1.0 General
1.1 The success
of a digitized document conversion operation, receipt or creation
of electronic records in native formats, or output of data as electronic
records depends upon a strict standardized process. A standardized
process that is repeatable and consistently followed will result
in authentic and reliable records. It also provides for quality,
creation, capture, conversion in the case of scanning, output, processing,
indexing, storage, search, retrieval, migration, and reproduction
of Defense Health Agency (DHA) records. For more information on
additional formats reference
Addendum B, paragraph 3.1.3.
1.2 All DHA
contractors shall maintain the following inactive records in either
Tagged Imaged File Format (TIFF) or searchable Portable Document
Format (PDF) files, with metadata. See
Section 2, Records
Series Subject and Description of Government records:
• DHA Claims.
• Claim Supporting Documentation,
including any documentation that either supports or denies payment
of a claim.
• Adjustment
Records.
• Adjustment
Supporting Documentation, including any documentation that either supports
or denies payment of the adjustment.
• Checks.
• Explanation of Benefit
(EOB) Forms and Summary Payment Vouchers (if scanned to produce
images).
2.0 Standards
2.1 The
contractor shall adhere to the
TRICARE
Systems Manual (TSM), Chapter 1,
General Automated Data Processing (ADP) Requirements. The contractor
shall ensure security and access requirements are met in accordance
with existing contract requirements for local area network security.
2.2 DHA records
that are imaged shall follow current Association for Information
and Image Management (AIIM) standards for imaging. All documents
converted into digital format shall be scanned into legible TIFF
or searchable PDF. AIIM acts as the voice of the Enterprise Content Management
(ECM) industry in key standards organizations, with the media, and
with Government decision-makers. AIIM is an American National Standards
Institute (ANSI) accredited standards development organization.
AIIM also holds the Secretariat for the International Organization
for Standardization (ISO) committee focused on Information Management
Compliance issues, TC171.
2.2.1 Imaged copies of DHA records
must be legible and reproducible. Image capture and storage systems
used by the contractor shall reproduce legible copies from the storage
medium. Should the contractor produce illegible copies of any record
or set of records, the contractor shall recover and re-image the
originals ensuring that the newly stored image is a legible, reproducible document.
2.2.2 The contractor shall provide an automated indexing
system that can be used independently of the contractor’s data system.
An automated indexing system
must not be subject to proprietary
hardware or software constraints. The automated indexing system
shall be able to identify the retrieval location of the original
claim and all related documentation, adjustment claims (including correspondence
on which the decision to adjust was based) and all related supporting
documentation.
Example 1: If back-end imaging is
done, the back-end document number assigned shall be cross-referenced
to the original claim number on the index.
Example 2: If the Internal Control Number (ICN) assigned
to the adjustment claim is different than the original claim number,
the contractor shall cross reference the adjustment claim ICN to
the ICN of the original claim being adjusted on the index. The index
shall be available for DHA on-site review.
2.3 The following
requirements are applicable to digital images (scanned), electronic
records (born-digital), and electronic data or records output in
PDF format:
2.3.1 PDF
File Specification For All PDF Records
2.3.1.1 Searchable
PDF records shall comply with PDF versions 1.0 through 1.7 (i.e.,
be compatible PDF file formats in existence on the approval date
of this guidance), and meet conversion requirements as outlined
below.
2.3.1.2 DHA will periodically update the list of acceptable
PDF versions provided in this guidance, as appropriate.
2.3.1.3 The automated
indexing system requirements identified in DHA records that are
imaged will follow the AIIM guidelines, and apply to all PDF records.
2.3.2 General Requirements
For All PDF Records
2.3.2.1 Security
Requirements
2.3.2.1.1 The media utilized to transfer records to the
Government shall be encrypted. However, PDF records shall not contain
security settings (e.g., self-sign security, user passwords, and/or permissions)
that prevent DHA or National Archives and Records Administration
(NARA) from opening, viewing, or printing the record.
2.3.2.1.2 All PDF
records shall have all security settings deactivated (e.g., encryption,
master passwords, and/or permissions) prior to transfer to DHA,
NARA, or for transit reasons. Deactivating security settings from
PDFs ensures DHA has the ability to support long term migration
and preservation efforts, especially records affected by legal holds.
The electronic media device containing PDF records with PII/PHI
for transfer shall be encrypted in a manner that is compatible with
the DHA environment.
