VAC Clinic
- The fellow on call over the weekend should attend VAC clinic on Friday.
- The VAC NPs will send a list of the mini VAC conference and clinic schedule, usually by Thursday. The mini VAC conference typically starts at 7:15 am (, unless otherwise specified) and is run by the attending staffing clinic.
- Bring one of the IR portable US machines to the clinic before 7:15 am with enough supply of washcloths, US gel and disinfecting wipes.
- After clinic, bring the US machine back to IR after clinic. Give the list of the US studies performed during VAC to the board runner to create the exams and transfer images so you can dictate the studies.
- The VAC US studies are dictated separately from the clinic note like any standard PACS dictation using “Radstar and PowerScribe”.
Clinic Notes
- VAC clinic notes are documented in PowerCchart as“Vascular Anomalies Visit”.
- Make sure you choose the correct encounter with the correct date and attending name when opening the patient’s chart (see first image below).
- Once you are in the note, pick the attending name from “Associated providers” and choose the “Sign” option, not the default “review” option. Use this option only for clinic notes.
- The easiest way to create a note in PowerChart is to dictate into PowerScribe using a fake accession number (we can show you how to do this), then cut and paste into PowerChart.
Clinic / Office Visit Dictation Template
1. Always start with Title “Interventional Radiology Clinic Visit” or "Vascular Anomalies Clinic Visit".
2. Reason for visit = Immediate reason for visit (e.g. recent swelling and bruising, post-op follow up, etc). This is not the main history or HPI.
3. History
- HPI = “X is a 3-year old girl with a lymphatic malformation on the posterosuperior aspect of the left calf…”. –- REVIEW OF SYSTEMS: Positive or “Has been reviewed with the family and is otherwise negative”.
- PMH: Positive or “Noncontributory”
-PSH: Operations/interventions (+dates), or “Noncontributory”
- MEDICATIONS: List or “None”.
- ALLERGIES: List or “No known drug allergies”.
- IMMUNIZATIONS: Up to date.
- FAMILY HISTORY: Positive or “Noncontributory”
- PRIOR IMAGING STUDIES: +dates), labs, physical examination+ US.
4. PHYSICAL EXAMINATION: General and site specific. When relevant: Weight X kg, Temp X degrees Celsius, pulse X bpm, PB X/XX mmHg.
5. LIMITED ULTRASOUND EXAMINATION: (State “Limited” otherwise inaccurate billing.) Limited ultrasound exam of the ... was performed during this visit and will be reported separately. The study showed ...
6. PLAN/ RECOMMENDATIONS: “X has a residual macrocystic lymphatic …… amendable to sclerotherapy, will be scheduled for ……GA/Sedation, more imaging, no treatment needed, FU (in x time), etc. .
7. Thank you note.
Thank you for allowing us to participate in the care of ….If you have any questions, please do not hesitate to contact us.
Sincerely,
5. Clinicians: e.g.
..., MD (IR Attending Physician).
..., MD (IR Fellow).
Division of Vascular and Interventional Radiology.
Boston Children's Hospital.
300 Longwood Avenue.
Boston, MA 02115.
Office: 617-355-6221.
Scheduling: 617-355-6579.
Fax: 617-730-0541.
The total face-to-face time with this patient was ... minutes, not including the time required for reviewing or performing imaging studies. Greater than 50% of face-to-face time was spent providing counseling on the treatment options, risks and benefits of treatment options and plan for follow up.
I, the attending physician, saw and evaluated the patient and performed the ultrasound study. I agree with the fellow's findings as written.
2. Reason for visit = Immediate reason for visit (e.g. recent swelling and bruising, post-op follow up, etc). This is not the main history or HPI.
3. History
- HPI = “X is a 3-year old girl with a lymphatic malformation on the posterosuperior aspect of the left calf…”. –- REVIEW OF SYSTEMS: Positive or “Has been reviewed with the family and is otherwise negative”.
- PMH: Positive or “Noncontributory”
-PSH: Operations/interventions (+dates), or “Noncontributory”
- MEDICATIONS: List or “None”.
- ALLERGIES: List or “No known drug allergies”.
- IMMUNIZATIONS: Up to date.
- FAMILY HISTORY: Positive or “Noncontributory”
- PRIOR IMAGING STUDIES: +dates), labs, physical examination+ US.
4. PHYSICAL EXAMINATION: General and site specific. When relevant: Weight X kg, Temp X degrees Celsius, pulse X bpm, PB X/XX mmHg.
5. LIMITED ULTRASOUND EXAMINATION: (State “Limited” otherwise inaccurate billing.) Limited ultrasound exam of the ... was performed during this visit and will be reported separately. The study showed ...
6. PLAN/ RECOMMENDATIONS: “X has a residual macrocystic lymphatic …… amendable to sclerotherapy, will be scheduled for ……GA/Sedation, more imaging, no treatment needed, FU (in x time), etc. .
7. Thank you note.
Thank you for allowing us to participate in the care of ….If you have any questions, please do not hesitate to contact us.
Sincerely,
5. Clinicians: e.g.
..., MD (IR Attending Physician).
..., MD (IR Fellow).
Division of Vascular and Interventional Radiology.
Boston Children's Hospital.
300 Longwood Avenue.
Boston, MA 02115.
Office: 617-355-6221.
Scheduling: 617-355-6579.
Fax: 617-730-0541.
The total face-to-face time with this patient was ... minutes, not including the time required for reviewing or performing imaging studies. Greater than 50% of face-to-face time was spent providing counseling on the treatment options, risks and benefits of treatment options and plan for follow up.
I, the attending physician, saw and evaluated the patient and performed the ultrasound study. I agree with the fellow's findings as written.
Please make sure clinic visits in IR or VAC are properly categorized as Consultation, New Patient or Established Patient.
The most important part is deciding whether to report the visit as New Patient vs. Consultation is about the INTENT.
Consultation = The referring physician asks your opinion about diagnosis or treatment.
New Patient = If the diagnosis and treatment are known and referring physician wants you to handle or transfer care. Patients who haven’t been seen within the past 3 years by the same specialty are New.
The templates are available in PowerScribe. Attached document provides further details about format, headings, proper attestations, QCC.
· Clinic Visit -VAC 2017
· Clinic Visit -IR 2017
· Consultation -VAC 2017
· Consultation -IR 2017
The most important part is deciding whether to report the visit as New Patient vs. Consultation is about the INTENT.
Consultation = The referring physician asks your opinion about diagnosis or treatment.
New Patient = If the diagnosis and treatment are known and referring physician wants you to handle or transfer care. Patients who haven’t been seen within the past 3 years by the same specialty are New.
The templates are available in PowerScribe. Attached document provides further details about format, headings, proper attestations, QCC.
· Clinic Visit -VAC 2017
· Clinic Visit -IR 2017
· Consultation -VAC 2017
· Consultation -IR 2017
Clinic Visit Template in Powerscribe

Instructions for Clinic Visit Template in Powerscribe |