ASTM E1959-05(2011)
(Guide)Standard Guide for Requests for Proposals Regarding Medical Transcription Services for Healthcare Institutions (Withdrawn 2020)
Standard Guide for Requests for Proposals Regarding Medical Transcription Services for Healthcare Institutions (Withdrawn 2020)
SIGNIFICANCE AND USE
This guide is intended to assist healthcare institutions in creating appropriate requests for proposals to be issued for medical transcription services.
This guide provides recommended guidelines for the essential elements to be included in requests for proposals issued to medical transcription services. The purpose of these requests is contracting for the production and delivery of transcribed patient care documentation for a healthcare institution.
This guide recognizes the necessity of a HIPAA Business Associate Agreement.
This guide recognizes the necessity of researching local, state, and federal requirements that may apply.
SCOPE
1.1 This guide covers recommended guidelines to healthcare institutions for the development and issuance of requests for proposals (RFPs), as well as guidelines for medical transcription service organizations (MTSOs) responding to requests for proposals. It does not purport to address all of the legal aspects of the RFP, if any, associated with its use. It is the responsibility of the user of this guide to establish appropriate legal guidelines prior to use.
1.2 It is appropriate for healthcare institutions to issue RFPs from time to time or at regular contractual intervals for the purpose of facilitating the process of contracting for medical transcription services.
1.3 It is anticipated that both a commercial contract for services and a HIPAA Business Associate Agreement will be based upon the responding proposals submitted to the RFP.
WITHDRAWN RATIONALE
This guide covers recommended guidelines to healthcare institutions for the development and issuance of requests for proposals (RFPs), as well as guidelines for medical transcription service organizations (MTSOs) responding to requests for proposals. It does not purport to address all of the legal aspects of the RFP, if any, associated with its use. It is the responsibility of the user of this guide to establish appropriate legal guidelines prior to use.
Formerly under the jurisdiction of Committee E31 on Healthcare Informatics, this guide was withdrawn in January 2020 in accordance with section 10.6.3 of the Regulations Governing ASTM Technical Committees, which requires that standards shall be updated by the end of the eighth year since the last approval date.
General Information
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Standards Content (Sample)
NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.
Contact ASTM International (www.astm.org) for the latest information
Designation: E1959 − 05 (Reapproved 2011)
Standard Guide for
Requests for Proposals Regarding Medical Transcription
Services for Healthcare Institutions
This standard is issued under the fixed designation E1959; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (´) indicates an editorial change since the last revision or reapproval.
1. Scope SecurityPrinciplesforHealthInformationIncludingElec-
tronic Health Records (Withdrawn 2017)
1.1 This guide covers recommended guidelines to health-
E1902 Specification for Management of the Confidentiality
care institutions for the development and issuance of requests
and Security of Dictation, Transcription, and Transcribed
for proposals (RFPs), as well as guidelines for medical
Health Records (Withdrawn 2011)
transcription service organizations (MTSOs) responding to
E2117 Guide for Identification and Establishment of a Qual-
requests for proposals. It does not purport to address all of the
ity Assurance Program for Medical Transcription
legal aspects of the RFP, if any, associated with its use. It is the
E2184 Specification for Healthcare Document Formats
responsibility of the user of this guide to establish appropriate
(Withdrawn 2011)
legal guidelines prior to use.
E2344 GuideforDataCapturethroughtheDictationProcess
1.2 It is appropriate for healthcare institutions to issue RFPs
2.2 Other Documents
from time to time or at regular contractual intervals for the
American Association for Medical Transcription (AAMT),
purpose of facilitating the process of contracting for medical
Metrics for Measuring Quality in Medical Transcription,
transcription services.
1.3 It is anticipated that both a commercial contract for AAMT Book of Style, Second Edition, 2002
Medical Transcription IndustryAssociation (MTIA), Billing
services and a HIPAA Business Associate Agreement will be
based upon the responding proposals submitted to the RFP. Method Principles
Public Law 1004-191 Health Insurance Portability and Ac-
1.4 This international standard was developed in accor-
countability Act of 1996 (HIPAA)
dance with internationally recognized principles on standard-
ization established in the Decision on Principles for the
3. Terminology
Development of International Standards, Guides and Recom-
3.1 Definitions:
mendations issued by the World Trade Organization Technical
3.1.1 audit trail—a record of users that is documentary
Barriers to Trade (TBT) Committee.
evidence of monitoring each operation performed. Audit trails
may be comprehensive or specific to the individual and event
2. Referenced Documents
2 (that is, document routing, version control, access, etc.).
2.1 ASTM Standards:
3.1.2 authentication—process of (1) verifying authorship,
E1384 Practice for Content and Structure of the Electronic
for example, by written signature, identifiable initials, or
Health Record (Withdrawn 2017)
computer key, or ( 2) verifying that a document is what it is
E1762 Guide for Electronic Authentication of Health Care
purported to be, such as comparison with other records, or
Information (Withdrawn 2017)
both.