2.3.2.2 Review Of Special Features
Contractors shall present the DHA Records Management
(RM) Officer with PDF use functional specification for use authorization
prior to enabling any special feature. Examples of special features,
include but are not limited to: digital signatures; links to other
documents; files or sites; embedded files (including multimedia
objects); form data; comments and/or annotations.
2.3.3 Requirements
for Scanned Paper or Image Formats Converted To PDF
2.3.3.1 Minimum Image Specifications
Paper records that have been scanned and converted
into PDF format shall adhere to the requirements identified with
the paragraphs above. Contractors with digitized records that do
meet the minimum image quality standard as stated shall contact
the DHA RM Officer for further guidance.
2.3.3.2 Optical Character
Recognition (OCR)
PDF records can contain
embedded searchable text based on OCR. DHA recognizes uncorrected
OCR’d text can assist with full text search capabilities; thus,
contractors shall be permitted to provide DHA with PDF records that
have been OCR’d using processes that do not alter the original bit-mapped
image. An example of an output process that accomplishes this requirement
is Searchable Image-Exact. Searchable PDF files output as Formatted
Text and Graphics, PDF Normal, or Searchable Image-Compact will
not be accepted for scanned paper or image formats.
2.3.4 Requirements
For Digital To Digital Conversion
Records
converted from their native electronic formats (e.g., office automation
products) and electronic data output (e.g., electronic information
systems) should be converted to searchable PDF files.
2.3.4.1 Embedded
Fonts
Electronic records that have been converted
to searchable PDF files from their native electronic formats must
include embedded fonts to guarantee the visual reproduction of all
text as created. All fonts embedded in searchable PDF files must
be publicly identified as legally embeddable (i.e., font license
permits embedding) in a file for unlimited, universal viewing, and
printing.
2.3.4.2 Font Referencing
2.3.4.2.1 PDF records
that reference fonts other than the “base 14 fonts” must have those
fonts referenced in the record (i.e., as a minimum, subsets of all
referenced fonts) embedded within the PDF file.
2.3.4.2.2 PDF records
must have all fonts referenced in the record, including the “base
14 fonts,” embedded within the PDF file. This requirement is met
by having, subsets of all referenced fonts embedded within the PDF
file, as a minimum.
2.3.5 Data Output From Electronic
Information Systems
Data output from electronic
information systems such as DHA records shall be in the format of
searchable PDF files. Because the source information is structured
or unstructured data, no OCR process is needed. When performing
a digital to digital conversion from native formats or data using normal
methods (not employing screen scrapes, special tools, etc.) the
output will yield a 100% exact searchable PDF file although, technically,
it is called a “Formatted Text and Graphics” PDF. Electronic records
created from data and native format conversions (digital to digital)
shall be accepted by DHA, as a PDF formatted text and graphics format.
4.0 Procedures
For Imaging
The contractor shall develop
and follow a system for imaging two-sided documentation and output
to electronic formats required by DHA to include written procedures
for Government inspection detailing the entire process. Documentation
shall include the following:
4.1 Planning for further technological
developments.
4.2 Providing for the ongoing functionality of
system components.
4.3 Assuring the imaging system
and electronic information systems have inherent flexibility and
a non-proprietary design that accepts future hardware and software
upgrades.
4.4 Monitoring and limiting the deterioration of
records stored on optical disks and digital data disk storage.
4.5 Document
preparation.
4.6 Imaging/Conversion Operations (flowchart or
other graphical depiction of the imaging process from start to finish).
4.7 Indexing,
Retrieval, and Cross-Referencing (method of indexing all portions
of the claim; i.e., mother claim, adjustments, related correspondence,
any documentation that substantiates the settlement of the claim,
EOB, check number, etc.). Ensuring that claims retrieval software
is Structured Query Language (SQL) compliant.
4.8 Quality
Control (must ensure 100% accuracy of readability of all imaged
documents, how each original will be imaged, what will occur if
errors are made, equipment failures, skewed margins, loss of data,
etc.) as well as comparable quality control processes and procedures
for data output as electronic records in PDF format.
4.9 Disaster
Recovery (shall be in place to ensure 100% recovery capability,
how content and media will be protected, the protection of the vital
records, and the location of the duplicate copies of the images,
indexes, and PDF records).
4.10 Disposition of Original Records
(how, when, where will the original documents be destroyed in accordance
with applicable laws and regulations, i.e., DHA Records Retention
Schedule (RRS), the Health Insurance Portability and Accountability
Act of 1996 (HIPAA), and the Privacy Act of 1974).
4.11 Documentation
of Imaging and Output Storage Requirements.