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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:

Download and Review the Participation Guide
  • This guide provides an overview of the program and step-by-step instructions to help interested participants enroll in RO-ILS.
  • 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 now here.
Complete the Enrollment Form.
  • This form is also included as Appendix A of the Participation Guide.
  • Send the completed form to Clarity PSO to indicate interest in the program and initiate the enrollment process.
Enrollment is then divided into three stages:
  1. Contracting: A practice must first contract with Clarity to establish the confidentiality and privilege protections afforded by the Patient Safety Act. Practices enter into a PSO Provider Service Agreement and a Business Associate Agreement with Clarity PSO.
  2. Onboarding: Practices then receive on-demand trainings, designate local staff leaders, customize selected sections of the Portal and establish local policies and procedures.
  3. Implementation: Lastly, the practice incorporates RO-ILS into existing processes and deploys the program to all staff.


Although there is no fee to participate, contracting is a requirement of the Patient Safety Act. 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 sublocation (i.e., facility-level) or in aggregate (i.e., practice-level). 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 773-864-8280.


During onboarding, practices will receive access to the RO-ILS Portal, housed on Clarity Group Inc. Healthcare SafetyZone platform.

The Portal is divided into two sections with associated user accounts.

  • "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 only a few minutes to complete. RO-ILS is structured to allow any provider (including radiation oncologists, medical physicists, dosimetrists, nurses, technologists and practice administrators) to submit an event. The “Submitter” account is a general login that should be shared with all staff across the practice. This allows staff to submit events anonymously.
  • "My Review"

  • The “My Review” page is where specialized users within the practice, called "Reviewers" can enter follow-up analysis and eventually report the event to the PSO. This section includes more detailed questions, some of which may require investigation into the event, such as causal factors. The practice initially chooses who will be Reviewers during on-boarding, but this can be changed at any time. There is a limit of 10 Reviewers per facility.

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. They can also added/correct information provided by the Submitter with a log tracking any changes.

The only patient-specific data elements in RO-ILS are the patient’s age (as a range) and gender. Both data elements are optional and include an answer option of “unknown” or “report not patient related.” These data elements were selected based on guidance from AHRQ, which developed “common formats” to facilitate standardization of data collection and aggregation across all PSOs.

RO-ILS does not require submission of protected health information (PHI). Nevertheless, all practices participating in RO-ILS enter into a BAA as defined by the HIPAA with Clarity prior to reporting any safety information. In the event PHI is submitted to RO-ILS or reported to the PSO, the HIPAA requirements for sharing PHI are met. Users are still encouraged to not include identifiable information (e.g., patient or clinician name) in free-text data fields to safeguard anonymity.

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