SOW_Transcription_Services.docx

STATEMENT OF WORK

1.1. The Contractor shall furnish all managerial, supervisory, direct and overhead personnel; equipment including maintenance; facilities; supplies; and other items or services; except specified herein as Government-furnished, to provide medical transcription services as defined in this contract for Radiology Department, Naval Medical Center San Diego.

NAVAL MEDICAL CENTER, SAN DIEGO SAN DIEGO, CALIFORNIA 92134-5000

1.2. The Contractor shall provide medical transcription services to transcribe and type from specific dictated directions when provided or in prescribed formats from highly specialized medical dictation. The dictation will cover all types of imaging modalities for the Radiology Department, including MRI, CAT Scan, Diagnostic Radiology, Mammography, Nuclear Medicine, Ultrasound, Angiography, and Radiation Therapy.

The Contractor shall transcribe from voice recordings (Government-owned digital dictation system) or voice-recognized text files in correct Government required format. In addition, the Government may provide hard-copy coded "normals" for transcription.

1.3. The Contractor shall enter transcription data directly into Composite Health Care System (CHCS). The Government will provide a web-based portal to access CHCS, subject to security requirements outlined in Section 4.3 below.

1.4. The Contractor shall perform all work off-site; no onsite spaces will be available.

1.5. Personnel. The Contractor shall provide and train sufficient qualified personnel to perform services specified in this contract beginning on the established start date of the contract. The Contractor shall also be able to provide disaster support if needed.

1.6. Transcription Service. Contractor shall perform transcription service for the Radiology Department, Naval Medical Center San Diego. The contractor will take digital voice files from the Government-owned dictation system and transcribe that data into the Composite Healthcare System (CHCS); performance standard is transcription returned within 24 hours of dictation. In addition to standard voice files from dictation system, the Government will also provide voice/text files generated using voice-recognition software from Government-owned Picture Archiving Communication System (PACS).

2.1. The Government uses a Lanier LX-147 digital recorder for physicians to dictate reports. The Contractor may use this system or propose a Contractor-provided system of equivalent or better capability for use to perform the services under this contract. The Contractor will provide any necessary equipment to access the dictation system, as well as pay for all associated telephone charges necessary to access the system if applicable. In addition, the Government is currently using a Carestream PACS system with Native Reporting voice recognition software.

2.2. The Government will provide user information and security codes for use by the contractor. The contractor will immediately terminate the use of these codes upon notification by the Government.

3.1. Line Counting Methods. For counting and billing purposes, reports entered into CHCS will be counted by the line counter module in CHCS. NOTE: CHCS uses 78 characters per line, and counts blank lines and pa11iallines as billable lines.

3.5. Procedures. Radiology Department physicians dictate onto a Government- or Contractor-owned dictation system. Some standard report sections, i.e., normal reports, bone boards, and mammograms are coded for "macros" which shall be utilized, added to, and kept up to date in the Composite Health Care System (CHCS). The contractor will access the dictations on the government-owned dictation system and enter the data directly to CHCS.

3.5.1 Voice Recognition. In addition to the repm1s dictated on the dictation system, the Government physicians will dictate reports on the hospital PACS system. The system currently in use is Carestream Native Reporting. All transcriptionist/clerks will be required to obtain credentials to access Carestream PACS via the Government Virtual Private Network (VPN), this can be coordinated through the Naval Medical Center Information System Security Manager. Reports will be accessed from a worklist set up specifically for transcriptionists use. All transcriptionist/clerks will copy and paste reports done via Native Reporting from the worklist within Carestream into CHCS. In the event there are reports that cannot be copied into a specific exam number (due to cancellation etc), NMCSD Radiology should be notified ASAP so that this can be remedied and transcriptions provided with updated exam number to copy report into CHCS.

3.6. Turnaround times for routine reports, including weekends, will be 24 hours. STAT reports will be returned no later than 4 hours from time of dictation.

