Segment 2: What Are Oncology Care Pathways?

The discussion began with each of the panelists providing their unique perspective on clinical pathways.

Michael Fisch, MD, MPH, said that they are optimal care choices among a larger set of evidence-based choices that oncologists come across, although “they may not be as comprehensive as the guidelines developed by the [National Comprehensive Cancer Network].” His organization, AIM Specialty, is more focused on drug regimen treatment choices, he added, with emphasis is on efficacy and safety, with cost considered only when the first 2 features overlap for the treatments being compared.

Kathy Lokay concurred with Dr Fisch, adding that Via Oncology takes a slightly different approach that caters specifically to their customer base, which is primarily cancer centers. Our pathway development committee leans toward a more stratified pathway driven by a specific case presentation. She added that while pathways were “initiated on the medical oncology drug side, they lend themselves to virtually every aspect of cancer care,” including radiation oncology, surgical oncology, and symptom management. She emphasized that the intent of clinical pathways is to standardize the best evidence-based care.

“If you want to be a purist, in my way of thinking about it, the element that’s unique about pathways is a longitudinal characteristic,” said Robert Dubois, MD, PhD, unlike guidelines that work off of a single node.

According to Blaise Polite, MD, MPP, clinical pathways are a way to ensure some consistency in how we see patients “such that if a patient comes into my office or comes into one of my satellite’s offices with the same diagnosis, they’re not being treated in several different ways. It’s not whose door [patients] choose to open on that day and what appointment they get, but much more a consensus driven opinion by experts using evidence-based medicine.”