Monday May 21 , 2012
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Scheduler

Scheduler Guidelines

This page is constantly being updated.  Send suggestions or questions to aafari@gmail.com (310-508-0784)

PACS User Guidelines (for all user) are here.

Assigned Personelle - Editing/Viewing:

  1. Select any particular study (left mouse button, 1 click)

  2. Click "i" button on the top for "information."

  3. Click the second tab on the top of the "Study Info" Window called "Assigned Personelle."  These are the assigned personelle that are assigned to the particular study (Referring Physician, Reading Physician/Radiologist, Performing Tech, Transcriptionist, Performing doc, consulting physician, etc.....)

  4. Make sure that that each assigned personell has the "Details" button to the right.  If they don't, they haven't been properly detailed and registered in the Ramsoft system!!!  Any time a new person has been put into the system, THEY MUST BE PROPERLY DETAILED.

  5. All assigned personelle must have last name, first name, email, cell phone, business phone, fax.

  6. All referring docs must have their reporting preferences checked off.  Autofax or autoemail.

  7. Additional information should include the referring doctor's specialty and any particular preferences they have.


DOCUMENT ATTACHING

  1. pacs.archrad.com

  2. Login as a PowerReader (Not referring portal)

  3. Worklist - Choose "All Statuses" or whatever list you like to create.

  4. Find the study by date, name, ID, accession, etc...

  5. Click on the documents icon (usually blue or white) on the same row as the study.

  6. Click on "Attach" button at the bottom.

  7. Browse at select the file (Word, PDF, JPG) you want to attach.

  8. Make sure the document is attached upright.

  9. You can rename the Name if you like.

  10. You can put the Type to Clinical, etc...

  11. Save.

Errors in Signed Reports (Header or Title)

  1. Scheduler can cut/past the report on to a blank letterhead and correct header info ONLY (Name, DOB, Referring Name).

  2. Don't change the history, technique, findings, or impressions.

  3. You can send corrected header info to referring without asking radiologist.

  4. You can attach to the study on PACS (Ramsoft) using the Document Attaching Instructions if the site chooses.

  5. For STAT corrections, call radiologist at 800-626-8315.

Errors in Signed Reports (History, Technique, Findings, Impressions)

  1. Click on the study to highlight it.

  2. Click "i" for information

  3. In the comments section, place the error that has occured

  4. Push the study to VERIFIED STATUS so it goes back into the front of the radiologists' queue.

  5. For STAT corrections, call radiologist at 800-626-8315.


ORDER ACCEPTANCE SUGGESTIONS - EXACT RULES ARE AS PER THE ENTITY BILLING THE "TECHNOLOGY COMPONENT" OF THE EXAMINATION:


General Rules:

  1. "Compliance" means that we are following the rules for the state, federal government, and the Payors that we are contracted with when accepting studies and scanning patients.  Various payor have different compliance rules.  Most of their info can be found on their website, but in general, you want to make sure that studies are scanned in accordance with state, federal, and payor rules.

  2. Did the referring provide a clinical indication (history) for the type of study being requested???

    1. If you're not sure, use your best judgement and check the list of common indications at AfariRadiology.com

    2. If you're not sure if the indication is compliant, discuss it with the biller/coder that is billing for the study.

    3. If you are still unsure, ask the radiologist.

  3. Physician signature?  Order form should have text for attestation of medical necessity.

  4. Do we have the name of the test ordered appropriately?

  5. Do we have the most recent MD's progress note with History and physical?  Suggested but not required.

  6. Do we have the correct contact info for referring party?  Name, Fax, Phone, Emergency Phone (Mobile), SMS.  This should be input into Ramsoft.

  7. If there are multiple orders on one order sheet - does each exam have a compliant history/indication/icd-9?  See #2 for questions.

  8. CLICK HERE TO GO TO THE Payors & Insurances Page.

    1. Make sure that you are following pre-authorization rules prior to scanning.  Check with the payor for the latest rules.  If there are any updates to the page needed, contact us.

