A triage-forward outpatient diagnostic pathway for cancer evaluation: Early experiences from a Suspicion of Cancer clinic.

e23252 Background: The UCSD suspicion of cancer (SoC) clinic was developed to address the systemic reliance on inpatient care for urgent malignancy workups, and reduce avoidable hospital admissions by providing an accelerated outpatient diagnostic pathway. The goal of the clinic was to utilize physician-led triage and expedited diagnostics prior to the initial consultation visit at the SoC clinic. This proactive model ensures that comprehensive diagnostic data is available at the time of the appointment, facilitating immediate clinical decision-making. Methods: This retrospective descriptive analysis reflects early operational data from the clinic launch using this new triage and referral workflow to evaluate its feasibility. Crucial components of this clinic model included creation of an SoC referral order set permitting referrals only from emergency department providers, inpatient providers, and specialty oncology clinics. When additional diagnostic data were required, the triaging SoC physician ordered or referred patients for expedited outpatient testing prior to clinic evaluation, if appropriate. Results: Between December 2025 and January 2026, 20 patients were referred to the SoC clinic. The average age was 65 years (range 31–91); 65% were female, with a racial distribution of 15% Asian, 35% White, and 50% other (40% identifying as Hispanic). Median time from referral to first contact by the SoC clinic was 3.5 days. Through physician-led triage, SoC ordered and coordinated expedited outpatient diagnostics for 7 patients (35%), including CT imaging, interventional radiology–guided biopsies, thoracentesis, nuclear medicine bone scans, and MRI, following ED or inpatient discharge. Once sufficient diagnostic information was obtained (or previously obtained testing had resulted), 11 of 20 patients were redirected to appropriate disease-specific oncology clinics or to primary care (for 2 patients with benign findings) without requiring an in-person SoC clinic visit. Nine patients were scheduled for SoC visits; one patient no-showed and one visit was declined due to insurance. Among the scheduled patients, the average time from referral to visit was 10.8 days, inclusive of time required to complete additional testing. Conclusions: Implementation of a physician-led triage within the SoC workflow facilitated early clinical assessment of referrals, expedited outpatient diagnostic testing pathway, and rapid redirection of patients to appropriate disease-specific oncology clinics without requiring in-person SoC visits. This model supports care coordination for urgent but non-emergent patient cases and judicious use of inpatient resources. Future work may assess how this impacts SoC clinic volume and sustainability, longitudinal evaluation of diagnostic timelines, and best practices for staffing SoC clinics with representatives from each oncologic group.