“The general concept of a care pathway is a multidisciplinary-managed, tool-based health care plan for a specific group of patients with a predictable clinical course in which the different tasks by the professionals involved in the patients’ care are defined, optimized and sequenced. Using clinical care paths benefits both patients—by improving patient experience and care quality—and health systems—by containing costs, helping to reallocate resources appropriately, uncovering areas of needed improvement and benchmarking performance …
The Cleveland Clinic
Something that is unique to Cleveland Clinic is the fact that physicians and administrators have viewed EHR [electronic health record] -embedded care pathways as a way to optimize the EHR and to provide care for patients at the highest quality and lowest cost, even before work began with their teams. Laying the groundwork for EHR-embedded care pathways was just one part of their goal to reduce overall care variation.
By taking the Clinic’s agreed-upon, evidence-based guidelines (or consensus-based where evidence was lacking) and hardwiring them into the EHR, the CABG [Coronary Artery Bypass Graft] care pathway becomes automated where possible. This enables the EHR to prompt care team members to take the appropriate care steps for the patient at the right time in his or her course of care …
By embedding care pathways into the EHR, they found that physicians were indeed blanket-ordering tests superfluously, increasing costs for both the patient and the health system. But with the electronic care paths, the appropriate tests were flagged for physicians in the EHR and ordered only when the physician was notified of a specific condition and prompted …
The Cleveland Clinic identified significant advantages to embedding care pathways within the EHR.
- Improve quality outcomes: Pathways ensure that a patient’s care follows evidence-based care guidelines, which maximize care standards and quality outcomes.
- Reduce care variation and control costs: The reduction of unwarranted care variation reins in costs by both reducing unnecessary diagnostic testing and focusing care dollars on proven care strategy.
- Engage multidisciplinary teams: It is important to engage the whole care team and show those who are caring for the patient the value of their work.”
The foregoing excerpt from the February 2, 2018, issues of the Health Data Management article by John Kontor, MD, entitled “How embedding care pathways in an EHR improves care” (http://bit.ly/2FaC6hK) demonstrates how clinical pathway automated definitions, embedded in conventional EHRs, can obtain significant case outcome improvement, cost of care reduction and multidisciplinary care team engagement coordination.
The Cloud Healthcare Appliance Real-Time Solution as a Service (CHARTSaaS)© reference architecture (RA), specifies a software development environment (SDE) including features for the inclusion of process/case design, Boolean rules/decision design, Bayesian multi-dimensional similarity and predictive analytics, connectivity and interoperability with electronic health record (EHR) systems and other CHARTSaaS© Subscriber sources of data. The non-IT expert healthcare provider subject matter expert (SME), can operate these features for the development and deployment of mobile applications or “apps” such as automated clinical care pathways using easy-to-use drag-and-drop and point-and-click software tools.
Please validate the foregoing clinical care pathway-related CHARTSaaS©-propositions to your own satisfaction by reading the white paper at http://bit.ly/2vmK1Rx, and viewing these presentations: https://www.youtube.com/edit?o=U&video_id=7NWcok1fi8Q, https://www.youtube.com/watch?v=j9VHOmsvSFQ. Healthcare providers will benefit significantly from appreciating and then applying a CHARTSaaS© RA-compliant IT solution. To do so will mitigate medical mistakes (currently the third leading cause of patient deaths. per Makaray and Daniel (http://bit.ly/1rtW6Sa); thereby minimizing patient adverse events and optimizing clinical case outcomes while maximizing the cost-effectiveness of care and treatment, and also accelerating the accrual and facilitating the application of medical knowledge. Please contact me, Pete Melrose, at jpmelrose@gmail.com or +1 (612) 201-2301 to discuss and decide re how you or your organization can participate — patient lives may depend on your decision. Thanks, and good wishes for another great day!