D.31 Radiology and Denton CBOC Service Agreement.pdf

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Attached to
Q201--Amendment to answer questions Federal contract opportunity
Solicitation number
36C25722R0015
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 17

About this file

This document outlines a service agreement between the Radiology Service and the Denton Community Based Outpatient Clinic. The agreement details the radiological services to be provided, which include plain film x-rays on site with referrals required for other modalities such as CT, MRI, mammography and ultrasound either to local VA medical centers or the community. Responsibilities of the radiology technologists and expectations for communication between radiology and referring providers are established. The process for ordering examinations, expectations for turnaround times on routine and stat interpretation, and how results will be documented is specified. Procedures for annual review and renewal of the agreement are also included.

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Text version

DEPARTMENT OF VETERANS AFFAIRS

NORTH TEXAS HEALTH CARE SYSTEM

RADIOLOGY SERVICE

February 19, 2020 549/114

VANTHCS Denton Outpatient Clinics/Radiology Service Agreement

This is a service agreement between Radiology and the Denton CBOC. The purpose of this agreement is to come to a consensus of the radiological procedure referring process between the referring providers and the Radiology Service on the established procedure request protocols. The goal is to ensure timely procedure results availability, notification of critical findings, and quality patient care for the benefit of our Veterans.

A. Services provided at Denton CBOC

1. Plain film X-rays will be provided at Denton CBOC

2. Angio, CT, R/F, Mammograms, MRI and Ultrasound will be referred to Dallas or to the community, per the Mission Act.

B. Radiology Technologist Quality Assurance

1. Technologist will assure images do not contain artifacts

2. Technologist will identify and repeat all overexposed, underexposed and over penetrated exams.

3. Review all images before sending to PACS

4. Technologist will identify errors in positioning to include planes, body positions, movement and projections. Example: assuring x-ray is taken in a true lateral view and not an oblique view

5. Technologist will assure all images are under correct accession number (do not place different anatomy under same accession number).

C. Communication between Radiology Service and Denton CBOC

1. The referring clinician may contact Radiology Service at the extensions listed below

• Radiology Admin Office (3rd floor) -7018

• Front Desk Reception (3rd floor) - 70170.70169

• ADPAC/QM-74978

• General -77052/77053

• Angio/IR-76589

• CT-/72155

• US-76055

• Mammogram-71614

• MRI-77581

D. Information to be provided by the referring clinicians

1. Complete radiology procedure requests in CPRS.

2. Provide a brief history of why the radiological procedure is requested.

3. Include a valid telephone and/or pager number of the referring physician

4. Provider will call radiology at 70185/71634 for a STAT interpretation is needed.

5. Radiology Service require immediate access to the referring physicians for communication of reports needing immediate attention. If unable to locate the requesting provider, communication will be addressed according to the Critical

Results Policy, MCM 00-09.

E. Information to be provided by the radiologist

1. Communicate results of critical findings to the referring provider or designated physician on call for the service within 24 hours

2. Provide consultative services for providers who have questions about radiology procedures

3. Interpret routine procedure requests within 48hrs from receipt of the request (i.e.

request for radiological procedure

4. STAT requests will be interpreted within 1 hour.

5. Radiology exams results will be documented in patient records CPRS/VISTA

F. Scheduling- Angio / IR, CT, R/F, Mammogram, MRI and Ultrasound exams:

1. The listed exams will be scheduled by the Radiology Scheduling Department or a consult will be entered for patient who request the Mission Act by radiology and signed by the provider.

This agreement will be reviewed and renewed on an annual basis.

Michael Ginsburg, MD

MICHAEL I.

GINSBURG 273862

Digitally signed by MICHAEL

I. GINSBURG 273862

Date: 2020.02.21 15:12:14 -06'00'

Chief, Radiology Service

File details come from the government source that posted it. Updated .