ASCO Releases Review of Prominent Commercial Clinical Pathway Vendors

02/13/18

The American Society of Clinical Oncology (ASCO) Task Force assessed six national pathway vendors to compare their products against the ASCO Criteria for High-Quality Clinical Pathways.

The review was published as a special article in the Journal of Oncology Practice (online February 7, 2018; doi:10.1200/JOP.17.00033).

In January 2016, ASCO released “ASCO Policy Statement on Clinical Pathways in Oncology,” which identified the need for robust criteria to support a high standard of quality among oncology pathway programs. ASCO released such criteria later that year, and the criteria are now regarded as the foundation of ASCO’s clinical pathways landscape assessment.

The ASCO Task Force—designed to address the proliferation of clinical pathways in oncology and to ensure that the pathways promote high-quality cancer care—identified six prominent pathway vendors: Anthem/AIM Cancer Care Quality Program, Cardinal Health P4 Pathways, eviti, eviCore, New Century Health, New Century Health, Value Pathways powered by NCCN, and Via Oncology. The vendors’ products were assessed with ASCO’s criteria for high-quality clinical pathways based on available information and in collaboration with the vendors.

The special article noted that some vendors modified their processes during the review because of ASCO criteria or direct interactions with task force members.

While the task force identified differences among the oncology clinical pathways and decision support tools they evaluated, they also found that all vendors met ASCO criteria for being expert driven, patient-focused, current, and comprehensive. All of the vendors also offered integrated decision support and provided outcomes-driven data.

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Contrarily, the review found that oncology clinical pathways collectively met fewer aspects of the criteria with regard to having clear and achievable expected outcomes and public reporting of performance metrics. This finding indicates that as pathway programs continue to become relevant in the health care delivery system, more information should be available on the specific cancer types pathways are designed to cover, as well as what constitutes on-pathway versus off-pathway care.

The review also identifies a need to ensure that pathway programs offer more robust reporting that reflects valid instances when off-pathway treatment is given.

"We are encouraged to see that, by and large, prominent pathway programs are adhering to ASCO's criteria for high-quality clinical pathways," said Robin Zon, MD, FACP, FASCO, chair of ASCO's Task Force on Clinical Pathways, and co-author of the special article, in a press release (February 7, 2018). "We hope our assessment of the pathways landscape will help these programs make further refinements, with the ultimate goal of improving the care of our patients."—Zachary Bessette