Cancer Care: From screening positive to diagnosis, and oncology team connection

Cancer screening procedures strive for effective early detection. In order to screen large numbers of at risk individuals, screening practices need to be simple, cheap and efficient. Diagnostic tests are used to determine the presence or absence of cancer. Symptomatic individuals, or individuals with positive cancer screening results, go through potentially invasive and expensive diagnostic procedures to establish the presence of a tumor.

As the cancer journey is complex and convoluted, the patient needs to meet with health professionals with different skill sets to facilitate the process. An oncologist oversees a patient’s care from diagnosis and throughout the course of treatment. Patients consult with their general practitioner and, at times in combination with, health insurance providers to be referred to the most appropriate oncologist. Databases, such as the American Society of Clinical Oncology (ASCO) [1], also provide open access lists.

Within the United States, approximately one third of patients aged 0 – 64 years (a population of approximately over 90 million) are referred to a specialist by their primary care physician [2]. A well-coordinated referral system needs to be established to accommodate this high frequency of referrals, in addition to connecting primary and specialty care.

All members of the oncology care team (oncologists, general practitioners, radiologists, nurse navigators, patient coordinators, registered dietitians, etc.) play an integral role in enhancing the quality of care received. The care provided encompasses diverse aspects of health services. In addition to appropriate care that is timely and appropriate, other elements of cancer care include psychosocial assessment, suitable and timely referral, and individualized treatment that considers each patient’s needs and preferences. A multidisciplinary team is needed to address these tasks, which may create complexities to care coordination in both hospital and community settings. Challenges include recognizing health professional roles and responsibilities, communication between the care team and with the patient, managing scarce resources, and transitioning patients through care.

Digital technologies have aimed to address these challenges [3]. These include:

  • Electronic portals

  • Electronic Health Records (EHRs)

  • Patient reported outcomes measures

  • Patient-centered education

They are utilized to enable collaborative care coordination systems. Patient experience and outcome is enhanced when implementation of optimal technologies are coupled with proper training and support for patients and the care team.

Recent evidence-based research has proven that improving quality of care through enhanced communication and a well-coordinated system is advantageous for the patient, the medical team, and healthcare system. Researchers have embarked on a series of studies aimed at identifying quality measures. Two examples of these cover:

1. The impact of EHRs and oncology EMR tools used by multidisciplinary teams in GP-oncologist communication and facilitation of cancer care. [4]

2. Use of IT-enabled measurements and patient reported outcomes by patients and the care team to enhance patient-centered care (allowing for a seamless incorporation of patient perspectives into cancer care practices). [5]

As a patient moves through from screening and diagnostics to workup, treatment plan, and the care planning stages – clear communication, education tools, and access improve patient engagement.

In our next article, we will take a closer look at different ways of engaging patients and their caregivers (e.g. patient portals, patient reported outcomes, and patient-centred education), and how they can ultimately improve the quality of health outcomes.

Main resources: https://www.ncbi.nlm.nih.gov/books/NBK223387/

Written by Dorri Mahdaviani , who holds a Masters of Public Health (MPH) from the University of British Columbia (UBC). Her academic and professional interests include the areas of chronic illnesses, health care systems and childhood health and development. 

Infographics and Design by Ann Wong, who holds a PhD in Biochemistry and Molecular Biology from the Faculty of Medicine at the University of British Columbia (UBC), Canada. She is an author of over 10 SCI publications, having taught at UBC and the Peking University Health Science Center (PUHSC) in Beijing. 

Elekta and Equicare Health establish reseller agreement to enhance cancer patient engagement, care and management

Agreement supports improved clinical outcomes through survivorship care plans that enable earlier detection and intervention for treatment-related side effects and disease recurrence

ATLANTA, February 1, 2018 – Elekta (EKTA-B.ST) today announced that it is has entered into a reseller agreement with Equicare Health, a leader in developing chronic care models for cancer survivorship that improve patient outcomes and maximize cancer centers’ operational efficiencies. Under the terms of the agreement, Elekta will now offer EQUICARE CS™ and Equicare’s Active Patient Portal to current and future users of Elekta’s MOSAIQ® Oncology Electronic Health Record (EHR). EQUICARE CS and the Active Patient Portal complement MOSAIQ, facilitating communication between patients and clinicians with no geographic restrictions. Patients can receive updates on their care plans, provide feedback and patient reported outcomes through the platform. Clinical information is integrated into MOSAIQ directly from EQUICARE CS.