E1869 Guide for Confidentiality, Privacy, Access, and Data
3.1.3 Certified Medical Transcriptionist—medicaltranscrip-
tionistwhohasmetthequalificationsforvoluntarycertification
This guide is under the jurisdiction of ASTM Committee E31 on Healthcare
set by the American Association for Medical Transcription
Informatics and is the direct responsibility of Subcommittee E31.15 on Healthcare
(AAMT), by demonstrating proficiency in the field, meeting
Information Capture and Documentation.
Current edition approved July 1, 2011. Published August 2011. Originally accepted standards, and maintaining the designation through
approved in 1998. Last previous edition approved in 2005 as E1959 – 05. DOI:
10.1520/E1959-05R11.
2 4
For referenced ASTM standards, visit the ASTM website, www.astm.org, or Available from American Association for Medical Transcription, www.aam-
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM t.org.
Standards volume information, refer to the standard’s Document Summary page on Available from Medical Transcription Industry Association, www.mtia.com.
the ASTM website. Available from U.S. Government Printing Office, Superintendent of
The last approved version of this historical standard is referenced on Documents, 732 N. Capitol St., N.W., Mail Stop: SDE,Washington, DC 20401. See
www.astm.org. also http://aspe.hhs.gov/admnsimp.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
E1959 − 05 (2011)
continuing education activities as required by the certification 3.1.22 medical transcription service organization
process established by AAMT. (MTSO)—provider of transcribed healthcare documentation;
also referred to as vendor or contractor.
3.1.4 compliance clause—item in a contract that defines
3.1.23 on-site users—individuals who use a facility’s com-
remedies for default of contract specifications.
puter system via a terminal and other hardware elements that
3.1.5 data destruction—eradication of data to a useless and
are physically connected to that system.
irretrievable state.
3.1.24 protected health information—individually identifi-
3.1.6 data elements—unitsoffundamentalinformationfrom
able health information, protected by HIPAA Privacy and
a healthcare record, organized in an analytical manner.
Security Regulations.
3.1.7 data extraction—specification of a subset of data from
3.1.25 remote users—individuals who use a facility’s com-
a master data source for a new data format.
puter system via modem or wide area network connection.
3.1.8 data mining—extractionofselectedelementsofstored
3.1.26 taped dictation—information that is stated or read
data to be used for a purpose other than the one for which the
aloudandrecordedbyananalogtapesystem,suchasacassette
information was originally intended.
recorder, as opposed to a digital system.
3.1.9 dictation—information that is stated or read aloud to
3.1.27 turnaround time (TAT)—elapsed time beginning with
be transcribed by another.
availability of the voice file to the contractor (also known as
3.1.10 dictator—one who dictates information to be tran-
MTSO or vendor) for transcription and ending when the
scribed by another; also known as originator.
transcribed document is delivered to the healthcare institution.
3.1.11 digital dictation—information that is stated or read
3.1.28 unit of measure—defined unit of production for
aloud and recorded by a digital recording system.
transcription, including but not limited to a character, word,
line, minute; measure used to quantify transcription produced.
3.1.12 document—report in any form (print, electronic, or
3.1.28.1 Discussion—Because production statistics may
voice file).
vary based on counting methods used, electronic or otherwise,
3.1.13 document access—ability to enter, exit, and, in some
even though units of measure are the same, the contractor
circumstances, edit or make use of a document.
should clearly define the unit of measure being used, and the
3.1.14 document destruction—eradication of all elements of
healthcare institution should require full disclosure of the
a document to a useless state.
methods used to quantify production.
3.1.15 document distribution—delivery of a document or
3.1.29 vendor site—any MTSO where patient health infor-
documents (original or copies) to appropriate recipients, in any
mation is stored, processed, or produced.
form (print, electronic, or voice file), authenticated or not
3.2 Acronyms:
authenticated.
3.1.16 document storage—repository for reports in any
AAMT = American Association for Medical Transcription
CMS = Centers for Medicare & Medicaid Services
form (print, electronic, or voice files), authenticated or not
CMT = Certified Medical Transcriptionist (as designated
authenticated, for later use or retrieval.
by the Certification at AAMT)
3.1.17 electronic authentication—verification of authorship
EHR = Electronic Health Record
of a document or verification that a document is what it is
ePHI = Electronic Protected Health Information
purported to be, or both, accomplished by electronic means or
HIPAA = The Health Insurance Portability and Account-
in an electronic format.
ability Act of 1996
3.1.18 electronic protected health information—
JCAHO = Joint Commission onAccreditation of Healthcare
individually identifiable health information in any electronic
Organizations
medium, protected by HIPAA Privacy and Security Regula- MT = Medical Transcriptionist; Medical Transcription
tions. MTIA = Medical Transcription Industry Association
MTSO = Medical Transcription Service Organization
3.1.19 full-time equivalent—work force equivalent of one
PHI = Protected Health Information
individual working full-time for a specific period, which may
RFP = Request for Proposal
be made up of several part-time individuals or one full-time
TAT = Turnaround Time
individual.