    2. See if we are in or out of network.

ORDERING/SCHEDULING AN EXAM IN RAMSOFT:

  1. Does the patient already exists?

  2. Search button type right. Advanced search top right. Second tab (patient's)

  3. Enter the last name. Static search top left.

  4. If the patient does not exist, click "File" and click "New Patient"

  5. Enter all of the demographic information:

    1. Patient ID (Number needs to be unique)

    2. Suffix (MR, MRS, MS) is not necessary

    3. Birth date and sex are mandatory

    4. Save.

  6. Search for patient again.  Select the correct patient.  Click “New Study” on the top middle row.

  7. Enter new study information.

    1. Priority, Status (Ordered = no time/date, Scheduled means know time/date), Study Description, Study ID, Accession Number (Unique to study), Date/time, Modality, Department (Flag Payor if Needed), ROOM (Flag Medicare or Other Payors if needed), FACILITY (ODI OR SIG).

  8. Top tab "Assigned Personelle".  Add all the appropriate assigned personelle to the study.  Referring, Consultants, Techs, etc....

  9. Referring Detailed?  Type last name (if already a known referring) it will already be in the system.  If this is a new referring physician, click New on the right and enter the referring physicians information. DO NOT JUST ENTER TEXT.  Each Referring must be fully entered and "Detailed" on the system or they will NOT receive a report.  Must include phone/fax/email.

  10. ATTACH SUPPORTING DOCUMENTS.

    1. Physician Order

    2. Patient Questionnaire.  Make sure all non-english has been translated to english by a professional medical interpreter!

    3. Latest History & Physical Exam.  Obtain this from the referring MD.

    4. Insurance Card

    5. Any other supporting documents needed.Documents button below.  Attach documents (Physician Order, Patient Questionnaire, Prior History/Physical, Insurance Card, etc…).  Save.

  11. Do Prior Images/reports exist (any institution)?

    1. If YES,

      1. Pull Old Studies into Ramsoft PACS (see "Remote Study Retrieval" instructions)

      2. Make sure that old images have the old report attached to them.

    2. If NO,

      1. Click on the study

      2. Click "i" for information

      3. Comments section:  write "no prior images/reports" and your initials

  • (PENDING) When patient arrives, change status from Scheduled to Arrived.  The Modality (CT, PT, MR, etc.) will then be able to retrieve dicom information from the local Gateway Router Computer.  Order image MUST be attached or it won't work.

    • PAYOR TYPE SELECTION:

    1. Click on the study (left mouse click once)
    2. Click on "i" for information (top of screen)
    3. For Department, select "Payor"
    4. For Room, select "MEDICARE" or whatever the payor type.

    PERSONNEL ASSIGNMENT:

     

      Click on the study once

    1. Click on "i" button on top for information.
    2. Click on Assigned Personelle Tab on the top.
    3. Make sure all the assigned personelle are correct.
    4. Don't just type in random text and hit tab.  If you don't see the physician as a registered referring (drop down), hit the create new Referring.

    Personelle Creation:

    1. When new referrings are created, they need a group.

    2. Select Settings

    3. Select "users and facilities"

    4. Select Referrers Tab

    5. Find the New Username (it usually comes up as the first initial and then the last name.  For Example John Smith will usually be jsmith)

    6. Assign to a Group such as "Own Studies Only" or the name of their group so they can access their entire groups' studies.

    7. Make their password equal to first initial and last name (such as jsmith).  They can change it later.  If they don't have a password, they won't be able to see cases online!

    8. Make sure their email is entered.

    9. Make sure their fax/phone numbers are entered.

    10. Enter their reporting preferences.  Click AutoFax or AutoEmail and reports will go to them automatically when signed.

    11. In the comments section, you can write their specialty or personal preferrences.

    PRIOR IMAGES - UPLOADING THEM TO RAMSOFT

      Place CD into the computer which has the Ramsoft Gateway Router software installed on it.

    1. Open the Ramsoft Gateway Router Software.  Username:  ADMIN; Pass:  ADMIN
    2. Select File/Import/DICOM Folder
    3. Try finding the DICOM files on the CD
    4. Select Push (2nd Panel, 5th button)
    5. Push to ArchPACS.

    Priority Changes in reading order:

    1. Right click the study
    2. Click priority
    3. Click STAT
    4. The study will become red color and radiologist will read it faster.
    5. If it can not wait hours, then call radiologist on-call at 800-626-8315 as well.

