DATE:
September 9, 2025
05
TO:
Board of Supervisors
SUBJECT
Title
REQUEST FOR EXTENSION OF IMAGETREND CONTRACT AND COMPETITIVE SOLICITATION AUTHORITY FOR PREHOSPITAL AND HOSPITAL DATA COLLECTION SOFTWARE (DISTRICTS: ALL)
Body
OVERVIEW
The County Emergency Medical Services Office (County EMS) is required by State law to collect certain prehospital and hospital data from local EMS and hospital providers and transmit it to the State of California. This data plays a critical role in promoting a robust quality management system, identifying emerging medical threats to the community, and improving EMS system outcomes.
On September 1, 2016, the County entered into a contract with ImageTrend, LLC (ImageTrend) for a software solution for the County's comprehensive system to collect, manage, and support prehospital data. In addition to the County EMS Office, there are 35 prehospital agencies and 22 medical centers in the region that utilize the system at no cost to them, including hospitals, fire departments, and private ambulance operators.
The current contract with ImageTrend expires on December 31, 2025. Continuity of existing services is necessary for County EMS to support our EMS delivery system and to remain in compliance with State law. To ensure uninterrupted and optimized service, County Fire is requesting to extend the current contract for up to five, one-year options, and authority for the Department of Purchasing and Contracting (DPC) to issue a competitive solicitation for a future data collection and management system.
Today's actions include authorizing the Director, Department of Purchasing and Contracting, to enter into negotiations with ImageTrend, and subject to successful negotiations, amend the contract to extend the term for up to five, 1-year option periods through December 31, 2030, and to authorize the Director, Department of Purchasing and Contracting to issue a competitive solicitation for prehospital and hospital data collection software for a term of 10 years.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. Waive Board Policy A-87, Competitive Procurement, approve and authorize the Director, Department of Purchasing and Contracting, to amend contract 554346 with ImageTrend, LLC for up to five (5) additional one year option periods through December 31, 2030.
2. In accordance with Section 401, Article XXIII of the County Administrative Code, authorize the Director, Department of Purchasing and Contracting, to issue a Competitive Solicitation for prehospital and hospital data collection software, and upon successful negotiations and determination of a fair and reasonable price, award a contract for an initial term of one (1) year with nine (9) one year option periods and an additional six months if needed; and to amend the contract as needed to reflect changes to services and funding, subject to the approval of the Director, San Diego County Fire or their designee.
EQUITY IMPACT STATEMENT
The collection of prehospital and hospital data from local EMS and hospital providers plays a critical role in promoting a robust quality management system, which seeks to reduce health disparities in our region. This provides a benefit to the improvement of the health, safety, and emergency medical care provided to the residents throughout the County of San Diego.
SUSTAINABILITY IMPACT STATEMENT
The proposed actions to extend the current contract with ImageTrend and authorize a competitive solicitation for prehospital and hospital data collection software, for the collection of data from local EMS and hospital providers in San Diego County, support efforts for the operations, values, and priorities, including equitable service delivery, to the residents in our region.
FISCAL IMPACT
Funds for this request are partially included in the Fiscal Year 2025-26 Operational Plan for San Diego County Fire. If approved, this request will result in an estimated costs and revenues of $1.2 million in Fiscal Year 2025-26. The funding source is existing General Purpose Revenue. Total costs and revenue for the remaining contract term are estimated at $1.5 million and will be included in future Operational Plans for San Diego County Fire.
BUSINESS IMPACT STATEMENT
N/A
Details
ADVISORY BOARD STATEMENT
On July 24, 2025, the proposed recommendations were presented to the Board of Supervisors Emergency Medical Care Committee (EMCC). The committee, with 11 members present, endorsed the proposed recommendations.
BACKGROUND
The San Diego County Emergency Medical Services Office (County EMS), a division of San Diego County Fire, is the Board of Supervisors-designated Local Emergency Medical Services Agency (LEMSA), as identified by Board Policy K-12 under California Health and Safety Code (HSC) 1797.200 and is responsible for ongoing oversight of the region's Emergency Medical Services (EMS) system. Under California legislation, including HSC 1797.227, EMS providers and certain hospital specialty care programs are required to submit data to the LEMSA. The California Code of Regulations Title 22 requires the LEMSA to deploy a prehospital data collection system to implement and evaluate emergency medical care.
