ASTM E2502-06

NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.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
An American National Standard
Designation:E2502–06
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 Office Ergonomics Training: www.office-ergo.com
National Institutes of Health—Division of Occupational
1.1 This guide identifies ways to improve the medical
Health and Safety: http://dohs.ors.od.nih.gov/ergo_com-
transcription workstation, including, but not limited to, the
puters.html
work environment, which encompasses ergonomics and secu-
http://dohs.ors.od.nih.gov/ergonomics_home.html
rity issues, equipment, references, and tools.
Department of Health and Human Services—Centers for
1.2 This guide will assist healthcare managers, vendors,
Disease Control and Prevention: www.cdc.gov/od/ohs/
medical transcription service owners, and individual medical
ergonomics/compergo.html
transcriptionists to make informed decisions related to the
Backrelief.com: www.backrelief.com/prevention/
design of an efficient medical transcription work environment
work_erg.html
compliant with federal regulatory agencies.
HealthyComputing.com: www.healthycomputing.com
1.3 This guide does not address the medical transcription
Occupational Safety and Health Administration:
process or training.
www.osha.gov
1.4 This standard does not purport to address all of the
Cornell University Ergonomics: http://ergo.human.cor-
safety concerns, if any, associated with its use. It is the
nell.edu/CUVDTchecklist.html
responsibility of the user of this standard to establish appro-
2.3 HIPAA Resources:
priate safety and health practices and determine the applica-
Public Law 104-191 Health Insurance Portability and Ac-
bility of regulatory limitations prior to use.
countability Act of 1996 (HIPAA)
2. Referenced Documents
American Association for Medical Transcription, HIPAA
for 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
3. Terminology
Security Principles for Health Information Including Elec-
3.1 Definitions:
tronic Health Records
3.1.1 color temperature—ascaleusedtoexpressthecontent
E1902 Specification for Management of the Confidentiality
of the color of a light source.
and Security of Dictation, Transcription, and Transcribed
3.1.2 desk—afurnitureformandclassoftableforwritingor
Health Records
keyboarding. This may include a computer cart, PC stand or
E1988 Guide for Training of Persons who have Access to
3 other types of furniture products that support keyboarding.
Health Information
E2117 Guide for Identification and Establishment of a
Quality Assurance Program for Medical Transcription Office Ergonomics Training, Ankrum Associates, 949 Lake Street, 3-G, Oak
Park, IL 60301.
2.2 Ergonomic Resources:
National Institutes of Health, Division of Occupational Health and Safety,
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, Missis-
Current edition approved July 1, 2006. Published August 2006. DOI: 10.1520/ sauga, Ontario, L4Z 3M6.
E2502-06. 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,
Withdrawn. The last approved version of this historical standard is referenced Dept of Design & Environmental Analysis, College of Human Ecology, Cornell
on 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
3.1.3 ergonomics—the engineering science concerned with 5.1.1.3 Allow adequate space to accommodate ventilation
the physical and psychological relationship between machines and electrical/connectivity access.
and the people who use them. 5.1.1.4 Secure cables, cords, and phone lines.
3.1.4 light intensity—theamountoflightgivenoffbyalight 5.1.2 The office location should be in a secured area that
source. will limit access to PHI by others. (See Specification E1902.)
3.1.5 seat pan—the seat surface of the chair that supports 5.1.2.1 Either an office with a door that can be locked.
the majority of the user’s weight. 5.1.2.2 Or an area that is accessed only by the MT with the
3.1.6 task lighting—task lighting increases light levels over computer facing away from view by passers by.
the work and immediate surroundings. 5.1.2.3 Locate monitors and desktops away from windows
3.1.7 workspace—the area where work is generally per- and traffic areas to ensure the security of PHI.
formed. 5.1.2.4 Safeguards should be in place to prevent voice files
3.1.8 workstation—an area outfitted with equipment and from being overheard by unauthorized individuals. (See Test
Method E1130.)
furnishings.Thismayinclude,butisnotlimitedto,desk,chair,
printer stand, computer, monitor, bookcases, equipment, stor- 5.2 Lighting—Lighting can enhance or detract from the
age, etc. quality of work and overall productivity. Illumination by
hyperbolic florescent lighting is preferable. Proper lighting,
3.1.9 work surface—the space available on a desk.
without glare and shadows, can reduce eye fatigue and head-
3.2 Acronyms:
aches.
3.2.1 AAMT—AmericanAssociation for MedicalTranscrip-
5.2.1 Avoid intense or uneven lighting as high illumination
tion
may “wash out” images on the display screen, so illumination
3.2.2 AHIMA—American Health Information Management
levels should be fairly low. Options for reducing illumination
Association
include the use of appropriate lighting fixtures, installation of
3.2.3 BOS—AAMT book of style
variable lighting, or turning off overhead lights. (See CDC.)
