Attachment 1 - SOW VISN Medical Transcription.pdf

Statement of Work

U.S Department of Veteran Affairs Medical Centers throughout VISN 19 have a requirement for digital dictation, traditional and correction editing medical transcription services using vendor-supplied dictation equipment. The contractor shall be responsible for 100% computer storage, security and management of all dictation received from the VA and shall be able to access information and records kept on this system at all times. Under no circumstances will this part of contract performance be subcontracted. Currently, facilities within VISN 19 use a variety of dictation equipment, including telephone lines, Dictaphone equipment and IPAQs. The awarded contractor(s) shall provide all management, personnel, security clearance, space and equipment (supplies, tools, materials, parts, hardware, software and toll-free telephone numbers) to all facilities for which services are awarded for purposes of performing medical transcription services as stated herein. Services shall be performed at the contractor’s place of business, outside of the premises of participating VA Medical Centers. The contractor will meet the standards of the Joint Commission (JC) during the period of the contract, to include any option years that may be exercised.

Contractor shall ensure that VA authorized staff receive the necessary training in the appropriate use of all telephone lines, portable dictation equipment and computer programs and software necessary to provide successful transcription services.

Contractor shall be required to understand and utilize specialized terminology, vocabulary, and acronyms for dictated reports from all the fields of medicine, surgery, psychiatry, and dentistry. Dictation includes a high incidence of clinical terminology and requires the transcriber to possess the skills, knowledge, and abilities to perform the tasks described herein.

The Government will not be required to alter, replace, upgrade, or purchase any systems, applications, computer hardware/software, or telephone equipment to accommodate any contractor offered systems, applications, or processes/procedures. Contractor shall be fully responsible for ensuring compatibility with Governments existing systems, equipment, computer programs, protocols, and telephone systems.

VISTA System: The Veterans Health Information Systems and Technology Architecture (VISTA) system is each medical center’s data processing network, which includes multiple Ethernet-linked, M (MUMPS) language-based microcomputer systems on which VISTA clinical, financial, and administrative software applications are run.

The operating system consists of multiple layered software products (e.g., VMS (Virtual Memory Server), DSM (Digital Standard Mumps), Digital TCP/IP Services and Kernel.

The VISTA imaging system utilizes the Microsoft operating system NT4.0 that supports VISTA imaging display, capture, storage, and the interface for imaging to the VISTA system.

The Computerized Patient Record System (CPRS) and the RPC broker are utilized to allow the images to be displayed at the workstation.

The VISTA information system is designed around a set of core programs referred to as Kernel. VISTA is an umbrella term for all software/hardware that is utilized by the facility. The Kernel program includes a device handling system, VA Fileman Database System, electronic mail, system security, a set of tools to manage user access and a set of tools to schedule report production and system maintenance functions.

Integrated systems aggregate data generated by individual subsystems for use by authorized internal and external customers. The integrated portion of the database includes (clinical): patient demographic information, prescriptions, lab results and data relating to an episode of care (administrative/financial): personnel and accounted data, accounts receivable, fee basis, integrated billing, control point activity, accounting, and procurement, etc.

Telephone Systems: Each participating VAMC utilizes the following telephone systems:

VAMC Fort Harrison, Montana – Cisco VoIP

VAMC Cheyenne, Wyoming – Cisco VoIP

VAMC Sheridan, Wyoming – Cisco VoIP

VAMC Salt Lake City, Utah – Cisco VoIP

VAMC Grand Junction, Colorado – ALCATEL PCX 4400

VAMC Denver, Colorado - NEC IPX 2400 PBX

VAMC Muskogee, Oklahoma – Siemens/Unify HiPath 4000 v8

VAMC Oklahoma City, Oklahoma - Siemens/Unify HiPath 4000 v8

REPORTS: The type of reports dictated for transcription by the Contractor shall include:

Discharge Summaries Transfer Summaries Surgery report and Operative Procedures Compensation & Pension Reports Cardiac Catheterization Reports Progress Notes Electroencephalogram Reports Pathology Reports STAT Reports – All

Dictation: The contractor shall be responsible for receiving dictation of properly formatted documents over conventional telephone lines. All transmitted documents shall contain accurate information as provided by each individual author. Contractor shall provide all communication hardware/software and utilize the TCP/IP file transfer protocol, or another protocol agreed and approved by the VA. Contractor shall be able to receive dictated reports via telecommunication lines or by handheld digital devices provided by the Contractor.

