Attachment_C_Task_Order_002_-_Physical_Storage-_A0001_Track_Changes.docx

U.S. Department of State Bureau of Medical Services SALVO 1.0 U.S. Department of State Bureau of Medical Services Performance Work Statement for Task Order 002: Physical Records Management

1.0 Introduction

The U.S. Department of State, Bureau of Medical Services (MED) has overseas Health Units (HU) associated with diplomatic facilities worldwide that, in the absence of an Electronic Health Record, have accumulated a large number of paper medical records that under U.S. Code must be moved to a National Archives and Records Administration (NARA) standards compliant storage facilities in or near to Washington D.C. Additionally, MED has closed a radiology facility that created and stored radiographic imaged exams performed for Foreign Service Officers and their families. MED is required to store all historical medical records containing records of examinations, laboratory assays, and medical care including the x-ray films, reports, and other historical documentation as directed by federal Record Disposition Schedules (44 U.S.C. 33). Due to space limitations, MED requires that most of these items be maintained in readily accessible offsite storage facilities. MED must maintain access to the records in case there are bona fide requests to have reports, films, or other information processed or forwarded to appropriate recipients. All physical records, including those already archived and those currently stored at Health Units overseas, must be indexed and scanned for inclusion in a future Electronic Health Record.

2.0 Background

The Department is required to maintain copies of medical records of patients ("Individual Medical Case Files" A-12-002-01 a-c) for whom it has provided medical care or records that have been obtained by the Bureau of Medical Services (MED) pertaining to personnel including eligible family members (EFM) in the course of providing a medical service, for the duration of the employee's employment and for a period thereafter as specified by the federal records disposition schedules. For retired or separated employees and their families, MED must maintain medical records until they are retired to The National Personnel Records Center (NPRC), National Archives (while NPRC is accepting records) or for the duration of the Disposition Schedule for records that cannot be transferred to NPRC.

3.0 Scope

The Government has a requirement for the inspection, indexing, digitizing, packing, shipping, and storing physical treatment records, including paper files, radiographic images, photos, recordings, and other artifacts of medical care provided to or received by eligible personnel.

3.1 Records Processing

The Government has a requirement to inspect, index, digitize, package, ship and transmit existing physical records from locations around the world.

Inspection The Contractor shall receive physical records and inspect the contents of each to remove duplicate copies of record pages and create scannable pages from non-standard artifacts of patient care. All pages wthin the Medical Treatment Record , including duplicate copies, shall be scanned and stored.

Indexing Medical records must be “Indexed” as they are acquired. “Indexing” means abstracting information from each record related to the Index Fields listed below., including the patient's first, middle and last name, registration identification (eMed2), Social Security Numbers, Date of Birth, previous file location, an d present file location. The maximum character counts within index fields is 20. The Contractor shall electronically transcribe the index information available to an external record identifier system (Multifield Indexing Information System -- MIIS) with data exported in a file format defined or approved by the Contracting Officer’s Representative. Record Index information shall be provided to MED during processing and transfer of medical records for record accountability.

Index Fields include:

1) First Name

2) Middle Name

3) Last Name

4) Registration Identification

5) Social Security Number

6) Date of Birth

7) Previous File Location

8) Current File Location

9) File Type (Care Record, Laboratory Report, Radiology Report, EKG, Image, and Other) Scanning The Government shall define, and may modify from time to time, business rules related to the filtering and scanning of provided medical records. All record scanning shall utilize a Scalable Imaging Management System to create NARA compliant electronic versions of medical record or radiographic hardcopies as NARA compliant searchable (OCR) .pdf or PDF/A documents. Scanning must create B/W or color documents at the Government’s direction and at a resolution of at least 300 DPI. or greater. Physical artifacts of patient care other than paper records shall be scanned or otherwise imaged in color to at least 300 DPI. Digital artifacts of patient care will arrive on either Compact Disk or Digital Video Disk, and may be extracted directly from that media to a digital file. The Contractor shall perform statistical image quality assurance procedures utilizing ANSI/ASQC standards to enforce acceptance/rejection and re-sampling parameters. Any deviation from that standard shall require technical direction and approval from the Contracting Officer’s Representative.

Data Storage The Contractor shall procure, one or more FIPS 140-2 certified hard drives that must be reviewed and approved by the Contracting Officer’s Representative. Once indexed and scanned, digital files shall be stored on that approved media.in a FIPS 140-2 certified hard drive. Each record shall have a corresponding index file that articulates the nature of the included record, and each data volume shall have a corresponding list of included individual records. A record of the retained data shall be submitted as part of the monthly project reporting using a format determined by the Contracting Officer’s Representative. The Government shall physically retrieve the approved media from the processing location, transfer the data to a Government server, and return the media to the Contractor for continued use on a schedule mutually agreed upon by the Contractor and the Contracting Officer’s Representative.

Packaging Once indexed and/or scanned, physical records shall be packaged into standard 1.2 cubic foot record boxes and archived (or prepared for shipment to the approved warehousing facility if geographically remote from the receipt and processing facility or directed by the Contracting Officer’s Representative). Boxes will be serialized, with a copy of the detailed inventory of records (see Indexing above) retained with the box and a copy provided to the Contracting Officer’s Representative prior to shipment.

