UCSD Musculoskeletal Radiology bonepit.com Procedures

Consults at the VA

1. New Consult sheets will be placed in the upper bin on the Bonepit door
2. Take the sheets out and go to one of the VA stations
3. Read the consult to see what is requested (steroid injection, joint aspiration, biopsy)
4. Review the relevant imaging on VA PACS
5. If the procedure is warranted, write “Schedule (procedure name)” and your name on the front sheet next to the current date and time…put consult back in upper box on door
   1. The IR nurses will then schedule the patient for the procedure
   2. You must also update the Consult in CPRS
   3. Open CPRS (you will need a username and password)
   4. Select patient using first letter of last name and last 4 digits of social security number
   5. Select “Consults” tab from tabs at bottom of screen
   6. Select the appropriate consult from the list on the right (look for Interventional Radiology)…consult will open on left
   7. Select “Action” from toolbar at top left
   8. Select “Consult Tracking”…select “Add comment”
   9. When window opens, type in something like “Chart and images reviewed. Will schedule patient for right shoulder steroid injection.”…hit OK
6. If procedure is NOT warranted, you will need to contact the ordering physician (see pager number listed near top of front sheet on consult) and discuss it with them
   1. If procedure is to be cancelled, you have to complete the consult
   2. Go to “Consults” tab at bottom, select “Action” from top left toolbar, select “Consult Results”, select “Complete/Update Results”
   3. When 1^st window opens, select any date and appointment (it doesn’t really matter)
   4. “Consult Note Properties” window will open…type rad…select RAD <CONSULT/RAD/RADIOLOGY/INTERVENTIONAL RADIOLOGY> (or any Rad note…again, it doesn’t matter)
   5. When new note window opens, type in that the consult is being cancelled, reason why, and that you discussed it with the referring doc…right click and select “Sign Note Now”, sign note with signature code
   6. Finally, write down on the front sheet of the consult that it is being cancelled and that you talked to the doc (so the IR nurses know not to schedule it)
7. When you actually complete the procedure that is being requested, you have to complete a couple things in CPRS to finish the consult
   1. Dictate the procedure as you normally would
   2. Write a quick note in CPRS that the procedure was completed and say see dictation for details

                                                              i.      Log-in to CPRS

                                                            ii.      Select patient

                                                          iii.      Select “Notes” tab, click “New Note” button in bottom left

                                                          iv.      If challenged with an Encounter box, pick any date with any appointment (it doesn’t really matter)

                                                            v.      Type rad, and select Radiology note

                                                          vi.      Type note…right click, select Sign Note Now…sign note with signature code (it will be the same as the first password you used for CPRS)

3. Now, you must complete the consult

                                                              i.      Go to “Consults” tab at bottom, select “Action” from top left toolbar, select “Consult Results”, select “Complete/Update Results”

                                                            ii.      When 1^st window opens, select any date and appointment (it doesn’t really matter)

                                                          iii.      “Consult Note Properties” window will open…type rad…select RAD <CONSULT/RAD/RADIOLOGY/INTERVENTIONAL RADIOLOGY> (or any Rad note…again, it doesn’t matter)

                                                          iv.      Write that the procedure was completed, right click and select “Sign Note Now”, sign note with signature code.

4. You’re finally finished with the consult…weep and rejoice