Clinical Pathways at the Crossroads of Evidence, Equity, and Sustainability
As we begin a new year, clinical pathways stand at a pivotal moment—one defined by accelerating innovation, mounting cost pressures, and an urgent need to ensure that evidence-based care delivers value for both patients and the health system. Having spent more than 20 years working at the intersection of patient advocacy, oncology policy, quality measurement, and value-based care, I have seen firsthand the critical role clinical pathways play in aligning evidence, equity, and affordability. I am honored to join the Journal of Clinical Pathways as Editor in Chief at this important juncture, and I look forward to working with our contributors, reviewers, and readers to advance pathways as a practical and impactful tool for care delivery.
Clinical pathways have always existed at the intersection of evidence, policy, and practice. As we enter 2026, that intersection is becoming increasingly complex. Forces well beyond traditional health care—ranging from employer benefit design and labor dynamics to artificial intelligence adoption and drug pricing reform—are now shaping how care is financed, delivered, and measured. For pathway leaders, this evolution underscores a growing imperative: clinical rigor alone is no longer sufficient without an understanding of the broader economic and operational context in which care decisions are made.
This issue reflects that reality. In our Transformative Business Trends column, Vogenberg explores how employer-sponsored health care strategies are evolving amid legislative uncertainty, rising utilization of high-cost therapies such as GLP-1s, and rapid advances in data and automation. His analysis reinforces a lesson familiar to pathway stakeholders —long-term sustainability in health care will require aligning clinical decision-making with broader economic and workforce considerations rather than approaching these challenges in silos.
Equally important, this issue highlights the critical role pathways can play in advancing equity. In our Original Research article, Balanean et al brings focus to equity in oncology care. Using national SEER data, the authors document persistent racial disparities in uterine cancer outcomes, including lower hysterectomy rates and significantly shorter survival among Black patients compared with White patients. Importantly, the study highlights the underexplored role that standardized, equity-focused clinical pathways may play in closing these gaps—particularly when paired with attention to social determinants of health and real-time outcome monitoring. The findings serve as both a call to action and an opportunity for pathway programs to more intentionally embed equity into their design and evaluation.
Throughout my career, my work has focused on aligning patient needs with evidence-based policy, quality measurement, and sustainable payment models. In that spirit, my vision for the Journal of Clinical Pathways is to remain a forum where rigorous research, practical insights, and policy-relevant perspectives come together to inform real-world decision-making.
I look forward to the conversations ahead and to shaping the future of clinical pathways together.
