Choosing a care plan template

With the release of ASTRO’s new survivorship care plan template in late November, we’ve seen a renewed focus on the care plan, and the logistical problems of delivering one.  What should a care plan look like and how do you choose a template?

The evidence for the need for care plans is strong. As ASTRO states in their press release, the American Cancer Society (ACS) predicts a 37% increase in the number of cancer patients surviving five years or longer over the next decade, and as the numbers of survivors grows, so does the need for structured follow up care.  Accrediting bodies like the ACS Commissions on Cancer (CoC) have included survivorship in their new requirements but providers report that delivering a survivorship care plan is the most difficult of the CoC’s new standards to meet (Association of Community Cancer Centers, 2015 membership survey).

The need for clarity on care plan content and format has resulted in a variety of care plan templates.  The ASTRO care plan, designed for Radiation Oncologists, joins templates from organizations including ASCO, LiveStrong, Journey Forward and others.  Each template varies slightly, but most include the following common elements:

  • Contact information for the patient’s care team
  • Patient diagnosis
  • Treatment summary including radiation therapy, chemotherapy, surgery, and enrollment in clinical trials.
  • Information on the side and late effects of treatment
  • Psychosocial distress screening
  • Follow-up plan

Most of these templates, including ASTRO’s latest addition, pack all that information into a short 2 -3 page format.  We know that many providers value the concise nature of these templates and others want to include much more.

So how much information should we include in a care plan?  How many years do we look ahead for follow-up?  How many years of treatment history are necessary?  Do we include educational articles and community resources within the care plan?

With a variety of templates from industry leaders, the answers to these questions aren’t clear.  Will a long care plan overwhelm some patients?   Or does a shorter plan run the risk of missing valuable information?  Depending on the patient, both may be true.

The right level of detail depends on the age, education level, diagnosis and treatment of the specific patient.  A one-size-fits-all care plan probably doesn’t exist but if we focus on where we can add the most value for patients, we’ll probably find the right balance.

As a vendor of survivorship software, we’re hardly neutral on this subject, but we are certainly passionate about doing the right thing for patients.  Equicare’s care plans can be as sparse as this 2-pager with just a treatment summary and follow up plan.  Or as detailed as this comprehensive one, which also includes detailed educational articles and info about questionnaires to complete.  Our goal is to deliver a care plan that not only ticks the requirements box of your accrediting body (which we certainly do!) but to make it easy for you to deliver a care plan that adds value to your patients, their families and your physicians.

pdf 2 Page Care Plan
pdf Comprehensive Care Plan

Which template do you use?  And why do you love or hate it?  We’d love to talk templates, so get in touch and let us know.

Thanks for joining us at HIMSS15!

Thanks to everyone who made HIMSS15 in Chicago a successful event this year! Our first year exhibiting at HIMSS, we joined more than 1,300 exhibitors and 40,000+ attendees for this world-class event focused on major global issues in healthcare—including care coordination, population health management, and optimizing cost efficiencies.

Equicare booth at HIMSS15
Before the floodgates opened.

Prominent keynote speakers, including Former President George W. Bush and current National Care Coordinator Dr. Karen DeSalvo, addressed the necessity of patient-focused and cost-effective care, as well as the large-scale impact of developing comprehensive population health management systems.

Steve Lieber, President & CEO of HIMSS, echoed these ideas, noting that organizations must embrace technology as a vital tool for connecting people to the healthcare system and affecting critical change to improve care.

At Equicare, we support these goals in everything we do. EQUICARE CS, our comprehensive care coordination solution, helps organizations improve patient outcomes with better quality care, while increasing operational efficiency and reducing costs. Everyone wins!

 

 

 

Out and about this spring: ACCC, NCBC & HIMSS!

It’s been a busy spring at Equicare Health! After attending two workshops at the end of February—Commission on Cancer’s (CoC) Accreditation 101 in Chicago and the UPMC: Cancer Survivorship for Healthcare Providers in Pittsburgh—, the Equicare team had the pleasure of participating in two industry events in March.