Customer Support: Contractor shall provide complete customer support which includes an off-site transcription system managed by the contractor and complete transcription support for dictated medical documents 24 hours per day 365 days per year, including Federal holidays. The contractor shall also provide a point of contact for VA facilities to contact 24 hours a day, 7 days a week for “over the phone” live support.

Transmission: The contractor shall electronically transmit all required reports into the Hospital’s mainframe, i.e., Veterans Information Systems & Technology Architecture (VISTA). The transmission and upload shall be done either from remote microcomputers, using ASCII or KERMIT protocol upload, or from Host Files (e.g., DOS, or VMS ASCII files) on the host- system. Connect charges shall be at the contractor's expense. The contractor shall be required to upload and download directly into the VISTA/CPRS (Computerized Patient Record System) TIU (Text Integration Utility) Package.

Upload Header & Footer Format: The contractor shall transcribe reports utilizing headers and footers and appropriate formats. Examples of appropriate format are attached. The contractor shall assure all header required text information complies with the dictation.

Header Information: Each document shall include the specified header conforming to the standard provided by VA for that type of document. This header includes the document type, patient social security number, date of encounter (date of surgery, date of admission), work type, the document author, dictation date and time, job number, and the transcriptionist identifier.

Text Information: The format for transcribed documents shall include the job number, patient’s name, name of author, the date and time dictated, date transcribed, date and time uploaded to VA, contractor’s name, and transcriptionist initials.

Each dictation shall consist of required information as described in the Department of Veterans Affairs, Health Information Management and Health Records (VHA handbook 1907.01, dated August 25, 2006).

View Alerts: Contractor shall be responsible for processing and clearing all View Alerts. The contractor shall clear uploading errors by verifying and editing header information as necessary (ex: SSN, visit, date, author, title and location) and successfully upload each document to the correct patient's medical record. The contractor shall notify the Contracting Officer's Representative (COR), station Point of Contact (POC) or Transcription Unit Coordinator via encrypted e-mail of all un-resolvable uploading problems within 24 hours of completed transcription.

Destination of Transcribed Documents: Each facility may elect to have transcribed documents, which may include Pathology and Nuclear Medicine reports, uploaded directly to each individual electronic patient record or batch transmitted to the VA VISTA system.

Upload Standards: VA staff are not to correct contractor uploading errors; all upload errors are to be corrected by the contractor and contractor’s employees and confirm reports are available for authentication in VISTA without charge to the U.S Government. However, if errors were found in dictated reports preventing uploading into VISTA, the contractor shall notify the COR/POC.

Method of Verification of Upload: The contractor shall stipulate, within its quote, its method for verifying that all uploaded cases are available in VISTA and ready for electronic authentication. Verification of all uploads shall be the responsibility of the contractor regardless of the manner in which transcribed documents are received in VISTA. For all reports, the contractor shall be responsible for identification and correction of all upload errors.

Length of Reports: The length of each report may vary according to the type of medical report required. The reports will be created and saved as ASCII text with only printable characters, single spaces, and carriage returns and line feeds.

The text is single spaced with double space between paragraphs. No report shall include any text other than what was dictated. Instructions to the transcriptionists shall not be included in the body of the report. Comments or questions shall be sent as separate correspondence referencing the dictation system job number. Typed comments or questions shall not be billable or paid by the Government.

Report Formats: Specific report formats provided by the VA shall be followed. Revised formats will be provided to the contractor as necessary. When revised formats are provided, the contractor shall revise format within 24 hours. Files to be sent to VISTA by the contractor shall be sent with field names and delimiters, and then merged at VISTA to fit the appropriate form. The VA will furnish the contractor with appropriate formats for the transcription of dictation.

Sample report formats are provided in Exhibit 1.

Abbreviations: The contractor shall confine abbreviations that are recognized by the medical community. A list of inappropriate abbreviations shall be provided to the contractor by the COR/POC that must not be used. This list will be updated periodically as needed. Symbols and abbreviations shall not be used when documenting final diagnoses and procedures or discharge summaries.

Retention of Reports:

Written Reports: The contractor shall retain these reports on appropriate medium for approximately six months after expiration of the contract and shall re-transmit, free of charge, all requested reports, including reports that have been returned due to errors in spelling, verbiage, grammar, punctuation, or that are of unsatisfactory quality.

Voice Reports/Recordings: The contractor shall retain voice reports on appropriate medium for a minimum of six months after the date of transmission and shall re-transmit, free of charge, all requested reports, including reports that have been returned due to errors in spelling, verbiage, grammar, punctuation, or that are of unsatisfactory quality.

