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.