    REMOTE STUDY RETRIEVAL:

    1. Search
    2. Advanced Search
    3. Click on "Remote Studies" tab
    4. Select the remote location you want to pull from...
    5. Click on "Request" (top)
    6. The study will be retrieve from the remote station into the Ramsoft PACS

    Reports - Addendum or Change Needed:

    1. Search for the study of interest.
    2. Right click study and move it from SIGNED to VERIFIED.
    3. Click "i" for information on the top.
    4. In the comments section (bottom right) explain what is wrong with the report.
    5. Radiologist will see studies in the VERIFIED queue and take care of them.

    REPORTING RESULTS (TO REFERRINGS) AUTOMATICALLY:

    1. Click on "i" information button - Study Info Detailed
    2. Click on "Assigned Personelle" tab on the top.
    3. Click on "Referring Physician" "Details" button.
    4. Enter email and or fax number, phone, mobile phone, reporting preferences, etc...
    5. Check AutoEmail FINAL or AutoFAX FINAL.
    6. Notes section for extra notes about what the doctor wants.
    7. When the study is SIGNED, the email or fax will get sent out.

    REPORTING OUT RESULTS MANUALLY:

    1. Click on "i" information button - Study Info Detailed
    2. Click on "Assigned Personelle" tab on the top.
    3. Click email button to the far right of the assigned personnel's name to send email (Outlook or outlook express needs to be setup)

    Retrieving Remote Studies

    1. Click Search (top right)
    2. Click Advanced search (top)
    3. Click Remote Studies (3rd tab)
    4. Select the remote station
    5. Enter last name or search parameters
    6. Click Start Search (top left)
    7. To pull a study to Ramsoft, highlight the study and hit "Request" (top)

    Searching for Studies:

    1. Click the button on the top right button "Search"
    2. Enter the accession number, name, etc...You can use part of a name for faster searching.  Entering "gom" will return everyone with the last name starting with "gom" such as gomez.
    3. Click on the "Start Search" button on the top left.
    4. Sometimes you have to click on "Retrieve Next Set" (3rd row, 4th button) if there are > 1000 results.

    Transmission of Images Failed:

    1. Make sure that images were sent from the modality to the local Gateway Router software.  Try again.
    2. If images made it to local Gateway Router but not to ARCHPACS, then pull the images to Ramsoft PowerServer ARCHPACS.
      1. Within the Ramsoft PowerReader hit Search (Top Right)
      2. Remote Studies (3rd Tab)
      3. Station = Local Gateway Name such as SIG-GR or ODI-GR
      4. Study Date (today) and (today) or whatever date.
      5. Start Search (Top Left)
      6. Click on the Study or Studies
      7. Request (Top, 4th Button)
      8. Check worklist and see if it wall manually pulled from Local Gateway to ARCHPACS
    3. Report your findings to:  support@ramsoft.com, aafari@gmail.com, Site Manager, and Local IT to investigate the etiology and prevent future occurences immediately.  Do not wait.

    Workflow

    1. SCHEDULER receives Order, H&P, Authorization, etc. and creates ORDERED or SCHEDULED (date/time known).
    2. When the patient shows up, SCHEDULER advances status to ARRIVED and the patient information populates the modalities.
    3. After the images are acquired, the TECHNOLOGIST pushes the study to the Ramsoft Gateway Local Router Archive (and Ramsoft Remote ARCHPACS) and study is received as COMPLETE.
    4. TECHNOLOGIST double checks documents and images on Ramsoft PACS and advances the status to VERIFIED.
    5. RADIOLOGIST interprets images and advances status to SIGNED.
    6. SIGNED triggers the images, documents, and reports to be backed up at the ODI-GR Local Archive.
    7. SIGNED reports are REPORTED (email/fax) to REFERRING.
    8. Billing can modify status to BILLED on either the LOCAL Gateway Archive (Unlimited time) or on ARCHPACS (limited time).
    9. Local ODI Gateway Router can Archive Images, Documents, Reports (Unlimited Time/Volume)
    10. Remote ARCHPACS can Archive Images, Documents, Reports (Limited Time/Volume.
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