HealthPathways in local context
HealthPathways is an online manual used by clinicians to help make assessment, management, and specialist request decisions for over 550 conditions.
Rather than being traditional guidelines, each pathway is an agreement between primary and specialist services on how patients with particular conditions will be managed in the local context. Each health jurisdiction tailors the content of HealthPathways to reflect local arrangements and opinion, and deploys their own instance of HealthPathways to their clinical community.
The target audience for HealthPathways is the primary care clinicians responsible for managing patients in the community, and for initiating requests (including referrals to hospital) for specialist assistance.
Over 40 instances of HealthPathways are being implemented throughout Australia, New Zealand, and the UK. More than 50 primary care and hospital care organisations have formed partnerships to jointly localise HealthPathways. These organisations are all part of the HealthPathways Community which enables them to share knowledge, processes, pathways, and infrastructure.
At the heart of the HealthPathways Community is Canterbury District Health Board (CDHB) which developed the initial 500 pathways, agreed to share them with other members of the Community, and continues to review and update the core pathways based on current evidence and specialist opinion.
The Canterbury Health System has been internationally recognised for its collaboration and integration in a report by acclaimed British health authority, The King's Fund (August 2017).
Canterbury Tales, presentation by Carolyn Gullery, April 2018. Click image to play presentation.
HealthPathways in use
HealthPathways started in Canterbury in 2008 and use has steadily increased to the point that 99% of general practitioners surveyed* use it weekly in their practice, 70% of whom use it daily. Use is also high by practice nurses, pharmacists, physiotherapists, community nurses, and other allied health services.
General practitioners most often use it during consultation as a memory jogger for diagnostics, medicine, and community and specialist assistance availability for the needs of the patient in front of them.
Patients benefit from general practice and other services being able to do more for them in the community, from the greater clarity clinicians can provide about the appropriateness and likelihood of obtaining further specialist services, and about alternative options.
*Looking to the Future: a survey of HealthPathways users by Canterbury Initiative in 2013.
Clinicians benefit through relationship building with their primary care and hospital specialist colleagues as they localise HealthPathways, and through greater confidence and options in managing their patients.
The local ‘health system’ benefits through less demand on acute and residential care services as patients are better managed in the community, freeing up resources to provide more elective services and increase assistance to primary care.
All members of the HealthPathways Community share a common platform provided by Streamliners. The common platform enables efficient sharing of pathways between members, and cost effective technical writing, publishing, and system administration services. Members do not need to invest in IT services.
Next steps to joining the HealthPathways Community
Self-assessment of readiness
Before applying to join the HealthPathways Community, organisations should self-assess their readiness for implementing the HealthPathways methodology and toolset.
Readiness criteria include having in place:
- A well communicated vision for community, primary, and secondary care services working together to give a highly effective and seamless service to patients.
- A primary and secondary care partnership for governing work programmes (including HealthPathways) at the interface.
- Committed leadership and resources for establishing a local HealthPathways team.
- Engaged and empowered clinicians.
Further information on these criteria is available by emailing firstname.lastname@example.org
Subject to meeting the readiness criteria, contact Andy Froggatt to arrange a discussion about HealthPathways implementation processes and expected outcomes.