Impact of Electronically Accessible Pathways (EAPathways) on clinical trial enrollment at a large multisite cancer center.

Abstract

6517 Background: Clinical pathways streamline evidence-based treatment decisions and provide consistent, high-quality, value-based care. A high-quality clinical pathway should enhance screening and access to clinical trials. Our healthcare system utilizes EAPathways to allow providers to select treatment regimens vetted by section experts, inquire about clinical trials, and refer to relevant programs (e.g. palliative medicine) or testing (e.g. genomics) at a main cancer center and 22 regional sites. With over 400 clinical trials, our goal is to provide access regardless of where a patient lives or receives treatment. We aim to explore the impact of EAPathways on clinical trial enrollment at our healthcare system. Methods: This study is a retrospective review to compare clinical trial inquiries through EAPathways and clinical trial enrollment using Oncore between 1/1/2017 and 7/31/2018. The primary outcome is the success rate reported as the total number of inquiries that resulted in clinical trial enrollment. Other outcomes include a comparison of inquiries and enrollments for hematology and solid tumor oncology, cancer treatment and non-treatment (e.g. specimen collection), and our main cancer center and regional sites. The number of and reason for opting out of treatments or trials was also analyzed. Results: A total of 29.1% (740/2539) of clinical trial inquiries through EAPathways resulted in clinical trial enrollment. Success rates for the following settings were reported: 39.5% (223/564) in hematology, 26.2% (517/1975) in solid tumor oncology, 27.0% (594/2203) in treatment trials, and 43.5% (146/336) in non-treatment clinical trials. Sixty-three percent of enrollments were at our main cancer center compared to regional sites. A total of 39.7% (3356/8453) of patients were enrolled into an opt-out pathway due to reasons such as performance status, organ dysfunction, or hospice. Conclusions: Clinical pathways can provide access to clinical trial enrollment in multiple settings. These baseline metrics will help assess process improvement needs to increase clinical trial enrollment success rates and address reasons for opt-out.