Retransmission of Reports: Retransmission of reports requiring correction shall be returned to the COR/POC or designee within 24 hours from the time of return to the contractor for correction, at no additional charge; all returned reports shall be accompanied by an explanation of the deficiency provided by the contractor.

VA Information Custodial Requirements: The contractor will not destroy information received from VA or gathered or created by the contractor in the course of performing this contract without prior written approval by the VA

Information Security Officer. Any data destruction done on behalf of VA by a contractor must be done in accordance with VA approved information destruction methods and requirements as outlined in VA Handbook 6500.

VA Obtaining Voice Files upon Request: The contractor shall provide the COR/POC with voice files stored on the contractor’s voice servers upon VA request. The contractor shall store the voice files on encrypted CD/DVD media and send by traceable mail method to VA.

CONTACTOR STAFFING REQUIREMENTS:

Medical Transcriptionist Staffing: The contractor shall provide all staff personnel necessary to perform all transcription requirements contained in this contract. The contractor shall provide information to verify staff adequacy. This information may be a list of medical transcriptionists, without names, but with individual qualifications (years of experience, credentials, previous education and training, work location and work hours) or a summary per location of the number of medical transcriptionists, the number or summary percentage of those who are certified medical transcriptionists or otherwise credentialed, or the FTE per work- hour designation.

The contractor shall maintain the resources necessary to ensure that transcription services are uninterrupted regardless of contingency or circumstance. In the event of VISTA failure preventing uploading, transcribed documents in an electronic format shall be provided by the contractor.

The contractor shall provide a plan as to how staff will be qualified, selected, and supported with initial training and continuing education.

The contractor shall be responsible for all personnel working under this contract. If there are emergent circumstances that may require the prime contractor to seek sub-prime assistance, the prime contractor must seek VA approval prior to utilizing the services from the subprime contractor. The contractor shall at no time authorize, disseminate dictations, allow dictations to be disseminated, or performed outside of the United States or its territories by any foreign contractor or other contractor operating outside of the United States or its territories.

Qualifications of Transcriptionists: All dictation and transcription shall be in the English language. Material will be dictated by physicians and other health care professionals and shall require the ability of the contractor and contractor personnel to accurately decipher and transcribe material containing variations in accents, speech, tone, voice, volume, delivery, pronunciation, and enunciation.

The contractor shall employ a highly skilled staff of medical transcriptionists possessing industry appropriate certification(s) and training.

The contractor shall be responsible for providing all services required under this contract.

The contractor shall be responsible for ensuring services are provided by qualified and competent personnel in accordance with the terms and conditions of this contract.

Any subcontractors furnishing services under this contract shall provide services in accordance with the terms and conditions of the contract.

Quality Assurance (QA) Personnel: Contractor shall provide a list and summary of administrative and technical QA personnel, including position and credentials, office location, hours available and telephone numbers.

Administrative and Management Personnel: The contractor shall provide a list and summary outlining the position and authority of all administrative and management personnel, including position and credentials, office location, hours available and telephone numbers.

Support Staff: The contractor shall ensure that a designated responsible individual is available for each participating VA Medical Facility to provide telephone support, service, and error correction services 24 hours per day seven days per week, excluding Federal holidays, at no additional expense to the Government.

HOURS OF SERVICE:

The contractor shall perform all transcription services to include electronic transmission of all transcribed reports to the VA daily, 24 hours per day, seven days per week, including Federal holidays. The 10 holidays observed by the Federal Government are as follows:

New Year’s Day Memorial Day

Martin Luther King Jr’s Independence Day

Presidents Day Labor Day

Columbus Day Veteran’s Day Thanksgiving Christmas Day

REPORTING AND BILLING

Daily Transmission Reports: The Contractor shall provide to the COR/POC or designee a daily report, either electronically or by fax, a listing of the transmissions upload for the day which shall include the total lines transmitted and shall include the following:

Report Type Patient name (full) Patient Social Security Number Event date (i.e. date of discharge, date of exam, etc) Transcriptionist’s identification Date Transcribed Name of Dictator Dictation date Number of lines transcribed (per report)

Date and Time Uploaded to VISTA

This report shall be alphabetized by patient’s last name and will be by work type, e.g., Discharge Summaries separate from Operative Reports, etc.

Daily Dictation Reports: The contractor shall describe within its quote its method for providing to the COR/POC or designee a daily report of total lines dictated and delivered to the VISTA system. This report shall include the same information as the transmission report.

Monthly Report: The contractor shall provide to the COR/POC or designee upon request, or at a minimum, by the fifth working day each month, a monthly report via encrypted e-mail or made available on a secure web site which shall include total lines transmitted for the month. This report shall also include a daily line count identified by the Transcriptionist’s initials with a total count of lines completed by each transcriptionist daily.

