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What Do Clinical Pathways Mean to You?
What does the concept of clinical pathways mean to you? The concept of clinical pathways—also referred to as “treatment pathways”, “patient pathways”, or simply “pathways”—can evoke different thoughts among different stakeholders. Payers often view treatment pathways in a similar way as they view care plans, in which the care provided to a patient is definitive and deliberate. Treatment pathways can range in scope from simply medication utilization to a comprehensive treatment plan. The hope is that the end result of treatment pathways is greater standardization of treatment regimens and sequencing as well as improved outcomes, from both a quality of life and a clinical outcomes perspective; thus fulfilling the goal of the Triple Aim.
Providers independently see treatment pathways as “cookbook medicine”, limiting their ability to provide the best and most appropriate care for their patients. However, there will usually be a high rate of consistency with most treatment pathways, especially for first and second lines of treatment. Many large group oncology practices are starting to embrace treatment pathways as a means to provide a foundation for the comprehensive care of their patients. It is their belief that, by the incorporation of treatment pathways into their practice workflows, they will be able to provide their patients with smarter, more efficient, and higher quality care. Smarter and more efficient prescribing results in cost control, which, coupled to a higher quality of care through patient follow-up, better positions the practice to assume financial risk for their patient population.
Finally, the patient may view treatment pathways as limiting their best chances for survival. While it is true that treatment options are initially limited, I am sure no payer wants to see their name in the headlines as denying life-saving treatment regimens. For the most part, I believe most payers view treatment pathways as a starting point of discussion between the oncologist and the patient; however, you will always hear reports of both extremes on the spectrum, from any treatment being allowed to treatments being denied. While specifically not a treatment pathway, the proposed ASCO Value Framework was developed with the intent of providing a tool for oncologists to use while discussing treatment options with their patients.
From whichever side of the fence you may sit with regards to treatment pathways, tell us what you are thinking.
- What is your perception of treatment pathways?
- Is it just a pilot program of today, or a tool for the future?
- Currently, treatment pathways are most common in oncology, but are there other areas for application?
- Do you see treatment pathways being replaced by the proposal for reimbursement by indication, or can the two concepts be integrated together?
We look forward to seeing your thoughts.
