The cancer care landscape continues to evolve. Not only do oncologists need to stay up to date on the latest treatment options for their patients, but also the age span of the general population is getting increasingly longer, leading to cancer patients with more comorbidities and greater need for survivorship care plans. These growing care complexities are supplemented by a health system that is moving toward a value-based care model for reimbursement. The convergence of these many forces underscores the importance of decision-support platforms and clinical pathways that can support clinicians effectively while saving time and money across the board. The features in this issue demonstrate how clinical pathways are making an impact, with the first feature showing return on investment and the second feature exploring a new platform in its pilot stage.
Created in close collaboration with the National Comprehensive Cancer Network (NCCN), Value Pathways powered by NCCN™ provides oncologists with a list of clinically proven treatment options that support the delivery of high-quality, cost-effective cancer care. In their Research Report, Lalan Wilfong, MD, and colleagues present a retrospective cohort study analyzing data from patients with metastatic non-small cell lung cancer (NSCLC) who were treated at US Oncology Network practices participating in the Oncology Care Model to determine the impact of following clinical pathways (page 52). Authors compare total cost of care and survival in patients who were treated on-pathway vs off-pathway. Notably, this is in an older patient population with more comorbidities and in a market landscape that includes substantially more expensive therapies. This provides further confirmation that clincal pathways can contribute to lowering the overall cost of care without negative impact to the clinical outcome.
The rising cost of cancer care has contributed to the shift from volume-based to value-based care, often with different payers having different requirements for reporting and reimbursement. Clinical decision support (CDS) systems were developed to help oncologists overcome some of these challenges; however, they have not yet been widely adopted in practice. In their Perspectives piece, Barbara McAneny, MD, and colleagues explore persistent barriers to clinical pathways and CDS uptake, and potential strategies for increasing their utility in the field (page 58). Authors detail a new CDS tool called Flatiron Assist™, born out of a collaboration between NCCN, Flatiron Health, and a group of oncology practices. The tool is currently being piloted, with creators hoping the novel functionality may be able to enhance user experience and data collection.
We are all experiencing uncertain times with regard to patient care and the future direction of our health care system. The Journal of Clinical Pathways is committed to keeping you abreast of the constantly evolving field of clinical pathways and their impact on this shifting landscape.
