DRAFT - Performance Work Statement - Medical Transcription.pdf

Performance Work Statement (PWS) MEDVAMC Medical Transcription Services

1. SCOPE

1.1 The Contractor shall provide medical transcription services of dictated material for the Michael E. DeBakey VA Medical Center (MEDVAMC) within prescribed turn-around-times. The Contractor shall transcribe reports utilizing headers and footers and appropriate formats. The VA prohibits subcontracting of work without prior approval by the Contracting Officer (CO). Under no circumstances shall work be performed outside the United States and its Territories without the expressed written permission of the CO.

1.2. Government Equipment: No equipment shall be provided by the Government. The Contractor shall be required to dictate into their own equipment.

1.3. Contingency Services: The Contractor shall maintain the resources necessary to ensure that transcription services for the MEDVAMC are uninterrupted, regardless of contingency or circumstances. The Contractor shall provide a written Contingency Plan (CP) with its quote.

1.4. Period of Performance: The government estimates awarding a Base Year plus 4 (four) Option Year periods (at the government’s discretion) estimated as follows:

• Base Year: October 1, 2020 – September 30, 2021

• Option Year 1: October 1, 2021 – September 30, 2022

• Option Year 2: October 1, 2022 – September 30, 2023

• Option Year 3: October 1, 2023 – September 30, 2024

• Option Year 4: October 1, 2024 – September 30, 2025

2. DEFINITIONS/ACRONYMS:

• Character – Printable ASCII characters, including a single space. A space between words is counted as 1 (one) ASCII character. Carriage returns to create blank lines are excluded.

• Contracting Officer (CO) – A person with the authority to enter into, administer, and/or terminate contracts and make related determination and findings. This is the only person who can bind the Government in all matters related to or arising under a contract.

• Contracting Officer Representative (COR) – The individual designated and authorized in wiring by the CO to perform specific technical or administrative functions. The COR has no authority to make changes to the contract.

• Line – 12-pitch with 80 characters per line

• Turn-Around-Time (TAT) – TAT for jobs dictated into a dictation system will begin to compute from the time the job becomes available for transcription. TAT for jobs on cassette tapes will be computed beginning 24 hours after the cassette is mailed via overnight mail. All dictated reports shall be properly transcribed and transmitted to the MEDVAMC within 24 hours of dictation excluding weekends and holidays. Weekends and holidays reports are due the next business day following holidays and weekends.

• VA Records – VA records include the dictated (voice) record and the transcribed report (text), as well as any paper copy of storage medium for voice or text.

• Veterans Information Systems Technology Architecture (VISTA) – The VA electronic healthcare architecture based on software modules developed with Massachusetts General Hospital Utility Multi-Programming System (MUMPS).

• STAT – Designation assigned by the Dictator to a dictation that requires transcription and delivery within 4 hours of dictation.

• Visible Black Character (VBC) - A VBC is defined as a strike-able and visible characters and includes any printed letters number, symbol, and/or punctuation mark excluding any or all formatting (e.g. bold, underline, italics, table structure, formatting codes, spaces, and returns). All VBCs can be seen regardless of whether it is viewed electronically or on a printed page.

• The VBC Line or the American Standard Code for Information Interchange (ASCII) no Spaces Line – A VBC line is defined as the total number of characters, printed or visible, that’s part of the final transcribed document. This includes any character contained in a header or footer. Spaces between words or sentences, carriage returns, hidden format instructions, such as bold, underline, text boxes, printer configurations, spell check, etc., are not included in total character count. A VBC line is calculated by counting all visual characters and dividing that number of characters by 65 to arrive at a number of defined lines.

3. GENERAL REQUIREMENTS:

3.1. Transcription of Tapes:

• In the event the dictation equipment provided by the Contractor is out of service (unavailable for dictation purposes) for greater than 24 hours, the Contractor shall have the ability to transcribe dictations from cassette tapes for the MEDVAMC facility. If the system failure originates on the Contractor’s end, Contractor shall incur all cost associated in the transportation of dictations done on cassette tapes. If the system failure originates on the facility’s end, the facility shall incur all cost associated in the transportation of dictations done on cassette tapes. In all instances, tapes shall be mailed and returned via overnight mail. The Contractor shall return all cassette tapes to the facility of origin upon completion of transcribed reports. All mailing or courier costs associated with the return of cassette tapes and diskettes shall be borne by the Contractor.

