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Benchmarking Survey Shows Increased Pathway Comprehensiveness

October 11, 2019

To kick off OCPC, Journal of Clinical Pathways (JCP) Editor-in-Chief Winston Wong, PharmD, highlighted the most notable findings from the 2019 JCP Oncology Clinical Pathways Survey. 

Clinical pathways continue to be an integral part of oncology care, he began, especially as care evolves to support alternative care models and reflect value-based care. The benchmarking survey was distributed and responded to by 75 individuals from across the pathway stakeholder landscape, including direct care providers (84%), physician assistant and nurse practitioners (16%), and cancer center pathway administrators (4%), among others. Dr Wong noted that there has been a shift from community to institutional settings responding to the survey year-over-year.

The distribution of financial model participation did not change much from 2018, with the predominant reimbursement model being fee-for-service (64.9%), he stated. Similarly, the level of oncology pathway utilization has not changed significantly since 2018. Sixty-six percent of respondents currently have pathways in place, and 14% plan to implement pathways within the next year.

Among the most noted drivers to implement clinical pathways include payer request/reimbursement, physician request, patient organization request, and alternative financial reimbursement models, Dr Wong listed. These are similar to the results reported in the 2018 benchmarking survey.

One of the most significant changes to pathway utilization and development in this year’s survey was a greater percentage of respondents creating pathways internally (23.7%) at the expense of utilizing third-party programs (10.5%). As a result of this trend, oncology clinical pathways appear to be trending toward more comprehensive options and guidance; there has been a significant increase in surgical, radiation, supportive care, and genomic profiling inclusion in pathways, according to the survey results.

In regard to pathway application, Dr Wong reported that 55% of respondents utilize pathways to track individual prescribing patterns, which corresponds to 47% of respondents being able to select off-pathway choices without some type of peer-review. The remaining 49% of respondents are unable to prescribe off-pathway decisions without prior approval. Furthermore, he noted that there appears to be improvement in the ability to access pathways through the electronic medical record.

Lastly, he noted that pathways are largely viewed to have a very beneficial impact on improving the quality of care and outcomes, streamlining data collection, and controlling cost.

A comprehensive report of the full survey results with an extended commentary on findings by Dr Wong will be published in an upcoming supplement to JCP.

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