FAQs

Find answers to your most commonly asked questions about Equicare below on the topics listed below.  Don’t see your questions listed? Please use the online form to Contact us and we’ll be happy to help.

General Care Provider ROI Calculation
Patient Technical

GENERAL QUESTIONS

  1. What is Survivorship?
    Survivorship refers to ‘surviving’ a diagnosis of cancer. Often, people are described as survivors from the day that they are diagnosed. This is because they are now living with cancer and surviving it on a daily basis. Cancer survivors need in-depth follow up care after active treatment to deal with the after-effects of many of the cancer treatments. Also, many patients do not receive the monitoring required to detect cancer recurrence or a new cancer. Survivorship care covers these needs.
  2. What is Navigation?
    Navigation is a process by which a person working within the health care system (often called a patient navigator, nurse navigator or navigator) helps ‘navigate’ patients through the tests and treatments needed to deal with their cancer diagnosis. The navigator is a highly resourceful person who is able to pay special attention to a patient’s medical and social situation. Their job is make sure that the patient gets the medical tests and appointments needed so that they get treatment in a timely fashion.  They can also help with other aspects of their lives such as financial, communication or emotional problems. A navigator can help a person prevent and eliminate some of the challenges they may encounter when facing a diagnosis of cancer.
  3. What is the difference between a Survivorship Program and Navigation Program?
    A Navigation Program is about helping a patient through a healthcare system that is sometimes cumbersome without guidance and support. A Survivorship Program provides support for patients after a cancer diagnosis including education for side and late effects of treatments, assistance finding community resources, and a customized care plan that details the next steps living through and beyond cancer.
  4. What is a Survivorship Care plan?

    A survivorship care plan should be provided to every patient in the transition period after cancer treatments are complete. The transition to “normal” life after cancer treatments can be a difficult time for patients. A survivorship care plan provides the patient with many important pieces of health care information which can help ease this transition.

    First, a survivorship care plan should include a summary of all the treatments received by the patient. This information can be provided to another doctor or health care practitioner, such as the patient’s Primary Care Physician. A survivorship care plan should also include a follow-up plan which is a timeline of recommended tests and appointments. This is to help the patient understand the follow-up care they will receive. This is a central part of ensuring that the patient knows they will still have contact with the care team in the future. If the patient is going to be transitioned back to the family doctor, the patient understands what needs to take place to ensure that they remain cancer free and do not suffer needlessly from any side effects of treatment. This follow-up plan can also be useful to the family doctor who may not be familiar with follow-up care recommendations.  A survivorship care plan should also include the contact information of care team members and information on the current and future side-effects the patient may be at risk for developing.

CARE PROVIDER

  1. Why should we develop a Survivorship Program?

    Survivorship Programs improve the quality of care for patients by:

    • Assisting the patient in the transition from treatment to more routine life
    • Improving daily quality of life by better managing side and late effects
    • Involving families in survivors’ care
    • Enabling and improving PCP involvement in patient care
  2. What services should our Survivorship Program offer?

    The following components are necessary to provide a comprehensive survivorship program:

    • Complete summary of treatment
    • Survivorship Care Plan with long term follow up
    • Customized / Personalized Education
    • Medical Surveillance Guidelines
    • Direct interaction with healthcare professionals
  3. What resources do we need to run a Survivorship Program?
    Typically a Survivorship Program is run by a Registered Nurse (RN), social worker or Nurse Practioner (NP) with detailed roles and responsibilities. One individual should have overall responsibility for your Survivorship Program. This is typically a dedicated role, staffed by a NP or RN. Depending on the volume of patients at your facility, the program may also include additional NPs, RNs, Social Workers or Nutritionists.
  4. When should patients be referred into our Survivorship Program?

    This will depend on your organizational operation workflow process. We encourage organizations to include patients in their program early, to improve engagement throughout treatment.  Some organizations use these milestones:

    • Initial Consultation
    • Start of Treatment
    • End of Treatment
    • 1st Follow-Up Visit
  5. We don’t have resources for a Survivorship Nurse. How will Equicare benefit my organization?
    With the built-in interfaces to treatment Oncology Information Systems, staff can create survivorship care plans using minimal staff time. This allows your center to provide meaningful survivorship care with minimal effort.
  6. What will I need to do to achieve / maintain ACOS Commission on Cancer Accreditation?

