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Editor's Page

Preserving Patient and Provider Voice in Clinical Pathway Development and Use

Authored by

Winston Wong, PharmD, Editor-in-Chief


J Clin Pathways. 2018;4(2):11.

In our increasingly digital world, providers’ and patients’ voices and individual needs must be prioritized. When it comes to treating others or being treated for incredibly complex illnesses, the health and wellbeing of both parties can often be at risk. Decision makers should ensure that the complexities and needs of both providers and patients are met. 

While all professionals in the health care field recognize the Triple Aim (outcomes, costs, and patient experience), a fourth area of concentration has been added and needs to be addressed to enhance the delivery of care: the workforce. In this month’s CP GPS column, Richard G Stefanacci, DO, MBH, MBA, AGSF, CMD, expands upon what it means to purse the Quadruple Aim, with the fourth aim specifically addressing better clinician experience in order to strengthen and preserve the workforce (page 33). Care professional burnout, says Dr Stefanacci, is associated with lower patient satisfaction, inferior health outcomes, and may increase care costs, thus threatening the pursuit of the Triple Aim. He suggests that more comprehensive clinical pathways may provide a way to address this issue. 

It is important to remember that while developments like clinical pathways and treatment guidelines are becoming increasingly important to clinicians and payers, they remain largely invisible to patients and caregivers. Indeed, few people being treated for serious illnesses are aware that pathways or guidelines exist or understand their potential impact on treatment options. In the first installment of a new column series focusing on patient advocacy,  Alan Balch, PhD, explains that while clinical pathways have been narrowly focused historically, steps can and should be taken by providers and stakeholders to ensure that individuals’ preferences and circumstances are adequately represented in clinical pathway development (page 39)

The advent of biosimilars is another example of how medicine is advancing. Understanding how people, providers specifically, view and react to them is another area of concern. Biosimilars have the potential to lower health care costs; seeing this potential, the Food and Drug Administration has created an abbreviated regulatory process for their approval. Nonetheless, prior studies have documented physician concern with biosimilars, which may hinder their uptake. In their research report, Chadi Nabhan, MD, MBA, FACP, and coauthors aimed to better understand community oncologists’ general understanding of biosimilars and their perception of barriers to biosimilars acceptance through surveys (page 43). Based on the responses, authors identified critical educational gaps that need to be addressed by manufacturers and policymakers in order for biosimilars to achieve their potential for lowering the cost of cancer care in the United States. 

Together, these articles emphasize the continued importance of not getting so carried away with technology, pre-approved plans, or theoretically ideal outcomes that the human aspect of medical care and care providers is lost.

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