ASTM E2502-06(2011)
(Guide)Standard Guide for Medical Transcription Workstations (Withdrawn 2020)
Standard Guide for Medical Transcription Workstations (Withdrawn 2020)
SIGNIFICANCE AND USE
This guide provides recommended guidelines for the essential elements to be included in the design and implementation of an efficient, secure, risk-free work environment for medical transcription and health information documentation.
Improve and increase production.
Reduce healthcare costs by minimizing injury/illness.
Increase retention and professional longevity.
Ensure regulatory compliance with state and local government requirements as well as federal privacy and security regulations.
SCOPE
1.1 This guide identifies ways to improve the medical transcription workstation, including, but not limited to, the work environment, which encompasses ergonomics and security issues, equipment, references, and tools.
1.2 This guide will assist healthcare managers, vendors, medical transcription service owners, and individual medical transcriptionists to make informed decisions related to the design of an efficient medical transcription work environment compliant with federal regulatory agencies.
1.3 This guide does not address the medical transcription process or training.
1.4 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.
WITHDRAWN RATIONALE
This guide identifies ways to improve the medical transcription workstation, including, but not limited to, the work environment, which encompasses ergonomics and security issues, equipment, references, and tools.
Formerly under the jurisdiction of Committee E31 on Healthcare Informatics, this guide was withdrawn in January 2020 in accordance with section 10.6.3 of the Regulations Governing ASTM Technical Committees, which requires that standards shall be updated by the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NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.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: E2502 − 06 (Reapproved 2011)
Standard Guide for
Medical Transcription Workstations
This standard is issued under the fixed designation E2502; 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 and Security of Dictation, Transcription, and Transcribed
Health Records (Withdrawn 2011)
1.1 This guide identifies ways to improve the medical
E1988 Guide for Training of Persons who have Access to
transcription workstation, including, but not limited to, the
Health Information (Withdrawn 2007)
work environment, which encompasses ergonomics and secu-
E2117 Guide for Identification and Establishment of a Qual-
rity issues, equipment, references, and tools.
ity Assurance Program for Medical Transcription
1.2 This guide will assist healthcare managers, vendors,
2.2 Ergonomic Resources:
medical transcription service owners, and individual medical 4
Office Ergonomics Training: www.office-ergo.com
transcriptionists to make informed decisions related to the
National Institutes of Health—Division of Occupational
design of an efficient medical transcription work environment
Health and Safety: http://dohs.ors.od.nih.gov/ergo_com-
compliant with federal regulatory agencies.
puters.html
1.3 This guide does not address the medical transcription http://dohs.ors.od.nih.gov/ergonomics_home.html
process or training.
Department of Health and Human Services—Centers for
Disease Control and Prevention: www.cdc.gov/od/ohs/
1.4 This standard does not purport to address all of the
ergonomics/compergo.html
safety concerns, if any, associated with its use. It is the
Backrelief.com: www.backrelief.com/prevention/work_
responsibility of the user of this standard to establish appro-
erg.html
priate safety and health practices and determine the applica-
HealthyComputing.com: www.healthycomputing.com
bility of regulatory limitations prior to use.
Occupational Safety and Health Administration:
1.5 This international standard was developed in accor-
www.osha.gov
dance with internationally recognized principles on standard-
Cornell University Ergonomics: http://ergo.human.cor-
ization established in the Decision on Principles for the
nell.edu/CUVDTchecklist.html
Development of International Standards, Guides and Recom-
2.3 HIPAA Resources:
mendations issued by the World Trade Organization Technical
Public Law 104-191 Health Insurance Portability and Ac-
Barriers to Trade (TBT) Committee.
countability Act of 1996 (HIPAA)
2. Referenced Documents AmericanAssociation for MedicalTranscription, HIPAAfor
2 MTs, July 2005
2.1 ASTM Standards:
Guide to HIPAA Privacy Rule, Lippincott Williams &
E1130 Test Method for Objective Measurement of Speech
Wilkins, 2006
Privacy in Open Plan Spaces Using Articulation Index
E1869 Guide for Confidentiality, Privacy, Access, and Data
SecurityPrinciplesforHealthInformationIncludingElec- 4
Office Ergonomics Training, Ankrum Associates, 949 Lake Street, 3-G, Oak
tronic Health Records (Withdrawn 2017) Park, IL 60301.
