A care pathway is a multidisciplinary management tool based on evidence-based practice for a specific group of patients with a predictable clinical course and an expected outcome. It is designed to standardize and optimize care processes over a specified time period (hours, days or visits).
The theoretical benefits of care pathways are: Increased job happiness because employees have a better understanding about their jobs, responsibilities and consequences. Reduced costs and improved quality of work due the reduced variation in work based upon predefined standards and criteria. There are also disadvantages: The dehumanization of work and a less personal relationship between patient and health professional. A lot of professionals are in a control position, which can lead to distrust and mistrust amongst them.
Care Pathways vs Integrated Medicine is an approach to medical practice that integrates best practices, guidelines and evidence-based medicine in order to optimise patient outcomes. It is often used with the concept clinical pathways. It allows physicians to make evidence-based choices about how and where to treat patients.
Pathways can help providers prioritize and allocate resources in a system where cost is increasingly a major concern. In addition, they can help clinicians identify clinical pathways that will benefit the most patients and achieve positive results for both patients and healthcare systems.
Many healthcare providers are currently implementing or planning on implementing care pathways in order to improve patient outcomes and decrease costs. However, the extent to which care pathways have had a significant impact on patient outcomes or have been effective at enhancing quality of care remains largely unclear. There is no comprehensive definition of care pathways, and existing conceptual frameworks contain various inadequacies that have made them difficult to implement.
Developing and evaluating care pathways requires careful selection of therapeutic areas, as well as the appropriate evaluation methods and metrics. The development process involves many stages with different stakeholders. Healthcare plans are responsible for monitoring care pathways. However, many of these activities aren’t documented and there is not much transparency.
Care pathways reimbursement is usually fee-for service or fee-per patient. Respondents to this question more than half said that reimbursement was tied to the care pathway. In these cases, target rates of on-pathway patients were considered the primary measure of compliance.
Care pathways are being designed and implemented in a variety setting, with a particular focus on chronic and acute care. There are many therapeutic areas that could be considered for care pathways. These include cancer, multiple sclerosis, cardiology, diabetes and rheumatology. A majority of respondents also expect that use of care pathways will continue to expand over the next 5 years.
Additional Resources:
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