Clinical Pathways in Oncology: A Challenging Opportunity to Improve Care

Dec 22, 2016

Clinical pathways in oncology are detailed, evidence-based treatment protocols for delivering cancer care for patients with specific disease types and stages. Increasingly being adopted across the health care system as a way to improve quality while controlling cost, pathways are a valuable tool to help improve care. However, increased proliferation of pathway programs has raised concerns regarding the lack of mechanisms in place to ensure they are consistent, transparent, and help—not hinder—quality cancer care.

The ASCO Task Force on Clinical Pathways conducted an assessment of the U.S. oncology pathways landscape and identified several key concerns. The Task Force found that clinical pathways in oncology are not developed or applied consistently by insurers and other pathways creators, resulting in wide variations in quality and utility. Additionally, pathway programs may be too rigid and can place too much emphasis on cost control, which may restrict patient choices and conflict with physicians’ clinical judgment. An additional concern is that pathways in oncology are often focused only on the selection of anticancer agents and do not include other critical aspects of cancer care, including diagnostic evaluation, laboratory testing, and palliative care services, which are central to quality patient care. Also of significant concern is that in many cases, pathways are not developed with transparency to patients and providers. The Task Force concluded that there is no system in place to guarantee the integrity of pathways coming to market, or to ensure that they are implemented in a manner that supports high-quality patient care.

To address these issues, last year ASCO released the ASCO Policy Statement on Clinical Pathways in Oncology, which proposed several recommendations to ensure that pathways promote high-quality care and better accommodate the diverse circumstances and characteristics of patients with cancer. The policy statement recommended that pathways be expanded to address the full spectrum of cancer care and updated regularly to reflect the latest in evidence-based clinical practice. Additionally, the statement called for a reduction in the administrative burden that pathways can place on physicians, distracting from the time that can be devoted to serving patients.

Since releasing the policy statement, the Task Force has engaged a range of stakeholders across the oncology community to create a set of criteria for developing and implementing pathway programs that effectively facilitate high-value, high-quality care delivery for patients with cancer. These criteria will ideally be used to guide the development, implementation, and analysis of pathway programs, as well as to help oncology providers and other stakeholders better evaluate clinical pathways and ensure they are developed and implemented in the way they are intended.

Visit ASCO in Action for the latest news on clinical pathways in oncology.

Comments

Mihaela C. Munteanu, MS

Jan, 13 2017 10:14 AM

This task force is indeed needed for equal access to good quality cancer care for patients. Good job in posting!! This is becoming increasingly important with an increased in life span. I am actually very interested in this topic of effective good clinical practice guidelines and pathways and I plan to conduct my dissertation in this area for lymphoma and general oncologists this year. How do I get involved w ASCO (I am a member of both ASCO and ASH) as a graduate student to collaborate perhaps, and also learn more?  Thank you Mihaela Munteanu 


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