Segment 6: Standardizing Clinical Pathways Across Health Plans

Surabhi Dangi-Garimella, PhD, asked what might be the administrative burdens for physicians as they try to adopt pathways that are not as standardized or different pathways prescribed by each health plan.

Blase Polite, MD, MPP, acknowledged that incorporating certain pathways into clinics can be a clunky process. He explained that a few of the US oncology practices have used pathways for 10-15 years, and this simplifies things as pathways can help make the choice of chemotherapy that is administered. For those practices that use pathways as a standalone, there have been some extra administrative burdens, and oncologists have been frustrated with the electronic health record.

As for adopting individual pathways for different providers, Dr Polite said that that situation would face considerable blowback from the oncology community; 1 single pathway would be simpler, and in order to unify, there would be need for consensus amongst payers, providers, and pharma. “[I]f it’s going to be some quasi-governmental deeming process like we do with clinical data registries you need to have buy-in from all the stakeholders.” explained Dr Polite. Without them, the process would be much more difficult.

Despite predicting some issues and disagreements, however, Dr Polite believes that consensus can be reached without great difficulty.