Using Real-Time Dynamics to Enhance Clinical Pathways

Davey Daniel, MD, Chief Medical Officer, OneOncology, closed out the opening session of the 2022 Oncology Clinical Pathways Congress with his presentation “The Impact of Real-Time Dynamics in Clinical Pathways.”

The need is to identify forces that are shaping pathways, and to learn how to build systems to support and enhance those pathways. This can be difficult in a world that is constantly accumulating new data and must take into account geographic factors, contracting, and payer preferences. Additionally, cost control is more challenging than in the past, and gaining compliance can be tough.

A shift is needed, Dr Daniel said, from a single health care provider’s knowledge to a network where information is shared and used to build new pathways.

“Physicians are not solitary knowledge engines,” Dr Daniel said. “I don’t think that’s healthy, and I don’t think that keeps them up to date. We need to build out this knowledge network. That’s how we think of what our pathways should be like.”

There are four pillars to the establishment of these pathways: research, precision medicine, care innovation, and clinical decision support. These are built upon a foundation whose key ingredients are technology, education, and quality care.

According to a recent OneOncology survey, more than 60% of oncologist respondents believe the field is changing rapidly and new skill sets are required.

OneOncology’s network of physicians uses a combination of pathways, testing, education, research, and integrated real-time feedback to help process information. A balance is found between valid expertise and accepted measurement, and this is reevaluated over time to see if current data has resulted in the need for new pathways to be studied.

Technology is key in clinical decision support, Dr Daniel concluded. Pathways, education, and performance must be easily accessible and able to be updated quickly, and supplemental information must be discoverable. In addition, there must be measurable compliance with feedback provided to physicians.

One pathway tool Dr Daniel discussed was Flatiron Assist, which provides real-time reporting at the physician, practice, and partnership levels. Within the OneOncology network, use of Flatiron Assist has improved preferred clinical pathway adherence for numerous types of cancer treatments, including breast, colon, and non-small cell lung cancers.

Physician education is critical, Dr Daniel said in closing. Content is driven by the needs of the physician and can utilize internal programs, IdeoOncology programs, and online dialogue.