HCPH) provides a wide range of medical, behavioral, case management, and outreach services to residents across multiple divisions. In 2024, HCPH facilitated over 40,916 patient encounters through the Community Health and Wellness Division, performed 12,937 patient encounters by Dental Health Services, administered 55,552 immunizations across all clinics, provided responses to 9,609 calls through Community Health and Violence Prevention’s Holistic Assistance Response Team (HART), and served nearly 900 vulnerable individuals through targeted Health Prevention and Coordinated Care initiatives.
Harris County Public Health (HCPH) provides a wide range of medical, behavioral, case management, and outreach services to residents across multiple divisions. Currently, HCPH relies on multiple Electronic Medical Record (EMR) platforms, including Cranford Medical, Dentrix, Dexis, and Harris Cares, which has resulted in significant operational inefficiencies, fragmented data, and inconsistent clinical documentation. Each HCPH division and program-ranging from Community Health and Wellness, Health Prevention and Coordinated Care, Community Health and Violence Prevention, and Epidemiology-has unique service delivery requirements. However, all programs share a common need for a unified electronic documentation system that supports seamless data exchange, efficient workflows, and robust compliance with regulatory standards.
The current fragmented approach presents critical challenges, such as:
• Workflow inefficiencies and redundant documentation
• Limited EMR access and inadequate user permissions
• Lack of standardized SOAP documentation
• Infrastructure constraints impeding system integration
• Paper-based processes still in use due to training and access gaps
• Inability to support mobile and field-based care delivery
These deficiencies not only hinder operational efficiency and patient experience but also expose HCPH to risks related to patient safety, regulatory compliance, and revenue loss.
To meet both federal and state regulatory requirements, such as those established by HHS, CMS, CDC, ONC, and Texas health authorities, HCPH must transition to a fully integrated electronic documentation environment. Leveraging the full capabilities of the Epic system, if properly implemented across all divisions, can address these pain points by streamlining care delivery, improving data integrity, enhancing staff productivity, and ensuring financial and regulatory accountability.
To support the mission of protecting health, preventing disease, and promoting well-being for all 5 million Harris County residents, HCPH requires a unified, integrated EMR system. The new system will serve as a single source of truth across programs, enabling collaboration, improving efficiency, and strengthening care delivery, data collection, analytics, sharing, and reporting.
Key drivers for replacement include:
1. Integration and Collaboration
o A single system will allow medical, behavioral health, case management, and outreach teams to collaborate effectively, improving care coordination and continuity.
o Coordinated Care will serve as the model for integration, with the unified EMR expanding this approach across all divisions.
2. Efficiency and Quality of Care
o Eliminating duplicate data entry and system redundancies will save staff time and resources.
o Streamlined workflows and shared access to records will improve patient experiences and outcomes by reducing gaps in service.
3. Compliance and Security
o The replacement EMR will meet all regulatory standards, including HIPAA, access controls, data lifecycle management, and secure backup/recovery.
o A modern platform reduces reliance on unsupported legacy systems and enhances data protection.
4. Data-Driven Decision-Making
o Centralized data will allow HCPH to produce robust analytics, dashboards, and reports for program evaluation, grant compliance, and population health monitoring.
o Leadership will be better equipped to identify trends, allocate resources, and adjust interventions.
5. Equity and Accessibility
o With a shared system, underserved populations will experience improved continuity of care and greater stability through coordinated medical, mental health, and social services.
o Enhanced data sharing will strengthen HCPH’s ability to address health disparities across communities.
This investment will reduce inefficiencies, eliminate silos, and establish a single system of record to improve collaboration across programs. These improvements would directly enhance HCPH’s ability to meet the clinical and social care needs of the community, such as by connecting women and children to effective care and resources through the Maternal and Child Health Program, providing comprehensive mental health and substance use resource navigation through Behavioral Health Services, preventing HIV and STIs through testing, counseling, education, and outreach in the HIV/STI Prevention Program, preventing vaccine-preventable diseases and delivering immunizations to the county’s most vulnerable residents, and reducing harm and injury through the Community Health and Violence Prevention Services Division. By aligning with the current Coordinated Care model, HCPH will modernize its infrastructure, safeguard compliance, and ultimately provide more effective, equitable, and integrated services to the residents of Harris County.
Anticipated Impact on Other Funds (If Applicable):
|
Fund Code |
Description |
Estimated Cost |
Funding Method (Existing or Future Budget Request Required) |
Estimated Date of Needs |
|
|
Annual Maintenance & Support Fees |
$862,000 |
Charity Care |
1/29/2026 |
|
Total |
|
$862,000 |
|
1/29/2026 |
County Strategic Plan Goal:
County Strategic Plan Objective: O: Increase access to quality health care, including preventive and behavioral health.
Justice/Safety Initiative (Goal 1): Choose an item.
Infrastructure Initiative (Goal 2): Choose an item.
Economy Initiative (Goal 3): Choose an item.
Health Initiative (Goal 4): O1: Coordinate health organizations to improve access and care.
Health Initiative (Goal 4): O4: Increase community health care capacity.
Climate/Resilience Initiative (Goal 5): Choose an item.
Housing Initiative (Goal 6): Choose an item.
Previous Court Action:
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Action Taken |
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Address:
Precinct(s): Countywide
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Fiscal and Personnel Summary |
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Funding Sources |
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Existing Budget |
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Total Current Budget |
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Additional Budget Request |
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Commercial Paper |
$ |
$3,690,000 |
$3,690,000 |
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Total Additional Budget Request |
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$3,690,000 |
$3,690,000 |
$ |
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Total Funding Request |
$ |
$3,690,000 |
$3,690,000 |
$ |
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Personnel (Fill out section only if requesting new PCNs) |
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Current Position Count for Service |
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Additional Positions Request |
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Total Personnel |
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Anticipated Court Date: 3/19/2026
Anticipated Implementation Date (if different from Court date): Click or tap to enter a date.
Emergency/Disaster Recovery Note: Not an emergency, disaster, or ARPA related item
Legal funding compliance confirmed by: Paige Abernathy, First Assistant County Attorney-Legal Operations, 3/8/2026
Department Approval by: Alexey Gruber, Director - Office of Operations & Technology Services, 3/11/26
OMB CIP Team Approval by: William McGuinness, Director-Capital Projects & Infrastructure, 3/9/2026
Commercial Paper Request (For OMB use only):
Receiving Department: Public Health Services
Project PeopleSoft ID: TBD
CP Series Description: Commercial Paper Series D-2 can be used for (1) construction of public works, (2) the purchase of automobiles, equipment and machinery, including computers, materials and supplies for the operation of the County’s precincts and departments (3) Professional services, including services provided by engineers, architects, attorneys, auditors, financial advisors, and fiscal agents, in connection with the contractual obligations described in (1) and (2).
Commercial Paper is being requested for the Electronic Medical Records System Replacement project and is expected to be repaid within the next three fiscal years either through bonds, budgetary means or pay-as-you-go sources.
Note: Commercial Paper is issued in increments of $5,000 and the excess is not available to be spent by the department.
OMB Financial Management contact: Fahad Gulzar, Acting Deputy Executive Director, Office of Management and Budget