The guidance that comes from clinical pathways encourages widespread and consistent evidence-based practice of medicine by incorporating the most up-to-date clinical guidelines with efficacy and, when appropriate, financial considerations. However, clinical pathways programs can vary greatly according to the goals of the organization implementing them, facility type, and care team. This issue features insights from an existing pathways program for prostate cancer, a prospective discussion of primary care-oriented, patient-level clinical pathways, and a preview of the 2019 Oncology Clinical Pathways Congress (OCPC) program.
An Integrated Prostate Cancer Program was developed and implemented at the Palo Alto Medical Foundation for Health Care, Research and Education in 2006. The foundation of the program is a multidisciplinary care delivery flow with the patient at the center: a patient navigation pathway with all care aligned with current National Comprehensive Cancer Network guidelines. Frank dela Rama, RN, MS, AOCNS, AGN-BC, provides a description of the environmental factors and facility needs leading up to and shaping the prostate care program, highlighting the importance of the nurse navigator role alongside standardized, supportive care.
While clinical pathways have been identified as a key strategy for succeeding under inpatient episode-based payment models, they have not been widely touted as part of primary care population-based arrangements such as accountable care organizations (ACOs). In fact, despite high interest in pathways among primary care physicians, overall utilization remains low. Primary care-oriented clinical pathways that focus on individual patients can serve as meaningful complements to drive performance and help achieve population-based payment model goals. In their article, Leah M Marcotte, MD, and colleagues use the ACO payment model as an emblematic example to highlight unique features of such pathways through comparison to hospital-based care and corresponding inpatient pathways.
Now in its fourth year, the OCPC serves as a forum for oncology care professionals interested in utilizing clinical pathways as a tool to facilitate more value-based care delivery in their facilities. This year’s Congress will take place in Boston, MA, from October 11 to 13. The featured session will discuss the Oncology Care Model, one of the most advanced efforts yet to shift the delivery of health care from a fee-for service model to a fee-for-value model. We spoke with a few of this year’s presenters to give you an idea of what else will be covered at the Congress.