Equicare booth at CoC Accreditation 101 Workshop
The calm before the storm: Equicare booth at the CoC workshop in Chicago
Ryan at CoC Accreditation Workshop, Feb 27, 2015
Ryan ready for action at the CoC Accreditation 101 Workshop!

 

 

 

 

 

 

 

 

 

 

 

We headed to Arlington, VA for ACCC’s 41st Annual Meeting:  CANCERSCAPE, where attendees gained insights into the healthcare policy landscape, quality measures and reporting, and the potential for big data to improve care. We were delighted to demonstrate how EQUICARE CS can help cancer centers improve patient care through coordinated navigation, survivorship, distress management and patient engagement programs.

NCBC was a wonderful opportunity to visit with our current customers and make new connections with other medical and industry professionals who are as dedicated as we are to improving breast health care for patients throughout their cancer journey—from diagnosis to treatment and through survivorship.

General session at NCBC
Another packed session at NCBC in Las Vegas

The HIMSS Annual Conference & Exhibition starts tomorrow in Chicago, showcasing the newest technologies, trends, and solutions in health IT. Equicare will be there—with 38,000 of our closest friends— to  demonstrate how we can help cancer centers and hospitals improve patient care and increase revenues. Drop by Booth 3376 to learn how EQUICARE CS can streamline your patient care coordination and help you deliver unparalleled survivorship care. Hope to see you this week!

Gearing up for HIMSS 2015!

HIMSS 2015 logo

Chicago welcomes the 2015 HIMSS Annual Conference & Exhibition, April 12-16, 2015, at McCormick Place. More than 38,000 healthcare industry professionals are expected to attend to discuss health IT issues and view innovative solutions designed to transform healthcare. We’re looking forward to showcasing EQUICARE CS, our complete oncology patient management solution, at this annual event.

Conference education sessions include pre-conference symposia on clinical and business analytics, HIEs, innovation, mobile health, nursing informatics, physicians’ IT and more. More than 300 peer-reviewed sessions, including workshops and roundtables, round out education offerings at HIMSS15.

George W. Bush, 43rd President of the United States, leads a strong roster of speakers that also includes Alex Gourlay, President, Walgreens; Bruce D. Broussard, President and CEO, Humana; and Jeremy Gutsche, Founder of Trendhunter.com and Author of “Exploiting Chaos.”

The HIMSS15 Exhibit Hall will feature the Connected Patient Gallery, Federal Health IT Solutions Pavilion, HIMSS First-Time Exhibitors Area, HIMSS Health IT Value Suite, HIMSS Interoperability Showcase™, Intelligent Health™ Pavilion (formerly known as Intelligent Hospital Pavilion), and three Knowledge Centers focused on clinical and business intelligence, disaster preparedness, and mobile health.

Drop by Booth #3376 for a demo of EQUICARE CS, our innovative patient care coordination solution. We look forward to seeing you!

Create a survivorship care plan in less than 5 minutes

Is it really possible to create a survivorship care plan that includes all of the Institute of Medicine’s recommendations in less than 5 minutes?  The answer from Equicare is an emphatic YES.   With the right tools you can prepare a comprehensive care plan that includes a treatment summary, targeted educational materials, scheduled questionnaires, a long term follow-up plan, care team contact info and more.

How do we compile all that data so quickly?  The key is in the interfaces we create between EQUICARE CS and your hospital information systems. By pulling existing patient data into the system, you eliminate manual data entry to very quickly prepare a patient specific care plan, which can be printed for patients and PCPs, and online through a patient portal.

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Demo: Create a survivorship care plan in less than 5 minutes

If you want to see exactly how it works, just play the video below, where we walk through all the steps in care plan creation in just over 3 minutes

Learn more about EQUICARE CS or contact us for a live demo of the software.