• Contractor shall have the ability to routinely transcribe dictations dictated on cassette tapes for the facility. All costs incurred with mailing tapes to the Contractor shall be borne by the facility. The Contractor shall return all cassette tapes to the facility upon completion of transcribed reports. All mailing or courier costs associated with the return of cassette tapes and diskettes shall be borne by the Contractor. In all instances, tapes shall be mailed and returned via overnight mail. To expedite delivery, the tapes can be hand delivered to the department’s COR representative in the HIMS section.

• Contractor shall have the ability to transcribe any size cassette tape.

• TAT on cassette tapes will begin 24 hours after the tapes are mailed via overnight mail service. Transcribed reports from cassette tapes shall be returned electronically as prescribed elsewhere in the contract.

3.2. Preparation & Format of Reports:

• General Format: The Contractor shall provide medical transcription services for dictated material that includes a high incidence of technical terminology and requires knowledge of specialized vocabularies. The Contractor shall be required to transcribe reports dictated by individuals from varied cultural backgrounds. Transcription requires adaptation to variations in speech, tone, voice volume, speed, delivery, pronunciation and enunciation. These medical reports shall include, but are not limited to, operative reports, consults, board of investigation reports, compensation and pension examinations and miscellaneous medical and other administrative reports as required. The specific format for each report will vary from facility to facility. The Contractor shall adhere to the format requirements of the facility.

• Header and Footer Format: The MEDVAMC will provide the Contractor with their header and footer needs. It is the Contractor’s responsibility to assure all headers and footer information complies with the needs of the facility. As a rule, the header and footer may include, but not be limited to the following

I. Header Information: Document type, patient Social Security Number (SSN), date of encounter, document author, dictation date, the attending physician and transcriptionist identifier.

II. Footer Information: Patient’s three initials and last four digits of the SSN; job number as assigned by the appropriate dictation system; and the initials of the author. An additional line shall include the Contractor’s name and transcriptionist’s initials.

III. Abbreviations shall not be used in the diagnosis and procedure sections of Discharge Summaries or Operative Reports. Abbreviations within the text are to be limited to those listed on an approved abbreviation list (provided by the facility after award) and those commonly used in laboratory value reporting.

3.3. Transmission of Documents to the VA:

• Destination of transcribed documents: VA may elect to have transcribed documents uploaded by the contractor directly to VISTA or batch transmitted to the VA host PC.

The decision regarding which documents will be directly uploaded and which will be batch loaded is at the discretion of each individual facility.

• Format of Transmissions: The Contractor is shall transmit properly formatted documents over conventional telephone lines, establishing a dial-up connect to the modem at a phone number the VA has provided to the vendor, by utilizing/entering a password provided by the VA. The Contractor shall provide his/her own communications software and utilize the transfer protocol agreed upon by the MEDVAMC.

• The Contractor shall be responsible for all costs incurred in transmitting dictations and transmitting transcribed documents by phone line to and from the Contractor’s place of business.

• For work that is to be batch transmitted to VISTA or the VA file server (PC), the Contractor shall transmit via the Contractor’s communication software. Separate batch files shall be uploaded for each report type. Each batch will include a log file listing the documents included in the batch. The reports transmitted in each batch shall adhere to the file naming conventions provided by each individual facility.

3.4. Contractor Equipment:

a. The MEDVAMC requires that the Contractor provide, at the Contractor’s location, central digital dictation systems accessible via toll-free telephone from anywhere within the continental United States. The dictation system shall be capable of handling a minimum of fifteen (15) concurrent Dictators. The dictation system shall:

I. Be accessible to VA authors round the clock, 7 (seven) days per week via a single telephone number.

II. Verbally acknowledge access and verbally prompt for author ID, report type and patient ID.

III. Be configured to log date and time of dictations as well as to recognize and log touch-tone codes for author ID (5 digits), Report Type Code (2 digits), and Patient ID (9 digits).

