The Future of Pathways

In my wrap-up of the 2022 Oncology Clinical Pathways Congress (OCPC) meeting last month, I suggested that the future of clinical pathways would include a transformation of what we know as a “clinical pathway” today into a “care pathway” tomorrow. In a care pathway, the clinical pathway becomes a component, along with pathways for diagnostics, social determinants of health and patient preference, patient engagement/navigation, and payer/employer interfaces. These pathways would be supported by the backbone of real-world data from existing disconnected data elements integrated into a single data set.

This transformation to a care pathway implies a greater degree of patient centricity that goes far beyond that of defining the most appropriate treatment option for a clinical presentation based upon the medication evidence. But do we need a patient-centered care pathway? The answer is yes. We are in an era transitioning to value-based care, where there is a greater accountability to improve clinical outcomes and improve the patient experience while controlling cost. Value-based care moves from a reactive and piecemeal approach to health care services, to a health care strategy centered on aligning stakeholders and care providers in the system around a common goal of doing what is right for patients. The central focus of a value-oriented health care system is to maximize the value for patients, derived from measuring health outcomes against the cost of delivering the outcomes, including consideration for the financial and social impact to the patient.

The OCPC sessions were insightful, describing the gap of where we are today and where we need to be in the future. The real opportunity here is to create a data set from real-world data that can be used for decision support, projecting clinical outcomes in various scenarios based upon population differences and needs.

Built on top of the data foundation would be the pathway pillars focused on clinical treatment options pathway, diagnostics, social determinants of health and patient preference, patient engagement/navigation, and payer/employer interfaces. Our call to action is to work to develop pathway decision algorithms in each of these pillars to the extent and sophistication as we have developed for clinical pathways. The call to action continues with the integration of these pillars with the real-world data, bringing us to the goal of a patient-centric care pathway. This transformation will not happen quickly; however, we must set the vision so all stakeholders are working toward a common goal.

Our Feature this month focuses on patient decision aids (PtDAs) and how they have emerged as tools for patients to take a more active role in their care decisions. Tom Valuck and colleagues summarize evidence on the impact of shared decision-making (SDM) as a process, PtDAs as tools to support decision-making, and the combination of SDM and PtDAs on cost, utilization, and prevention-related care.

Also in this issue, you will find Patient Perspectives and Pharma Insights. Be sure to check out our new column OCPC: In Session and read the results of the 2022 Clinical Pathways Benchmark Survey. And finally, stay up to date on the latest news and find out what ACCC has been up to.

As always, let us know any comments, questions, or suggestions you may have. And if you’d like to submit your data, please visit our website.