Billing Format: Billing shall be presented to VA monthly. A billable line shall equal 65 visible black characters in accordance with the line count methodology herein.

All transcription and verification services must be performed in the United States of America, including US territories.

There are No Exceptions.

Line Count Methodology: Line count is based on 65 Visible Black Characters equaling a VBC line. A Visible Black Character is defined strike-able and visible characters and includes any printed letter, number, symbol, and/or punctuation mark excluding any or all formatting (e.g., bold, underline, italics, table structure, formatting codes). All visible black characters can be seen with the naked eye as a mark, regardless of whether viewed electronically or on a printed page. The following chart illustrates visible black characters.

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z a b c d e f g h i j K l m n o p q r s t u v w x y z ̀ 1 2 3 4 5 6 7 8 9 0 - = [ ] \ ; ‘ , . / “

A VBC Line is defined as the total number of characters in the transcribed document that you can see with the naked eye, divided by 65. Characters contained within a header or footer. Spaces, carriage returns, and hidden format instructions, such as bold, underline, text boxes, printer configurations, spell check, etc., are not counted in the total character count.

A VBC Line is calculated by counting all visual characters and simply dividing the total number of characters by 65 to arrive at the number of defined lines.

The billing line count methodology and the overall error rate, by month, shall be provided with the monthly invoice, along with types of dates and corrective action. A monthly report shall be provided to the VA Transcription COR/POC

TURN AROUND TIME (TAT)

TAT Time Frames: All dictation shall be transcribed and uploaded into VISTA in accordance with the following time frames:

Discharge Summaries 24 hours

Transfer Summaries 24 hours

Operative Reports 12 hours

Compensation & Pension Reports 24 hours

Cardiac Cath Reports 24 hours

Progress Notes 24 hours

Clinic Notes 24 hours

Pathology Reports 6 hours

Admission History & Physical 4 hours

STAT Reports – All Work 3 hours

TAT Reports TAT: Discharge summaries, transfer summaries, operative reports, and nuclear medicine reports may be dictated as STAT reports at the discretion of the clinician dictating the report.

Calculation of TAT: TAT will be calculated by the COR/POC of each facility. Calculation of TAT will occur for all work performed by the contractor, including Federal holidays. This method accounts for 100% of reports and will be run at least monthly by the COR/POC.

Failure to Meet TAT: At least 95% of all reports shall meet the TAT requirements during each billing cycle. A 1% deduction from payment will be applied for each percentage point below 95%. If TAT falls to 85% and below, a 20% deduction from payment will be applied to the entire invoice. The COR/POC shall submit the TAT report to the Contracting Officer for approval of deductions. The minimum acceptable standard for TAT is 85.5%. If TAT is at 85% or less for two consecutive months or 65% or less for four consecutive weeks, work performance will be deemed unacceptable and may be cause for termination. All percentages will be rounded to the nearest whole number.

DEFINITIONS

As used throughout this contract, the following terms shall have the meaning set forth below.

Where “as directed”, “as required”, “as permitted”, “acceptance”, or words of a similar import are used, it shall be understood that direction, requirement, permission, approval, or acceptance of the Contracting Officer is intended unless stated otherwise.

Automated Information System (AIS) – An assembly of computer hardware, software and/or firmware configured to collect, create, communicate, compute, disseminate, process, store, and/or control data or information.

Authentication – Process of (1) verifying authorship, for example, by written signature, identifiable initials, or computer key or (2) verifying that a document is what it is purported to be, such as comparison with other records, or both (AAMT E1959-98, p.1).

Author – The person responsible and accountable for the creation, content, accuracy, and completeness of each dictated and transcribed event or health record entry (ASMT E2117-00, pg 1).

Concurrent review – Quality review of transcribed reports performed while listening to dictation and comparing transcribed document content. Concurrent review is generally performed before reports are delivered to a patient’s record, either in print form or electronically, and before they are made available for author signature (ASMT E2117-00,

pg. 1).

Contracting Officer (CO) – The Contracting Officer is a person with the authority to enter into, administer, and terminate contracts and make related determinations and findings. This includes certain authorized representative of the Contracting Officer acting within the limits of their authority as delegated by the Contracting Officer.

Contracting Officer’s Representative (COR) or Station Point of Contact (POC) - Individual(s) who furnishes technical guidance and advice or generally supervises the work performed under the contract. Designations for CORs (not POCs) will be in writing from the Contracting Officer and will define the authorities and limitation of the representatives’ authority.

