Oncology Pathways Research: Challenges, Adoption, and Future Trends
The Clinical Pathways Congress + Cancer Care Business Exchange (CPC+CBEx) annual meeting, held in Boston, September 6-8, 2024, brought together oncology leaders from across the care continuum in a dynamic forum to discuss persistent challenges in the business of oncology. The conference provided a platform to explore strategies for enhancing cost-efficiency, improving quality, and expanding access to high-quality cancer care.
In an exclusive interview with the Journal of Clinical Pathways, Cindy Chen, MBA, Head of Research at HMP Market Access Insights, shares insights into the challenges, adoption, and future trends of oncology pathways research (Figure). Her discussion draws on crucial points from her CPC+CBEx session with Lee Blansett, Executive Vice President of HMP Market Access Insights. The following is an edited excerpt from the video interview for clarity and brevity.
What would best support pathway adoption among oncologists?
Cindy Chen: Pathways and pathway adoption have been a hot topic over the last few days [of CPC+CBEx]. As we launched our inaugural research and are planning for our second year of research, what we set out to do, which is the first part, is to understand how oncologists engage with pathways. So, how do they perceive pathways, what do they use, and how does that fit into their daily lives. Regarding the factors that would drive adoption or encourage the use of pathways, we learned a couple of key drivers in our research.
The first driver is that oncologists need to understand how recommendations are selected for the pathway, [eg,] transparency of the type of clinical data, the selection process, and the selection criteria.
For the oncologist to understand that process, it creates or improves that credibility with them. They can see the oncology pathway as a clinical decision tool. If they view it as a clinical decision tool, then oncologists are more likely to use it. But equally important, the second point that the oncologists want us to understand is that it’s great to have a good decision tool, but it must be easy to access. Oncologists are busy; they want to spend most of their time treating patients, so they must integrate the treatment pathway into their daily workflow well. Integrating the pathways into their electronic medical record (EMR) is a good start. When we discuss this topic with the oncologists, some refer to this as the clickability factor. So, the fewer clicks they need to get to with that viable set of recommendations, the more likely they will use that pathway.
What general trends have you noticed in oncology pathways through your research?
Chen: Although this is only our second year of research, we’ve been looking into oncology pathways for a while. We’ve been looking at pathways through our specific integrated delivery network (IDN) research, community oncology research, and payer research. One of the things I want to bring up is the trends that we see. Although oncology pathways are useful in terms of helping clinicians make clinical decisions, they are also complicated to implement and, once implemented, require constant maintenance.
It is an undertaking, and because it is an undertaking, we primarily see oncology pathways and what we consider to be sophisticated and well-resourced networks, [eg,] large IDNs or community practices, which are often affiliated with a network like the US Oncology Network or the OneOncology network. But we also saw this year, particularly in our IDN research, that once these institutions have implemented the pathway in their first or second site, we are now seeing a more consistent rollout of pathway programs across all of their sites.
It’s no longer that only the academic medical center is using pathways, or a particular site is adopting pathways. We now see more consistent usage across all sites in a particular network!
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