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ASTRO and AAPM announce launch of RO-ILS: Radiation Oncology Incident Learning System

Fairfax, Va., June 19, 2014 The American Society for Radiation Oncology (ASTRO) and the American Association of Physicists in Medicine (AAPM) today announced the launch of RO-ILS: Radiation Oncology Incident Learning System, a new, national patient safety initiative to facilitate safer and higher quality radiation oncology care. Announced at a Congressional Briefing today in B-339 of the Rayburn House Office Building on Capitol Hill, and co-hosted by U.S. Representatives Frank Pallone, (D-N.J.) and Ed Whitfield (R-Ky.), ASTRO Chair Colleen A.F. Lawton, MD, FASTRO, and John E. Bayouth, PhD, president of AAPM, unveiled the details of RO-ILS. Comments and perspective were also provided by Jeffrey Brady, MD, MPH, director of the Center for Quality Improvement and Patient Safety at the Agency for Healthcare Research and Quality (AHRQ).

Leaders from ASTRO and AAPM have worked together to develop RO-ILS, an online portal that will allow radiation oncology centers to provide non-patient-specific data about the radiation therapy near-misses and safety incidents that have occurred at their facility in a secure, non-punitive environment. RO-ILS is the only medical specialty society-sponsored radiation oncology incident learning system within a federally recognized Patient Safety Organization (PSO), Clarity PSO. Data collected in RO-ILS will educate the radiation oncology community about how to improve safety and patient care. The RO-ILS platform will provide centers with the ability to track and to analyze their data through a secure online interface. There are no fees for radiation therapy centers to participate in RO-ILS. RO-ILS can be used as a stand-alone incident learning system or as a complement to an institution's existing system. A panel of experts chosen by ASTRO and AAPM, called the Radiation Oncology Healthcare Advisory Council (RO-HAC), will work with Clarity PSO, the independent PSO contracted to develop and to administer RO-ILS, to analyze the aggregate data and to inform radiation oncology safety procedures and processes, best practices, practice guidelines and/or recommendations.

"We are excited to partner with AAPM on the launch of RO-ILS, a centerpiece of ASTRO's Target Safely initiative that demonstrates our commitment to safe and high quality radiation oncology treatment," said Dr. Lawton, chair of ASTRO's Board of Directors. "The complex and highly specialized radiation care we deliver to cure cancers and to treat more than one million patients each year requires that we be continually vigilant to ensure the safety of our patients and our radiation oncology care team. We are grateful that Congress, through the Patient Safety and Quality Improvement Act of 2005, provides us with the necessary protections to use RO-ILS to gather invaluable patient safety information as we strive to provide the safest and highest quality radiation treatments. One error is too many, and learning from near-misses is crucial to averting errors."

"We take great pride in our integral role in the radiation oncology treatment process, and we are pleased to have developed RO-ILS with our ASTRO partners to promote the safe delivery of radiation therapy treatments," said Dr. Bayouth, president of AAPM. "RO-ILS is an exceptional endeavor that will provide enormous returns for our collective knowledge. The entire radiation oncology care team is devoted to the utmost accuracy and safety for the complex radiation therapy process. RO-ILS will support our achievement of these critical goals."

"I applaud ASTRO and AAPM for their leadership in creating RO-ILS to safeguard radiation therapy care, and it is particularly meaningful that physicians and physicists have led the way to proactively protect patients with an incident learning system," said Rep. Pallone.

Rep. Whitfield added, "I am pleased that ASTRO and AAPM have partnered to tackle the important task of improving the safety and quality of radiation therapy treatments, thereby advancing radiation oncology care for our nation's cancer patients."

AHRQ's Dr. Brady noted the importance of learning from near misses and adverse events. "Patient safety events are often too rare for a facility to identify causal factors with certainty," he said. "Each provider benefits from the insights that it can obtain from PSOs that aggregate large volumes of event data from multiple providers." The PSO program continues to grow, with 80 PSOs currently listed in 29 states and the District of Columbia, according to the AHRQ PSO website,

RO-ILS is a key milestone in ASTRO's Target Safely campaign, a patient protection plan to improve safety and quality for radiation oncology. PSOs, established by the Patient Safety and Quality Improvement Act of 2005 (PSQIA), facilitate the reporting and analysis of safety events by offering legal and confidentiality protections to U.S.-based practices. ASTRO has contracted with Clarity PSO, one of the earliest organizations to be federally qualified as a PSO, to build the online interface and to provide the affiliated patient safety services outlined in PSQIA.

RO-ILS began with an initial testing and evaluation period in September 2013 with a select number of testing sites who have served as early adopters of the system. The early adopters include a variety of practice settings located across the country: large academic centers, community hospitals and freestanding clinics. In order to ensure a comprehensive assessment of the program, early adopters experienced the full participation processfrom signing the necessary contract with Clarity PSO to RO-ILS training, data submission and analysis.

RO-ILS also includes a Practice Quality Improvement (PQI) template as a free companion to the RO-ILS portal. The RO-ILS PQI template is qualified for physicians and physicists by the American Board of Radiology (ABR) in meeting the criteria for practice quality improvement, toward the purpose of fulfilling requirements in the ABR Maintenance of Certification Program. As a PQI project, radiation oncology practices participating in RO-ILS will complete two consecutive cycles of the four-part Plan-Do-Study-Act (PDSA) process for quality improvement using the RO-ILS online portal to submit and internally track events. The first PDSA cycle will help radiation oncology practices to set baseline data, to evaluate their performance and to develop a quality improvement plan. The second PDSA cycle will remeasure their performance with regard to this quality improvement plan and assess whether the goals have been achieved.

Clarity PSO is a division of Clarity Group, Inc., a healthcare professional liability risk management organization. Neither Clarity PSO nor Clarity Group, Inc. is affiliated with ASTRO; they are independent entities providing PSO services to the radiation oncology practices enrolled in RO-ILS.

Detailed information about RO-ILS and participation forms are available at


Contact: Michelle Kirkwood
American Society for Radiation Oncology

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