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The Passport For Care® (PFC) application is an innovative healthcare project developed by researchers at Baylor College of Medicine and the Texas Children’s Cancer Center that addresses the need to provide patients and survivors of chronic illnesses with increased access to their medical information, healthcare guidelines, and appropriate follow-up care recommendations. The PFC is an interactive Internet resource that provides the user with accurate, timely, and individualized healthcare information available electronically 24/7. The PFC was developed for survivors of childhood cancer based on the Survivorship guidelines provided by the Children’s Oncology Group (COG). The PFC provides tailored guidelines in a computerized/digitized and automated way by combining the treatment input data with the COG guidelines to generate a comprehensive survivorship care plan with follow-up care recommendations and educational information.

We encourage you to explore how the PFC can be used as a patient database. The reporting function allows your clinic to use this site as a patient database and customize the returned set of records using a number of options to filter included patients and control which data is displayed. However, keep in mind that the Passport for Care is not a replacement for an Electronic Medical Record. Additionally, the Passport for Care has been further expanded to include the Survivor website that allows the survivor 24/7 access to their own treatment information, follow-up care recommendations, and thus make it sharable with any healthcare providers.

Logging on:

Step 1: Note your user name and password. Usernames and passwords are unique to each individual and should not be shared.

Step 2: Go to https://www.passportforcare.org to access the PFC.

Step 3: Enter into the designated fields the assigned username and password and click the “Sign In” button.

Once logged in, you will notice your name at the top of the screen. Verify that it is the correct name.

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Logging off:

Step 1: Click on your name on the top right.

Step 2: Find and click the “Sign Out” button.

Once the “Sign Out” button is clicked you will be logged off and you will be directed to the PFC site’s login page.

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For security purposes, we recommended that you enable the two-factor authentication that will help you keep your account secure. Two-factor authentication is an extra layer of security for your Passport for Care account that will help ensure you’re the only person who can access it even if someone knows your password.

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By enabling two-factor authentication, you will use the token sent to the primary token device every time you log in. You may select either one of the following authentication methods:

• Text message authentication will send a text message to any phone number you wish to receive your authentication token. Before completing, this method will have you validate your phone number by entering a token sent to your phone.

• Token generator authentication will auto-generate a token on your dedicated smartphone app, such as Google Authenticator. Before completing, you must scan the QR code using an app such as Google Authenticator to complete the set-up. If you are unfamiliar with how applications like Google Authenticator work - see How to Set up 2-Step Verification.

Once complete, both authentication methods allow you to set-up the following backup methods in case your primary token device is unavailable:

• Add Backup Phone Numbers - can be a set of multiple phone numbers

• Generate Backup Tokens - auto generates a set of codes you may safely store for later use

• Disable the two-factor authentication method

The PFC Cancer care summary is based on the “Summary of Cancer Treatment” document provided by the Children’s Oncology Group.

There are two ways to view your clinic's care summaries, comprehensive view (default), and abbreviated view.

Users can toggle back and forth from one view to the other. Information entered into one view feeds into the other. Both will generate the same set of Followfollow-Up Guidelinesup guidelines.

• The comprehensive view displays all entry fields when entering patient information and displays all the information submitted when viewing the care summary page. This view allows for the entry of additional treatment summary forms that do not affect guidelines generation but may help create a more complete record, for instance, treatment summaries such as Complicationscomplications/Late Effects and Adverse Drug Reactionslate effects and adverse drug reactions. Remember the survivor can see these entries on their Survivor website account, so please include them when applicable, as they may be valuable for the survivor and outside providers.

• The abbreviated view only displays required fields on forms when entering patient information. These fields are required to generate guidelines. This view only displays the required fields when viewing the care summary page and does not collect any additional information.

The comprehensive view is a unique view of the care summary page only. The view displays all entry fields when entering patient information and displays all the information submitted when viewing the care summary page. Information entered into the comprehensive view will display for the survivor to see on their Survivor Website.