County EMS has held a contract with ImageTrend, LLC (ImageTrend) since September 1, 2016, for the data collection software system for San Diego County. State law requires that EMS ambulance transportation providers submit electronic patient care records (ePCR) to their LEMSA and that the LEMSA transmit this data to the State. This can be done if an agency uses the LEMSA data collection software system or authorizes a third-party platform to send the data to the LEMSA. There are 35 prehospital agencies and 22 medical centers in the region that utilize the County's data collection system at no cost, including hospitals, fire departments, and private ambulance operators. By having as many agencies as possible on one system, the County is better able to establish a seamless EMS delivery system for patients in our region.
County EMS uses the data collection system to better serve our EMS workforce and residents through multiple functions, including:
* Credentialing the county's 10,000 EMS workers. The licensing module allows staff to review online applications within 2 business days 93% of the time.
* Permitting private ground and air ambulance services, including more than 350 annual and spot vehicle inspections.
* Ensuring high-quality EMS education programs, including 12 EMT schools, five paramedic training institutions, and 63 continuing education providers.
* Managing real-time hospital resource tracking, alerting, and patient status updates.
* Collecting and analyzing epidemiological data to enhance responses and communication during disasters, and the 250,000 emergency medical calls made annually.
* Hosting three specialty care data repositories for the 39 combined programs to improve the quality of critical care for county residents and visitors.
On August 27, 2024 (13), the Board of Supervisors reviewed the Comprehensive Base Station Hospital Report and authorized the Director of San Diego County Fire to collaborate with stakeholders on implementing key recommendations. County EMS is partnering with the San Diego County Fire Chiefs Association, Hospital Association, and Ambulance Association to pilot and evaluate these initiatives, focusing on electronic patient data transfer and real-time clinical information sharing. These efforts are vital for improving system efficiency, patient outcomes, and ensuring compliance with state laws for data transmission. While full implementation may take 18-24 months, maintaining the existing data collection system during this period is critical for system stability and regulatory compliance. If a new vendor is selected, a multi-year transition will be planned to prevent disruptions.
In Spring 2025, County Fire and the Department of Purchasing and Contracting completed a Request for Information (RFI) to receive feedback from all potential prehospital data collection companies for future contracting options. County staff received five written responses, held four virtual presentations, and involved field and hospital stakeholders in the review process. The questions and responses were developed and reviewed with EMS system partners to ensure future County EMS decisions includes system users' needs.
Justification for Single Source Procurement:
Under Board Policy A-87 D6, by maintaining the existing contract with ImageTrend, County EMS will be able to maintain continuity through the existing services, established integrations with 57 other agencies, and allow for the proper time to develop and accomplish the EMS system redesign project. To provide more time for the EMS system redesign project to be completed, and minimize disruption to users, County EMS staff is recommending an extension, consisting of up to five, 1-year option periods with ImageTrend and authority for DPC to issue a competitive solicitation in the future. This proposed extension will allow County EMS and its partners time to complete the redesign project and work collaboratively with data collection companies to ensure a future contract meets the needs of the EMS system workforce and supports enhanced patient outcomes.
Today's actions include authorizing the Director, Department of Purchasing and Contracting, to enter into negotiations with ImageTrend, LLC, and subject to successful negotiations, amend the contract to extend the term for up to five (5) one-year option periods through December 31, 2030, and to authorize the Director, Department of Purchasing and Contracting to issue a competitive solicitation for prehospital and hospital data collection software for a term of 10 years.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today's proposed actions support the Community and Equity Strategic Initiatives of the County of San Diego's 2025-2030 Strategic Plan by addressing the provision of robust, equitable, and accessible emergency medical services throughout the region.
Respectfully submitted,
EBONY N. SHELTON
Chief Administrative Officer
ATTACHMENT(S)
N/A
SUBJECT:
REQUEST FOR EXTENSION OF IMAGETREND CONTRACT AND COMPETITIVE SOLICITATION AUTHORITY FOR PREHOSPITAL AND HOSPITAL DATA COLLECTION SOFTWARE (DISTRICTS: ALL)
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COUNTY OF SAN DIEGO
AGENDA ITEM
BOARD OF SUPERVISORS
PALOMA AGUIRRE
First District
JOEL ANDERSON
Second District
TERRA LAWSON-REMER
Third District
MONICA MONTGOMERY STEPPE
Fourth District
JIM DESMOND
Fifth District
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