Transcript:

Dr Monica Schmidt: I'm Dr. Monica Schmidt. I work with Cone Health. We are a large health organization in Central North Carolina. I'm Executive Director of Health Economics.

Can you please give some background about your study and what prompted you to undertake it?

Dr Schmidt: One of the things my team does, we're a group of health economists, we're always looking for unwarranted care variation. And we had a hypothesis that if you treat patients using Elsevier's ClinicalPath product, that you are following guidelines and adhering to the most recent guidelines and that unwarranted care variation may be reduced. 
So we were prompted to look at this particular product and how it impacts 12 month survival and cost of care across Cone Health.

Please describe how the study was conducted.

Dr Schmidt: This is a retrospective cohort study with matching. So we used body site, clinical stage, treatment goals, Elixhauser Comorbidity Indices, year of diagnosis, age, race, and gender to match patients that were treated on Elsevier's ClinicalPath pathway product to those that were not treated on clinical pathways. And we actually ended up looking over a 12-month time horizon, from the time treatment started until the patient either dies or survives or 12 months has passed. So our observation period was 12 months.

What were the key findings of your study?

Dr Schmidt: The key findings were, if you are treated using Elsevier's ClinicalPath product to guide decision making along your cancer journey, we saw statistically significant outcomes in survival. So patients are half as likely to die within a 12-month time period if treated using Elsevier's ClinicalPath product, and we have a more complicated story for cost of care. We actually saw the variable direct cost—so how much it cost a system or healthcare system to treat a patient rise if you're treated on pathway versus off pathway. However, because we're hearing the guidelines, payer reimbursement offset that and we actually found that the margin improved by about an associated 74% when ClinicalPath was used to treat patients.

Looking ahead, what potential impact did you hope your findings will have on increasing the use of clinical pathway decision support tools?

Dr Schmidt: I think we realized there's a really complicated story here. So number one, using ClinicalPath had an impact, was associated with better survival. It may help to inform the shared decision making between provider-patient, and that may be why we're seeing these 12-month survival improvements. I think it's a more complicated story for health systems considering using any type of pathway product or clinical decision tool for treatment in that it may cost more to treat on pathway, but because you're hearing the guidelines, payers are recognizing that and offsetting through reimbursement so that the system, this is definitely a sustainable program moving forward for healthcare systems.

Is there anything else you would like to add?

Dr Schmidt: I feel like it's our duty to not only look at outcomes, but how to reduce the cost of care for not only healthcare systems but for our patients. And so this study brings those two elements together, and I feel that's really important moving forward as we do more and more research in oncology.