3.2.4 HIPAA—Health Insurance Portability and Account-
5.2.2 Adjust lighting to avoid direct glare on the computer
ability Act
monitor. Soften the back light on the computer screen to avoid
3.2.5 MT—medical transcriptionist
excessive brightness and eye fatigue.Adjust drapes and blinds
3.2.6 MTSO—Medical Transcription Service Organization
toreduceglare.Positiondesklampifusedsothatitilluminates
3.2.7 NIH—National Institutes of Health
sourcedocumentswithoutcausingeitherglareonthecomputer
3.2.8 OSHA—Occupational Safety and Health Administra-
screen or direct illumination to eyes.
tion
5.2.3 All light bulbs should have the same color tempera-
3.2.9 PHI—protected health information as defined by
ture. Use indirect or shielded lighting where possible to avoid
HIPAA in its Privacy and Security Rule regulations
uneven lighting.
5.2.4 Use task lighting as needed.
4. Significance and Use
5.3 Flooring—Unobstructed, stable, and static-free flooring
4.1 This guide provides recommended guidelines for the
or mats are recommended.
essential elements to be included in the design and implemen-
5.3.1 Keep wires, cords, and cables out of the traffic area
tation of an efficient, secure, risk-free work environment for
and secured in a fashion so that they cannot be easily
medical transcription and health information documentation.
dislodged.
4.1.1 Improve and increase production.
5.3.2 Flexible cords should be connected to devices and
4.1.2 Reduce healthcare costs by minimizing injury/illness.
fittings so that strain relief is provided in order to prevent pull.
4.1.3 Increase retention and professional longevity.
5.4 Color—Colorcanplayakeyroleinmood,enhancingor
4.1.4 Ensure regulatory compliance with state and local
detracting from concentration.
government requirements as well as federal privacy and
5.4.1 Keep the color of the workstation area a neutral,
security regulations.
glare-resistant matte finish. Softer, lighter colors should be
used to better reflect indirect lighting and reduce dark shadows
5. Workstation Environment
and contrast.
5.1 Location—Place workstation in a secure and quiet
6. Workstation
environment with limited access, free from interruptions from
nonwork-related activities. This should not be in any public 6.1 Desk—The desk is a key component of the workspace.
area, such as waiting rooms within physician offices or family
It supports equipment, references, and can enable efficiencies
rooms within a home environment. The work area should be of tasks. A properly designed and adjusted desk provides an
large enough to allow full range of motion involved in
ergonomically-correct work environment. (See HealthyCom-
performingrequiredtasks,andprovideroomfortheequipment puting.com and Guide E2117.)
and materials that make up the workstation.
6.1.1 Dependent upon the user, the desk height should be
5.1.1 Organize the desktop so that frequently used objects between 20 to 28 in. high.
are close to the user to avoid excessive extended reaching.
6.1.2 Provide stable, height-adjustable keyboard/mouse tray
5.1.1.1 Avoid overcrowding computer work areas. system beneath the work surface.
5.1.1.2 Control climate to proper temperature, humidity, 6.1.3 Use a matte finish on the work surface to minimize
ventilation, and absence of drafts. glare and reflections.
E2502–06
6.1.4 Select a desk with rounded desktop edges or pad the 6.2.5.4 Ensure adequate space between the tops of the
edges to avoid contact stress. thighs and the underside of the keyboard tray or work surface.
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, periph-
6.2 Chair—A properly designed and adjustable chair pro-
erals, software, and network interface as applicable. When in a network
vides appropriate support to the back, legs, buttocks, and arms.
situation, the computer should have the stand-alone option available when
needed.
Adequate support can reduce contact stress, overexertion, and
fatigue and allow for proper circulation to the extremities. The
7.1 Monitor—The monitor placement is important in creat-
correct adjustment of the chair is related to the proper
ingacomfortableworkstationinordertoreduceawkwardhead
placement of the monitor, keyboard, mouse, and work surface.
and neck postures, fatigue, eyestrain, and/or headaches. Posi-
6.2.1 Don’t stay in one static position for extended periods tion the monitor directly in front of the user to avoid excessive
of time.
twisting of the neck.Adisplay screen that is placed too high or
too low or placed to the side may, over time, cause awkward
6.2.2 Whenperformingdailytasks,alternatebetweensitting
and standing at regular intervals. postures and increased stress of the muscles of the neck,
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 designed for
6.2.4 Choose a seat pan and backrest to support a comfort-
working at the computer. Wearers of bifocals and trifocals
able posture that allows for frequent changing of the seating
often unknowingly tilt their heads backwards so they can read
position. Proper size, shape, or choice of material for the seat
the screen through the lower portion of their glasses.
and backrest results in even weight distribution, reduced stress,
7.1.1.2 Divert eyes from the computer screen every 20 min
and promotes circulation of the extremities and good posture.
to avoid staring and eye strain. (See Office Ergonomics
(See OSHA.)
Training.)
6.2.4.1 Select a seat pan to accommodate the user. It should
7.1.2 Comfortable viewing distance should be 18 to 24 in.
be padded and have a rounded edge in order to reduce contact
from the user. Viewing distances that are too long or too short
stress to the back of the legs.
can cause eyestrain. Comfortable viewing distan
...