Finding the ROI in Survivorship

Based on our experience, most oncology healthcare providers believe in the value of navigation and survivorship, and most patients appreciate having access to it. These services can help providers ensure patients receive the long-term care they need, and help patients play a more active role in their health. The Institute of Medicine has been advocating survivorship since their 2005 “Lost in Transition” paper, and the American College of Surgeons Commission on Cancer has now changed their accreditation requirements to include survivorship planning.

So why isn’t everyone doing it?  One of the most common obstacles organizations face is cost.  Managing a large-scale survivorship program usually requires the use of new electronic tools, and often hiring dedicated staff members. For many organizations, the investment is hard to justify, especially in a time of shrinking budgets.

What many organizations don’t realize is that survivorship & navigation can actually deliver a return on investment, often within a few years of implementation. We are now pleased to introduce a Pro-forma tool that calculates what we expect this return to be. For example, take a look at the 5-year return from 2 fictitious, though typical, organizations below.

This tool was developed in partnership with American Medical Accounting & Consulting Inc (AMAC), one of the leading firms in the radiation oncology industry. Based on this reimbursement data, and information about the size, make-up and growth projections of an organization, we can calculate an expected 5-year ROI to help justify an initial investment. Although the data above is fictitious, it represents the real return organizations can expect to realize when using an electronic survivorship product like EQUICARE CS.

Don’t believe us?  Let us prove it!  Contact us to learn more about where these numbers come from and get an ROI calculation specific to your organization.

More questions?  We’ll try to answer some below:

  1. 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.
  2. What is a manual survivorship program?
    In the table above, we reference a manual survivorship program – this 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 like the one in the example above, actually causes the organization to lose money.
  3. Where does the revenue come from?The major sources of revenue are from:
    • Increased rates of patient attendance at reimbursable follow-up appointments
    • Increased Nurse Navigator efficiency – fewer FTEs can manage the same (or more) patients
    • For hospitals with imaging – we include revenue from additional in imaging studies, which may have been lost without survivorship & navigation
  4. 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.

Workflow Analysis – Why do we do it?

The EQUICARE CS installation and support program includes a full analysis of your clinical workflow, conducted to ensure survivorship, navigation, and patient engagement tools  are incorporated into your daily operations effectively.  Finding a workflow that works for your organization important to the success of your  programs; and in fact, we think it’s so important that we employ a full time Workflow Specialist.  Meet Tricia Cox, former Nurse Navigator and ECS user, and current Clinical Workflow Specialist at Equicare.

Every organization is different, so Tricia works with each customer to develop workflow solutions that work for their unique needs.  What does that look like?  Tricia describes the process and how it can help below…

What does a workflow specialist do for customers?

I work with clients to determine what is working and what is not within their current workflow.  Usually that means I find processes that need to be added to benefit patients for navigation and/or survivorship care.  Many facilities are trying to incorporate new standards of care for distress screening or survivorship care, but others are trying to improve current models of care.  The ultimate goal is to improve the patient care process within the facility.

Do you have any examples of how a Workflow analysis helps customers?

Yes, I’ve got lots!

When one site began using the software, the nurse navigator was using check marks on paper to figure out her patient contacts.  She then entered her data into an excel spreadsheet to meet reporting guidelines for her administrative team.  After taking a look at her needs, I showed her how to use the report capabilities within our software and was able to generate excel spreadsheets and reports automatically—freeing her time to see more patients.

Another site self-identified workflow problems and so I went out for a site visit after they had been running for several months.  Upon visiting the facility, we mutually determined some workflow enhancements, like a centrally located print station and the consolidation of efforts between team members.  Often care providers are entrenched in their systems and find it difficult to see the problems, although they know they exist!

When does a workflow analysis usually occur?

I typically get involved with an institution or center once ECS has been purchased and decisions on implementation are being made.  We start this process with something called Kick off, and this is usually when the nuances of the software are presented.  I like to get involved as early as possible to better understand who is involved with patient care, what their roles are and how they currently impact their patients.  We have frequent calls/web interactions as we go over workflow.  I can go on site early in the process if we cannot figure out the workflow process via web calls, otherwise we can wait and have an on site visit closer to going live or after going live.  Ultimately the timing is driven by customer needs.