IV. Automatically log date, time and total length of dictation.

V. Have rewind/fast forward, playback and editing of dictation capability.

VI. Have “STAT” designation capability for any dictation.

VII. Have verbal completion acknowledgement.

VIII. Have “Listen” capability available to designated personnel.

b. The transcribed The transcribed data that will be batch uploaded into VISTA shall be transcribed in ASCII format with data elements separated by delimiters. Delimiters will be specified by the appropriate staff at each facility. To permit proper uploading, the Contractor shall insure that proper ASCII formatting is done of each report at the on-line delivery systems to permit the appropriate staff at each facility to conduct the upload.

Transcribed documents shall be delivered electronically. The on-line delivery systems shall be supplied by the Contractor.

c. If the option to have data transmitted to the VA host PC is exercised, the Contractor shall provide all necessary equipment and software to provide on-site delivery system. This equipment shall include, but not be limited to printers, modems and PC’s. The Contractor shall be responsible for maintenance and repair for Contractor furnished equipment and expendable supplies, except for paper, ink cartridges and diskettes. The Contractor shall provide the facility with personal computers, software, modems and accessories that will meet the minimum specifications. All hardware and software shall be approved by the facility’s Information Resource Management (IRM) Service and Information Security Officer (ISO) prior to installation or use by the Contractor.

d. Dedicated phone lines will be provided by each facility, but all costs associated with the transmissions shall be borne by the Contractor.

e. The Contractor shall coordinate, within ten (10) days after contract award, the initial installation of the printer and PC and system setup with IRM personnel at the facility.

The Contractor shall be liable for all costs associated with the installation of equipment, except for phone lines. The VA will incur all expenses associated with providing (making available) an incoming phone jack and number for return data transmissions.

All returned data shall be in ASCII format. All contract-required equipment shall be installed and fully operational within thirty (30) days from the date of an award. Failure to meet this requirement may result in contract termination. Fully operational is defined as able to operate at the equipment’s maximum capacity. All transcription formats shall also be loaded and able to be used within this period.

f. Removal of Contractor-owned equipment is required within 30 days after contract expiration.

g. Relocation of equipment located at the VAMC facility, if necessary, will be provided by VAMC personnel at VAMC expense.

h. Equipment Maintenance:

i. The Contractor shall be responsible for the maintenance and repair of Contractor equipment placed in the facility. A maximum of a four (4) hour turnaround time will be allotted for equipment repair or replacement. All equipment to be placed in the facility shall be inspected by Engineering Service staff as appropriate before installation. Actual installation will be coordinated with IRM staff.

ii. The MEDVAMC will be responsible for any costs incurred due to the Contractor’s equipment located at the facility being lost, stolen or damaged due to negligence by VA personnel. The MEDVAMC will not be liable for damage caused by daily normal use.

iii. The Contractor’s equipment is to be used solely for the purpose of doing business with the Contractor. Under no circumstances is the equipment to be used for any function other than transcription services.

iv. Backup equipment or a backup system shall be furnished or in place for any equipment failure greater than four (4) hours. The Contractor shall be responsible for all costs associated with the backup equipment (delivery, installation, setup, preventive maintenance, etc.). This backup system shall include the capabilities of being able to pick up and transcribe dictations on tape.

The Contractor shall be capable of transcribing any size tape.

4. TAT STANDARDS & MONITORS:

4.1. TAT Price Discount: At least 95% of all reports shall meet TAT requirements during each billing cycle, or a 5% discount will be applied to the entire month’s invoice. If less than 90% of all reports meet TAT requirements, a 15% discount will be applied to the entire month’s invoice. If less than 85% of the reports meet TAT requirements, a 30% discount will be applied to the entire month’s invoice. Consistent failure to meet the 95% standard may be cause for termination of the contract. TAT may be waived by the VA in the event of VA equipment failure

4.2. TAT-all dictated reports shall be properly transcribed and transmitted to the MEDVAMC within 24 hours of dictation excluding weekends and holidays. Weekends and holidays reports are due the next business day following holidays and weekends.

5. GOVERNMENT RESPONSIBILITIES:

5.1. Electronic access to A computer and dictation systems.

5.2. Training of Contractor staff including upload staff if applicable during a 30-day phase-in period between contract award and the commencement of live production. A reasonable amount of consultation with designated VA staff will be available as needed during the course of the contract.

5.3. Advance notification whenever possible regarding workflow fluctuations or other changes which may impact the Contractor’s ability to perform.