This sub-task shall be priced as a Firm Fixed Price for inspection, indexing, upload, and packaging on a per record basis and a Firm Fixed Price for scanning on a per page basis. Firm Fixed Prices are inclusive of all material and labor costs, indirect costs, and profit for the base period and all option years. Associated shipping shall be invoiced under the Other Direct Cost line item

3.2 Records Storage and Retrieval

The Contractor shall provide a central receiving point that is a NARA compliant space for processing and storage of allfor records and artifacts in standard 1.2 cubic foot record boxes in a warehouse space (estimated at 15,000 cubic feet) at a location that meets the following specifications:

1) Full Environmental Protection for the stored records including:

a) Climate (temperature and humidity control);

b) Automated fire suppression system;

c) Stand-by, emergency power generator;

d) Fully enclosed redundant water supply/fire loop;

e) 24 hour central station monitoring;

2) NARA-compliant storage chambers including availability of NARA/DoD

a) NISPOM-compliant classified storage cages;

3) Monitored and Controlled Fire Suppression System including:

a) 3 hour fire resistant walls between storage chambers;

b) Roof construction with noncombustible materials;

c) National Fire Protection Association (NFPA) -compliant sprinklers;

d) Fire detection and suppression systems certified to meet NFPA guidelines;

4) Security Protection to include:

a) Fenced truck access & parking with surveillance and/or electronic or monitoring

b) Security activation access controls providing access 24 hours / 365 days per year

c) 24 hour central station monitored & alarmed entry system utilizing exterior and interior steel doors;

Within two working days, upon request of the Government, the Contractor shall locate, retrieve, make a true copy of the requested record and ship specific the true copy records to a designated Government location in the 20037 postal code. Original records are returned to their location in the archive.from their boxed location to an address specified in the service request.

This sub-task shall be priced as a Firm Fixed Price per cubic foot of records storage, inclusive of all material and labor costs, indirect costs, and profit for the base period and all option years. Associated shipping costs shall be invoiced under the Other Direct Cost line item (CLIN 003).

3.3 Project Management

The Government has a requirement for a dedicated Project Manager that will work closely with the program office to oversee and direct Contractor efforts in the management of physical records. Qualifications for this Key Personnel position are detailed in Attachment A to the base contract.

4.0 Anticipated Requirement

The Government currently maintains NARA-compliant storage of approximately 700 cubic feet of treatment records through a legacy contract with Iron Mountain Inc. Storage of those records will transition to the Contractor under CLIN 001 of this Task Order.

The U.S. Department of State operates Health Units in 200 locations worldwide. Each Health Unit currently maintains an archive of physical records that will be processed under this Task Order, and shipped by the Government to the United States for processing and storage by the Contractor. The Government estimates the entire requirement to include approximately 200,000 individual treatment records (including approximately 180,000 of backlog records and an anticipated continuing requirement for 20,000 records between award and June 30, 2024), each with approximately 1500 pages or artifacts, generating up to 20,000 cubic feet of stored records. Work under this Task Order shall include all physical records and artifacts of patient care generated prior to July 1, 2024. The Government, through the Contractor’s Program Manager, shall provide monthly workload projections in order to allow theContractor to program adequate resources to keep pace with the requirement for processing of records within 10 business days.

5.0 Performance Management, Schedule and Deliverables

This task shall be accomplished in five phases. Schedules included below are based on the Government’s projection of records collection and shipment for processing by the Contractor. Records will be shipped from overseas posts utilizing the Government’s Diplomatic Pouch and Mail system. At the completion of this Task, all physical records provided by the Government to the Contractor shall be processed, digitized, archived, and stored in a compliant CONUS location.

5.1 Responsibilities of the Government in Performance of this Task Successful completion of the work contemplated under this task requires careful coordination between diplomatic posts overseas, the Government’s Director of Quality Management within the Bureau of Medical Services, and the Contractor. While the Contractor bears ultimate performance responsibility, it is understood that the Government shall bear responsibility for the following tasks:

1. The Government will provide controlled means of shipment for the movement of Protected Health Information, including records and other artifcats of care, from their current location. Posts are responsible for packing and shipping all inactive medical records. Posts will retain only those records that pertain to patients currently undergoing care. Posts will coordinate shipment of unfiltered records from their current location to a central receiving facility (NARA compliant storage facility) mutually agreed upon by the Government and the Contractor. Each record will be placed in a shipping box with folded side down (open record side up) and visible file tab displaying at least, patient’s last and first name. The number of records in a packed box should allow an estimated 1 to 1.5 inches of open space.

2. As boxes are packed, Posts will label each box with a “name of Post origin” and a sequential box number (e.g. “London Record Box #_1_”). Additionally, Posts must create an electronic list of the records in each box (e.g. Excel xlxs file) containing Last Name, First Name and one additional identifying number (e.g. DOB, SSAN, eMed2 Number, etc. in addition to Box number and Post of Origin). The electronic list of records with initial indexing information shall be forwarded from the Government to the Contractor.

3. Development, refinement, and communication of business rules for the additional filtering and processing of records by the contractor for records delivered to the Contractor at the Central Receiving Point (NARA compliant storage facility) prior to the arrival of the first records shipment.

4. Adjudication of questions related to the processing of records within 5 working days.

5. Develop, refine, and execute quality assurance activities, with reports on a bi-weekly basis, to validate the quality of records processing activities during Phases 1-4 of this task, and provide technical direction through the COR regarding required changes not more than 3 working days after identification of problems or concerns.

6.0 Quality Assurance Surveillance Plan