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Exploring Oncology Pathways: A collection of ClinicalPath publications

Clinical pathways can help cancer centers with operational functions including standardization, cost savings and clinical trial accrual, that all contribute to high-quality patient care. Explore publications from leading oncology journals that feature ClinicalPath and the value pathways offer. 

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Pathways impact on cancer care

Leveraging Evidence-based Oncology Pathways to Inform Multidisciplinary Tumor Board Decisions in Melanoma

Recognizing the revolution in melaoma treatment options over the past decade and the need to shift their treatment approach, AdventHealth’s team established the Cutaneous Oncology Consortium (COC), along with a dedicated Multidisciplinary Melanoma Tumor Board (MMTB). Read how knowledge gained from ClinicalPath committee meetings guides evidence-based decisions during MMTB meetings. [2021, Journal of Clinical Pathways] 

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Clinical Pathways at Roswell Park Comprehensive Cancer Center: Understanding Off-Pathway Decisions

Learn about the clinical pathways program at Roswell Park Comprehensive Cancer Center, including key drivers for pathways use, clinical trial management, pathways as a tool to enhance patient-provider goals-of-care discussions, and a review of care administered off-pathway. [2021, Journal of Clinical Pathways] 

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Integrating academic and community cancer care and research through multidisciplinary oncology pathways for value-based care: A review and the City of Hope experience

Multidisciplinary oncology care pathways are essential components of value-based care. Read about City of Hope’s academic and community-team-based approaches for implementing multidisciplinary pathways, and the supportive components with available results towards enterprise-wide value-based care delivery. [2021, Journal of Clinical Medicine] 

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Prognostic value of the “surprise question” among UPMC Hillman Cancer Center patients with select stage IV cancer diagnoses

The “Surprise Question” — Would I be surprised if this patient died in the next 12 months? — was developed to help clinicians predict when patients are nearing the end of life. This study assesses the “Surprise Question’s” ability to predict survival among Hillman Cancer Center patients with select stage IV cancer diagnoses. [2020, Journal of Clinical Oncology] 

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Going off pathway: Problem or good care?

Clinical oncology pathways (COP) provide decision support and benchmarking against national standards.  Treatment other than COP recommended is appropriate for some cases. Learn more about the on and off pathway rates and reasons for off-pathway treatment in one cancer center. [2020, Journal of Clinical Oncology] 

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Developing and piloting an electronic telephone triage application

Telephone triage is a vital part of today’s oncology practice. Read about a collaboration to develop and pilot a prototype of an electronic telephone triage application, with key components defined as decision support, EHR integration, reporting, and workflow management. [2020, Journal of Clinical Oncology] 

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Cost and survival analysis before and after implementation of Dana-Farber clinical pathways for patients with stage IV non-small-cell lung cancer

Read about the use of clinical pathways to support clinical decision making and manage resources prospectively across the network. After introduction of a clinical pathway in metastatic NSCLC, cost of care decreased significantly, with no compromise in survival. [2019, Journal of Clinical Oncology] 

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Managing costs with oncology pathways

Reducing Cost of Care with Clinical Pathways at a Large Academic Medical Center

For patients receiving chemotherapy, clinical pathways have been shown to reduce care variation and cost, adding value to oncology care. Findings in this analysis indicate clinical pathways use for chemotherapy decision-making decreased overall drug costs. [2021, Journal of Clinical Pathways] 

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Effects of rising drug costs on efforts to control overall cost at a large academic cancer center

Value-based payment programs like the Oncology Care Model (OCM) have focused efforts to reduce costly acute care use through improvements in access and coordination. Read about how participation in OCM affected total cost of cancer care at a large academic cancer center. [2019, Journal of Clinical Oncology] 

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Use of treatment pathways reduce cost and decrease ED utilization and unplanned hospital admissions in patients with stage II breast cancer

Find out how standardized usage and adherence to evidence-based pathways resulted in significant cost savings and reduction in ED/hospital utilization for on- pathway patients. [2019, Journal of Clinical Oncology] 

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Pathways impact on OCM drug cost

An NCI-designated cancer center found drug costs represent a majority of their total costs. To reduce treatment (Tx) variability, they chose to implement pathways. They hypothesized pathway driven Tx standardization would favorably impact total chemotherapy costs at the implementation site. [2019, Journal of Clinical Oncology] 

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Expanding indications of existing drugs and associated costs under risk reimbursement models

New payment models in oncology will likely include taking risk on drug costs. While new drugs could be excluded, existing drugs with expanded indications are problematic as the payer has limited data needed to exclude these costs. Read this review of treatment starts documented by providers and calculated costs. [2017, Journal of Clinical Oncology] 

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Clinical pathways: management of quality and cost in oncology networks in the metastatic colorectal cancer setting

Pathways provide evidence-based guidance for specific patient presentations based on the merit of efficacy, then toxicity, and finally cost. This study evaluates the impact of a change to the guidance in the metastatic colorectal cancer setting across two large, integrated health networks, and how clinical pathways can act as a tool to assist oncology practices in decreasing costs and quickly responding to changing treatment paradigms. [2017, Journal of Oncology Practice] 

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Clinical research and trials

Increasing Physician Awareness of Clinical Trials Through Oncology Pathways

As an active member of the National Cancer Institute Community Research Program, it is critical that Geisinger’s Cancer Institute oncologists are aware of clinical trials being conducted across the institution. Learn how research trials embedded into the clinical workflow increases the ease of coordinating with the research team and adds to the number of patients accrued to trials. [2021, Journal of Clinical Pathways] 

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Use of treatment pathways reduce cost and increase entry into clinical trials in patients with non-small cell lung cancer (NSCLC)

Since implementing pathways, clinical trial entry at one oncology center rose from 27 to 66 per year during a two-year study. Learn how pathways helped with clinical trial accrual, as well as standardization and cost savings. [2020, Journal of Clinical Oncology] 

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Radiation oncology

Lag time between evidence and guidelines: Can clinical pathways bridge the gap?

The 2018 American Society for Radiation Oncology guidelines state that hypofractionated whole-breast irradiation may be used for early-stage breast cancer regardless of age, although evidence to support this became available years ago. Before guideline publication, an integrated, comprehensive radiation oncology network sought to change their practice pattern using clinical pathways. [2018, Journal of Oncology Practice] 

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A peer review process as part of the implementation of clinical pathways in radiation oncology: Does it improve compliance?

Implementation of a pathway is a collaborative process, requiring the active involvement of physicians. This approach promotes acceptance of pathway recommendations, although a peer review process is necessary to ensure compliance and to capture and approve off-pathway selections. Read this investigation of the peer review process and factors associated with time to completion of peer review. [2017, Practical Radiation Oncology] 

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Precision oncology and biomarkers

Patterns of biomarker testing rates and appropriate use of targeted therapy in the first-line, metastatic non-small cell lung cancer treatment setting

Clinical pathways were used to understand biomarker testing patterns and ensuing first-line treatment decisions for patients with metastatic NSCLC at 7 cancer programs. Among providers using clinical pathways, biomarker testing rates were high and appropriate selection of targeted therapy was observed.  [2018, Journal of Clinical Pathways] 

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Using clinical pathways to understand biomarker testing patterns

Learn how data from clinical pathways software can be utilized to understand biomarker testing rates among providers, to then generate hypothesis about patterns of care that may include patient parameters, size of network or other factors that can be further analyzed and tested. [2017, Journal of Clinical Oncology] 

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