Patient Voice Shapes Oncology Pathways: Edward Arrowsmith, MD, MPH

Clinical pathways in oncology need to move beyond static documents and incorporate the patient's voice through real-time data, according to Edward "Ted" Arrowsmith, MD, MPH, of Tennessee Oncology and OneOncology. In an interview at the Patient-Centered Oncology Care® 2026 conference hosted by The American Journal of Managed Care^® in Nashville, Tennessee, September 24-25, 2026, Arrowsmith discussed topics from a panel on bringing patient perspectives into pathway development and how OneOncology builds its pathways.

Why Oncology Pathways Need to Become More Dynamic

Pathways have historically been fairly static, Arrowsmith explained, often taking the form of a PDF paired with clinical decision support tools. The panel focused on how to move past that model by drawing on a wider range of data to guide treatment decisions.

"Where we'd all like to go is getting a variety of data, particularly electronic patient-reported outcomes, that we can pull in and help us with decision-making to have a more dynamic approach," Arrowsmith said.

That shift matters because the patients oncologists treat in practice often look very different from those enrolled in the clinical trials that have historically driven treatment decisions. Patients seen in clinic tend to be older and to have more comorbidities, Arrowsmith noted, which makes it important to account for their experiences and outcomes when choosing a therapy.

Electronic patient-reported outcomes (ePROs) offer 1 way to capture that information directly from patients and bring it into the decision-making process, rather than relying only on trial evidence generated in narrower populations.

How OneOncology Disease Groups Build Pathways

At OneOncology, the centerpiece of the pathway process is its disease groups, Arrowsmith said. Each of the network's more than 30 practices has a representative on the disease groups, which cover common cancers including lung cancer, breast cancer, and hematologic malignancies.

Drawing physicians from practices across the country gives the groups a broad view of the patients they serve, according to Arrowsmith. That geographic and clinical diversity provides multiple inputs when the groups make treatment decisions.

"That diversity of physicians from across the country allows us to think about that broad range of patients so that we have multiple inputs as we make treatment decisions, and it affects the whole nationwide scope of OneOncology," Arrowsmith said.

Because the pathways apply across the full OneOncology network, decisions made by the disease groups reach practices nationwide. Arrowsmith said combining that broad physician input with patient-generated data such as ePROs could help pathways better reflect the real-world patients who receive care in community oncology settings.