ClinicalPath (formerly Via Oncology) Publications
Pathways impact on cancer care
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. [Abstract].
Weese James et al. Use of treatment pathways reduce cost and decrease ED utilization and unplanned hospital admissions in patients (pts) with stage II breast cancer. J Clin Oncol 37, no. 15_suppl, 2019
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. [Article] [PubMed].
Cost and survival analysis before and after implementation of Dana-Farber Clinical Pathways for Patients with Stage IV Non-Small Cell Lung Cancer. J Oncol Pract. 2017 Apr;13(4):e346-e352
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. [Abstract] [Poster].
Ellis PG et al. Developing and piloting an electronic telephone triage application. J Clin Oncol 35, 2017 (suppl 8S; abstract 137)
Learn how evidence-based, physician-driven pathways can improve quality of cancer care by disseminating evidence quickly and enabling practices to evaluate adherence to changing treatment paradigms. [Abstract].
Friedland D et al. Evaluating the impact of Via Pathways (VP) on the adoption of changing treatment paradigms in metastatic hormone-sensitive prostate cancer (mHSPC). J Clin Oncol 34, 2016 (suppl; abstr e16510)
The cost of cancer care has been of increasing concern to patients, payers and providers. There is general agreement that, when clinical outcomes are comparable, the least costly therapy should be offered to the patient. This study examines the distribution of recommendations between efficacy, toxicity and cost using the evidence reviews from ClinicalPath Disease Committee meetings. [Abstract].
McCutcheon S et al. Frequency of efficacy, toxicity and cost as the deciding factor when determining clinical pathways. J Clin Oncol 34, 2016 (suppl; abstr e18169)
ASCO addressed the importance and role of treatment pathways in value based medicine. The goal of this study was to determine if pathways would be accepted by a large, diverse and geographically separated group, decrease the number of treatment algorithms used, increase clinical trial enrollment, and reduce ED utilization. [Abstract] [Poster].
Weese JL et al. Implementation of treatment pathways in a large integrated health care system. J Clin Oncol 34, 2016 (suppl; abstr 6613)
ClinicalPath is a decision support tool that integrates patient information, their disease, and goals of care to develop a treatment algorithm. Read about the integration of ClinicalPath into the Epic EHR and acceptance by physicians. [Abstract] [Poster].
Shamah CJ et al. Integration of a clinical pathways software into an EHR in a large, multisite, hospital-affiliated community oncology setting. J Clin Oncol 34, 2016 (suppl 7S; abstr 129)
Through a dynamic process of assessing and modifying physician practice and patterns of care, clinical pathways provide cancer centers with a platform to ensure delivery of consistent, high-quality care to patients throughout their network. Learn how clinical pathways can be used when there are several effective and accepted treatment regimens but a lack of published data. [Abstract] [Poster].
Heron DE et al. The standardization of skin cancer treatment recommendations through the analysis of clinical pathways data and an evidence-based, physician-driven committee process. J Clin Oncol 34, 2016 (suppl 7S; abstr 147)
Learn about how clinical pathways allow quick response to the changing treatment norms of oncology care. The results in this simple example of substituting equivalent drugs based on cost exemplify the power of clinical pathways to rapidly change prescribing habits across two large cancer networks. [Abstract] [Poster].
Ellis PG et al. The usefulness of clinical pathways (CP) in managing quality and cost in oncology networks. J Clin Oncol 34 (suppl 4S; abstr 715) 2016
Managing costs with oncology pathways
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. [Abstract]
Adelson K, et al. Effects of rising drug costs on efforts to control overall cost at a large academic cancer center. J Clin Oncol 37, 2019 (suppl 27; abstr 2)
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 - read the results. [Abstract] [Poster].
Pracilio Csik V et al. Pathways Impact on OCM Drug Cost. J Clin Oncol 37, 2019 (suppl 27; abstr 109)
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. [Abstract].
Page R et al. Expanding indications of existing drugs and associated costs under risk reimbursement models. J Clin Oncol 35, 2017 (suppl; abstr e18306)
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. [Article] [PubMed].
