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Challenges in Personalization, Integration of Pathways

October 27, 2018

On day 2 of the 2018 Clinical Pathways Congress (September 27, 2018; Boston, MA), Linda Bosserman, MD, FASCO, FACP, City of Hope (COH) Medical Group, gave a presentation on her real-world experience in implementing and operationalizing pathways to support value-based care.

COH’s pathways program began using VIA Pathways (initiated in January 2017) and the EPIC EHR system (live December 2017). Treatment pathways as well as comprehensive surgical pathways, enhanced recovery after surgery (ERAS) pathways, were included in this pathways discussion. 

In her discussion, she touched on the practical steps as well as challenges during implementation of a pathways program, how EHRs and other decision support tools need to be leveraged alongside of pathways, and how solutions such as standardized patient-reported outcomes can efficiently address the needs of multiple stakeholders.

Integral to adding more value to care through pathways, Dr. Bosserman noted, is to agree on a common set of data elements, eg, diagnosis, therapy, outcomes, as well as standardizing data element collection, eg, through the EHR and clinical workflows. Data that is produced from your pathways use and work flow should then be placed in the context of big data.

The ultimate goal, she explained, is to build the proper decision support that combines and incorporates evidence-based care and real-world data for patient-focused tools. She called out a few of the groups to look for who are developing comprehensive tools that can support patient-centered pathways, including Cota, GenomOncology, Flatiron, Philips, IBM Watson for Oncology, and My Cancer Genome.

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In closing, Dr. Bosserman said that with the overwhelming amount of new research data coming out on medical care and treatments, in oncology care in particular, decision support tools that integrate care pathways and make use of collected data in real time will be essential for providers to keep up with the most effective treatments and recommendations.—Amanda Del Signore

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