Epic Collaboration

In collaboration with Epic, the ASTRO Communications Committee has begun working toward integrating radiation related patient educational material into the patient portal. The goal of our collaboration is to provide accurate and timely information as patients travel through their radiation oncology journey. Download the handout.

WHAT IT IS

Care Companion is a feature within Epic’s MyChart, that allows for patients to be given educational materials over a pre-specified amount of time. Each group of educational materials is considered a care plan, which is further organized into “tasks.” These tasks are assigned to the patient at pre-defined time points over the patient’s course of treatment. Patients are notified via MyChart the day each individual tasks is available to act on and see the education. We have adapted this feature to deliver timely radiation oncology specific content via ASTRO’s RTAnswers.org website, where written, visual and other media content is available pertaining to their place along their cancer journey.

WHO IS THIS DESIGNED FOR:

This care companion module is designed for patients being referred to radiation oncology for cancer. Currently, the list of modules currently available include the following:

HOW IT WORKS

1. Prostate cancer (intact, definitive)
2. Breast Cancer (postoperative, definitive)

Additional updates will be provided at a later date to provide directed information to radiation oncology patients receiving other treatment modalities (including prostate brachytherapy and systemic radionuclide therapy) or at other times (including postoperative prostate radiation, palliative radiation for metastases) and other disease sites (including lung cancer, colorectal cancer, and bladder cancer).

Once a patient is (1) referred to radiation oncology via an order placed in Epic, (2) has a diagnosis of prostate cancer, and (3) is not currently on the prostate cancer care plan, the person placing the order for the consult request will be prompted with a “OurPractice Advisory.” This advisory will state the patient meets criteria to be placed on the first part of the prostate cancer specific care plan and ask whether they would like the patient to be enrolled. Once the patient is enrolled, the patient will be given information prior to their consultation about radiation oncology in general as well as specific topics relating to radiation and prostate cancer. This information is not meant to replace a consultation with a physician, but will hopefully provide quality information to patients who want to learn more before meeting with their radiation oncologist.

Once the consultation is complete, if the patient elects to move forward with definitive radiation for their prostate cancer and a simulation appointment is scheduled, a behind-the-scenes “OurPractice advisory” will queue up a new set of tasks. The patient will receive additional information about the simulation and treatment. Additional educational tasks are queued up corresponding to their first on-treatment visit and first follow-up appointment after treatment.

HOW DO I HAVE THIS INITIATED AT OUR INSTITUTION

The radiation oncology prostate care plan is a standard part of the Epic’s Foundation System, with new editions released quarterly, most recently in August 2025. If your organization has signed with Epic and your environments were created with the August 2025 version, or later versions the build is already in your system. You would need to turn on the OurPractice Advisory on-ramp records for clinicians to see the advisories and get patients on the care plan.

If your institution is already live or is installing Epic software on a version prior to August 2025, please speak to your Epic analyst about adding the “Prostate Cancer Radiation Therapy” Care Plan (the Epic specific name is “Project 288814 Prostate Cancer Care Companion”) or “Breast Cancer Radiation Therapy” Care Plan (the Epic specific name is “Project 288814 Breast Cancer Care Companion”). These will be an available “Turbocharger package” (this is a term that should be familiar to the Epic analyst). Please read the “MyChart Care Companion Care Plan Catalog” section on Epic’s Galaxy documentation portal about the Prostate Cancer Radiation Therapy care plan and the Breast Cancer Radiation Therapy care plan.

HOW CAN WE CUSTOMIZE THE CARE PLAN FOR OUR INSTITUTION – DECISION POINTS:

The Care Companions are designed to be used by users in their standard implementation but may require some adjustments to ensure it works for any particular institution’s workflow.

Initiation
The care plan is started when the patient has four specific things:

1. A referral to radiation oncology
2. A diagnosis of cancer corresponding to the intended care plan
3. The patient is not currently on the respective cancer care plan
4. The person entering the referral order adds the patient to the respective cancer care plan

This will require education to your referring physicians, as they may be the ones entering these orders and initiating the care plan prior to the patient ever seeing a radiation oncologist. This is by design, but may capture more patients who are not receiving definitive radiation or patients with a history of cancer who are being referred for another diagnosis. However, the information given to the patients prior to their consultation is generic and will hopefully help all patients who have the relevant cancer diagnosis.

There may be some situations where the radiation oncologist or their team would like to add specific patients to the care plan after the patient is referred. With some additional configuration, you can enroll patients individually or in bulk without the OurPractice Advisory. Work with your Epic technical support for these options.

Post Consultation
Once patients have been seen by a radiation oncologist, they may be arranged to have a simulation. The second part of the care plan will be initiated once the following steps are completed:

1. A simulation appointment is scheduled
2. The patient is already on the initial radiation oncology cancer care plan
3. The person placing the order adds the patient to the care plan

This part of the care plan will begin after the patient has been scheduled for a simulation. This information will pertain to the simulation itself, issues arising during treatment and issues at treatment completion and follow up.

The care plan can be customized by your Epic analysts to meet the needs of your institution, for example your institutions visit-types may not match perfectly with the visit types used in the Foundation System. The care plan was designed to be functional without any changes, but it is also understandable that many institutions have different practices so updating some of the aspects of the care plan may be ideal in fitting the care plan to your institution’s processes.

The notable aspect of the care plan that might need to be customized is the visit types used in any given clinic. Tasks are associated with the patient’s appointments having specific visit type and available to the patient in MyChart starting 3 days before the appointment. The tasks were assigned in this way to make sure the information arrived to the patient before they actually experienced time point, but it may be too soon or too late for your practice). If the specific visit types are not present or don’t match, the content will not be presented to the patient. Please reach out to your analyst to have these parameters updated, if necessary.

CONCLUSION

We hope the radiation-related cancer care plans will be a useful tool in providing timely information for your patients. Please feel free to contact us if you have any questions, concerns, comments or suggestions for improvements or future updates regarding the cancer care plans!