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REMINDER | |
The Pathways Fax Form is an optional program feature.
When your practice returns the fax form credit for compliance is granted.
Click the link below for the UPDATED form.
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Greetings!
This email serves as a clinical pathways program update from the Oncology Physician Resource (OPR). This issue features:
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Steering Committee Meeting Update |
The Clinical Pathways Steering Committee met on June 17, 2010.
The Committee made two revisions to the current pathways and selected four new tumor types for year two (begins January, 2011). The Committee is currently formulating the actual pathways for the new tumor types. 
Pathway Revisions
Changes are highlighted in RED
Highlighted changes adhere to NCCN guidelines
Colon Cancer Treatment Pathway
Metastatic Colon*
2nd Line *
·Clinical Trial
·Chemotherapy
·Capecitabine based regimen: H2 , FN<10%
·Capecitabine + Irinotecan: H5, FN 10-16%
·Cetuximab if not previously given: H1, FN<10%
·Cetuximab + Irinotecan: H4, FN 10-16%
·Fluorouracil + Leucovorin + Oxaliplatin: H5, FN 10-16%
·Irinotecan based regimen: H4, FN 10-16%
·Panitumumab if not previously given: H1, FN<10%
·Best Supportive Therapy/Hospice * Cetuximab, or panitumumab: may be given in 2nd or 3rd line treatment if not previously given.
Patients may receive one line of bevacizumab (Avastin) in either the first line or the second line of metastatic colon cancer.
Supportive Care Pathway
Nausea/Vomiting Pathways (Continued) *
·Hesketh 1 and 2 levels
·Generic Zofran or Generic Kytril or Non-5HT3 or non-aprepitant agents.
·Other 5HT3 agents or aprepitant are not allowed unless there is documented uncontrolled N/V in previous cycle
·Hesketh 3, 4, and 5 levels
·5HT3 or palonosetron hydrochloride
·Aprepitant optional
·Hesketh 4 and 5
·5HT3 or palonosetron hydrochloride +/- aprepitant
* The use of steroids, lorazepam, and other non-5HT3 or non-aprepitant agents is left to the discretion of the individual treating physician.
Pathways participants will receive a current Pathways packet with the revisions.
Year Two Tumor Types
- Lymphoma
- Myeloma
- Ovarian
- Prostate
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Charting the Course with
Michigan Clinical Pathways
and QOPI Meeting
June 25th | |
The first Annual Michigan Clinical Pathways & QOPI Data Sharing Meeting was a great success with the participation of over 90 attendees.
Presentations were made by:
Phil Stella, MD
CEO, Oncology Physician Resource
Tom Simmer, MD
Senior Vice President, BCBSM
Doug Blayney, MD
Physician Lead, MOQC
Jim Koeller, MS
University of Texas at Austin
Attendance at this meeting met the Clinical Pathways participation requirement.
Thank you to everyone who attended!! |
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PGIP Enrollment |
To be eligible to participate in the BCBSM Clinical Pathways Program, physicians must be enrolled in BCBSM PGIP (Physician Group Incentive Program).
Initially this requirement was waived until the first open enrollment period for PGIP. The open enrollment period took place in June.
Of the 190 physicians enrolled in the Pathways Program, approximately 50 were not enrolled in PGIP. OPR worked with these physicians, their practices, and other physician organizations to process the enrollment for all 50 non-PGIP physicians. The deadline for enrollment was June 24th.
The enrollment verification report from BCBSM will be available on August, 16, 2010.
Thank you to everyone who participated in the enrollment process. |
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Portal Passwords
Compliance Reports |
All Pathways Web Portal Usernames and Passwords have been distributed.
If you have NOT received the information please contact Jane M. Tozer, Clinical Pathways Manager.
Web Portal Confidentiality
Each practice was contacted by P4 Healthcare staff to get email addresses for the physicians and practice administrators. The email addresses were used to issue secure passwords. Each practice was asked to identify who should get super access, which is access to each of the physician's compliance and their non-compliant patient list that is in the practice.
Super access was given to one lead physician and one office administrator, but there were exceptions to the rule.
Each physician will be able to view the network score as a whole, their practice's aggregate score, and their individual score.
Clinical Pathways Program Compliance
·Quarter One Compliance:
DOS January 4, 2010-March 30, 2010
·The Compliance numbers will improve over time as more information is collected and appeals are submitted.
·This compliance slide was provided by P4 Healthcare.
How does a physician know if a patient has been determined to be non-compliant for Pathways?
A list of patients whose treatment has been determined to be non-compliant will be available on the Pathways web portal. The name of the patient and dates of treatment will be visible to the treating physician. The physician then has the opportunity to appeal the determination.
What happens to a practice if they do not meet the compliance rates?
The practice compliance is reviewed, and following the reconciliation process, may be determined ineligible to participate in the Pathways Program.
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FOR PATHWAYS PROGRAM INQUIRIES CONTACT:
Jane M. Tozer
Manager of Business Operations & Clinical Pathways
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