5.4. Adequate support from VA personnel.

6. CONTRACTOR RESPONSIBILITIES:

6.1. The Contractor shall provide a Primary and Alternate Point of Contact (POC) by name and phone number who will function as the liaison with the COR on day-to-day operations. The POC shall be available from 8:00am to 5:30pm Central Standard Time (CST) 7 (seven) days a week.

6.2. The Contractor shall provide a company officer/representative who is authorized to resolve on-going problems that have not been resolved at the operations level.

6.3. The Contractor shall ensure all information technology used in performance of this contract is compatible with VA systems; and is virus free.

6.4. The Contractor shall provide enough transcriptionists to meet contract requirements, in addition to a plan to address periodic fluctuations in VA workload.

6.5. The Contractor shall provide qualified and experienced personnel to meet the quality standards of this requirement.

6.6. The Contractor shall provide the COR and CO with a phase-in plan for the transition period between contract award and live production.

7. CONTRACTOR QUALIFICATIONS:

• Regularly established transcription business

• A minimum of 3 (three) years of experience with similar work types and volumes

• Personnel working on this contract shall be a Certified Medical Transcriptionist (CMT) or have at least 3 (three) years of experience in transcription of all specialty areas of medical terminology.

8. ADDITIONAL REQUIREMENTS/INFORMATION:

8.1. Dictators access dictation system via telephone and may dictate 24 hours a day, seven days a week. Completed reports are returned to the VA as outlined in the solicitation. About 5% of dictation is stat, about 90% of dictation is done during business hours.

8.2.The contractor may have access to VISTA via IP routing

8.3. All transcription and verification services shall be performed in the United States of America (including US territories).

8.4. The Contractor shall transmit Delivery Logs with each batch of transmitted transcribed reports. Each delivery log shall contain the patient’s name, Social Security Number (SSN), type of report, name of the dictator and the date transcribed. The Contractor shall submit a monthly report of all log sheets sent during the billing cycle.

8.5. The Contractor shall provide a Dictation Log covering midnight to midnight of previous day’s dictation (Friday through Sunday on weekends) showing date, time, report type, author identification, and length of dictation. This shall be transmitted to a designated VISTA report printer by 10am (CST) each business day.

8.6. The Contractor shall provide a Transcription Log covering midnight to midnight of all the previous day’s non-Radiology transcription (Friday through Sunday on weekends) showing patient name, social security number, report type, dictation date, transcription date, author name and dictation reference number (job number). This report shall be transmitted to the designated report printer by 10am (CST) each business day.

8.7. Visible Black Character (VBC): A The Contractor shall provide a Transcription Log covering midnight to midnight of all the previous day’s non-Radiology transcription (Friday through Sunday on weekends)

9. QUALITY ASSURANCE:

9.1. Typed documents shall be of high quality and accuracy. The Contractor is responsible for all proofreading. There shall be no blanks in text as a result of dictation which is understandable to VAMC personnel. Reports considered unacceptable will include:

i. Misspelling

ii. Inappropriate abbreviations

iii. Blanks (unless an acceptable explanation is received)

iv. Missing/inaccurate information (such as patient or physician name – unless as a result of facility error)

v. Gross grammar

vi. Punctuation errors

vii. Formatting other than specified by the facility

9.2. The Contractor’s final copy will be checked for accuracy by the COR. The COR will reject documents containing errors. The Contractor will be notified of such documents. All transcription rejected shall be corrected, within four (4) hours. The percentage of allowable Contractor-submitted documents, which require return for corrective action, shall not exceed 2% of the total contract workload for the month. Error margins greater than 2% will result in a reduction of payment to the offeror by the total percentage of error for the measurement period. The reduction of payment will offset the cost of COR’s time to recheck work. Failure to maintain at least a 98% accuracy rating for any prolonged period may result in termination of the contract.