    Beginning in 2012, organizations must implement a Survivorship Program to achieve / maintain ACOS CoC Accreditation. The intent for the standards is to ensure that cancer patients and family members have access to resources such as:

    • patient navigation
    • pyscho-social distress management
    • survivorship care plans

    Contact us to learn more about how Equicare can help you achieve accreditation.

  7. Is there any ROI for the Survivorship?

    Yes, and we can provide your organization with an estimated ROI that highlights how survivorship can:

    • Enable reimbursement for NP led follow-up
    • Retain survivors and gain incremental revenue from follow-up procedures
    • Provide competitive advantage, increasing referrals
    • Increase oncologist capacity for new treatment

    Learn more about how you can achieve an ROI from survivorship, or use our ROI calculator to get your estimate now.

  8. What is the long term value for patients?
    • Improved patient access to treatment details so they are better able to communicate with cancer care providers.
    • Enhanced ability to recognize signs and symptoms to report to healthcare providers.
    • Better appreciation of resources available to the patient.
    • Increased patient sense of ownership and participation in the cancer follow-up process.
  9. Can I control which information patients view in the patient portal?
    Yes. EQUICARE works on the basis of clinician “publishing” information to the patient portal so it is available to the patient. Only information that is published by the clinician is visible to the patient.
  10. Can I manage when information is released to patients on the patient portal?
    Yes. The EQUICARE allows multiple layers of configuration for publishing information to the patient portal. Specific items can be set to automatically publish, publish after an explicit number of days allowing the clinician to review first, or not publish at all.
  11. Can we provide EQUICARE access to external care providers, such as social workers or nutritionists? How does this work?
    Yes.  EQUICARE works on an install basis, not a license basis. This means that as many people as needed can become users of the system. There is no licensing or cost associated with the number of users. Additionally, because ECS is web based, any computer can be used to access ECS. No dedicated computers are needed.
  12. Does EQUICARE integrate with our Oncology Information System (OIS)? Which OIS can we integrate with?
    Equicare Health interfaces with Varian’s ARIA OIS and Elekta’s MOSAIQ OIS..
  13. Can I launch EQUICARE from within my OIS? How does that work?
    Equicare Health is a partner of Varian Medical Systems. As such, our integration with Varian’s ARIA OIS is quite significant. Links can be created within the ARIA RO and MO products that lead to specific pages within EQUICARE. These links will also bring the basic patient identifiers so that the patient being worked on in ARIA is opened in ECS. These features streamline the workflow process for the clinician.
  14. Which information is shared between my OIS and EQUICARE?

    The information shared with EQUICARE will depend on the OIS you are using, but may include the following:

    • Demographics and relevant family history
    • Appointments
    • Diagnosis
    • Surgery
    • Chemotherapy, Hormone Therapy, Radiation Therapy and other therapies
    • Transplant History
    • Comorbidities
    • Allergies
    • Events During Treatment
    • Test Results
    • Medical Notes
    • Healt Information Summary (CCDA)
  15. Can I add my own education material to the patient portal?
    Yes, while there is an extensive articles of educational articles within EQUICARE, you can add your own educational content to the patient portal in a pdf format.
  16. Can I add or customize questionnaires for patients?
    Yes, while we have an extensive library of questionnaires available to hospitals/clinics, clinicians can create their own customized questionnaires which they can use for their own patient population.
  17. Is there an audit trail of who is using ECS?
    ECS includes an extensive auditing system for tracking access to information by both staff and patients.