4. Significance and Use
3.1.20 healthcare institution—any facility whose primary
purpose is delivery of health care, for example, hospital, clinic, 4.1 This guide is intended to assist healthcare institutions in
physician practice, multi-campus healthcare system. creating appropriate requests for proposals to be issued for
medical transcription services.
3.1.21 medical transcription—process of interpreting and
transcribing dictation by physicians and other healthcare pro- 4.2 This guide provides recommended guidelines for the
fessionals regarding patient assessment, workup, therapeutic essential elements to be included in requests for proposals
procedures, clinical course, diagnosis, prognosis, etc., into issued to medical transcription services. The purpose of these
readable text, whether on paper or on computer, in order to requests is contracting for the production and delivery of
document patient care and facilitate delivery of healthcare transcribed patient care documentation for a healthcare insti-
services. tution.
E1959 − 05 (2011)
4.3 This guide recognizes the necessity of a HIPAA Busi- 6.1.1.10 Reference requests,
ness Associate Agreement. 6.1.1.11 Scope of services (to include quality improvement
program, staffing capabilities, and transition plan),
4.4 This guide recognizes the necessity of researching local,
6.1.1.12 Product pricing to include change orders,
state, and federal requirements that may apply.
schedules, etc.,
5. The Current RFP Process 6.1.1.13 Compliance clauses to include HIPAA, and
6.1.1.14 Selection process to include the weighting criteria
5.1 Healthcareinstitutionsoftenoutsourcetheproductionof
and timeline scheduled for selection.
patient care documentation to an external vendor known as a
medical transcription service organization (MTSO). Therefore
6.2 TheRFPshouldbesetupinsuchawaythatitwillallow
requests for proposals (RFPs) for those services are more
the MTSO an adequate opportunity to present the full scope of
important than ever for management consideration. Establish-
services to the healthcare institution as a partner in achieving
ing sensible standards for the RFP process is a necessary
the healthcare institution’s goals. It should not be so rigid that
beginning for successful partnerships between healthcare insti-
the MTSO cannot demonstrate creative solutions and ap-
tutions and MTSOs. RFPstandards will help to ensure that the
proaches to service and pricing. This sort of openness, while
healthcare institution’s goals and expectations become an
making clear the requirements of the institution, promotes a
integral part of the working relationship with the MTSO.
response of cooperation toward a common goal.
5.2 In reviewing RFPs presently in use, it is clear that no
6.3 In each of the sections of the RFP, the document should
particular standards are being followed in their composition.
set out the requirements in such a way that the compliance or
5.2.1 The information necessary to select an appropriate
noncompliance of the MTSO can be verified. This should be
MTSO should be realistic in order to achieve the desired
followed by a field for comment by the MTSO. In areas where
results. Otherwise, inadequate service may result or other
the healthcare institution has a preference, but not necessarily
difficulties may arise after the contract is awarded. If an RFP
a demand, the same format can be followed. Some sections
does not ask for sufficient information about the MTSO for the
may be an invitation for information from the MTSO and
healthcare institution to be able to judge the company fairly or
should be so arranged. Such an invitation acknowledges
to make an informed decision, or does not give enough
respect for the MTSO’s expertise in its field, while wisely
information to enable the MTSO to provide an informed
protecting the interests of the healthcare institutions.
response or set up the account adequately, the outcome may be
unsatisfactory to all parties. This may leave the healthcare
7. Structure of the RFP Document
institution with poor service, no service, or rebidding.
7.1 Current Status of the Healthcare Institution:
Furthermore, the cost to the healthcare institution of repeatedly
7.1.1 A complete description of the healthcare institution’s
re-establishing relationships with MTSOs can be excessive,
existing technology and transcription practices and current
andthequalityofserviceduringthetransitionmaybelessthan
status enables the MTSO to formulate comprehensive answers
optimal, adversely impacting patient care and patient safety.
to the requirements listed in the RFP.
5.2.2 The healthcare documentation process and quality of
7.1.2 Organizational Picture—A general description of the
the data are enhanced by well-defined requirements as set forth
healthcare institution’s corporate structure (that is, number and
in the RFP. High-quality data supports quality patient care,
type of locations for healthcare facilities) should be specified.
improves efficiency, and results in cost-effective services.
The healthcare institution’s relevant policies and procedures
6. Systematic Approach to Writing RFPs (thatis,NoticeofPrivacyPractices,etc.)shouldbeprovidedto
the MTSO.
6.1 A systematic approach to the RFP includes items that
7.1.3 Healthcare Documents—A description of healthcare
make the situation of the healthcare institution clear to the
documentspresentlygeneratedforeachsiteshouldbespecified
MTSO, including the healthcare institution’s existing state of
and described:
transcription, goals for the future, and the requirements for
7.1.3
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