National Institutes of Health, Division of Occupational Health and Safety,
E1902 Specification for Management of the Confidentiality
Building 13, Room 3KO4, 13 South Drive, MSC 5760, Bethesda, MD 20892-0003.
Department of Health and Human Services, Centers for Disease Control and
This guide is under the jurisdiction of ASTM Committee E31 on Healthcare Prevention, Public Inquiries/MASO, Mailstop E11, 1600 Clifton Road,Atlanta, GA
Informatics and is the direct responsibility of Subcommittee E31.15 on Healthcare 30333.
Information Capture and Documentation. Backrelief.com, Wyeth Consumer Healthcare Inc., 5975 Whittle Road,
Current edition approved July 1, 2011. Published August 2011. Last previous Mississauga, Ontario, L4Z 3M6.
edition approved 2006 as E2502–06. DOI: 10.1520/E2502-06R11. HealthyComputing.com, Inc., 9245 Regents Road, Suite 324, LaJolla, CA
For referenced ASTM standards, visit the ASTM website, www.astm.org, or 92037.
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM Available from Occupational Safety and Health Administration (OSHA), 200
Standards volume information, refer to the standard’s Document Summary page on Constitution Ave., NW, Washington, DC 20210, http://www.osha.gov.
the ASTM website. Cornell University Ergonomics, ProfessorAlan Hedge, PhD, FErgS,AFBPsS,
The last approved version of this historical standard is referenced on Dept of Design & Environmental Analysis, College of Human Ecology, Cornell
www.astm.org. University, MVR Hall, Forest Home Drive, Ithaca, NY 14853-4401.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
E2502 − 06 (2011)
3. Terminology nonwork-related activities. This should not be in any public
area, such as waiting rooms within physician offices or family
3.1 Definitions:
rooms within a home environment. The work area should be
3.1.1 color temperature—ascaleusedtoexpressthecontent
large enough to allow full range of motion involved in
of the color of a light source.
performingrequiredtasks,andprovideroomfortheequipment
3.1.2 desk—afurnitureformandclassoftableforwritingor
and materials that make up the workstation.
keyboarding. This may include a computer cart, PC stand or
5.1.1 Organize the desktop so that frequently used objects
other types of furniture products that support keyboarding.
are close to the user to avoid excessive extended reaching.
3.1.3 ergonomics—the engineering science concerned with
5.1.1.1 Avoid overcrowding computer work areas.
the physical and psychological relationship between machines
5.1.1.2 Control climate to proper temperature, humidity,
and the people who use them.
ventilation, and absence of drafts.
3.1.4 light intensity—theamountoflightgivenoffbyalight 5.1.1.3 Allow adequate space to accommodate ventilation
source. and electrical/connectivity access.
5.1.1.4 Secure cables, cords, and phone lines.
3.1.5 seat pan—the seat surface of the chair that supports
5.1.2 The office location should be in a secured area that
the majority of the user’s weight.
will limit access to PHI by others. (See Specification E1902.)
3.1.6 task lighting—task lighting increases light levels over
5.1.2.1 Either an office with a door that can be locked.
the work and immediate surroundings.
5.1.2.2 Or an area that is accessed only by the MT with the
3.1.7 workspace—the area where work is generally per-
computer facing away from view by passers by.
formed.
