To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Contract #23-914 with UpToDate, Inc.
Recommendation: Recommendation of the County Administrator
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County a Content License Agreement (Contract #23-914) with UpToDate, Inc., a corporation, in an amount not to exceed $91,557, to provide its pharmaceutical drug database solution, Lexidrug, for Contra Costa Regional Medical Center (CCRMC) and Contra Costa Health Centers, for the period June 30, 2026, through June 29, 2029.
FISCAL IMPACT:
This Contract will result in contractual service expenditures of up to $91,557 over a 3-year period and will be funded 100% by Hospital Enterprise Fund I.
BACKGROUND:
This Content License Agreement meets the needs of the County by providing a software license subscription to access UpToDate’s® Lexidrug™ Formulink, a Formulary Monograph Service (FMS) module available under its Clinical Decision Support (CDS) system utilized to aid CCRMC and Contra Costa Health Centers clinicians in making care decisions. Lexidrug™ is an evidence-based drug referential solution that provides real-time content for clear guidance in making complex drug decisions using advanced machine learning to power search results and drug content sets. As an integrated component of UpToDate (procured under County Contract #23-887) Lexidrug™ offers clinicians immediate access to detailed medication guidance, including dosage adjustments, contraindications, interactions, and recommendations that help reduce unnecessary or inappropriate medication use. This depth of clinical support is essential for managing complex patient needs and maintaining consistent, high-quality standards of care.
This Contract was approved by Health Services Personnel to ensure there is no conflict with labor relations. CCRMC’s Quality Management, Utilization Management and Contract Monitor Staff meet on a regular basis to ensure monitoring and performance measures in the Contract are upheld. A summary of service contract deliverables, including measurable outcomes required of the Contractor to be monitored by the department in compliance with Section III (B)(7) of the Purchasing Policy include County’s access and permitted use of the licensed content. This Contractor was approved by the Public Works Department’s Purchasing Department on April 22, 2026.
Under this Contract #23-914, the parties will execute UpToDate Content License Agreement. The Content License Agreement limits UpToDate’s liability under the Agreement to the amounts the County has paid in the twelve (12) months preceding the claim. Under this Contract the County is obligated to indemnify the vendor for third party claims arising out of County’s use of the licensed content.
Approval of this new Content License Agreement (Contract #23-914) will allow the Contractor to provide County access to its licensed content (including documentation) in conformance with the permitted use of its FMS pharmaceutical drug referential document management solution for CCRMC and Contra Costa Health Centers clinical decision support through June 29, 2029. The Pharmacy Department is requesting a retroactive effective date for this Contract due to extended negotiations with the Contractor.
CONSEQUENCE OF NEGATIVE ACTION:
If this Contract is not approved, disruptions to the delivery of high-quality, evidence-based healthcare and clinical based decision-making may cause challenges which could ultimately impact patient outcomes.