MOSAIQ is a leading open system that also provides actionable analytics to support improvements in the quality and cost of care. MOSAIQ is designed for interoperability with a broad array of digital health solutions to drive the open exchange of information and promote an all-inclusive workflow empowering patient care providers.

“The evolving needs of our customer base require us to think beyond what individual software solutions can offer,” said Margaret Nash, Global VP of Sales for Equicare. “Equicare’s products provide a unique and much-needed solution for efficiently managing and communicating with cancer patients. Cancer centers using our digital solutions in the context of MOSAIQ’s comprehensive EHR will now have a powerful system for connecting these patient interactions to the treatment management process. This allows an entire care team to document and review a patient’s complete history, starting as early as the patient’s first screening visit and extending well beyond the last day of treatment, improving patient outcomes while optimizing the use of oncology resources.”

EQUICARE CS is used to coordinate cancer care, manage patient navigation and facilitate the creation of survivorship plans based on recommendations from the Institute of Medicine and the American Society of Clinical Oncology. Patient navigation and survivorship plans are both required for cancer care centers to receive accreditation from the Commission on Cancer. The Active Patient Portal allows patients undergoing cancer treatment to access the latest medical information, stay on top of scheduled appointments, lab results and medical notes, as well as send/receive secure messages with care team members. It also provides insight into patient populations by aggregating valuable data collected in questionnaires that can help measure long-term clinical outcomes for entire patient populations.

“Elekta is committed to ensuring that our digital solutions interface seamlessly with systems and applications across the evolving healthcare ecosystem that share our goal of advancing patient care,” said Andrew Wilson, Vice President of Global Marketing for Software Solutions at Elekta. “We believe that the combination of MOSAIQ and Equicare’s offerings gives users unparalleled resources for effectively managing the entire oncology care continuum and improving survival and quality of life for cancer survivors.”

 

For further information, please contact:

Gert van Santen, Group Vice President Corporate Communications, Elekta AB

Tel: +31 653 561 242, e-mail: gert.vansanten@elekta.com

Time zone: CET: Central European Time

Raven Canzeri, Global Public Relations Manager
Tel: +1 770 670 2524, e-mail: raven.canzeri@elekta.com
Time zone: ET: Eastern Time

 

About Elekta

Elekta is proud to be the leading innovator of equipment and software used to improve, prolong and save the lives of people with cancer and brain disorders. Our advanced, effective solutions are created in collaboration with customers, and more than 6,000 hospitals worldwide rely on Elekta technology. Our treatment solutions and oncology informatics portfolios are designed to enhance the delivery of radiation therapy, radiosurgery and brachytherapy, and to drive cost efficiency in clinical workflows. Elekta employs 3,600 people around the world. Headquartered in Stockholm, Sweden, Elekta is listed on NASDAQ Stockholm. www.elekta.com.

About Equicare Health

Equicare Health is the industry’s leading provider of comprehensive care coordination and patient navigation solutions. Equicare’s flagship solution EQUICARE CS™ (ECS) is a multi-facility web-based software tool, which enables cancer centers to influence clinical outcomes for patients, optimize revenue streams, and increase operational efficiency. ECS facilities patient engagement through patient reported outcomes, patient navigation, and survivorship care. The software provides other clinical tools (including MDT, Clinical trials, education material, and patient engagement) as well as an administrative suite of worklists and reports for managing adherence to accreditation standards (including Meaningful Use, Commission on Cancer (CoC), NAPBC, QUOPI, OCM). ECS enables cancer centers to influence clinical outcomes for patients, optimize revenue streams, and increase operational efficiency. To learn more, please visit www.equicarehealth.com.

 

Impacts of Cancer Screening on Patients, Oncologists, and the Care Process

Cancer screening revolutionized the world of cancer care with its aim to detect cancer before symptoms appear. Early detection is paramount for the control of any disease. When symptoms are detected or apparent, diagnostic tests are used to find out the cause of the symptoms. A procedure, ranging in complexity and invasiveness, can have significant influences on detection, diagnosis, and trajectory of care. Once detected, engaging an oncologist early and connecting the screening results to the expertise needed enhances patient outcomes.

There are different cancer screening procedures in use across the range of cancer types. In the case of breast cancer and colorectal cancer, early detection is correlated with lowering mortality rates [1]. There are times that early detection does not lengthen the life of the patient, but may have other benefits with creating patient awareness. In general, screening tests are recommended and offered to all at-risk individuals, regardless of the outcome. This makes it imperative to be aware of the positive and negative impacts.

