Virtual navigation and clinical pathways help reduce costs and improve patient experience in oncology care

As oncology care grows more complex and costly, payers and providers are turning to clinical pathways and virtual navigation tools to improve outcomes and better manage spending. At the recent AMCP Annual Meeting in Nashville, Abby Kim, Pharm.D., and Sneha Sharma, Pharm.D., of Prime Therapeutics highlighted how these approaches are beginning to show measurable impact in real-world oncology care.

In the past, care navigation has been reactive, meaning it started after a patient had a problem or needed extra help. Kim, senior director of clinical strategy and oncology specialty solutions, said that is now changing. With new digital tools, care teams can support patients more consistently through virtual navigation programs. This is important because most cancer care happens between doctor visits, when patients are managing symptoms on their own or with a caregiver.

“We’re seeing lots of different companies enter the market to help solve for this in-between-visit cancer care, and we’re starting to see some real results from that,” Kim said. “We see some of this digital enablement and care navigation decreasing acute care utilization… improving side effect management, which results in fewer ED visits, fewer inpatient admissions.”

Kim said these tools are helping patients manage side effects earlier, which can prevent serious issues and reduce emergency department visits and hospital stays. She also noted that better communication helps patients understand their condition and make care decisions that match their goals, including at the end of life. This can lower costs, but more importantly, it can improve the overall patient experience.

Sharma, director of specialty clinical solutions, added that clinical pathways still play an important role in guiding treatment. These pathways help ensure patients receive effective, evidence-based care while also helping control costs. However, she said they should not be used alone. Pharmacists and care teams still need to review each case and make adjustments based on the patient’s needs.

Sharma also pointed to research showing that patients who have access to care navigation support often have better experiences and smoother treatment. Having someone to guide them through symptoms or questions can make a big difference.

Together, Kim and Sharma said the best approach combines both tools. Clinical pathways provide structure for treatment decisions, while virtual navigation supports patients throughout their care, especially outside of the clinic.