3.7 CHCS or Other Automated Information System Procedure. The Contractor shall enter patient reports into the CHCS computer network. For all work types, number of lines and reports transcribed by each individual transcriptionist will be performed by the CHCS line counting feature, which includes 78 characters per line. When using preprogrammed data (standard paragraphs or "macros") line counts of repor1s will be based on actual lines per printed report.

4.1. Hours of Operation. Transcription services are required 24 hours per day, 365 days per year.

4.2. Confidentiality. The Contractor shall ensure strict adherence to all security requirements for all contents and systems of reports applicable to this contract; meeting all requirements as imposed by the Health Insurance Portability and Accountability Act and by the Joint Commission.

4.3 Information Systems Security. All Navy Medicine IT systems must maintain an appropriate level of confidentiality, integrity, authentication, non-repudiation, and availability. The Business-To-Business (B2B) Gateway provides confidentiality, integrity, authentication, non-repudiation, and availability to Navy Medicine Enclaves. The B2B Gateway is the solution to be used by Navy Medical Treatment Facilities (MTF) to provide remote connectivity to MHS Business Partners. The B2B Gateway is designed to provide Military Health System (MHS) Business Partners with a securely managed, single point of entry into Navy Medicine Enclaves. The B2B Gateway is sponsored by the Tri-Service Infrastructure Modernization Project Office (TIMPO) and is managed by the Defense Information Systems Agency (DISA).

All contractor systems that will communicate with Department of the Navy (DON) systems will interconnect through the established Military Health System (MHS) Business to Business (B2B) gateway. For all Web applications, contractors will connect to the DISA-established Web Demilitarized Zone (DMZ). More detailed information can be obtained via the Defense Information Systems Agency website; highlights are given below.

Contractors will connect to the B2B gateway via a contractor procured Internet Service Provider (ISP) connection and assume all responsibilities for establishing and maintaining their connectivity to the B2B gateway. This will include acquiring and maintaining the circuit to the B2B gateway and acquiring a FIPS-140-2 Virtual Private Network (VPN)/Firewall device compatible with the MHS VPN device. Maintenance and repair of contractor procured VPN equipment shall be the responsibility of the contractor.

Contractors shall configure their network to support access to government systems (e.g., configure ports and protocols for access).

Contractors shall provide full time connections to a TIER I or TIER2 ISP. Dial-up ISP Connections are not acceptable.

Contractors will comply with DoD guidance regarding allowable ports, protocols and risk mitigation strategies

Prior to accessing DON networks, all contractors will be required to complete a DISA Form 2875 System Authorization Access Request form (SAAR). In addition, contractor staff will be required to complete applicable DoD IA training.

Vendors shall follow all current DoD and Defense Information Systems Agency (DISA) standards and requirements for acceptable Ports, Protocols, and Services. Any requests for exception to using the current DISA Ports, Protocols, and Services standards requires an request for exception sent through the Program Manager.

Because of the unique circumstances presented by DoD and DON networks, personnel security requirements shall be followed to ensure appropriate precautions are taken prior to allowing vendor personnel access to the network. Any vendor personnel that will be accessing the medical device/system while installed on the hospital network will be required to have a National Agency Check (NAC) completed. Typically, this requires an investigation to support a "Public Trust Position" and requires the person(s) to complete and submit a Standard Form 85P (SF85P), Questionnaire for Public Trust Positions, via the Electronic Personnel Security Questionnaire (EPSQ). Questions relating to SF85Ps and the EPSQ process may be directed to 1-888-282-7682 or online at http://www.dss.mil/index.htm. Contractor personnel accessing equipment connected to the hospital network will be required to complete a System Authorization Access Request-Navy (SAAR-N) (form OPNAV 5239/14). Copies of this form can be obtained from the Navy PACS Office. Additionally, contractor personnel are required to complete the annual DoD IA training requirements.