Why does Equicare feel so strongly about the value of Workflow Analysis?

This analysis makes a BIG difference to customers, usually by identifying ways to save time on administrative tasks, leaving more time to focus on patient care.  Planning  workflow is one of the tasks that may be overlooked by busy organizations, but taking the time to find out the most efficient was of using the software ultimately benefits not just the organization but the patients, by enabling more regular contact and follow up.

And from my perspective – I just love problem solving!  Every site is slightly different and so is their workflow, which is very appealing from a problem solving perspective. Each site uses software features differently and working to see what works best for each site is very gratifying. Ultimately, if we work to improve patient care and patient experience, everyone wins.

Please contact us to learn more about conducting a workflow analysis in your organization.

CASE STUDY: Southside Regional Medical Center Installs ECS

“EQUICARE CS is incredibly intuitive and user friendly.  The great service and easy-to-use interface has made implementing ECS at Southside extremely easy, and we’re very pleased with the results.”
Lori McNulty, RN,
Oncology Nurse Navigator, SRMC

pdfDownload the SRMC Case Study (pdf)

BACKGROUND

Southside Regional Medical CenterThe Cancer Center at Southside Regional Medical Center (SRMC) offers advanced technology for treating a wide range of cancers and is fully accredited with Commendation by the American College of Surgeons (ACS) Commission on Cancer (CoC). SRMC has a busy radiation therapy center that diagnoses nearly 500 new cases of cancer each year. In 2012 the center introduced a medical oncology program, added a full time Nurse Navigator to their team, and began seeking a software tool that would enable the provision of organized navigation and survivorship care for their patients. Additionally, as the next phase of CoC  accreditation requires that cancer centers have a formal plan for the delivery of continuum of care services (which include navigation, psychosocial distress screening and survivorship  programs), SRMC wanted to be proactive in providing these programs to maintain their  accreditation.

Initially using a paper based system to track patient navigation, SRMC was seeking a  software solution that would provide the tools necessary for the Navigator to centrally track patients in both Radiation and Medical Oncology. SRMC was also looking to provide  long term survivorship care plans, distress assessments, questionnaires, and educational materials for their patients. SRMC wanted to ensure that all of the information collected  through the system would be available to the full care team, including care providers working externally. Finally, with a rapidly growing cancer program, SRMC also wanted to ensure that  their selected solution was scalable, intuitive and easy to use, with minimal administrative overhead.

SOLUTION

Southside Cancer center selected EQUICARE CS (ECS) as their navigation and survivorship  tool in March 2012 and went live with the system three months later in June 2012. The installation process began with a kick off meeting at which members of both the Equicare and SRMC teams discussed and agreed upon IT needs, workflows and other system configurations, and was followed by routinely scheduled status meetings to ensure the process went smoothly. SRMC’s Nurse Navigator is the primary system user and administrator, but ECS is also used by infusion nurses, social workers interns and others.

SRMC analyzed their workflows and use cases prior to installation and as a result, were able to launch with customizations specific to their organization including unique documentation, specific categorization and display of various assessments, and several custom fields. Equicare provided training, suggestions, and back-end development, but with the configurable design of ECS, the SRMC team was able to  perform many configurations on their own.  SRMC ramped up their Navigation program over a period of time and as of April 2013 all patients requiring Navigation were entered using ECS.

SRMC’s nurse navigator  uses the system to track referrals and patient appointments, distribute and collect responses to distress screening assessments, add notes to patient records, assess pain, provide nutritional and educational information, and track the financial resources that are sourced for patients. The system is also used to generate a variety of reports including system utilization and user time tracking, referrals assessment, changes in patient distress over time, patient outcomes, and navigational summaries. SRMC uses the survivorship functionality in ECS to provide their radiation oncology patients with long term survivorship care plans that include treatment summaries, care team information, follow-up plans, and educational information specific to each patient. This printed plan is generated through ECS by the radiation therapy RN, and then provided to patients at the one month follow up appointment after radiation completion.