5.1.2.3 Locate monitors and desktops away from windows
3.1.8 workstation—an area outfitted with equipment and
and traffic areas to ensure the security of PHI.
furnishings.Thismayinclude,butisnotlimitedto,desk,chair,
5.1.2.4 Safeguards should be in place to prevent voice files
printer stand, computer, monitor, bookcases, equipment,
from being overheard by unauthorized individuals. (See Test
storage, etc.
Method E1130.)
3.1.9 work surface—the space available on a desk.
5.2 Lighting—Lighting can enhance or detract from the
3.2 Acronyms: quality of work and overall productivity. Illumination by
hyperbolic florescent lighting is preferable. Proper lighting,
3.2.1 AAMT—AmericanAssociation for Medical Transcrip-
tion without glare and shadows, can reduce eye fatigue and head-
aches.
3.2.2 AHIMA—American Health Information Management
5.2.1 Avoid intense or uneven lighting as high illumination
Association
may “wash out” images on the display screen, so illumination
3.2.3 BOS—AAMT book of style
levels should be fairly low. Options for reducing illumination
3.2.4 HIPAA—Health Insurance Portability and Account-
include the use of appropriate lighting fixtures, installation of
ability Act
variable lighting, or turning off overhead lights. (See CDC.)
3.2.5 MT—medical transcriptionist 5.2.2 Adjust lighting to avoid direct glare on the computer
monitor. Soften the back light on the computer screen to avoid
3.2.6 MTSO—Medical Transcription Service Organization
excessive brightness and eye fatigue.Adjust drapes and blinds
3.2.7 NIH—National Institutes of Health
toreduceglare.Positiondesklampifusedsothatitilluminates
3.2.8 OSHA—Occupational Safety and Health Administra-
sourcedocumentswithoutcausingeitherglareonthecomputer
tion
screen or direct illumination to eyes.
3.2.9 PHI—protected health information as defined by
5.2.3 All light bulbs should have the same color tempera-
HIPAA in its Privacy and Security Rule regulations ture. Use indirect or shielded lighting where possible to avoid
uneven lighting.
4. Significance and Use
5.2.4 Use task lighting as needed.
4.1 This guide provides recommended guidelines for the
5.3 Flooring—Unobstructed, stable, and static-free flooring
essential elements to be included in the design and implemen-
or mats are recommended.
tation of an efficient, secure, risk-free work environment for
5.3.1 Keep wires, cords, and cables out of the traffic area
medical transcription and health information documentation.
and secured in a fashion so that they cannot be easily
4.1.1 Improve and increase production.
dislodged.
4.1.2 Reduce healthcare costs by minimizing injury/illness.
5.3.2 Flexible cords should be connected to devices and
4.1.3 Increase retention and professional longevity.
fittings so that strain relief is provided in order to prevent pull.
4.1.4 Ensure regulatory compliance with state and local
5.4 Color—Color can play a key role in mood, enhancing or
government requirements as well as federal privacy and
security regulations. detracting from concentration.
5.4.1 Keep the color of the workstation area a neutral,
5. Workstation Environment
glare-resistant matte finish. Softer, lighter colors should be
5.1 Location—Place workstation in a secure and quiet used to better reflect indirect lighting and reduce dark shadows
environment with limited access, free from interruptions from and contrast.
E2502 − 06 (2011)
6. Workstation 6.2.4.2 Choose a seat pan with an adjustable tilt to assure
the worker is able to maintain proper support in different
6.1 Desk—The desk is a key component of the workspace.
positions.
It supports equipment, references, and can enable efficiencies
6.2.5 Chair Height Adjustment:
of tasks. A properly designed and adjusted desk provides an
6.2.5.1 Adjustchairheightsothattheentiresolesofthefeet
ergonomically-correct work environment. (See HealthyCom-
canrestonthefloororafootrest,andthebacksofthekneesare
puting.com and Guide E2117.)
slightly higher than the seat of the chair. This position allows
6.1.1 Dependent upon the user, the desk height should be
blood to circulate freely in the lower extremities. (See NIH.)
between 20 to 28 in. high.
