Segment 5 - The Use of Tools and Electronic Health Records in Pathway Adherence

In this segment, panelists discussed the various tools that are used to measure pathway adherence.

Dr Nabhan said that short of monitoring patients' adherence to the proper pathways via electronic health records (EHR), there are not many tools that come to mind for driving adherence. He said there should always be the expectation that some patients will not be adherent.

Dr Tischler said due to variability, there may be up to 25% of patients who “fall out” of adherence. However, providers have a responsibility to determine what the cause of non-adherence is. Web portal monitoring could be 1 way to make this easier and more streamlined.

In fact, Dr Malin said that WellPoint uses a Web portal to monitor adherence. However, the tools and goals of pathways adherence can be different. Some pathways have a “single-best approach” that focuses on population health management, where other pathways can have 3-4 treatment options that might be applicable.

“I think when you’re looking at adherence rates across different pathway programs, you can’t necessarily assume that you should see the same benchmark for different programs because it may vary with how the program is designed,” said Dr Malin.

Dr Yu said he has not seen successful integration of pathways with the EHR commonly used by oncologists. The current system can cause extra work, and there is lack of efficient pathway mapping. Vendors also currently lack incentive to improve EHR systems.