Decision support tools that help providers better manage utilization, variations in care and costs — such as clinical pathways — have become increasingly common as the country transitions to a value-based payment model, according to a new paper by Avalere Health.
Avalere defines clinical pathways as "multidisciplinary plans that provide specific, evidence-based guidance on managing and sequencing care for certain patients whose diagnosis signals a predictable clinical course."
According to the report, clinical pathways are most often used today in the field of oncology, although many providers are working on developing these tools for other high-cost or high-prevalence conditions.
To better understand how clinical pathways impact patient experience, outcomes and expenditures, Avalere researchers employed a multi-method qualitative study by collecting data from a variety of sources and conducting semi-structured interviews with 15 stakeholders involved in or affected by clinical pathways.
Here are five findings gleaned from the study.
1. The most common reasons organizations implement clinical pathways are to improve care quality and reduce variation in treatments and costs.
2. How organizations develop, test and update clinical pathways varies greatly. For instance, pathway developers differ in who is involved in committees that design pathways and what sources of evidence are used. Also, the testing or validation process varies.
3. It is uncommon for patients to be directly involved in the clinical pathway development process, except in limited cases where patient-reported outcomes are explicitly used in the evidence to design the clinical pathways.
4. Ultimately, there is fairly limited evidence on the exact impact of clinical pathways, although some pilot studies have indicated the potential for improved quality of care and reduced costs.
5. One concern stakeholders raised regarded whether clinical pathways inhibit a physician's ability to tailor care plans to unique patient needs, especially for those whose conditions vary in disease manifestation and patient experience.
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