Ellis PG, O’Neil BH, Earle MF, et al. Clinical pathways: management of quality and cost in oncology networks in the metastatic colorectal cancer setting. J Oncol Pract. 2017 Apr 5
Decisions by manufacturers about which vial sizes to manufacture can have a significant impact on the total cost to the cancer patient and payer. Read about the use of cost comparison data for cancer drug regimens. [Abstract] [Poster].
Lokay K, Ellis PG.Impact of single dose vial size availability on drug costs. J Clin Oncol 34, 2016 (suppl; abstr 6623)
Assumptions used in comparing the costs of oncology IV drug regimens billed under Medicare Part B need to reflect real-world variables. Read about the use of cost comparison data for cancer drug regimens. [Abstract].
Ellis PG et al. Impact of varying approaches used to compare costs between drug regimens. J Clin Oncol 34, 2016 (suppl; abstr e18262)
Clinical research and trials
Clinical trials are essential to advancing cancer care; however, actual patient accrual rates generally fall well below the Institute of Medicine’s stated goal of 10% of all newly diagnosed patients. Learn how the ClinicalPath clinical pathways decision support tool promotes awareness of locally available clinical trials and provides associated analytics for cancer centers. [Abstract] [Poster].
Ellis PG, Weese JL. Clinical pathways as a platform to support clinical research. Proceedings of the 107th Annual Meeting of the American Association for Cancer Research, 2016 (ABSTR 2594)
Patient enrollment to clinical trials is lower than desired. Even large organizations with extensive research support services have many barriers to recruitment and poor rates of enrollment. Read about the results of ClinicalPath implementation for clinical trial accrual in a multisite, hospital affiliated, community oncology setting. [Abstract] [Poster].
Shamah CJ, Saphner TJ. Effect on clinical trial participation by integration of a clinical pathway program into an electronic health record (EHR). J Clin Oncol 34, 2016 (suppl 7S; abstr 167)
This report describes the first year of a new program site for the NCI Community Oncology Research Program, including improvements in accrual to NCI-sponsored trials. [Article].
Insights From Building a New National Cancer Institute Community Oncology Research Program Site. J Clin Oncol 34, 2016 (suppl; abstr 6613)
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. [Report] [PubMed].
Gebhardt BJ et al. Peer review process for implementation of clinical pathways (CP): Does it improve compliance? Pract Radiat Oncol. 2017 Jan 19. pii: S1879-8500(17)30006-1. doi: 10.1016/j.prro.2017.01.006.
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. [Article] [PubMed].
Rodríguez-Lopéz JL, Ling DC, Heron DE, Beriwal S. Lag Time Between Evidence and Guidelines: Can Clinical Pathways Bridge the Gap? JOP. December 2018:JOP.18.00430
Read about the use of a radiation oncology clinical pathways program to ensure consistency and rapid adoption of best evidence-based care in a large, integrated NCI-designated comprehensive cancer center. [Abstract] [Poster].
Heron DE et al. The benefits of clinical pathways (CP) for radiation oncology in a large cancer care network. J Clin Oncol 34, 2016 (suppl 7S; abstr 148)
Precision oncology and biomarkers
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. [Manuscript].
Mason C et al. Patterns of Biomarker Testing Rates and Appropriate Use of Targeted Therapy in the First-Line, Metastatic Non–Small Cell Lung Cancer Treatment Setting. J Clin Pathways 2017 4(1):49-54.
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. [Abstract].
Ellis PG et al. Using clinical pathways to understand biomarker testing patterns. J Clin Oncol 35, 2017 (suppl; abstr e18189)
Breast cancer diagnostics have the ability to predict disease recurrence and the benefit of chemotherapy. This study measures the use of a diagnostic assay, Oncotype DX, when embedded in a breast cancer decision support algorithm and, on the basis of the assay results, the use of chemotherapy in the adjuvant setting. [Article] [PubMed].
Ellis PG et al. Pathways Clinical Decision Support for Appropriate Use of Key Biomarkers.JOP May 24, 2016 JOPR010546
Oncologists use clinical pathways to drive standardization to best evidence-based cancer care. Read about the ability of clinical pathways to promote testing of key biomarkers and use of appropriate targeted agents. [Abstract] [Poster].
Ellis PG et al. Actionable biomarkers in a non-small cell lung cancer (NSCLC) clinical pathway (CP). J Clin Oncol 34, 2016 (suppl 7S; abstr 155)