Contractor – The term contractor as used herein refers to both the prime contractor and any subcontractors. The prime contractor shall ensure that his/her subcontractors comply with the provision of this contract.

Electronic Authentication – Verification of authorship of a document or verification that a document is what it is purported to be, or both, accomplished by electronic means or in an electronic format (ASMT E959-98, pg. 1).

Federal Holiday – Legal holidays recognized by the Federal Government in accordance with 5 U.S.C. 6103, Executive Order 11582 and Public Law 94-97 or any other by the President of the United States to be a national holiday.

ISO – Information Security Officer

Line - Visible Black Character. A Visible Black Character is defined strike- able and visible characters and includes any printed letter, number, symbol, and/or punctuation mark excluding any or all formatting (e.g., bold, underline, italics, table structure, formatting codes). All visible black characters can be seen with the naked eye as a mark, regardless of whether viewed electronically or on a printed page.

Line Count Methodology – Visual Black Character (VBC) Line or ASCII no Spaces Line. A VBC Line is defined as the total number of characters you can see with the naked eye, divided by 65. It includes any character contained within a header or footer. Spaces, carriage returns, and hidden format instructions, such as bold, underline, text boxes, printer configurations, spell check, etc., which are not counted in the total character count. A VBC Line is calculated by counting all visual characters per transcribed document and simply dividing the total number of characters by 65 to arrive at the number of defined lines.

Quality Assurance (QA) – A method used by the Government to provide some measure of control over the quality of purchased goods and services received.

Quality Assurance Evaluator (QAE) – The Government employee designated the Contracting Officer to control the quality of goods and services produced.

Quality Assurance for Medical Transcription – The process of review that is intended to provide adequate confidence that dictated patient care documentation is transcribed in a clear, consistent, accurate, complete, and timely manner and that it satisfies stated or implied requirements for dictated and transcribed documentation or patient care (ASMT 2117-00).

Quality Control (QC) – A method used by the contractor to control the quality of goods and services produced.

Regular Working Hours – For purposes of this contract 24 hours per day seven days per week.

Retrospective review – Quality review of transcribed reports performed after documents have been released for author signature and delivered to a patient’s record. The dictation may no longer be available for comparison with the transcribed documents (ASMT E2117-00. pg. 1).

Turn-around-time (TAT) – Elapsed time beginning with the availability of dictation or voice file for transcription and ending when the transcribed document is delivered and available for authentication (ASMT E2117-00, pg. 1-2).

VAMC, VA or Health Care System – Department of Veterans Affairs Medical Center

VISN 19 – Veterans Integrated Service Network 19. This is the corporate office of the Rocky Mountain Networks VA Medical and Health Care Centers which includes the VAMC Fort Harrison, Montana, VAMC Cheyenne, Wyoming, VAMC Sheridan, Wyoming, VAMC Salt Lake City, Utah, VAMC Grand Junction, Colorado, VAMC Denver, Colorado, VAMC Muskogee, Oklahoma, VAMC Oklahoma City, Oklahoma and all surrounding Community Based Outpatient Clinics operated by these facilities.

VISTA – Veterans Information Systems & Technology Architecture. The VA’s proprietary computer system is running on Alpha computers utilizing Windows NT and Open M by Inter-Systems; formerly called Decentralized Hospital Computer Program (DHCP).

GOVERNMENT- OWNED EQUIPMENT AND SERVICES

Installation Costs: Individual VISN 19 VA Healthcare Systems will absorb all expenses associated with in-house telephone jacks and telephone numbers for return data transmission.

Provision of Dictated Reports: The VA will provide the contractor with dictation via contractor owned; digital equipment transmitted via telephone lines, or through handheld digital dictation systems.

Transcription Outsourcing Using VA Provided Dictation Equipment: The individual VISN 19 VA Healthcare Systems have a requirement for traditional and speech recognition, correction editing transcription services. The contractor must provide transcription services utilizing the VHA owned dictation system identified by the individual VISN 19 Healthcare System by electronically accessing or downloading VHA’s digital dictation voice files while meeting VHA information security requirements. The contractor is not to subcontract the work or any portion thereof to another firm without prior approval from the Contracting Officer (CO).

Staff Lists: The VA COR/POC at each facility shall provide a complete and current VA listing of staff clinicians who dictate. The listing will be updated every month and periodically as needed.

