All OnCore statuses will be used to either drive or stop Epic account review and/or billing activities for CMS required compliant Clinical Trial Policy (CTP) billing.
OnCore statuses flow to Epic near-time and will be available for use shortly after your entry. Per policies at SCCA, UW Medicine, and the Consortium, your entries should be made within 24 hours.
OnCore status changes will show in Epic in the Past Updates section and will be available for billing review. If you are not yet working in OnCore, then you would step through the appropriate Epic statuses (in this example, “Consented”, “Not Eligible”, “Consented”, “Eligible”, “On Study”, “On Treatment”, etc.)
Billing offices will begin review and/or perform CTP billing with the status of “Consented” and will work with all statuses up until entry of “On Treatment” for interventional studies and “On Study” for other studies such as observational studies. Along with these statuses, indications on your orders, visit linking, and appointment notes will be important.
Billing offices will review and/or bill beginning with the status of “On Treatment” and through the entry of “Off Treatment” for interventional studies. “On Study” will be used for observational studies without a treatment phase. “On Study” will also be used until “On Treatment” has been entered for all subjects’ post go live who are on interventional studies. During the treatment phase, CTP billing is in place for research-related patient billable items. Along with these statuses, indications on your orders, visit linking, and appointment notes will be important.
Billing offices will review and/or bill beginning with the status of “Off Treatment” and through the entry of “Off Study”. For Observational Studies and during the go-live period (until on treatment dates have been entered for all subjects on interventional studies) Billing offices will review and/or bill with the status if “On Study” and through the entry of “Off Study”. “On Follow Up” will also alert the billing offices that there are potential patient or study billable follow up related services. Along with these statuses, indications on your orders, visit linking and appointment notes, will be important.
Billing offices will cease review and/or billing with the statuses of “Not Eligible”, “Withdrawn”, and “Off Study”.
If the subject is in an Active status (Consent waived, Consented, Eligible, On Study, On Treatment, Off Treatment, On Follow up), CRBB uses the enrollment’s “Active start date” in Epic to help determine whether a particular charge is potentially research-related. If the subject is in an Inactive status (Withdrawn, Not Eligible, Off Study, Expired), CRBB uses the enrollment’s “Active start date” and “Active end date” in Epic to help determine whether a particular charge is potentially research-related.
Subject signed initial consent, but prior to any screening activities occurring, the subject needed to sign a revised consent. No activities occurred between first and second signing. Which date should we use for Consented Date?
For go-live purposes, please indicate the earliest consent date.
On Study is defined as the date the study subject has been registered to the study after having completed the eligibility step and has received a subject ID from the sponsor. The On Study date is the required date in OnCore for accrual credit. It is not related to billing. In the CTMS workflow, subjects will be marked as Billing Active in Epic as soon as they have consented to the study and have a consented date recorded in OnCore.
On Follow Up date is the first actual protocol-defined follow up visit date and will be on or after the Off Treatment date. For example, depending on your protocol, the EOT visit may be the last On Study date and the first On Follow Up date.
The Off Treatment date is the date the study subject stops receiving the study intervention or when the study treatment or procedure the study is tracking ends.
On Follow Up: The date the study subject is enrolled in the follow-up phase of the study regardless of whether study specific billing is occurring or not.
Off Study: The date the study subject is completely off the study at study completion. No further activity occurs, including billing activity.
To identify what constitutes the start of the follow-up phase, we suggest deferring to what each protocol defines as the start of the follow-up phase. It might be first visit post last dose, 28-day follow-up etc., depending on the specific protocol. For the existing studies if you would like to adopt a simplified approach of applying the date related to the first visit post last dose that may be acceptable.
On Treatment, On Follow Up and Off Treatment don’t necessarily apply to all studies. For example, subjects on observation studies may directly progress from On Study to Off Study without being marked as On Treatment, Off Treatment or Follow Up.
We do not need On Follow Up or Off Study dates for subjects who did not enroll into studies (i.e. screen fails).
The CTMS Program Office will update all deceased patients as Off Study using the deceased date as the Off Study date.
All subjects regardless of site of enrollment need to go in to the CTMS. If we have site of enrollment from PATS, we will attach those subjects to their respective site. If we do NOT have site information for a subject, it will be up to the study team to accurately match the subject to the site.
The implementation strategy is divided into three targets:
Timing for each Target varies. Currently:
UW/FH Cancer Consortium Oncology studies and FH Non-Oncology study teams will go live in 2018 as part of Group 1 (July 16, 2018) or Group 2 (September 17, 2018). Non-oncology studies will go live in 2019, exact dates yet to be determined. To find out if your team is in Group 1 or Group 2, please see our earlier announcement.
Yes. OnCore is set up to receive demographics information from Epic, provided that participants have a patient record in our Epic system.
CRS will continue uploading documents into Clinical FYI for an interim period of time.
After all T1 study teams are live in OnCore and stable (by Q1 of CY 2019), OnCore will replace Clinical FYI as the repository for current protocol documents. At that time study teams will need to upload current versions of documents into OnCore. Study Teams do NOT need to upload documents in OnCore upon go-live.
Clinics will continue to use Clinical FYI for protocol documents until after all Target 1 groups (UW/FH Cancer Consortium and FH Non-Oncology) are live.
Specific information on when clinics will need to access documents directly in OnCore will be made available in May/June 2018.
We are assessing the appropriate workflow for this scenario and will have more information later in summer of 2018.
For chart reviews, reporting enrollment data is optional.
For specimen banking, enrollment data may be required if you are required to obtain an Epic Research Study Account number for the specimen collection. If you are obtaining patient consent, you will need to enter enrollment information. In other cases it may be optional. Specific guidance on when enrollment data is required will be provided as part of CTMS training.
For FH/UW Consortium and FH non-oncology, all human subjects research will be tracked in the CTMS, including minimal risk studies. The amount of information entered into the CTMS will vary depending on the type of study.
Yes, faculty and staff who require access to study information and documentation will have permission to view basic protocol information and to download study documents across groups.
No, there are no required document submission changes. We encourage staff to attach all relevant documents with their initial submission to prevent delays later in the process.
Working documents will be uploaded via the REDCap Intake Form. Any new or modified documents will be submitted via REDCap as well. The Amendment Decision Tree Survey will tell you where to do that. Final Billing Grid will be available on the OnCore Activation/OTA Task list in the PC Console > Status > Task Lists tab and in Clinical FYI.
If the study has not been submitted to sRAMP prior to go live on June 1st, the study team will need to submit a REDCap Study Intake Form. The RG number auto-generated by the REDCap form will be updated with the RG number already assigned in OnCore.
The sRAMP SharePoint allows for reverting back to previous versions of the billing grid by way of the document history. Will this functionality be maintained when the documents are hosted on the OnCore task list?
No, OnCore does not support that level of version history.
No, the CTO Informed Consent review only includes billing compliance level review, verifying alignment with billing grid and other documents, and Medicare Secondary Payer (MSP) language.