9.3. Upload Standards: If Contractor is responsible for uploading directly into the patient record under this contract, errors in note titles assigned during upload, uploading to incorrect patient name, SSN, or appointment/admission date (or date of admission or procedure), and errors in the name of dictating provider, and attending physician (if applicable) assigned, during upload shall be at no cost to VA. Upload errors caused by errors or omission on the part of the VA author do not count against the Contractor’s TAT performance, provided that the

Contractor notified the COR in a manner mutually agreed upon between the project manager and COR. If there is no clinic appointment slot open for a transcribed report, Contractor shall notify VA and transmit the report to the VA host PC within the required TAT; VA will create a slot and upload the report, if this option is exercised by the facility

9.4. The Contractor shall establish a “flagging” system to indicate unintelligible dictation, incomplete dictation, dictation defects or other problems noted in dictation, for the appropriate personnel at each facility to remedy the situation. The symbol “%%%” shall be used for blank flags.

9.5. The Contractor shall have in place a written Contingency Plan (CP) for action for managing the dictations in the event of equipment failure. The Contractor’s CP shall be submitted along with the contractor’s quote. If the Contractor has the capacity to allow the VA to dial into their dictation equipment as a CP, please provide complete information including the cost to be charged per line.

9.6. Retention: The Contractor maintain transcribed reports on archive disks for a minimum of 1 (one) year.

9.7. Lost Reports: Lost reports are defined as reports dictated by the physicians and transcribed, 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 four (4) hours at no charge to the VA. Any more than three occurrences of lost reports in a period of twelve-months may result in contract termination.

10. VA RECORD SECURITY MEASURES: The Contractor shall have their facility security and ADP security necessary to safeguard VA records. The Contractor is subject to all laws and regulations governing the privacy of patient information. Additionally, the Contractor shall ensure the confidentiality of all patient and employee information and shall be held liable in the event of a breach of confidentiality

10.1. Background Investigations: Contractor personnel performing work under this contract shall satisfy all requirements for security eligibility. Managerial personnel and those personnel who will be designated to these positions on weekends and in the event of an absence shall have a background investigation prior to performing work under this contract. The type of investigation conducted will depend on the sensitivity of the data access or the harm that could result in system misuse. In any event, employees of the contractor shall have at least a minimum background investigation conducted

10.2. The contractor shall be required to show that the employee(s) hold or that the contractor has initiated actions to acquire such investigations within three working days of each employee assuming operational responsibility. Cost of such investigations shall be the responsibility of the contractor. The ability to obtain and maintain such clearance is a mandatory requirement for continued employment for this contract. Any employee shall be removed from the contract within 24 hours of notification of ineligibility for such investigation.

10.3. Privacy and Cybersecurity Training: Contractor’s staff shall be required to complete the mandatory VA Privacy and Cybersecurity Trainings prior to being allowed to access VA system records and annually thereafter. The VA Talent Management System (TMS) course is easily accessible and provided to the Contractor’s staff at no charge, however, Contractor is responsible for paying their staff for the time required to take the course. Contractor’s representative will provide a copy of the completion certificate to the Transcription COR.

Contractor will notify Transcription COR when contracting staff changes are made i.e. either staff leaving, or new staff is hired.

http://www.iprm.oit.va.gov

10.4. Records: Contractor personnel who obtain access to hardware or media which may manipulate or store drug or alcohol abuse data, sickle cell anemia treatment records, records or tests or treatment for or infection with HIV, medical quality assurance records, or any other sensitive information protected under 38 U.S.C. §4132 or §3305, as defined by the Department of Veterans Affairs, shall not have access to the records unless absolutely necessary to perform their contractual duties. Any individual who has access to these data will disclose them to no one, including other employees of the contractor not involved in the performance of the contractual duty for which access was obtained. Violation of these statutory provisions, as stated in department regulations by the contractor’s employees may involve imposition of criminal penalties.

10.5. System of Records: The VA system(s) of records to which the contractor personnel will have access in order to perform their transcription duties is “Patient Medical Records – VA

(24VA136).

10.6. System Security: The Contractor shall provide VA with the full assurance that security measures have been implemented which are consistent with OMB Circular A-130 and VA

Departmental Standards. The contractor and their personnel shall be subject to the same Federal laws, regulations, standards and VA policies as VA personnel, regarding information and information system security if applicable. These include but are not limited to Federal Information Security Management Act (FISMA), Appendix III of OMB Circular A-130, and guidance and standards, available from the Department of Commerce’s National Institute of Standards and Technology (NIST). This also includes the use of common security configurations available from NIST’s Web site at: http://checklists.nist.gov

Any remote access to VA systems that contain sensitive information must be done through the One-VA Virtual private Network (VPN). After contract award and prior to VA granting VPN access, the contractor will be required to complete all security requirements.

