Skip to content

Can we fill in the gaps? Authoring custom oncology pathways vs surfacing NCCN preferred recommendations alone


July 2023


Maniago R, Ricottone M, Calip GS, Dias-Foundas T, Hamrick J. Can we fill in the gaps? Authoring custom oncology pathways vs surfacing NCCN preferred recommendations alone. Journal of Clinical Pathways. 2023.06.23. 


Clinical decision support (CDS) tools are crucial in delivering cancer care based on value and improving its quality while reducing variations. Flatiron Assist is an EHR-embedded and customizable CDS tool designed for medical oncologists based on National Comprehensive Cancer Network (NCCN) Guidelines and locally preferred treatment regimens. 

Providers rely on two types of guidance: treatment guidelines and treatment pathways. Guidelines provide flexibility with multiple equivalent treatment options but can result in variations in care. Treatment pathways offer specific recommendations but may not consider local nuances or payer preferences. 

While NCCN-preferred recommendations cover 57% of real-world scenarios, 43% remain unaccounted for. This gap suggests an opportunity for custom-preferred pathways to offer more precise guidance. In this study, researchers compared the availability and provider concordance between NCCN-preferred recommendations and custom-preferred pathways within Flatiron Assist.

Why this matters

The study’s findings on concordance between recommended treatments and provider choices identify variations and deviations from guidelines. This enables targeted interventions and improvements to deliver high-quality, guideline-concordant care. 

Additionally, a universal pathway that suits all situations is unlikely to exist in the complex landscape of healthcare and specialty drugs. Healthcare providers need accurate and accessible information to navigate the intricate web of guidelines and pathways specific to each patient’s scenario. Cancer clinics can potentially mitigate unwanted variations and ensure more consistent and effective treatment decisions by integrating a CDS tool into the point-of-care workflow.

Read the research