CONTRACTOR-FURNISHED EQUIPMENT AND SEREVICES

Contractor Furnished Equipment:

The contractor shall provide all equipment, communications software, toll free telephone number for the facility and all accessories to connect to the participating VISN 19 facility’s VISTA system to download and upload dictations/transcription on a continuing basis throughout each working day. All expenses related to the purchase/rental/lease, set-up, use and maintenance of such, shall be responsibility of the contractor. Equipment (i.e. voice services) shall be directly maintained and controlled by the primary contractor, not the subcontractor. The contractor shall provide a toll-free long-distance line for all transmission of dictations at no cost to the VA.

Dictation and Transcription Outsourcing Using Contractor Supplied Dictation Equipment.

The individual VISN 19 VA Healthcare Systems have a requirement for digital dictation, traditional and correction editing medical transcription services using contractor supplied dictation equipment. In accordance with FAR 4.703, contract files must be maintained for 3 years after final payment. The contractor must destroy the files on the anniversary of the third year after final payment using the 35-pass Gutmann-level deep scrub method or other equivalent methods. The method proposed by the contractor must have prior approval from the CO. The contractor is not to subcontract the work or any portion of the work to another firm without prior approval from the CO.

The contractor shall notify all VA facility COR/Point of Contact of any technical problems impacting the flow of dictation, transcription, and uploading (telephone line outage, voice service issues, etc.).

The contractor shall provide all equipment, communication software, toll free telephone number for the facility and accessories necessary to connect VISN 19 participating in-house staff to contractor’s system and contractor shall be responsible for distribution of appropriate workload to VA’s in-house staff members.

In accordance with Section 508 of the Rehabilitation Act of 1973, as amended 29 U.S.C. § 794 (d), the contractor shall provide all equipment, communication software, toll free telephone number for the facility and accessories necessary to allow connection and operation by VA in-house staff, to include employee with disabilities to contractor’s system at no additional cost to VA.

Installation Time Frame: All contractor owned equipment shall be fully installed and operational within 30 calendar days from date of award. The contractor shall coordinate with a designated Information Resource Management Service (IRMS) representative at the contracted facility to ensure that equipment is operational.

Installation Costs: The contractor shall be liable for all costs associated with the installation of contractor owned equipment with the exception as provided in Section 3 Government Furnished Property and Service.

Equipment Maintenance and Repair: The contractor shall be responsible for maintenance and repair of all contractors owned equipment. On-site response time for equipment repair or replacement shall be 4 hours after notification by the COR.

Minimum Requirements for Equipment Maintenance: Contractor shall be required to demonstrate abilities to meet minimum requirements by:

Submitting equipment maintenance policies and procedures to include a plan for backup systems in the event of emergency repairs to Contractor owned equipment AND

Submitting documentation on proposed equipment to be utilized in the performance requirements ensuring compatibility with the VA VISTA and telephone digital dictation systems.

Contractor Furnished Items: The contractor shall provide sufficient toll-free telecommunication lines to allow access for participating VISN 19 facilities. Additional telephone lines or dictation ports shall be added if there is a significant increase in volume. A minimum of four separate STAT lines, per facility, shall be available to digitally identify STAT dictations.

Communications Package Software: Contractor’s software shall be compatible with the VA VISTA system, which enables the user to upload transcribed reports into VA VISTA. In cases in which transcribed reports cannot be uploaded because of errors, the contractor shall provide an error-list that shall include social security numbers (SSN), provider names, dates and locations of visits and other commensurate data.

Technical and Service Contracts for Hardware and Software: A listing of the technical service contracts for hardware and software provided by the contractor shall be furnished to the COR/POC.

Re-route Requirements: The contractor shall be responsible for all re-record hardware and software necessary to route work to their staff at no expense to the Government.

TRAINING

Initial Training: The contractor shall provide training on site for authorized VA staff at each facility. Training shall include staff from, HIMS and IRMS services to ensure that the technical aspects of the digital dictation system are in place.

Training shall also include appropriate clinical staff as necessary. Training shall be of sufficient length to cover all aspects of the dictation system with a minimum of three days on site at the participating facility. Contractor shall provide an additional two days of training for each facility at the request of the facility. A qualified member of the contractor’s staff shall conduct training at no expense to the facility. The location of the training shall be coordinated with the COR/POC at each VA Medical Facility.

Annual Training: If required, the contractor shall provide annual training on site to each requesting facility. Training shall be a minimum of one day. A qualified member of the contractor’s staff shall provide training at no expense to the facility. The location of training shall be coordinated with the COR/POC of each facility.

Training Materials: The contractor shall provide appropriate educational materials, brochures, or reminder cards explaining the dictation process in detail. Contractor provided training material shall be provided at no cost to the VA.