6.2.5.2 Position trunk and upper legs to form an angle of
6.1.2 Provide stable, height-adjustable keyboard/mouse tray
90°.
system beneath the work surface.
6.2.5.3 Useafootrestifthesolesofthefeetdonotrestflatly
6.1.3 Use a matte finish on the work surface to minimize
on the floor.
glare and reflections.
6.2.5.4 Ensure adequate space between the tops of the
6.1.4 Select a desk with rounded desktop edges or pad the
thighs and the underside of the keyboard tray or work surface.
edges to avoid contact stress.
6.2.6 Useawide-basedpedestalforstabilityandcastersthat
6.1.5 Arrange the desk so there is space to access cords or
move smoothly for mobility.
cables and allow ventilation.
6.2.7 Sit upright in the chair with the lower back and
6.1.6 Provide adequate storage and shelving for needed
shoulders against the backrest.
work and reference materials.
6.2.8 Thighs should be parallel to the floor and knees at
6.1.7 Use a document holder if documents are referred to
about the same level as the hips.
while transcribing.
6.2.9 Backs of the knees should not come in direct contact
6.1.7.1 The document holder should be stable and adjust-
withtheedgeoftheseatpan(thereshouldbe2to3in.between
able (height, position, distance, and angle of view).
the edge of the seat and the back of the knee).
6.1.7.2 The document may be supported on either side of
6.2.10 Adjust height and/or width of armrests so they allow
the monitor at the same distance from the eyes as the display
the user to rest arms at their sides and relax/drop their
screen to avoid frequent changes of focus without moving the
shoulders while keyboarding. (See NIH.)
neck or back.
6.2.10.1 Where armrests are used, elbows and lower arms
6.1.8 Keep area underneath the desk uncluttered. There
should rest lightly so as not to cause circulatory or nerve
should be adequate legroom to allow the MTto stretch out and
problems.
preventsittingwiththelegsinafixedpositionforlongperiods.
6.2.10.2 Do not use armrests to slouch.
Cables should be secured so that they do not become dis-
lodged.
7. Equipment
6.1.9 Use of an adjustable foot rest is recommended. NOTE 1—Equipment includes the monitor, keyboard, computer,
peripherals, software, and network interface as applicable. When in a
6.2 Chair—A properly designed and adjustable chair pro-
network situation, the computer should have the stand-alone option
vides appropriate support to the back, legs, buttocks, and arms.
available when needed.
Adequate support can reduce contact stress, overexertion, and
7.1 Monitor—The monitor placement is important in creat-
fatigue and allow for proper circulation to the extremities. The
ingacomfortableworkstationinordertoreduceawkwardhead
correct adjustment of the chair is related to the proper
and neck postures, fatigue, eyestrain, and/or headaches. Posi-
placement of the monitor, keyboard, mouse, and work surface.
tion the monitor directly in front of the user to avoid excessive
6.2.1 Don’t stay in one static position for extended periods
twisting of the neck.Adisplay screen that is placed too high or
of time.
too low or placed to the side may, over time, cause awkward
6.2.2 Whenperformingdailytasks,alternatebetweensitting
postures and increased stress of the muscles of the neck,
and standing at regular intervals.
shoulders, and upper back.
6.2.3 Adjust the height of the backrest to support the natural
7.1.1 The computer screen should be positioned so the top
inward curvature of the lower back.
ofthescreenisslightlybeloweyelevel.Whenthescreenistoo
6.2.3.1 It may be useful to use a rolled towel or lumbar pad
low, the neck is forced to flex or bend forward. (See Backre-
to support the lower back.
lief.com.)
6.2.3.2 Thebackrestangleshouldbesetsothatthehip-torso
7.1.1.1 Bifocal and trifocal wearers should lower the com-
angle is 90° or greater.
puter monitor or purchase glasses specifically design
...
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