Current through Register Vol. XLI, No. 25, June 21, 2024
Section 11-9-14 - Radiologist Assistant Utilization14.1. The tasks a radiologist assistant may perform are those which require technical skill, execution of standing orders, routine radiologic tasks and procedures which the supervising radiologist may wish to delegate to the radiologist assistant after the supervising radiologist has satisfied himself or herself as to the ability and competence of the radiologist assistant. The supervising radiologist may, with due regard for the safety of the patient and in keeping with sound medical practice, delegate to the radiologist assistant those radiologic procedures and tasks that are usually performed within the scope of the practice of radiology, subject to the limitations set forth in this rule at section eight (8) and the West Virginia Medical Practice Act, W. Va. Code § 30-3-1 et seq. and the training and expertise of the radiologist assistant.14.2. The radiologist assistant shall, under the appropriate direction and supervision by a radiologist, augment the radiologist's data gathering abilities in order to assist the supervising radiologist in reaching decisions and instituting plans of care for the radiologist's patients. A radiologist assistant shall have, the knowledge and competency to perform the following functions and may under appropriate supervision perform them; the standard job description is not meant to be specific or all-inclusive: a. Review patient medical record to verify the appropriateness of a specific exam or procedure and report significant findings to radiologist.b. Interview patient to obtain, verify, and update medical history.c. Explain procedure to patient or significant others, including a description of risks, benefits, alternatives, and follow-up. Patient must be able to communicate with the radiologist if he/she requests or if any questions arise that cannot be appropriately answered by the radiologist assistant.d. Obtain informed consent. Patient must be able to communicate with the radiologist if he/she requests or if any questions arise that cannot be appropriately answered by the radiologist assistant.e. Determine if patient has followed instructions in preparation for the examination (e.g., diet, premedications).f. Assess and review with the radiologist the risk factors that may contraindicate the procedure (e.g. health history, medications, pregnancy, psychological indicators, alternative medicines).g. Obtain and evaluate vital signs.h. Apply ECG leads and be able to recognize life threatening abnormalities.i. Perform urinary catheterization. Catheterization can be performed by appropriately trained radiologist assistants under general supervision. If a patient is known to have an anatomic anomaly, recent surgery in the area, etc., direct supervision would be needed.k. Monitor IV for flow rate and complications in compliance with facility and regulatory rules.l. Position patient to perform required procedure, using immobilization devices and modifying technique as necessary. Application of restraints should be in compliance with departmental rules and regulations.m. Assess patient's vital signs and level of anxiety/pain and inform radiologist when appropriate.n. Recognize and respond to medical emergencies (e.g. drug reactions, cardiac arrest, hypoglycemia) and activate emergency response systems, including notification of the radiologist.o. Administer oxygen as prescribed.p. Operate a fixed/mobile fluoroscopic unit.q. Assure documentation of fluoroscopy time.r. Explain effects and potential side effects to the patient of the radiopharmaceutical and contrast media required for the examination.s. Administer medications, including conscious sedation medications, only under the personal supervision of the supervising radiologist.t. Under direct supervision, meaning the radiologist must be present in the office suite and immediately available to furnish assistance and directions throughout the performance of the procedure, may perform the following fluoroscopic examinations and procedures including contrast media administration and operation of fluoroscopic unit: 1. hysterosalpingogram (imaging only)3. contrast injection into joint for MR or CT arthrogramu. Under general supervision, may perform the following fluoroscopic examinations and procedures including contrast media administration and operation of fluoroscopic unit: 7. retrograde urethrogram8. nasoentric and oroentric feeding tube placement12. lower extremity venography13. ductogram (galactogram)v. Evaluate images for completeness and diagnostic quality, and recommend additional images as required in general radiography, CT or MR. (Additional images only in the same modality such as additional CT cuts.)w. Evaluate images for diagnostic utility and report observations to the radiologist in general radiography, CT, and MR.x. Review imaging procedures, make initial observations, and communicating observations only to the radiologist.y. Communicate radiologist's reports to referring physician consistent with American College of Radiology Communication Guidelines.z. Provide physician-prescribed post care instructions (no medicines) to patients.aa. Perform follow-up patient evaluation and communicate findings to the radiologist.bb. Document procedure in appropriate record and document exceptions from established protocol or procedure.cc. Write patient discharge summary for review and co-signature by radiologist.dd. Participate in quality improvement activities within radiology practice (e.g. quality of care, patient flow, reject-repeat analysis, patient satisfaction).ee. Assist with data collection and review for clinical trials or other research.ff. Perform specialized CT/MR post processing.14.3. A radiologist assistant making application to the Board of Medicine for job description changes or additions shall document that his or her training and competency supports the request.14.4. If the supervising radiologist absents himself or herself in such a manner or to such a manner or to such an extent that he or she is unavailable to aid the radiologist assistant when required, the supervising radiologist shall not delegate tasks to his or her radiologist assistant unless he or she has made arrangements for another supervising radiologist. The legal responsibility for the acts and omissions of the radiologist assistant remains with the supervising radiologist at all times.14.5. It is the responsibility of the supervising radiologist to ensure that supervision is maintained in his or her absence.14.6. Designated representatives of the Board of Medicine are authorized to make on-site visits to the offices of supervising radiologists and facilities utilizing radiologist assistants to review the following:a. The supervision of radiologist assistants.b. Utilization of radiologist assistants in conformity with the provisions of this section.c. Identifications of radiologist assistants.d. Compliance with certification requirements.14.7. The Board of Medicine reserves the right to review radiologist assistant utilization without prior notice to either the radiologist assistant or the supervising radiologist. It is a violation of this rule for a supervising radiologist or a radiologist assistant to refuse to undergo a review by the Board of Medicine.14.8. The provisions of this section may not be construed to require medical care facilities or radiologists to accept radiologist assistants or to use them within their premises. It is appropriate for the radiologist assistant to provide services to the hospitalized patients of his or her supervising radiologist under the supervision of the radiologist, if the health care facility permits it.14.9. Radiologist assistants employed directly by health care facilities shall perform services only under the supervision of a clearly identified supervising radiologist. 14.10. It is the supervising radiologist's responsibility to be alert to patient complaints concerning the type or quality of services provided by the radiologist assistant.14.11. In the supervising radiologist's office and any office in which the radiologist assistant may function, a notice plainly visible to all patients shall be posted in a prominent place explaining the meaning of the term "Radiologist Assistant". The radiologist assistant's certificate must be prominently displayed in any office in which he or she may function. A radiologist assistant may obtain a duplicate certificate from the Board of Medicine if required.14.12. The radiologist assistant is required to notify the Board of Medicine of changes in his or her employment within thirty (30) days. The radiologist assistant must provide the Board of Medicine with his or her new address and telephone number of his or her residence, address and telephone number of employment and name of his or her supervising radiologist.14.13. The supervising radiologist is required to notify the Board of Medicine of any changes in his or her supervision of a radiologist assistant within ten (10) days.