Results

EQUICARE CS meets the needs of SRMC by providing organizational, clinical, and administrative benefits, as well as enabling their maintenance of accreditation compliance. By taking advantage of the navigation features in ECS, the center can include more patients in their navigation program, and by providing survivorship care plans and distress assessments they may also improve the quality of care for patients. With EQUICARE CS, Southside is on track to provide full navigation, psychosocial distress screening, and survivorship programs in  order to meet the next phase of CoC accreditation requirements.

Through ECS, SRMC’s Nurse Navigator has the tools to become more efficient in tracking referrals, appointments and assessments, and the center can therefore include more patients in the navigation program. The number of patients included in the Navigation program has approximately doubled since ECS was implemented. Additionally, Equicare’s navigation tools provide the center with a centralized way to store and access documents, patient details, and care team information, which ensures that accurate data is available to all members of  the care team, regardless of their physical location. As the center continues to grow, they will also have the capability to easily scale their  program to include more campuses and care team members.

By providing patients with distress assessments and questionnaires that can be completed prior to their appointments, SRMC minimizes the time patients spend waiting in the clinic, which may improve satisfaction with care. Additionally, through analysis of patient responses, SRMC now provides feedback to patients in distress, and aggregates population data to determine points of care where the patient experience can be improved. SRMC’s provision of long term care plans in printed format can also improve patient care by reducing the distress patients may feel at the end of treatment, which is often a time of uncertainty

Prior to ECS implementation, the generation of printed care plans was prohibitively time-consuming, and so this information was shared with patients orally. Through ECS survivorship care plans are now provided to 100% of Radiation Oncology patients, many of whom have provided positive feedback to the center on the content of these plans. Additionally, the inclusion of targeted educational material in these plans ensures patients are aware of side and late effects of treatment, and provides suggestions for health and nutritional activities that can improve outcomes.

As a busy and growing cancer center, it was important for SRMC to minimize the administrative overhead involved in implementing a new tool like ECS. The Equicare project team fixed issues as they arose, and also added feature requests to the product road map to ensure future releases better meet SRMC (and other customer) needs. ECS was intuitive and easy for SRMC’s team to learn, and the software has rapidly become an integral part of their cancer program.

SRMC sought out a care coordination solution to improve the quality of care for patients, and thereby maintain CoC accreditation; with ECS, the center is on track to do both. Not only do the tools in ECS provide functionality to improve the patient experience and meet CoC requirements for continuum of care, but the reports generated by ECS make providing information to auditors faster and easier. Additionally, by documenting Navigator time, and the benefits to patients, SRMC can rapidly evaluate and rationalize the investment in a Navigation program.

ABOUT SOUTHSIDE REGIONAL  MEDICAL CENTER

Southside Regional Medical CenterSouthside Regional Medical Center is a 300-bed, general acute care hospital located in central Virginia. The hospital has more than 1,500 employees and the medical staff is comprised of nearly 340 physicians representing more than 35 specialties.  The 420,000 square foot facility is situated on a 50-acre campus and offers the latest technology in order to serve more than 200,000 local residents. SRMC offers a full array of comprehensive outpatient services on its main campus and boasts five satellite outpatient centers: Southside Regional Renal Services (Petersburg), Southside Behavioral Health Services (Petersburg), Southside Rehabilitation Services (Petersburg and Colonial Heights), and Colonial Heights Imaging, a full service diagnostic imaging center (Colonial Heights).  The hospital is also home to three professional schools: Southside Regional Medical Center School of Nursing, School of Radiation Sciences, and School of Diagnostic Medical Sonography. A new cancer center will open on campus, adjacent to the hospital in January, 2014. For more information, please visit: www.srmconline.com

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