PATIENT QUESTIONS

  1. What kinds of medical information can the patient portal provide to me?

    The following types of information are available through the patient portal:

    • the contact information for all the members of your health care team
    • a complete list of past, present and future appointments
    • a summary of all the treatments that you have received as well as other related health information
    • education articles that provide information on cancer, treatment options and side effects of the treatments
    • questionnaires which can be used to understand how you are feeling
    • results of lab tests and other tests.
    • secure messages sent from your care provider(s)
  2. When can I see the results of some of my medical tests on the patient portal?
    Lab tests and medical notes are often reviewed by your health care team first before becoming available on the patient portal. Your health care team may want to include a note to you about the results, or investigate the results further before they make them available to you. Some routine test results may become available to you as soon as they are entered into the hospital computer system. Your care team can let you know exactly when test results and other information will be available to you on the patient portal.
  3. Why are some medical tests not available to me on the patient portal?
    If there is no link between the patient portal and the computer system where the test results are entered, the results may not show up on the patient portal for you to view. For example, if a blood test is done at a lab which does not have a link to the computer system used by your hospital, the result may not become available through the patient portal. Also, your doctor may feel that some results are not meaningful to you or may be difficult to understand. These results will not become available through the portal. You can always discuss these tests at one of your appointments with your doctor.
  4. If some of the information on the patient portal is not correct, what should I do?
    We all want the information on the patient portal to be 100% accurate so that it is a source of reliable information for you. If you think some information on the portal is not correct, speak to a member of your health care team the next time you are in the clinic. They will then take the steps to check the information and correct it, if necessary.
  5. Can I send a message to my doctor using the patient portal?
    Yes, there is a secure messaging function available in the patient portal that allows you to securely send and receive messages with your healthcare team.   The patient portal also has a ‘Contact Us’ and ‘Request an Appointment’ communication link. The ‘Contact Us’ link allows you to send a non-secure message to your health care team. The ‘Request an Appointment’ link allows you to communicate the need for an appointment or appointment change. When you use either of these communication links, a member of your health care team should contact you shortly to discuss the issue. Please note that the patient portal messaging should not be used in urgent situations. Please contact your doctor for urgent needs or call 911 in an emergency.
  6. Can I let my family view my health information on the patient portal?
    Yes, you can authorize family members or friends to view and interact with the patient portal using the “Authorized Representative” function.  This provides your personal contacts with their own unique login access, so you do not need to share your password with anyone.
  7. What is a Survivorship Care Plan and why do I need one?
    Your survivorship care plan should be given to you by your health care provider. A survivorship care plan provides you with many important pieces of health care information. First, a survivorship care plan should include a summary of all the treatments you received. This information can be provided to another doctor or health care practitioner. A survivorship care plan should also include a follow-up plan which is a timeline of recommended tests and appointments. This is to help you play an active role in your long term health by informing you of when to have tests completed. This is a central part of ensuring that you remain cancer free and do not suffer needlessly from any side effects of treatment. What side effects are you currently experiencing? Are they impairing your ability to lead a normal life? The care plan is set up to help you manage side effects and also let you know when it is appropriate to notify your health care provider. Other information in a survivorship care plan should include the contact information of your care team members and information on the current and future side-effects you may be at risk for developing.
  8. What is a treatment summary and why do I need one?
    A treatment summary shows all the various surgeries, medications, radiation treatments and unusual events that happened during your cancer treatment. It also includes details like hospitalizations, fevers and adverse reactions. With this all in one document, it is easy to inform your current and future care givers about your history with cancer.
  9. Who decides which education information I see on the patient portal?
    Any member of your health care team can make education articles available to you on the patient portal. One brochure or book which covers everything about your type of cancer can be difficult to understand. With the patient portal, your doctor or nurse can assign specific articles when the information is important to you. Most often, your care team will try not to overwhelm you with a lot of information at one time. They will ensure that you receive information that you need prior to any procedure or treatment so you are prepared, physically and emotionally.
  10. If I want to find more information that might be related to my disease, is there a way to do that?

    Your healthcare team will assign specific education articles that they feel are relevant to you. However, many other articles are available through the patient portal. Simply go to the Resources menu item and select “Education Library” to access a library of oncology specific articles.

