Dot reports can provide valuable timing information about your pathway activities and workstreams. This is useful when linking to Google Analytics data or other metrics. See HealthPathways Online Help – Reports.

Google Analytics is a useful tool for observing usage trends on your HealthPathways site. However, analysis needs to be high level and not over-interpreted. These metrics can give a false sense of precision if you are not aware of the data's limitations.

We highly recommend enrolling in a free Google Analytics Academy course before using this data source. For more information, see HealthPathways Online Help – Google Analytics.

Campaign tracking is a useful tool in Google Analytics. It can identify activity generated from custom URLs. For example, if you send regular newsletters, you can see how many recipients have clicked on the custom URLs in the newsletter. This can help assess the impact of your activities.

For more information, see HealthPathways Online Help – Google Analytics: Common Tasks.

Data Studio is another Google product that integrates well with Google Analytics and Google Sheets. You can use it to create simple dashboards to display your Google Analytics data.

HealthPathways only provides limited support for Google Analytics and does not support Data Studio. For support, see Google Support – Data Studio Help.

Feedback can provide insights from different user perspectives. Log all feedback, good and bad, to review during evaluations and also for other reporting.

Possible sources of feedback:

• Dot
• GPs
• Engagement and education activities
• Key clinical and non-clinical leaders
• Clinical working groups (CWGs)
• Meetings between subject-matter experts (SMEs) and clinical editors (CEs)
• Executive sponsors

Consider gathering feedback on your programme activities whenever possible, e.g. a short survey at the end of a clinical working group.  

Consider setting up systems or procedures to obtain department metrics, e.g.:

• Acute demand
• Acute hospital bed days
• Elective bed days
• Length of stay
• Readmissions
• Emergency Department attendance
• Wait times
• Referral decline rates
• Did not attend (DNA) rates
• First specialist assessment (FSA), surgery, and follow-up (FU) rates
• Quality of referral information

Ethics approval may be required. Please consult with your local ethics committee.

Another possible data source is the third sector and the wider health system, e.g.:

• Non-governmental organisations (NGO)
• Allied health
• Aggerated data, e.g. usage and referral from GPs

Consider HealthPathways as a useful tool for negotiating inter-professional roles and task changes, e.g. allied health in glaucoma care, primary care access to allied health.

Canterbury used an outcomes matrix, featuring multiple cascading measures, to measure the accumulative impact of many small gains such as reduced treatment-related errors and shorter inpatient stays.

• Ensure you establish a baseline.
• Key items to include:
  • Acute (urgent) admission rates
  • Readmission rates
  • Length of stay
  • Emergency Department attendance rates
  • Frail elderly rates
  • Outpatient did not attend (DNA) rates and wait times
  • Elective surgery metrics, e.g. specialist assessment to surgery times and rates

For example, measure the perception of whether whole-of-system thinking is changing and how by conducting repeat surveys among staff and patients in all sectors and at all levels. Questions could include:

• For staff:
  • Do you feel part of the health system?
  • Do you feel a responsibility for patients whether in or out of hospital?
  • What do you think of relationships between hospital, general practice, and the third sector?
  • What key values or phrases have you adopted? For example, Canterbury uses patient waiting times as a proxy for efficiency and quality.
• For patients:
  • How was your experience of the hospital/practice?
  • Do you think the hospital/practice could improve its way of working?
  • Do you think we are doing fine?

Consider measuring:

• the quality of referrals balanced by the quality of hospital discharge and advice letters.
• referral processes, e.g. use of e-Referral.
• the quality of triage against capacity and acuity.
• the use of alternatives to hospital care, e.g. written or phone advice, allied health or third sector responses.
• first specialist assessment to follow-up ratios.

At the departmental level, look at:

• the above system toolbox and patient flow metrics at a service level.
• whole-of-system participation, attitudes, and leadership.
• movement of new and follow-up work to assess whether hospitals are providing the services that only they can provide or are also providing primary care.
• the quality of community follow-up and drop-out rates.

Consider obtaining departmental metrics from before and after the launch of a pathway or suite of pathways, e.g.:

• Referral decline rates
• Did not attend (DNA) rates
• First specialist assessment (FSA), surgery, and follow-up (FU) rates
• Quality of referral information

You could measure desirable outcomes, such as moving tasks traditionally performed by hospitals into the community, GP tasks to nursing or pharmacy, and pharmacy and nursing tasks to patients or the third sector.

For example, increased:

• Use of the third sector
• Proportion of patients provided with patient information
• Prevalence of joint decision-making or advance care planning

A SWOT analysis may encourage your team to think widely and conduct a broader assessment. It is a simple, easily implemented tool that promotes analysis of internal and external strengths and weaknesses.

• Strengths – Positive internal aspects of the evaluation
• Weaknesses – Negative internal aspects of the evaluation
• Opportunities – Positive external aspects of the evaluation environment
• Threats – Negative external aspects of the evaluation environment

For more information, see BetterEvaluation – SWOT Analysis.

Interviewing is an important methodology for qualitative research and evaluation. You can collect data and narrative information to better understand respondents' perspectives and opinions.

Advantages

One-to-one interviews may:

• enable a 'deep-dive' and open a window into people’s thoughts and processes.
• provide new insights not discoverable from other data sources. 

Disadvantages

• They can be time-consuming and labour-intensive. 
• Interview data can be difficult to analyse.
• Interviewers can introduce bias.

Focus groups and workshops can be a useful method of analysing issues. However, they require careful planning and a skilled facilitator to be effective.

For an example of focus and work group questions, see HealthPathways Improving Access to Care (2019) appendix 2.

We have compiled a list of previous HealthPathways Survey Questions from the following articles:

• Goddard-Nash et al (2020)
• Gill et al (2019)
• McGeoch et al (2015) 

Advantages of using the standard questions include:

• saving time and resourcing on devising questions.
• making comparisons between new and previous studies.

Web-based surveys such as Survey Monkey are an easy option. 

Advantages

• Cheap – Many online survey tools operate using a "freemium" model and the basic survey tools are free.
• Fast – Data is available almost immediately and can exported.
• Question and page skip logic can be built into surveys.
• Invitations and reminders are easy to send.
• Surveys are easy to repeat.
• They are convenient for respondents, who can complete them at their leisure.

Disadvantages

• Questions cannot be clarified and may be misunderstood.
• Surveys do not elicit new responses.
• The response rate is often low as survey invitations are easily ignored.