A Preview of the Clinical Pathways Congress


Journal of Clinical Pathways. 2017;3(6):19-20.

In September 2016, Journal of Clinical Pathways (JCP) launched Clinical Pathways Congress, its official meeting. The weekend-long event attracted key opinion leaders from all aspects of clinical pathway development and implementation, including clinicians, administrators, and payers, representing the full spectrum of pathways in oncology and beyond. This year’s Clinical Pathways Congress will take place in Washington, DC, from September 8–10, and promises to include a wide array of topics representing up-to-the-minute advancements in the field.

The Steering Committee for the 2017 Clinical Pathways Congress includes Alan Balch, PhD, chief executive officer of Patient Advocate Foundation (Hampton, VA); Stacey Ban, MD, medical director of oncology and specialty drugs at AIM Specialty Health, a subsidiary of Anthem, Inc (Chicago, IL); Peter G Ellis, MD, clinical professor of medicine at University of Pittsburgh School of Medicine, and deputy director of clinical services and associate chief medical officer at UPMC Medical Center (Pittsburgh, PA); Joan S McClure, MS, senior vice president of National Comprehensive Cancer Network (Philadelphia, PA); and Robin T Zon, MD, FACP, FASCO, chair of the American Society of Clinical Oncology Clinical Pathways Task Force, vice president and senior partner at Michiana Hematology Oncology Associates, and JCP Editorial Advisory Board member (South Bend, IN).

The Clinical Pathways Congress will commence on Friday, September 8, 2017. Following a welcoming reception and opening remarks, Friday’s sessions will look at clinical pathways in a wide variety of disease states. Jennifer R Brown, MD, PhD, director of the Chronic Lymphocytic Leukemia Center at Dana-Farber Cancer Institute (Boston, MA), will present “Emerging Treatments and Evolving Pathways for the Management of Chronic Lymphocytic Leukemia” (3:30 pm). Robert M Rifkin, MD, FACP, of University of Colorado School of Medicine (Denver, CO), and Gary H Lyman, MD, MPH, of University of Washington School of Medicine (Seattle, WA), will then present “Biosimilars and Value-Based Oncology Treatment Pathways” (4:30 pm); followed by “Quality and Clinical Pathways in the Oncology Care Model” (5:30 pm), presented by Andrew York, PharmD, JD, Center for Medicare and Medicaid Innovation (Washington, DC).

Saturday’s sessions will include “ASCO’s Policy on Clinical Pathways” (4:35 pm), presented by Dr Zon and Robert Daly, MD, of Memorial Sloan Kettering Cancer Center (New York, NY); “Integrating Therapeutic Advances and Stakeholder Perspectives to NSCLC Clinical Pathways Discussion and Implementation” (2:35 pm), presented by David M Jackman, MD, of Dana-Farber Cancer Institute (Boston, MA); and “Health Information Pathways—Bringing Pathways to Life: Challenges and Opportunities” (3:35 pm), featuring an expert panel culled from key opinion leaders working in provider and payer industries.

On Sunday, presenters will discuss clinical pathways in relation to ovarian cancer, prostate cancer, and pharmaceutical management. Also on the schedule is “Can Clinical Pathways Support Patient-Centered Care and Improve Outcomes?” (8:00 am), which will consider the role of patient advocacy in clinical pathway development. The session will be headed by Pamela S Becker, MD, PhD, of University of Washington School of Medicine, and Alan S Balch, PhD, chief executive officer of Patient Advocate Foundation (Hampton, VA). The Clinical Pathways Congress will conclude with closing remarks at 1:00 pm.

One of the most highly anticipated events of the 2017 Clinical Pathways Congress will be a mock pathways development session, led by Bruce A Feinberg, DO, JCP Editorial Advisory Board member, and vice president of clinical affairs and chief medical officer of Cardinal Health Specialty Solutions (Dublin, OH). The presentation, which will take place at 8:00 am on Saturday, will focus on the hypothetical development of a breast cancer clinical pathway. “Breast, colon, and prostate cancer represent greater than 50% of the cost and patient volume in oncology,” Dr Feinberg told JCP. “This is a rare opportunity to gain insight into the decision making and treatment selection process by physicians.” Dr Feinberg believes this session will allow participants from all background to better understand the process of developing and implementing a pathway: “As we move to value-based care, understanding how providers assess and weigh value among potential conflicting parameters should be of interest to all health care stakeholders.”

Recently, JCP spoke with Winston Wong, PharmD, president of W-Squared Group (Longboat Key, FL) and editor-in-chief of JCP, about the upcoming highlights of the Clinical Pathways Congress.

How does this year’s Clinical Pathways Congress reflect advances in the field of clinical pathways?

This year’s meeting will build on the groundwork we laid last year at our inaugural congress. We will hear focused discussions on various topics that impact clinical pathways. These discussions serve as an indicator that stakeholders are acknowledging the role of clinical pathways as an important tool as we transition into a more accountable care model. The continued conversations happening around the future of health care in the country will surely have an impact on the discussions that we will be having in DC.

What will practitioners, payers, and advocates learn at this year’s conference?

Attendees will hear firsthand how clinical pathways play an integral part in the management of patients with ovarian, prostate, and non–small cell lung cancer. We will also be conducting a mock pathway development session in breast cancer. I think that some clinicians, even those who are committed to clinical pathways, may not realize all the work that goes into developing a specific pathways program. The chance to be involved in creating a pathway from the ground up should be an eye-opening experience for stakeholders coming from all sides of the clinical pathways conversation.

How does this year’s Clinical Pathways Congress anticipate future developments in the field?

We will hear how the use of clinical pathways has changed the patient management culture in a large oncology practice taking on greater accountability for both financial and quality performance. Financial and clinical outcomes performance are key to as we move forward with the Oncology Care Model and accountable care organizations care models. We are constantly moving in a direction of accountable care, which influences everything related to the care we deliver.

JCP also spoke with Andrew Hertler, MD, FACP, chief medical officer of New Century Health (Brea, CA). Dr Hertler will present “The Integration of Genomics Into Clinical Pathways,” a presentation that addresses the potential benefits of adding and valuing genomic testing to clinical pathway programs.

How are pathway programs improved through the integration of genomics?

There are many benefits to be gained through the integration of genomics into clinical pathways. First, the availability benefits patients, because it can guide them to therapies that have a higher likelihood of working. In this respect, they can also aid in the management of potential “financial toxicity,” because there will be a higher likelihood of avoiding therapies that are likely to fail and then require further therapies. Genomics can also help oncologists in terms of providing guidance in test selection, interpretation, and therapy selection in the face of an increasingly complex and rapidly changing genomic database. It also helps delivery stakeholders focused on value-based care in the development of advanced clinical management strategies.

Are there matters of tension between the use of genomic testing and the design/implementation of pathways?

There does not have to be tension between the use of genomic testing and the design and implementation of pathways. Genomics, along with tumor type, defines an increasing number of “unique diseases.” This will in turn lead to the development of increasingly granular pathways. These pathways will be needed by physicians to manage the increasing clinical complexity driven by a massive database.