  11. What are the questionnaires used for?
    Questionnaires are a quick and easy way to ask questions about your health. A member of your health care team may assign you a questionnaire to fill in on a regular basis or because of a specific health concern. Please fill the questionnaire out as soon as possible. Answer the questions as an honest reflection of how you are feeling. A member of your care team will look at the results and if necessary, take action based on your responses.
  12. Is the patient portal secure?
    The patient portal is very secure. We take great care to ensure that your health information is safe and private. Any person who logs onto the patient portal must do so with their own unique name and password. Only health care providers who are directly involved in your care will have access to any of the information available on the patient portal.
  13. What is the privacy policy related to the patient portal?
    The patient portal is fully compliant with federal and state laws related to your privacy and the privacy of your health information. Your personal and health information are not available to any outside parties.
  14. Which web browsers are recommended to use to view the patient portal?
    The patient portal is best viewed using Internet Explorer version 9 and later as well as the current versions of Firefox, Chrome, and Safari.
  15. Do I need to change my browser if I don’t have a version that is recommended for viewing the patient portal?
    It is not necessary for you to change your browser. If your web browser is one that is not supported, some items may not be displayed as they were intended. However, the information displayed, like lab test results or appointment information, is still correct.
  16. If I don’t have a web browser that is recommended for the patient portal, do I need to buy a new one?
    No. Many browsers are free to download on the internet. It is a simple process to download a new web browser and start using it.  Current versions of Google Chrome and Mozilla Firefox are available at the following links:
    https://www.google.com/intl/en/chrome/browser/
    https://www.mozilla.org/en-US/firefox/all/
  17. I have Microsoft Edge, which is not recommended for viewing the patient portal. How do I change to a recommended browser?
    Although in Windows 10 Microsoft Edge is the default browser, IE 11 is also included and can be made to be the default browser.  To do this, go to Control Panel>Default Programs>Set Default Programs, and select Internet Explorer in the list of programs.  Select “Set this program as default” and the patient portal will open in IE 11 automatically.

TECHNICAL QUESTIONS

  1. What are the Computer/Browser requirements for the patient portal?

    Anyone with internet access and a compatible browser can log into the portal. The Equicare Patient Portal is best viewed using Internet Explorer version 9 & newer as well as the current versions of Firefox, Chrome, and Safari. We strive to make sure that the latest version of the browser is supported so that technical problems are minimized.

    While the portal is designed for devices with large screens, it can be accessed from handheld devices. The web address (url) for the patient portal is included on the invitation letter given to the patient.

  2. Do I need any third party hardware or software to use ECS?
    All that is needed is access to the internet and a web browser that is supported by Equicare (Internet Explorer, Safari, Firefox, or Chrome). A pdf viewer like Adobe Reader is needed to view some items in Equicare such as medical notes.
  3. With which Oncology information systems can ECS interface?
    Equicare CS currently supports integration with Varian’s ARIA RO, MO, and CCS as well as Elekta’s MOSAIQ.
  4. Does ECS support HL7 interfaces?
    Yes.  EQUICARE is compatible with the ADT, ORU, MDM, and SIU message types. These four HL7 message standards contain essential patient data which EQUICARE uses to help you manage patients and ensure their medical records are complete and up to date.
  5. How do you maintain information security?

    Equicare does a number of things to make it as easy as possible for our customers to maintain information security.

    The Equicare database is hosted in the customer’s network environment inside their own firewall to leverage all of the IT networking security already in place. Because we don’t host the solution you don’t lose control over the security of your information. Access to the Equicare database is limited to a small number of system accounts with complex and non-default passwords. Care providers and patients cannot access the database directly but have to access the data through the Equicare web application, limited to their access rights.

    Every Equicare release is tested for web security vulnerabilities using the Open Web Application Security Project (OWASP), security project industry best practices, and an industry leading vulnerability testing tool. In addition, SANS and US CERT bulletins are monitored to identify and address any potential security vulnerabilities in the components used by Equicare.

  6. How do you provide secure access to ECS and manage user roles?
    The Equicare web application security system uses role based access to grant permission to application functionality, and strictly enforces a user’s access to patient data through a combination of direct assignments (care team assignments) and role based assignments (workgroup membership of user and patient). The Equicare password policies for length, strength and expiration of passwords are configurable to implement your organization’s password policies. User passwords are encrypted using the industry standard SHA-512 algorithm with additional salting. Passwords are never stored or displayed as plain text.
  7. How do Equicare’s customer support team access our system securely?