Two procedures that have been proven to be very effective at reducing cancer mortality rates are colorectal cancer and breast cancer screening. Colorectal cancer is the second leading cause [2] of cancer deaths in the United States. It mainly develops from abnormal growths in the colon or rectum. Screening tests can identify these abnormal growths. They can also detect tumors, and prevent the development of cancer before growths metastasize.

Interestingly, breast cancer mortality rates are lower than colorectal cancer rates. However, the rate of breast cancer diagnosis are higher within American women [3]. How is it that death rates are lower and diagnoses are higher for breast cancer, when compared to colorectal cancer? The answer is complex and depends on the screening tools used along with the nature of the cancer type and stage. Mammography is currently the most commonly supported screening procedure for breast cancer. Its greatest benefit is the decrease in breast cancer mortality: mammography screening has been associated with a 15% to 20% reduction in breast cancer mortality in women aged 40 to 74 years [4]. Despite the differences between colorectal and breast cancer, it is evident that timely and regular screening is key in lowering mortality rates.

An example of where early screening does not necessarily decrease mortality rates is the prostate-specific antigen (PSA) test for prostate cancer detection [5]. This blood test is able to detect prostate cancer at an early stage. However, routine PSA testing is debated. It is unclear whether early detection and treatment lead to significant changes in the cancer trajectory and the patient’s quality of life. The inadequate evidence of benefits for PSA testing hinders support for this screening test, and shines light on some unintentional consequences.

Recognizing the diversity of cancer screening modalities allows us to understand the scope of their influence across the cancer care spectrum. All tests are followed by results, and cancer screening is no exception. The test has either identified cancer in the individual, or it has not. However, there are truly four outcomes:

 

True Negative The screening test says the patient does not have cancer when they do not truly have cancer
False Positive The screening test says the patient has cancer when they do not truly have it
False Negative The screening test was not able to detect cancer when the patient truly has cancer
True Positive The screening test says the patient has cancer and the patient truly has cancer

 

In the True Negative scenario (an ideal case as a patient is cancer free), the potential implications from the screening test are procedural and financial. For example, when screening for colorectal cancer through colonoscopy, perforation and bleeding may occur.

For False Positive and Negative results, the screening test was not able to accurately identify the true state of the disease. When screening results appear abnormal even though there is no cancer (False Positive), anxiety may arise and each additional procedure may pose its own risks. For breast cancer, on average, 10% of women will be recalled from each screening examination for follow-up, only 5 of the 100 women recalled will have cancer [6]. In the case of False Negative, medical care is not sought in a timely manner. Treatment may even be delayed if cancerous symptoms are present. Understandably, the severity of the unintended consequences depend on the type and stage of the cancer.

It has been argued that screening may result in unnecessary earlier treatment or over-treatment. For breast cancer, the diagnosis and treatment of cancers that would otherwise never have caused symptoms or death in a woman’s lifetime can expose a woman to immediate risks. These include surgical deformity or toxicity from radiation therapy, hormone therapy, or chemotherapy, and late effects of therapeutic radiation – new cancers, scarring, cardiac toxicity.

Timely screening has proven to be an effective tool in curtailing cancer mortality rates. With early screening and engagement, health professionals are able to better tailor treatment plans to the individual tumor characteristics. Some screening tests and treatments are almost always recommended as the benefits outweigh the risks posed.

In our next article, we will explore the need for tools that facilitate the transition of care following a positive screening (False Positive and True Positive) through diagnostic, workup, and treatment plan. We will also elaborate further on directly engaging oncologists and the care team.

Written by Dorri Mahdaviani , who holds a Masters of Public Health (MPH) from the University of British Columbia (UBC). Her academic and professional interests include the areas of chronic illnesses, health care systems and childhood health and development. 

Infographics and Design by Ann Wong, who holds a PhD in Biochemistry and Molecular Biology from the Faculty of Medicine at the University of British Columbia (UBC), Canada. She is an author of over 10 SCI publications, having taught at UBC and the Peking University Health Science Center (PUHSC) in Beijing. 

Jump-start the new year with MACRA: Looking ahead to 2018

This time of the year is one for both reflection and anticipation. As our profession looks back on the issuance of the first Quality Payment Program (QPP) final rule a year ago and celebrates our collective progress toward adoption of the Medicare Access and CHIP Reauthorization Act (MACRA), so too must we look ahead to the program’s future.

