Relentless Health Value

Recently I was talking to someone, a civilian not in health care, and I mentioned something about how patients don’t always get a treatment plan based on the best evidence, or sometimes even any evidence. He literally recoiled in surprise. I’m going to take that anecdote as at least 1 data point to suggest that there’s a disconnect between what patients think is going on and what is going on relative to the ways that some—not all, of course—clinical decisions are made. Alex Akers from Health Catalyst in episode 176 and Clint Phillips from Medici in episode 201 get into this in detail.

Today I speak with Kathy Lokay from Via Oncology, an Elsevier company originally spun out of the University of Pittsburgh Medical Center (UPMC) that develops and implements clinical pathways in collaboration with its network of cancer centers. We talk about the pros and the gaps inherent in National Comprehensive Cancer Network^® (NCCN^®) pathways, which most consider the gold standard of oncology treatment guidelines. And we also talk about the reasons why standardizing cancer care around pathways is so important in these days of value-based care and to improve patient outcomes. But there are a bunch of challenges, including the sad reality that it’s tough to measure the impact of pathways in the absence of a control group of patients who have been treated without the use of pathways or, said another way, an evidence-based methodology, but for whom somehow clinical outcomes have still been meticulously recorded. Oddly, no facilities are stepping up to participate in that clinical trial.

You can learn more at viaoncology.com.

Kathy Lokay is general manager, as well as chief cheerleader and idea generator, for Via Oncology. Kathy joined UPMC in 2008 to launch the Via Oncology product that UPMC CancerCenter started in 2004. Her background as a CPA combined with her 20 years of experience in oncology have been a great foundation to help her lead Via’s overall strategy and execution. She is passionate about driving the volume to value transition in oncology and has made clinical pathways her personal mission for the past 11 years. Kathy was previously senior vice president at US Oncology with responsibility for several business units. She received her Bachelor of Business Administration in accounting from the University of Texas.

02:15 Evidence-based care vs best practice.
03:21 How the lack of comparing treatments head-to-head creates challenges for pathways.
04:30 Why community physicians are more accepting of pathways.
05:11 Winning the support of academic physicians.
06:49 What a pathway looks like.
08:43 How pathways are helping physicians run tests for diseases they normally wouldn’t run without it being inefficient.
10:21 How the pathways account for the patient’s choice.
11:50 Standardizing nationally and what these benefits are.
13:37 “We should all be approaching the same cases the same way.”
15:43 The barriers to standardizing.
17:06 “You really need strong leadership that says, ‘This is why this is so important.’”
20:39 “Pathways may actually not reduce costs.”
21:31 “The #1 goal is to improve patient outcomes.”
24:30 How clinical trials fit into pathways.

You can learn more at viaoncology.com.