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.