Read More…

Equicare Health releases latest product, Equicare CS (ECS) 4.7

Vancouver, CANADA –December 1, 2017 – Equicare Health, the leading provider of oncology care coordination and patient navigation solutions, releases latest version of their product, Equicare CS (ECS) 4.7.

“We’re excited to be releasing ECS version 4.7 to our customers. With this version we’ve completely re-designed the patient portal to provide beautiful, clean screens and simple workflows,” says Malcolm Wright, VP of Product Management at Equicare Health.

ECS 4.7 supports mobile, so patients can access the portal from their mobile phone, tablet, or desktop. The system also supports multiple languages, so patients can benefit from ECS whether or not they speak English. Version 4.7 supports English and Spanish, and additional languages will be added with each release.

ECS 4.7 is now available. For more information on the new release, please contact Equicare to learn more.

About Equicare Health

Equicare Health is the industry’s leading provider of comprehensive care coordination and patient navigation solutions. Equicare’s flagship solution EQUICARE CS™ (ECS) is a multi-facility web-based software tool, which enables cancer centers to influence clinical outcomes for patients, optimize revenue streams, and increase operational efficiency. ECS facilities patient engagement through patient reported outcomes, patient navigation, and survivorship care. The software provides other clinical tools (including MDT, Clinical trials, education material, and patient engagement) as well as an administrative suite of worklists and reports for managing adherence to accreditation standards (including Meaningful Use, Commission on Cancer (CoC), NAPBC, QUOPI, OCM). ECS enables cancer centers to influence clinical outcomes for patients, optimize revenue streams, and increase operational efficiency. To learn more, please visit www.equicarehealth.com.

For more information, please contact:
Celina Lam
Marketing Communications Specialist
celina.alisa.lam@gmail.com
604-398-2956

FDA: Medical Device Orgs Must Offer Patient Access to Health Data

FDA has issued final guidance to authorized medical device manufacturers, clarifying that it is acceptable for those manufacturers to open patient access to health data for those patients who request access.

The guidance states that medical device manufacturers are not prohibited from sharing this information with patients and providers upon request. The guidance does not amend any current law, including HIPAA, nor does it override any existing FDA governance. The guide simply serves as a clarification for medical device manufacturers.

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Equicare Health introduces Equicare CS (ECS) 4.7 at the ASTRO 2017 Annual Meeting

Vancouver, CANADA – September 21, 2017 – Equicare Health, the leading provider of oncology care coordination and patient navigation solutions, will introduce the  latest release of their product, ECS 4.7, at the ASTRO 2017 Annual Meeting in San Diego.

“Every year, ASTRO showcases the best of oncology technology and we are excited to show off our latest release – ECS 4.7 – at this year’s meeting. Version 4.7 introduces some significant additions to our software, including a newly designed patient portal that optimizes the user’s experience,” says Malcolm Wright, VP of Product Management at Equicare Health.

ECS 4.7 follows a responsive design, where patients can use the portal from any device including their mobile phone, tablet, or desktop. The system also supports multiple languages, so patients can benefit from ECS whether or not they speak English. Version 4.7 supports English and Spanish, and additional languages will be added with each release.

ECS 4.7 will officially be available to the public in October.

ASTRO attendees and registrants are encouraged to visit Equicare during exhibit hours; September 24 to 26 from 10:00 a.m. to 5:00 p.m. in Booth #2455 to learn more about Equicare’s products and services.

About Equicare Health

Equicare Health is the industry’s leading provider of comprehensive care coordination and patient navigation solutions. Equicare’s flagship solution EQUICARE CS™ (ECS) is a multi-facility web-based software tool, which enables cancer centers to influence clinical outcomes for patients, optimize revenue streams, and increase operational efficiency. ECS facilities patient engagement through patient reported outcomes, patient navigation, and survivorship care. The software provides other clinical tools (including MDT, Clinical trials, education material, and patient engagement) as well as an administrative suite of worklists and reports for managing adherence to accreditation standards (including Meaningful Use, Commission on Cancer (CoC), NAPBC, QUOPI, OCM). ECS enables cancer centers to influence clinical outcomes for patients, optimize revenue streams, and increase operational efficiency. To learn more, please visit www.equicarehealth.com.

