Patient Care and Research

RO-ILS Participation

ROILS Process Overview


The RO-ILS Process Overview diagram summarizes the necessary enrollment steps to participate in RO-ILS and the cyclical nature of incident learning. Click on the image to the right to view in full size.

To Join RO-ILS:

  1. Download the Participation Guide. ASTRO membership is not required for RO-ILS participation; however, you do need a Web User ID to log in and download the Participation Guide. If you do not have a Web User ID, you can create one here
  2. Complete the Participation Form (Appendix F of the Participation Guide) and send to Clarity PSO. This will initiate the contracting process. 
  3. Sign a PSO Provider Service Agreement ("Agreement") with Clarity PSO. Upon receiving your Participation Form, Clarity PSO will send you an editable Agreement for your review. At this time you may propose changes and discuss the Agreement with Clarity PSO. A final Agreement will need to be signed and returned to Clarity PSO. Although there is no financial obligation to participate, practices must sign this Agreement with Clarity PSO to establish the federal protections outlined in the PSQIA. 
  4. Receive Training. Upon signing the Agreement, practices will receive training and login information from Clarity PSO, after which you may begin entering data.


Although there is no fee to participate, practices must sign a PSO Provider Services Agreement with Clarity PSO to receive the confidentiality and privilege protections outlined in the PSQIA. Only US-based practices are currently eligible to participate in RO-ILS. A signed Agreement will cover all reporting within that practice. In some instances, one Agreement may cover multiple facilities, for example when a practice sees patients at multiple locations. In this case, data can be viewed by location or in aggregate. Each facility could also choose to sign independent Agreements with Clarity PSO, in which case its data would be kept isolated from the other facilities in the practice. Please note, a practice can participate in more than one PSO. If you have specific questions regarding your contract, please contact Clarity PSO at radoncsupport@claritygrp.com or 708-667-7730.

View Contracting FAQs.


Once a practice has signed an Agreement with Clarity PSO, providers will receive access to the RO-ILS portal, housed on Clarity Group Inc. Healthcare SafetyZone platform.

The portal is divided into two sections: 

Individual roles can be determined and changed at any time after the PSO Provider Services Agreement is executed. Clarity Group, Inc. and Clarity PSO offer additional guidance regarding access to the RO-ILS portal at the time of contract signing.

  • "Submit Event"

  • The purpose of the “Submit Event” page is for any user to perform initial, front-line reporting. This page includes less than 10 questions and typically takes less between 5 and 10 minutes to complete. RO-ILS is structured to allow any provider who is part of the radiation oncology treatment team, including radiation oncologists, medical physicists, dosimetrists, nurses, technologists and practice administrators, to submit data. While it is up to each individual practice to decide who is responsible for submitting incidents, we recommend that the one general login information be distributed to all staff.
  • "My Review"

  • The “My Review” page is where users can enter follow-up analysis and eventually report the data to the PSO. This section includes more detailed questions, some of which may require investigation into the event, such as causal factors. The full-access logins were designed for “advanced users,” such as the chief physicist or medical director, who will play an active role in directing the practice’s patient safety activities. Per the Agreement, a practice will receive a total of two full-access logins.

Individual roles can be determined and changed at any time after the PSO Provider Services Agreement is executed. Clarity Group, Inc. and Clarity PSO offer additional guidance regarding access to the RO-ILS portal at the time of contract signing.

Data Elements

On the “Submit Event” page, front-line reporters will be asked to write a short narrative explaining the event, identify the event classification, treatment technique (if applicable), and provide other basic information. 

On the “My Review” page, advanced users are asked to enter more detailed event information such as the workflow steps involved, patient effects and contributing factors. For the full list of data elements, see Appendix B of the Participation Guide. 

The only patient specific information entered into RO-ILS is a patient’s age (as a range) and gender. Date and time of the event is also collected which may potentially correspond with a date of treatment. These elements were suggested by AHRQ in its common formats in order to facilitate standardized data collection and aggregation across all PSOs. Under the Health Portability and Accountability Act (HIPAA), PSOs are considered business associates of health care providers, and Clarity PSO signs business associate agreements with each of the RO-ILS participants. 

RO-ILS is largely consistent with other systems, such as the International Atomic Energy Agency's SAFRON (Safety in Radiation Oncology) and the Conference for Radiation Control Program Directors (CRCPD) report form structure.