Of the many facades to IT applications, the one that is revolutionized to a great deal is the Healthcare Informatics sector. The application of computers to generate, validate, secure and integrate healthcare data to support the decision making activities of clinical and administrative professional has added an entirely new dimension to the functioning of healthcare industry. Coupled with the benefits of easier and faster service, is the reduction in the cost of providing healthcare services, thereby, making it more affordable to a larger populace. Techniques from Quality Management Science are among the newer approaches to managing the delivery of healthcare. One such application of this science to healthcare is Clinical Pathways.

Clinical Pathways, also known as Integrated Care pathways, practice guidelines or critical pathways, are documents that describe a process within health and social care, and collects variations between planned and actual care.

This paper attempts to study the concept of Clinical Pathways, the terms and definitions associated with it, its integration with the SRIT products; RCare Magnum and RCare and guidelines for development and implementation of clinical pathways.

Introduction

Clinical Pathways (CP) are multidisciplinary plans of best clinical practice for specified groups of patients with a particular diagnosis that aid the co-ordination and delivery of high quality care. They are both, a tool and a concept, which embed guidelines, protocols and locally agreed, evidence-based, patient-centered, best practice, into everyday use for the individual patient. A clinical pathway essentially contains four components; a timeline, activities and their interventions, intermediate and long-term outcome criteria, and the variance record. This typically forms a part of the patient’s medical record. We have introduced also the concept of Pathways working closely with non clinical activities like Inventory to ensure that minimum stock is available within the Hospital at any given point of time for each CP based on the Historical trends.

Definition

A Clinical Pathway defines the expected flow of services for a group of patients with a particular diagnosis or undergoing a particular procedure, during which it recommends tests and therapies based upon a combination of clinical practice consensus & evidence from the scientific literature and records the outcomes.

The potential of a Clinical Pathway is optimized when used within a conceptual framework. This framework is a combined whole consisting of a systematic cycle of activities based around the development and use of a CP document to ensure continuous improvements to practice and outcome. The activities include selecting CPs to use with patient groupings, developing CP content and layout, using CPs simultaneously as patient record, recording, analyzing and comparing any variations from planned activity and outcome, and continuously updating practice as a result.

Constituents of Clinical Pathways

Clinical Pathways may essentially contain;

• Multi-disciplinary, multi-agency, clinical and administrative activities
• Structured Variance Tracking
• Local and National standards
• Evidence based, locally agreed, best practices
• Tests, charts, diagrams, information leaflets, satisfaction questionnaires, etc.
• Scales for measurement of clinical effectiveness
• Outcomes
• Freehand notes
• Scalability to add activities to a standard CP for individualized care for a particular patient
• Problem, Plan, Goal and Notes or similar structured freehand area