THE AMSP PROCESS AND PROTOCOL

Asbestos workers presenting to the MTF for medical surveillance follow MTF Asbestos Surveillance Process. After registering, NAVMED 6260/5 sections 1 and 2 are completed by the worker, weight, height, and spirometry data are entered by the staff, and the remaining information is completed by the provider. The form is scanned, the original is placed in the worker's employee health record, and the scanned forms are sent to NMCPHC via DoD Safe to: usn.hampton-roads.navmcpubhlthcenpors.list.nmcphc-amsp@mail.mil  Completed forms must not be saved on the local computer, as it contains personal health information covered by Health Insurance Portability and Accountability Act of 1996 (HIPAA).

B reading protocol for workers exposed to ASBESTOS or SILICA
For workers due for a B reading chest X-ray (see NMCPHC - TM OM 6260 Medical Surveillance Procedures Manual and Medical Matrix), NAVMED 6260/7 section 1 is completed (see AMSP Forms and Instructions), and is reviewed by MTF staff for accuracy and completeness. A single view, posterior-anterior (PA) chest X-ray is obtained and reviewed by the local radiologist. The digital image, along with the chest X-ray images of other asbestos workers at the MTF, is copied to a CD/ DVD. (This is generally done by Radiology but may be done by the Occupational Health clinic, depending on local policy.) If two exposures were required to obtain the PA chest image (i.e., the person is so large that two exposures were necessary to cover the entire chest), count these two images as one chest image, and prepare one NAVMED 6260/7. As few discs as possible are to be used: There are to be no fewer than 2 images per disc (unless the MTF has had only a single X-ray in a month) and no more than 100 images per disc. Once a month or after the MTF has 100 images (whichever comes first), the MTF contacts NMCPHC for authorization, which is required to obtain a B reading.

Authorization is obtained as follows. Using this SAMPLE MEMO, a request is sent to NMCPHC at usn.hampton-roads.navmcpubhlthcenpors.list.nmcphc-amsp@mail.mil. (The UIC in the memo is the MTF’s UIC shipping the chest image CD.) The exact number of radiograph evaluations requested is to be in the memorandum from NMCPHC. (The number of B readings is not to be estimated; the request must include the actual number of B reading X-rays that already have been done.) For silica workers, NAVMED 6260/5 is not used.

All the NAVMED 6260/7 forms and the CD/ DVD with their corresponding chest X-ray images are to be sent in the same package. Forms should be stacked in the order the corresponding image is listed on the CD/ DVD. The NMCPHC Memorandum authorizing the B readings is to be included. Mark the envelope Confidential.

The B reader will not make comparisons with old images. Radiology reports, other X-rays, History and Physical forms, or related information is NOT to be sent to the B reader. Chest X-ray images are not to be sent to NMCPHC.

A certified tracking method (certified mail by USPS, FEDEX, or UPS) is used, and this information is emailed to usn.hampton-roads.navmcpubhlthcenpors.list.nmcphc-amsp@mail.mil.

The B reader will return the completed form along with the CD and invoice for payment to NMCPHC for processing into the Data Registry. NMCPHC will use DoD Safe to send the completed forms back to the ordering MTF. If the NAVMED 6260/7 form is returned to the MTF by the B reader with the determination that the radiograph was unreadable, the MTF is responsible for taking appropriate action to obtain a readable chest radiograph.

When the completed NAVMED 6260/7 is received back from the B reader, the MTF compares the number of forms received to the number sent. (If forms are missing, a new copy of NAVMED 6260/7 is generated for each missing form and NMCPHC is contacted.) The provider at the MTF reviews the B reading and takes any action appropriate, and the NAVMED 6260/7 is placed in the worker's employee health record.

If the completed NAVMED 6260/7 forms are not returned to the clinic within 30 days from the date the images were mailed, then NMCPHC is to be contacted at usn.hampton-roads.navmcpubhlthcenpors.list.nmcphc-amsp@mail.mil.