The creation of a General Cancer Council (GCC) and the implementation of flexible, accessible electronic medical record (EMR)–integrated clinical decision pathways (CDPs) have led to significant improvements in care standardization, workflow efficiency, dynamic responsiveness, and multidisciplinary collaboration across a multi-site comprehensive cancer center.

This research was presented by Kathryn Mason, FNP, NP-CSC, Yale New Haven Health, New Haven Connecticut, at the 2025 Journal of the Advanced Practitioner in Oncology (JADPRO) meeting in National Harbor, Maryland.

Prior to this initiative, the cancer center, which spans 5 hospitals and 15 ambulatory sites, lacked a unified mechanism for clinical practice guideline (CPG) development. The absence of standardization resulted in substantial care variation, particularly in areas with limited national guidance. 

To address this, a pathway prioritization tool was created, scoring 5 domains which included: impact/potential benefit, best practice alignment, feasibility/implementation, user experience/adoption, and funding availability. Pathway proposals were reviewed by advanced practice provider (APP) leads and presented to the GCC, while APP-led clinical consensus groups (CCGs) comprising APPs, physicians, pharmacists, and other stakeholders developed each CDP. 

The resulting CDPs were fully embedded into the EMR, allowing real-time clinical decision support linked to orders, patient education, and institutional workflows. Following implementation in July 2023, over 113,000 CDP uses have been logged by 2,854 oncology providers, impacting care for more than 10,400 patients. Currently, 40 CDPs have been developed across multiple specialties, with participation from more than 150 multidisciplinary stakeholders. In addition to disease-specific guidance, CDPs address treatment complications, policy integration, and serve as training and orientation tools for new staff. 

The researchers concluded, “the development of the council, using a project management methodology, as well as the creation of the pathways, has led to standardization of care, workflow efficiency and more individualized care.” 

They added, “These pathways are easily accessible, dynamic and allow for changes when new research is published, making our institute early adapters of new cancer treatments and technology.”

Source:

Mason K, Davies M. Developing a Signature of Evidence-Based Care Across a Large Comprehensive Cancer Center Utilizing Clinical Decision Pathways. Presented at the 2025 Journal of the Advanced Practitioner in Oncology Meeting. October 23-26, 2025; National Harbor, Maryland. Abstract JL1316C.