Security Training: All contractor employees and subcontractors are required to complete the VA's on-line Information Security Awareness Training Course and the Privacy Awareness Training Course annually. Contractor shall provide signed certifications of completion to the COR/POC during each year of the performance requirements. This requirement is in addition to any other training that may be required of the contractor and subcontractor(s) employees.

All contractor employees and subcontractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA networks and shall repeat the training on an annual basis:

Sign and acknowledge understanding of and responsibilities for compliance with the attached National Rules of Behavior (ROB) relating to access to VA information and information systems. The ROB may be found as attachment G of VA Handbook 6500.

Successfully complete VA Cyber Security Awareness training and annual refresher training as required. This training may be found at: https://www.ees-learning.net

Successfully complete VA General Privacy training and annual refresher training as required. This training may be found at:

https://www.ees-learning.net

The contractor shall provide to the contracting officer a copy of the training certificates for each applicable employee within 1 week of the initiation of the contract and annually thereafter, as required.

Failure to complete this mandatory training within the timeframe required will be grounds for suspension or termination of all physical and/or electronic access privileges and removal from work on the contract until such time as the training is completed.

http://www.ees-learning.net/ http://www.ees-learning.net/

SPECIFIC TASKS SURVIELENCE METHODOLOGIES

TASKS

QUALITY

STANDARD

ACCEPTABLE

QUALITY LEVEL

METHOD OF

SURVIELENCE

DEDUCTIONS FOR

FAILURE TO MEET

AQL

Upload Routine transcription reports to VA VISTA System within required TAT

100% of all documents

95%/month Random Sampling Performance will be reflected on CPARS

85.5%/month Performance will be reflected on CPARS

Upload STAT transcription reports to VA VISTA System within required TAT

100% of all documents

95%/month Random Sampling Performance will be reflected on CPARS

85.5%/month Performance will be reflected on CPARS

Upload all transcribed documents complete and error free (meet quality standard)

100% of all documents

95%/month Random Sampling Performance will be reflected on CPARS

90.5%/month Performance will be reflected on CPARS

Daily transmission report

100% 95%/month Random Sampling Performance will be reflected on CPARS

Monthly Report 100% 95%/month Random Sampling Performance will be reflected on CPARS

Monthly Invoices (FSC

& VA)

100% 100% Random Sampling No deduct, however, payment will be delayed until receipt of proper invoice.

QUALITY MANAGEMENT

Quality Control System: The contractor shall implement and maintain a QC system that results in correction of potential and actual problems throughout the scope of contract performance. The QC system shall contain processes for corrective actions without dependence upon Government direction and shall maintain records of all Contractor QC inspections and corrective actions. Offeror’s established Quality Control System shall be provided with its quote.

Quality Reports: Reports shall be of the highest professional quality in the body of the text as well as the information in the header and footer. Contractor shall use a medical spell checker on each document and perform corrections for spelling and grammar. The contractor shall be responsible for ensuring that all transcription is prepared using correct grammar, spelling and medical terminology, including that particular to all subspecialties of medicine surgery, psychiatry, neurology, and rehabilitative medicine. Contractor shall be responsible for checking medical dictionaries and current reference sources as required to distinguish between similar sounding medical terms.

Screening and Proofreading: The contractor shall maintain a procedure that provides for screening and proofreading for accuracy of all reports prior to transmittal to the VA. For any words or phrases that cannot be transcribed due to difficulties in hearing the dictators voice then the transcriptionist shall type the symbol for a blank @@@_ _ _ or ***_

Correction Reports: Any reports returned to the contractor for correction for reasons stated herein, or reports that are otherwise unacceptable to the VA will be returned to the contractor within 48 hours of discovery of the error or problem and shall be corrected within 24 hours of receipt at no additional expense to the Government.

Inaudible Reports: If any dictation should prove to be significantly or totally inaudible or otherwise unable to be transcribed, the contractor shall notify the COR/POC or designee within 24 hours of receipt of dictation. Failure to notify the COR/POC representative within the time period allowed shall be subject to deductions in accordance with Section 1.6.4 Failure to Meet TAT.

Order of Transcriptions: Reports must be transcribed in the order in which they were transmitted. Consistent skipping of jobs to avoid certain report types or author is not allowed. STAT and Operative Reports shall be prioritized separately and processed in the order transmitted.

Partial Dictation: A partial dictation is any incomplete report. Dictation may be interrupted if there is an equipment malfunction or if the dictator terminates the dictation prior to the end of the report. Contractor shall combine segments of the same report prior to final preparation, delivery, and billing to the VA. Otherwise, the contractor shall submit partial dictation unless specifically cancelled by the originator of the dictation.