10.7. Procedures for User Access: Access requirements to VA information systems by contractors and contractor personnel shall meet or exceed those requirements established for VA employees as described in VA directives and in any subsequent VA policy statements. A written and signed request for user electronic access by VA Management, or designee(s), constitutes management approval (sponsorship) to initiate a request for access to any sensitive automated information system. Access shall be granted to non-VA users only if the purpose for access meets criteria of the Privacy Act and VA Confidentiality regulations and transfer.

10.8. Security and Privacy: Contractors shall comply with all national guidelines for security and privacy including the Federal Information Security Management Act (FISMA) as amended (44 U.S.C. §§ 3541 et seq.), the Health Insurance Portability and Accountability Act of 1996 (HIPAA), (Public Law 104-191), it’s implementing regulations, the Privacy, Security and Breach Notification rules located at 45 Code of Federal Regulations (CFR), Part 160 and subparts A and E; the Privacy Act of 1974, Public Law 93-579; and any additional Department of Veteran Affairs (VA) or VHA directives or requirements for compliance.

http://www.iprm.oit.va.gov/ http://checklists.nist.gov/

10.9. Contractor will be required to sign and abide by the Department of Veterans Affairs (VA)

National Rules of Behavior and Rules of Behavior for VA VPN Service.

11. CONTRACT ADMINISTRATION:

11.1. Changes to Contract or PWS: The CO is the only individual authorized to approve changes or modify any of the requirements under this PWS or impending contract. The Contractor shall communicate with the COR on all matters pertaining to contract administration. The COR is designated to represent the CO in furnishing technical guidance and advice regarding the work being performed under this contract. Only the CO is authorized to make commitments or issue changes affecting price, quantity or performance of this contract. Costs incurred by the Contractor through the actions of parties other than the CO shall be borne by the Contractor.

11.2. Payments: The Contractor shall submit requests for payment electronically to the VA’s Tungsten Network. Billing for lines shall be based on a 12-pitch typing line of 80 characters per line. Invoices shall be paid Monthly, in arrears for all authorized work performed, upon receipt of a properly prepared invoice submitted to: https://www.fs.va.gov/einvoice.asp

Invoices shall include, at a minimum, the following information:

• Name and address of the contractor

• Invoice date and number

• Contract Number, Purchase Order Number, contract line item number

• Total line count and total charge submitted for each type of report

• Detailed description of quantity, unit of measure, unit price and extended price of the services performed

12. SERVICE DELIVERY SUMMARY: The COR will utilize the below standards to monitor the Contractor’s quality standards of performance:

Performance Objective

Contract/PWS Paragraph

Performance Standards Acceptable Quality Level

Surveillance Method

Contingency Services

1.3 Uninterrupted services

regardless of contingency or circumstances

100% Uninterrupted Services

Direct Observation

Transcription of Tapes

3 The Contractor shall adhere to all service requirements listed in Paragraph 3 of the PWS.

100% Cassette tapes transcribed per standard.

Direct Observation

TAT Standards & Monitors

4 The Contractor shall adhere to all service requirements listed in Paragraph 4 of the PWS.

100% Review of Reports

Contractor Responsibilities

6 The Contractor shall adhere to all requirements listed in Paragraph 6 of the PWS.

100% Meets all requirements

Observation

Contractor Qualifications

7 The Contractor shall adhere to all qualification requirements listed in Paragraph 7 of the

PWS.

100% Periodic Inspection https://www.fs.va.gov/einvoice.asp

(End of Performance Work Statement)

Additional Requirements /Information

8 The Contractor shall adhere to all requirements listed in Paragraph 8 of the PWS.

100% Periodic Inspection

Quality Assurance

9 The Contractor shall adhere to all requirements listed in Paragraph 9 of the PWS.

100% Periodic Inspection

VA Record Security Measures

10 The Contractor shall adhere to all requirements listed in Paragraph 10 of the PWS.

100% Periodic Inspection

Payments 11.2 The Contractor shall submit properly prepared invoices for payment in accordance with Paragraph 11.2 of the PWS.

100% Periodic Inspection