Making Clinical Pathways Unique to the Patient Journey

Lee Fleisher, MD, Chief Medical Officer for the Centers for Medicare and Medicaid Services, and Director of the Center for Clinical Standards and Quality at CMS, discusses balancing the need for uniform quality care for all patients with finding the proper unique pathways for individual patients.

Transcript

My name is Lee Fleisher. I'm the Chief Medical Officer for the Centers for Medicare and Medicaid Services, and I'm also the director of the Center for Clinical Standards and Quality at CMS. I also am Professor Emeritus of Anesthesiology and Critical Care at the University of Pennsylvania.

One of the interesting discussions today is about clinical pathways. And we know that the more uniformity that we provide in our clinical care, it actually enhances that. So a lot of people talk about concordance. At the same time, my own research, and as we think about just complex patients, the interaction of not only their disease, but all the other diseases they have, as well as the social determinants, how is it the right clinical pathway and how do we adapt it for individuals based upon those complexities? So while I strongly believe in sort of the uniformity of care and making sure everyone gets that high-quality care, making sure we understand how important those other factors are to decide how to modify the clinical pathway for the individual. And one of the key things about the models and the entire national quality strategy is really patient-reported outcomes. How is it concordant with the patient's own belief of how they want to be treated? One of the key things is trust and respect, and how do we get to the outcomes that they desire given the issue of oncologic disease.