Lost Reports: Lost reports are reports dictated by the clinician and verified transmitted but not delivered to the VA.

The contractor shall be accountable for any lost reports. Any transcription redone due to a lost report shall be transcribed and returned within 4 hours after receipt of notice. A deduction of 50% of the line count will be assessed for reports that are not located within 72 hours. Any transcription redone due to a lost report shall be transcribed and returned within 4 hours after receipt of notice at no charge to the VA.

Errors: Errors are defined as incorrect or omitted medical terminology that is clearly dictated, punctuation or spelling which changes the meaning of the sentence, entering material that is not dictated, entering material that is not part of the report such as dictator’s directions to transcriptionist, unauthorized abbreviations, misspelled words that would have been caught by a spell-check program, and blank lines, @@@ or *** or dictation that is clearly intelligible.

For errors meeting the criteria of this paragraph contractor shall be subject to any deductions as outlined in paragraph “7.14. Failure to Meet Quality Standard” of this section.

Confidentiality Standards: The contractor shall ensure the privacy and confidentiality of all patient information and shall be held liable in the event of breach of confidentiality. The contractor shall comply with the provisions of the Federal Privacy Act of 1974 (Public Law 93-579), the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1972 (Public Law 93- 282), the Drug Abuse Office and Treatment Act of 1972 (Public Law 93-255), as well as other statutes regarding confidentiality of patient information, Protection of all patient rights is of highest priority. The contractor shall adhere to Health Insurance Portability and Accountability Act regulations. See www.cims.hhs.gov/hipaa.

http://www.cims.hhs.gov/hipaa

VA Process for QA: Quality Assurance of medical transcription begins with the author of the dictation. Accuracy and completeness of document content are the responsibility of the author. The QA process shall be based primarily on auditing of transcribed reports with a minimum of 20 reviews per billing cycle. Of these, up to 15 may be retrospective reviews and a minimum of 5 reports must be concurrent reviews.

QA Audit Process: The selection process by which documents are reviewed should be truly random or at least unpredictable. For quality assurance, the Contracting Officer will select a random sample of 20 reports monthly. The Contracting Officer will randomly select the date and reports and send to each facility COR. The contractor must send the dictation log for the selected day and the Contracting Officer will select a minimum of 20 random reports for review.

The COR or designee at each facility is responsible for conducting the QA audit. The Contracting Officer will maintain a monthly random sampling report for each participating facility.

Quality Standard: Contractor shall maintain a quality standard of 95% accuracy based on the monthly random sampling report. The random sampling report will include the total number lines of all reports included in the sample. Percentage is based on ratio of errors to lines. (Example: 1000 lines produced, 20 errors: 20/1000=0.02 errors. Accuracy is 98%).

Failure to Meet Quality Standard: For each percentage point below 95% or If the random sampling reports falls to 90% or below of reports meeting quality standards, the failed performance measure will be detailed in CPARS. The minimum acceptable standard for the quality standard is 90.5%. If the random sampling report shows a quality standard below 90.5% for two consecutive months, work performance will be deemed unacceptable and may be cause for termination.

All percentages will be rounded to the nearest whole number.

Contractor QC Reports: By the seventh working day, at the beginning of each quarter, the contractor shall provide a quarterly data validation report to the COR. This report shall include information on QC results for the prior quarter and shall include a sample formatted double density disk or reports validated and transcribed in the prior quarter.

Estimated Period of Performance Base Year 7/1/25 – 9/30/25 Option Year 1 10/1/25 – 9/30/26 Option Year 2 10/1/26 – 9/30/27 Option Year 3 10/1/27 – 9/30/28 Option Year 4 10/1/28 – 9/30/29 Option Year 5 10/1/29 – 9/30/30

LOCATION(S): Services are to include locations listed below and affiliated facilities (CBOCs, etc.)

Cheyenne VA Health Care System 2360 E Pershing Blvd., Cheyenne, WY 82001

Grand Junction VA Health Care System 2121 North Ave, Grand Junction, CO 81501

VA Eastern Colorado Health Care System 13611 E. Colfax Ave., Aurora, CO 80045

Montana VA Health Care System 3687 Veterans Drive, Fort Harrison, MT 59636

Salt Lake City VA Health Care System 500 Foothill Drive, Salt Lake City, UT 84148

Sheridan VA Health Care System 1898 Fort Road, Sheridan, WY 82801

Eastern Oklahoma VA Health Care System 1011 Honor Heights Drive, Muskogee, OK 74401

Oklahoma City VA Health Care System 921 NE 13th St, Oklahoma City, OK 73104