    The Equicare Support team securely accesses your system by one of two methods:

    • Bomgar – Bomgar is an industry leading remote connectivity solution. The Bomgar solution creates an encrypted connection between the Support Technician’s computer and the Equicare Server on your site. Only authorized Equicare support personnel can connect to the Bomgar system. For more information about Bomgar, please visit www.bamgar.com.
    • Your VPN solution – Some customer prefer to allow access to the system via their own VPN solution. Equicare will work with your IT personnel to configure and use this system for connectivity if required.

    Access by Equicare employees is directed by strict enforcement of our Customer System and Data Access Policy. That policy ensures that only employees with certification of HIPAA security awareness training and a clear criminal record check access customer data. In addition, the policy ensures Equicare follows not only HIPAA best practices but the customer’s security policies whenever required to access customer data in order to support that customer.

  8. Do you provide software upgrades? How often?
    Software upgrades are provided to all customers with a current Software Support Agreement (SSA). Maintenance releases with defect fixes are typically delivered 4 to 6 times a year. Major releases every 6 to 9 months.
  9. How does the installation process usually work?
    Equicare strives to make the installation process as smooth and painless as possible. Projects all begin with a kick-off meeting to set timelines and project objectives. The Equicare Project Manager will guide your team through the process and keep the project on track. The Equicare Workflow Specialist will work with your clinical staff to understand your current workflows and help transition those workflows for use with Equicare CS. Prior to go-live, an Applications Trainer will spend time with your team to help them get up and running with the system.
  10. What can I expect for support after the software is installed?
    Equicare’s expert customer support team is committed to providing you with prompt, helpful service so you can remain focused on caring for your patients. Support services include technical assistance, troubleshooting, and application specific support to ensure your software is meeting your needs. Support hours are 6AM to 7PM PST Monday through Friday, excluding holidays. We provide same day responses during normal support hours, and next business day responses after hours.  Additionally, Equicare Health has several clinical staff who can help ensure that your navigation and survivorship programs get up and running. A workflow specialist can provide valuable input to your specific needs.

ROI Calculation Questions

  1. How do we calculate the ROI?
    Equicare Health partnered with American Medical Accounting & Consulting Inc (AMAC), one of the leading firms in the radiation oncology industry, to develop a comprehensive pro-forma tool.  Based on reimbursement data, and information about the size, make up and growth projections of an organization, we can use the pro-forma to calculate an expected five year ROI.  You can often get an ROI by running a paper or excel based survivorship program, so we calculate that information, and present the incremental net income too.
  2. Where does the revenue come from?
    The major sources of revenue are from increased Nurse Navigator efficiency – fewer FTEs can manage the same (or more) patients, additional imaging studies, which may have been lost without pro-active survivorship planning, and increased rates of patient attendance at reimbursable follow-up appointments.
  3. What’s the difference between incremental net income and ROI?
    The ROI is simply the difference between the total revenue and expenses of managing a survivorship program.  The incremental net income is the difference between the ROI an organization realizes when using an electronic tool like ECS, and the ROI from running a manual survivorship program.  This is an important figure to present when considering whether to introduce an electronic tool, or attempt a manual program.
  4. What is a manual survivorshop program?
    Manual survivorship  is how we describe programs that are run using paper or excel spreadsheets.  While it’s possible to run a program like this, it’s less efficient, and for some organizations, particularly free-standing clinics, may cost more to run than the revenues generated.
  5. Why is my ROI for a manual survivorship program negative?
    Running a manual survivorship program is less efficient than using a dedicated tool.  Because survivorship programs require paid staff time, the cost to run the program manually may be greater than the revenues the program generates.
  6. Do you include staff salaries in this calculation?
    Yes, we use your current size and plans for the growth of the program to estimate the number of nurse navigators (or other dedicated employees) required to manage the program now and in the years to come.   This is included in the expense calculation.
  7. Why would HL7 interfaces affect my ROI?
    The set up of HL7 interfaces between hospital systems and ECS increases the cost of survivorship implementation, and is included in the expense calculation.