I’ve also heard the term “pathway” discussed and debated more times than I
like to recall.
The challenge is that if you get clinical/IT folk in a room to try to agree
the definition of a “care plan” or “care pathway” you’ll get a different
definition every time.
Such is the state of maturity of the art/science of informatics, we have
some distance to go to get a common language between the
clinical/management/technical folk that need to be involved.
Having looked at this in the past, if you want to delve into pathways I
would draw attention to a few things.
“Designing Guideline-based Workflow-integrated Electronic Health Records”
http://www.openehr.org/resources/publications#workflowinhealthcare
& a related (brief) paper here
I would suggest that pathway material generally involves crafting a blend
of people + process + information + technology.
One way of explaining it, which Barretto does so well in her thesis is that
the information elements involve a mix of
#WHAT needs to be done (clinical content, ie archetypes/EHR content)
#WHY (rules , such as IF, ELSE etc… rules engine)
#WHO #WHEN (workflow/task management … workflow engine)
So to support any 1 pathway could require quite a bit of kit… IF you
are trying to support pathway(s) at scale…otherwise you’d hack something
together… that won’t scale ;o)
To start that journey, many of us focus on the WHAT first … the clinical
content… which usually closely relates to the clinical process.
One other nugget is that typical business process analysis/management (eg
BPMN) usually explores a change from the Physical As-Is … to Physical
To-Be.
If you look at healthcare with those eyes you see a dizzying variety of
process.
What is missing is the fractal patterns of generic/logical clinical process
that underpin the breadth of healthcare…
So whats needed to make sense of this space is a generic/logical modelling
layer is needed in the middle…
Physical As Is
+Logical As Is
+Logical To Be
Physical To Be
That search for logical/generic clinical process support led me to openEHR,
which has 4 core/generic process-oriented classes (Observation, Evaluation,
Instruction & Action) which is why openEHR imho is the critical foundation
layer we are currently building out… the more fanciful/sophisticated
“pathway” support can come later…
More related writings here…
Hope that helps>hinders.
Tony