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    Clinical pathways: A roadmap to medical success


    The AUA is certainly not the only organization to issue guidelines for the treatment of this condition. For example, the United Kingdom has a well thought-out pathway and one of our industry partners, Medtronic, also offers guidelines.

    The availability of guidelines does not ensure that patients are well treated or even treated at all. I learned this fact when I recently attended a dinner hosted by Medtronic. Yes, I understand the inherent conflict of interest that exists regarding Medtronic and OAB. But the company’s presentation is well footnoted, and I agree with its conclusions.

    Also read: SUFU launches clinical care pathway for OAB patients

    With that caveat, according to a 2003 paper in the World Journal of Urology (2003; 20:327–36), of the approximately 37.4 millions Americans with OAB, 8.5 million of them actively seek treatment and 3.2 million of those actively seek further advanced treatments due to either medical treatment failure or an inability to tolerate medications (antimuscaranics certainly have their share of side effects). This means that 37% of all patients who seek care for OAB symptoms will need advanced treatments.       

    Most practices do not approach that number of patients treated for OAB, according to data from Medtronic, which says as few as 1.8% of patients undergo treatment. Therein lies the opportunity to both improve patient care and thrive financially.

    To get there, you need to better understand your own group’s dynamics and this involves data analytics and quality assurance. Like you, when I hear the phrase “data analytics and quality assurance,” I usually dismiss it as the language of a consultant who wants me to pay him or a bureaucrat who’s looking over my shoulder. But this is different. This is the step whereby practices can apply good, evidence-based, pathway-driven medicine to not only provide excellent outcomes for patients, but also be financially successful in the process.

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    Do I have your attention yet? I should. To achieve this two-part goal, you need to start with data analytics. Honestly look at your own practice: Ask how many patients you treat with OAB? What insurance environment are we in and what medications are preferred? What advanced treatment option (neurmodulation via the sacral nerve or tibial nerve; Botox) does my group have the best results with? Take that data and use it to develop a practice-specific care pathway.

    Creating a pathway

    Henry Rosevear, MD
    Dr. Rosevear, a member of the Urology Times Clinical Practice Board, is in private practice at Pikes Peak Urology, Colorado Springs, CO.


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