For more information, please contact:

Celina Lam
Marketing Communications Specialist
celina.alisa.lam@gmail.com
604-398-2956

 

Equicare Health ranks 217th on the 2017 PROFIT 500

Vancouver, CANADA – September 14, 2017 – Equicare Health, the leading provider of oncology care coordination and patient navigation solutions, ranks 217th on the 29th annual PROFIT 500 as one of Canada’s Fastest-Growing Companies.

“It is never easy to earn a spot on the PROFIT 500, but this year’s applicant pool was the most competitive yet,” says Deborah Aarts, PROFIT 500 Program Manager. “This year’s winners demonstrate the resilience, innovation and sheer management smarts it takes to build a thriving business today. Canada—and the world—needs more entrepreneurial success stories like these.”

PROFIT 500 is an annual listing that ranks Canadian businesses by their five-year revenue growth. This year, PROFIT 500 companies will be published in the October issue of Maclean’s magazine and CanadianBusiness.com

“Equicare is honoured to be part of this year’s PROFIT 500, being recognized alongside many innovative companies nationwide,” says Len Grenier, CEO at Equicare Health. “Our continued success reflects the hard work and commitment of our team. We will continue to build on our successes and deliver leading oncology care coordination solutions to cancer patients and oncology care providers.”

PROFIT 500 follows Equicare’s recent recognition as one of Business in Vancouver’s (BIV) Fastest Growing Companies earlier this month.

About Equicare Health
Equicare Health is the industry’s leading provider of comprehensive care coordination solutions. Equicare’s flagship solution EQUICARE CS™ (ECS) is a Multi-facility web-based software tool that facilitates patient engagement including patient reported outcomes, patient navigation, survivorship care and a number of other clinical tools, i.e. MDT, Clinical trials, a suite of educational material, etc.. In additional to the clinical toolset, Equicare also offers an administrative suite of worklists and reports for managing adherence to accreditation standards including Meaningful Use, Commission on Cancer (CoC), NAPBC, QOPI, OCM, etc… ECS enables cancer centers to influence clinical outcomes for patients, optimize revenue streams, and increase operational efficiency. www.equicarehealth.com

About the PROFIT 500
For 29 years, the PROFIT 500 has been Canada’s most respectable  and influential ranking of entrepreneurial achievement. Developed by PROFIT and now published in Maclean’s magazine and at CanadianBusiness.com, the PROFIT 500 ranks Canadian companies on five-year revenue growth. For more information on the ranking visit PROFIT500.com or CanadianBusiness.com.

About Canadian Business
Founded in 1928, Canadian Business is the longest-serving and most-trusted business publication in the country. It is the country’s premier media brand for executives and senior business leaders. It fuels the success of Canada’s business elite with a focus on the things that matter most: leadership, innovation, business strategy and management tactics. Learn more at CanadianBusiness.com.

For more information, please contact:
Celina Lam
Marketing Communications Specialist
celina.lam@equicarehealth.com
604-398-2956

Equicare Health enters its third year as one of BC’s Fastest Growing Companies

Vancouver, CANADA – Sept 6, 2017 Equicare Health, the leading provider of oncology care coordination and patient navigation solutions, is pleased to announce that it has been recognized as the 20th fastest growing company on the list of the Top 100 Fastest Growing Companies by Business in Vancouver (BIV) for British Columbia.

“We would like to thank Business in Vancouver for this award. Receiving this recognition for the third year is encouraging as the team at Equicare strives to deliver cutting-edge solutions in oncology care coordination,” says Len Grenier, CEO at Equicare Health.

Equicare Health saw a 332% increase in revenue growth between 2012 and 2016 and was previously recognized in the 2013 and 2015 BIV Top 100 list.

 About Equicare Health

Equicare Health is the industry’s leading provider of comprehensive care coordination solutions.  Equicare’s flagship solution EQUICARE CS™ (ECS) is a Multi-facility web-based software tool that facilitates patient engagement including patient reported outcomes, patient navigation, survivorship care and a number of other clinical tools, i.e. MDT, Clinical trials, a suite of educational material, etc.. In additional to the clinical toolset, Equicare also offers an administrative suite of worklists and reports for managing adherence to accreditation standards including Meaningful Use, Commission on Cancer (CoC), NAPBC, QOPI, OCM, etc… ECS enables cancer centers to influence clinical outcomes for patients, optimize revenue streams, and increase operational efficiency. www.equicarehealth.com

For more information, please contact:
Celina Lam
Marketing Communications Specialist
celina.lam@equicarehealth.com
604-398-2956

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