Building Better Oncology Pathways With Specialty Pharmacy Integration: Part 2
Key Takeaways:
- Integrating specialty pharmacy services into oncology care creates a more coordinated, team-based model that improves medication access, enhances communication among providers, and enables earlier identification of adherence issues, side effects, and drug-related concerns.
- Study findings showed substantially lower rates of oncology-related emergency department visits and hospitalizations compared with national benchmarks, highlighting the value of proactive pharmacist-led interventions in supporting patients receiving oral cancer therapies.
- Presenting the research at the Clinical Pathways Congress helped advance discussions about embedding pharmacists within clinical pathways, while the team's Innovation Award recognition has supported continued growth, broader adoption of the care model, and expanded outcomes research.
In Part 2 of our interview with Kishen Patel, PharmD, he discusses how integrating specialty pharmacy services into oncology care teams can improve care coordination, reduce hospitalizations and emergency department visits, and support value-based cancer care. Dr Patel also reflects on presenting these findings at the Clinical Pathways Congress, the broader implications for oncology pathways, and how his team's Innovation Award recognition has helped advance pharmacist-led care models nationwide.
How has integrating specialty pharmacy services into the oncology care team changed the way your organization manages patients on oral cancer therapies?
Dr Patel: Integrating specialty pharmacy services into the oncology care team has transformed care from being somewhat fragmented to more coordinated, continuous care. Instead of patients navigating between different prescribers and different external pharmacies, pharmacists are embedded directly into the workflow from the very beginning. What that means for the patients is faster medication access, fewer delays, and more consistent follow-up. And most importantly, it allows the patient to be seen and be heard starting from day one.
From a clinical perspective, it allows pharmacists to identify issues like side effects or drug interactions or dose modifications due to kidney or hepatic function, not adherence. We're able to identify these issues much earlier and often before they can escalate. And because of this, it also improves communication with providers since interventions can be addressed in real time. Overall, it creates a more continuous team-based model of care, which is especially important for oral therapies where patients don't really have those frequent in-clinic touchpoints, but this is where the pharmacist can jump in and fill in those gaps.
With lower rates of hospitalizations and emergency department visits reported in this study, what implications do these results have for oncology pathways focused on improving quality and value of care?
Dr Patel: Our study showed ER visits and hospitalization utilization of 1.5 and 6.2%, respectively, for utilization related to oncology symptoms, which is much less compared to the national benchmark of 20%. As a whole, the percentage of Shields oncology patients reported in hospital and emergency department visits were about 3.6%. And again, this is compared to the national benchmark of 20%. This highlights the impact of proactive pharmacist-led care, which can help reduce these hospitalizations in ER visits.
From a pathways perspective, these findings suggest that optimizing outcomes isn't just about selecting the right therapy, it's about how that therapy is supported and will continue to be supported over time. It reinforces the importance of incorporating pharmacist-led services into pathways as a driver of both quality and value, particularly as oncology care continues to move toward more outpatient and self-managed treatment models.
Why was the Clinical Pathways Congress the right venue to share this work, and what conversations were you hoping to spark among oncology providers and pathways leaders?
Dr Patel: I was very fortunate to be able to present and attend the Clinical Pathways Congress (CPC) in Boston last year. CPC is a strong venue for this work because it's recognized as a leading forum where oncology providers, pharmacists, and pathway leaders come together to share evidence, exchange ideas, and learn from one another. It's a setting where attendees are not only presenting innovative research, but they are also actively engaging with new data and thinking about how to incorporate these insights into their clinical practice and care models. From my perspective, it's one of the environments where you are consistently being consistently exposed to emerging evidence and best practices that can directly shape how we deliver care day-to-day.
This made it an ideal place to share our work because our goal was not just to present outcomes, but to contribute to a broader conversation around how integrated pharmacy services can enhance clinical pathways, beyond the treatment selection. We were hoping to spark discussions on how pharmacists can be more intentionally embedded into pathways, how their impact can be measured, and how health systems can translate these models into their own settings. Ultimately, we see conferences like this as an opportunity to learn from others and share practical and scalable approaches that can be incorporated into everyday clinical practice to improve patient care.
Your team won the Innovation Award at last year's Clinical Pathways Congress. Looking back, how has that recognition influenced your work, and what progress have you made since receiving the award?
Dr Patel: Winning the Innovation Award was incredibly meaningful for our team. It validated the work that we have been doing and reinforced the importance of this model in oncology care. Since receiving the award, we continued to expand and refine our approach, both by increasing pharmacist involvement across therapies and strengthening integration into care pathways.
We've been able to collect more robust outcomes data, particularly around adherence and health care utilization. It has also helped raise awareness of our model within our organization as well as externally, which has supported further adoption. For example, it was included in the 2025 Shields Clinical Outcomes Report, which covers 12 chronic and complex disease states including oncology, but also other conditions such as obesity, diabetes, hyperlipidemia, and rare disease. Because of this exposure, we're able to expand, gain more outcomes, and have a better impact on patient outcomes.
We've also been able to grow our network. We now partner over with 80 different health care systems nationwide and support approximately 700 000 patients on our service. Most importantly, it motivates us. It helps us continue to improve how we deliver care and to keep demonstrating the value pharmacists bring to our oncology care team. Ultimately, our goal is to help patients move forward more safely, more confidently, and with better outcomes—because at the end of the day, we're all patients.
