Opening the black box: the impact of an oncology management program consisting of level I pathways and an outbound nurse call system.
OBJECTIVE
The Innovent Oncology Program aims to improve the value of cancer care delivered to patients. McKesson Specialty Health and Texas Oncology (TXO) collaborated with Aetna to launch a pilot program. The study objectives were to evaluate the impact of Innovent on Level I Pathway compliance, implement the Patient Support Services program, and measure the rate and costs associated with chemotherapy-related emergency room (ER) visits and hospital admissions.


METHODS
This was a prospective, nonrandomized evaluation of patients enrolled in Innovent from June 1, 2010, through May 31, 2012. Data from the iKnowMed electronic health record, the McKesson Specialty Health financial data warehouse, and Aetna claims data warehouse were analyzed.


RESULTS
A total of 221 patients were included and stratified according to disease and age groups; 76% of ordered regimens were on pathway; 24% were off pathway. Pathway adherence improved from TXO baseline adherence of 63%. Of the 221 patients, 81% enrolled in PSS. Within the breast, colorectal, and lung cancer groups, 14% and 24% of patients had an ER visit and in-patient admission (IPA; baseline) versus 10% and 18% in Innovent, respectively; average in-patient days decreased from 2.1 to 1.2 days, respectively. Total savings combined for the program was $506,481.


CONCLUSIONS
Implementation of Innovent positively affected patient care in several ways: Fewer ER visits and IPAs occurred, in-patient days decreased, cancer-related use costs were reduced, and on-pathway adherence increased.
US Oncology Network, McKesson Specialty Health, The Woodlands; Texas Oncology, Dallas, TX; and Aetna, Hillsborough, NJ.
J Russell
JR
Hoverman
Ira
I
Klein
Debra W
DW
Harrison
Jad E
JE
Hayes
Jody S
JS
Garey
Robyn
R
Harrell
Maria
M
Sipala
Scott
S
Houldin
Melissa D
MD
Jameson
Mitra
M
Abdullahpour
Jessica
J
McQueen
Greg
G
Nelson
Diana K
DK
Verrilli
Marcus
M
Neubauer
D000293:Adolescent; D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000191:economics*; D024802:Nurse's Role; D005791:Patient Care / Q000191:economics* / Q000379:methods; D015397:Program Evaluation; D011446:Prospective Studies; D015203:Reproducibility of Results; D013689:Telephone; D013781:Texas; D055815:Young Adult