The Commander, Joint Task Force-Global Network Operations (JTF-GNO) has mandated the implementation of Public Key Infrastructure (PIG) across the DoD on all unclassified servers. These servers must be configured to only trust DoD authorized Certificate Authorities. PK-enabled systems may be configured to accept External Certificate Authorities (ECA), but only in cases where the Information Assurance Manager (JAM) has coordinated with the Bureau of Medicine and Surgery. (BUMED) Chief Information Officer (CIO). The trusting of ECA certificates and associated access control techniques must be documented. This requirement is applicable to medical devices that are installed on DoD networks. Vendors must indicate their willingness and ability to meet this requirement. The DoD has also mandated two factor authentication for access to information systems. This is most commonly accomplished by using a DoD issued Common Access Card (CAC). CAC authentication is mandated by Computer Tasking Orders (CTO's) for any PC connected to the Navy Network.

Access to the medical devices will be limited to authorized users as determined by local policy. Vendors whose systems do not yet meet the requirement for CAC authentication must indicate their willingness to do so, and offer a timeline for compliance.

Complete administrative system rights shall be provided to the government System Administrator for the purpose of conducting device vulnerability scans as needed.

5.1. Quality Control. The Contractor shall ensure that completed transcription is medically consistent and accurate in content. This requires an extensive knowledge of medical terminology, including but not limited to anatomy, pharmacology, surgical procedures, laboratory values, etc. The Contractor shall analyze transcription for accuracy and meaning to ensure transcribed report is an accurate representation of the dictated report. The Contractor shall, in all cases possible, ensure that the demographic information at the top of each report is complete using information provided by the Government. The Contractor shall assure work is free of grammatical and typographical errors prior to returning it to the originator.

5.2. Clarification. The Contractor shall call the originator regarding clarification of work submitted or questions about specific requirements. Unusual terminology or pronunciations shall be verified with the originator when unclear.

6.0 Quality Assurance Surveillance Plan. The QASP will consist of the following elements:

6.1 Transcription Service

Performance Objective: Perform transcription services as set forth in the Performance Work Statement. Contractor shall perform transcription service for the Radiology Department, Naval Medical Center San Diego. The contractor will take digital voice files from the Government owned dictation system and/or PACS system and transcribe that data into the Composite Healthcare System (CHCS) within 24 hours of dictation. Transcribed reports shall contain no more than three (3) errors of spelling, punctuation, grammar, or mis-match with dictation.

Performance Standard: Transcription returned within 24 hours and meeting quality standard.

Acceptable Quality Level: 95%

Monitoring Method/Performance Assessment: Monthly spot checks by the COR. When performance is below standards, contractor will remedy deficiency at no additional cost to the Government. Remedy must be completed within 1 workday of notification by COR. Contractor performance will be documented in CPARS.

6.2 Customer Service and Response to Routine and Emergency Inquiries

Performance Objective: The government may, on occasion, request that the contractor provide a special transcription services to meet immediate needs due to the patient care emergencies that cannot wait until the regular scheduled delivery. These requests will be kept to a minimum. No additional charges will be authorized for these services as they are considered normal transcription procedures and the billing procedure will be the same as all delivered items.

Customer Service support will be available during working hours of 9:00am to 5:00pm (Pacific Time) on weekdays.

Contractor will designate a representative in accordance with FAR 52.236-6, when designated representative is not available to provide support, a backup representative will be provided.

The Representative shall have authority to act for the contractor on all contract matters relating to daily operation of this contract.

Performance Standard: Within 4 hours of routine or emergency service request notification to the contractor, the contractor will confirm the requested service to the COR.

Acceptable Quality Level: 95%

Monitoring Method/Performance Assessment: Monthly spot checks by the COR. When performance is below standards, contractor will remedy deficiency at no additional cost to the Government. Remedy must be completed within 1 workday of notification by COR. Contractor performance will be documented in CPARS.