The comprehensive view allows for the entry of the following treatment plans:

• Primary Diagnosis - one required

• Relapses - one or more possible

• SMN - one or more possible

Multiple individual treatment summaries can be assigned to a treatment plan. Those treatment plans include:

• Radiation

• Surgery

• Chemotherapy

• Transplant

• Other Therapeutic Modality

The Comprehensive view also collects the following additional information:

• Treatment Centers

• Protocols

• Complications/Late Effects

• Adverse Drug Reaction

The Abbreviated abbreviated view is a unique view of the care summary page only. The view displays only required fields when entering patient information and displays only those fields when viewing the care summary page. The Abbreviated abbreviated view also gives you a collapsed view of the patient's care summary page that does not include additional treatment summary forms such as Complicationscomplications/Late Effects and Adverse Drug Reactionslate effects and adverse drug reactions.

The Abbreviated abbreviated view collects the following:

• Treatment plans

• Treatment summaries

The Abbreviated abbreviated view does not collect the following additional information:

• Treatment Centers

• Protocols

• Complications/Late Effects

• Adverse Drug Reaction

Any information you would like to add to which the system may not have a dedicated field can be entered using the additional information page. These entries will be displayed in the Cumulative Summary cumulative summary and will not affect the algorithm when guidelines are generated. Additionally, when creating entries you can choose to have the entry be either visible to patients on their Survivor Website or hidden so that it is only visible to other clinicians in your clinic who access the patient care summary.

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The Cumulative Summary cumulative summary displays an entire overview of the patient’s cancer experience(s) entered. While no edits can be made in on this page, it combines all the data entered through either the Abbreviated abbreviated or the Comprehensive comprehensive view.

The Cumulative Summary cumulative summary is available in PDF and as an editable Word Document.

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The Abbreviated Summary abbreviated summary displays only required fields from patient's information entered in on the care summary page. While no edits can be made in on this page, it mirrors the data that can be entered through the Abbreviated abbreviated view. As in the Abbreviated abbreviated view, this summary does not display the following sections: Treatment Centerstreatment centers, Protocolsprotocols, Complicationscomplications/Late Effectslate effects, and Adverse Drug Reactionsadverse drug reactions.

The Abbreviated Summary abbreviated summary is available in PDF and as an editable Word Document.

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Follow-Up Guidelines up guidelines are system generated using the required fields and running them through an algorithm to produce the following tailored reports.

Follow-Up Guidelines

• Late Effects for the patient - with associated exposure

• Sorted by Body Systembody system

• Sows Late Effectslate effects, Exposureexposure, Section section (Scorescore), and Screening screening accompanied by the Frequencyfrequency

• Available as PDF

Evaluations

• Evaluations The evaluations (Fullfull) view shows evaluations for the patient with long descriptions of the history and physical

• Sorted by Body Systembody system

• Shows Body System, Late Effect, Exposure, Section, Screening, and FrequencyScreening Only body system, late effect, exposure, section, screening, and frequency

• The screening only view shows a list view of labs, imaging, and additional evaluations without descriptions of the history and physical

• Available as PDF or Word Document

PLE Patient Output

• Mirrors content that will be displayed on the Survivor Website

• Sorted by Body Systembody system

• Shows Body System, Late Effect body system, late effect risks, and rationale of why you may be at risk for the late effect

• Available as PDF and in Spanish

Health Links

• Lists all associated health link documents in multiple languages

• Available as PDF or Zip download

Printable Guidelines for This Patient

• Shows tailored guidelines for the patient

• Shows Section Number, Therapeutic Agents, Potential Late Effects, Periodic Evaluations, Health Counseling/Further Consideration, Additional Information and References section number, therapeutic agents, potential late effects, periodic evaluations, health counseling/further consideration, additional information and references

• Each entry has an Evidenceevidence-Based Score based score

• Optional display of Referencesreferences

• Available as PDF

All Printable Guidelines

• Printable versions of complete guidelines associated with the care summary in its original COG PDF format.

