SBRT presence

[RickyScott]

physicist out with mild case of virus. Been in the field for a while but never seen the actual regulations regarding physics presence during SBRT. Are these state or CMS or just best practices?

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[medgator]

Best practices i think.

Not the same as if we are talking GK or HDR which falls under NRC regs

 

[Gfunk6]

Agree with gator. It is considered mandatory to maintain ACR or APEX accreditation, but otherwise best practice.

However, as we've seen in the pandemic era, a lot of "ironclad" lines in the sand have been thrown out the window . . .

 

[medgator]

Agree with gator. It is considered mandatory to maintain ACR or APEX accreditation, but otherwise best practice.

However, as we've seen in the pandemic era, a lot of "ironclad" lines in the sand have been thrown out the window . . .

No reason you can't tele supervise sbrt currently if the conditions call for it. Best practice is still to be there obviously, but it probably isn't feasible at all practices currently

 

[RadOncDoc21]

No reason you can't tele supervise sbrt currently if the conditions call for it. Best practice is still to be there obviously, but it probably isn't feasible at all practices currently

From what I read, this is actually acceptable of course worst case scenario. Honestly, this could be something we could possibly implement in the future. I interviewed at a shady practice in TX where the doc viewed the images “online” prior to delivery of treatment.

At the time, it wasn’t kosher but technically not something that I would consider to be “bad practice.”

 

[evilbooyaa]

No reason you can't tele supervise sbrt currently if the conditions call for it. Best practice is still to be there obviously, but it probably isn't feasible at all practices currently

This is only b/c of COVID-19 right? Does it require video chatting to the therapists at the console?

 

[medgator]

This is only b/c of COVID-19 right? Does it require video chatting to the therapists at the console?

View attachment 302052

"Tele" presence per the CMS definition for direct supervision requires real time AV communication. Of course this doesn't really apply to hospital based anything these days right, since it went "general" supervision in Jan 2020 (?)

 

[evilbooyaa]

"Tele" presence per the CMS definition for direct supervision requires real time AV communication. Of course this doesn't really apply to hospital based anything these days right, since it went "general" supervision in Jan 2020 (?)

I thought SBRT and brachytherapy were still not under 'general' supervision and required direct? Or was that institutional policies that made that distinction

 

[medgator]

I thought SBRT and brachytherapy were still not under 'general' supervision and required direct? Or was that institutional policies that made that distinction

Institutional i think... Maybe @scarbrtj can weigh in further. Unless you are doing electronic brachy, NRC regulations would kick in and you need to be at the console while treating brachy