Cancer Screening Guidelines

• COG General Screening Guidelines general screening guidelines for the patient

• Sorted by Gendergender

• Shows Section Numbersection number, Organ, Standard Risk Parameters and Screening Guidelines, Highest Risk Parameters and Screening Guidelines, Health Counseling/Further Considerationsorgan, standard risk parameters and screening guidelines, highest risk parameters and screening guidelines, health counseling/further considerations

• Available as PDF

Evidence-Based Scoring

• Explanation of how the evidence-based score is derived

• Available as PDF

The Survivor Account survivor account page allows you to generate instructions and code for your survivors to allow them to create their account to their Survivor Website - see [How to Generate a Video] & Clinician Guide to Survivor Website

After code generation and the first successful login by the survivor, the page will describe the type of user, usually a Parent/Guardian for an account with a patient under 18 and the survivor once thereafter. On the survivors' 18^th birthday, existing accounts will be disabled and a new generation code will have to be generated.

Next to the type of user column will be the status of the Survivor survivor account either active, inactive, or disabled. Next to that will be an action column with a button allowing you to manage the account where you are able to change the survivor’s username, role, and status.

Lastly, there is a Login Activity login activity column that keeps a record of the survivor’s number of total logins and timestamps of the last five times the survivor has logged into their Survivor Website.

The revision history page can be found under individual patient care summaries. Revision History history tracks all additions, updates, and deletions. It details changes by page, date, time, action taken, the user who made the changes, the fields modified, and values for those fields.

Additionally, selecting “Include View Only Entries” displays an expansive list of activities by users that includes previous instances where the patient care summary has been viewed.

System Notifications are used b PFC for communication across all clinics or select clinics based on the message. These may include important reminders, system downtime, special instructions, etc.

System notifications will display at the top of the screen and are removable by pressing the “Dismiss” button.

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The Help/FAQs tab of the site's navigation bar links to the Passport for Care General Information and Resources webpage where current users can access educational materials that provide guidance. Resources include the Video Training and Tutorial Series, Frequently Asked Questions, and the Quick Reference Guide.

Additionally, it is a public-facing site where non-enrolled but interested clinicians or facility staff can access to learn more about what the site provides. Information on both the clinician facing Passport for Care Clinician Website and the patient-facing Passport for Care Survivor Website is provided.

The Contact Us contact us tab of the site's navigation bar links to the Helpdesk webpage Help Desk Webpage where you are able to request assistance, updates, and submit suggestions and questions. Please use the Helpdesk for all your issues so the development team can track items and their resolutions throughout the life cycle of the Passport for Care.

Additional features are added to the Administrator administrator accounts to help them manage their clinic system from their location. These features can be accessed by clicking on the additional tabs located on the site's navigation bar.

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User Administration

Administrators using the User Administration user administration tab can add new users, assign security roles, and do general account management.

After clicking on the Use Administration user administration tab users will be presented with a list view where administrators can see the user's full names, last login, sign in security, and whether the user is a clinic administrator.

Security roles are:

• Administrator: This security level allows users to create and train new clinic users of the system, assign security roles, and do general account management. The clinic administrator will also be the point of contact between the clinic and BCM-CCIT for technical support.

• Editor: This security level allows users to create care summaries, enter patient information, and view guidelines recommendations.

• Read-only: This security level allows users to only view care summaries and guidelines recommendations.

Patient Report

Administrators using the Patient Report patient report tab are able to run clinic wide reports with the help of filter tools to retrieve care summaries and download reports.

Located under the list of filters, administrators are able to use toggle buttons to customize reports by narrowing the data included in the reports. By clicking on the '+' symbol next to these toggle buttons, a list of data points appears which, if turned off, will exclude them from the report.

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