Digital Patient Pathways: What are they and how do they fit within existing models of care

You may be familiar with terms like the "digital front door" or eForms — the process of IT teams scanning your existing paper-based forms and booklets into an electronic copy.

While creating some efficiencies, often you’re just converting the problems inherent with the existing process into a digital form. A significant proportion of clinical time is still spent collecting information from patients, tracking down paperwork, reviewing it manually, and then attempting to reach patients via phone to provide them with the appropriate next step in their journey.

These inefficiencies consume scarce clinical and support staff time that could otherwise be directed at providing high-value care to the patients most in need.

Below is an excerpt from the Guide Digital Patient Pathways [2022 Edition]. You can access the full article here.

Digital Patient Pathways offer more than just online forms and reminders.

Digital patient pathways are a daily mobile checklist of things patients needs to do, know, or forms and assessments they need to complete as part of their episode of care.

These steps in the pathways are traditionally converted from paper forms and phone calls and may take the form of questionnaires, videos, digital posters, text and more.

From the outset, these pathways need to be:

• Patient-centric designed

Deliver patients a convenient way to access the right information and tasks at the right time before or after their episode of care.

• Seamless for the patients

Simple, relevant, and digestible for patients whilst maintaining the depth of detail required by the health service.

• Clinically specific and responsive to a patient's changing needs

Health services can tailor the information and tasks a patient receives — based on nuances in the patient cohort data, hospital location, and procedure and treatment details.

In addition, there are nuances that should be automated into the pathway at the patient level. For example — two patients both having knee surgery would have varying levels of monitoring and preparation depending on their pre-existing risk factors — BMI and cardiac history, for example.

Given the challenges facing healthcare, why are patient-centric digital patient pathways important?

The patient journey with their healthcare service is complex — rife with individual nuance.

Studies show that patients are spending less and less time with their clinicians in a consult or during an admission to a hospital. Therefore, more of the patient journey is taking place in the time before and after their admission or appointment. Combined with the increasing demand for healthcare services, there is a driving need for efficiencies and to support patients when they are not physically within the healthcare setting.

Hospitals track and monitor every indicator we can once a patient arrives. However, it's often their prior preparation that determines how complicated or costly the admission or appointment is, and it's often how well they recover in the hours and days post-procedure that determines whether the patient achieves what they needed out of the treatment or procedure and therefore directly impacts:

• cancellation rates
• length of stay
• patient satisfaction
• theatre utilisation
• re-admission rates / complication rates
• safe transition back to the community
   

By streamlining the repetitive tasks, enabling patient education, and monitoring patient risks in real time; digital patient pathways enhance the healthcare team's workflow and improve the patient experience.

Examples of patient-centred Digital Patient Pathways

Digital Patient Pathways touch various points throughout a patient's episode of care and are influenced by nurses, administrators, surgeons, and more.

The digitisation of pathways should focus on supporting healthcare teams to reduce unnecessary admin and phone calls, enhance workflows, and improve the overall patient experience — whether you're a public or private hospitals and clinics — or supporting 250 or 25,000 patients per month.

Here are some examples of how different points along the patient journey can be digitised. This list is not exhaustive, however, gives an indication of the depth and breadth of Digital Patient Pathway adoption in 2022:

• Etriage and health history screening

Incorporate all pre-admission telehealth appointments, tasks, and reminders into one seamless pathway — including all surgical preparedness and waitlist management; may include Direct Access Pathways.

• Outpatients

Coordinating appointments and screening requirements for outpatients. May include COVID-19 screening questions, information about the appointment preparation, day procedure details, and reminders.

• Preadmission Preparation and Consent

Ensure patient education and preparation information is read and accepted, and patients are aware of when and where to go.

• Discharge Planning

Easily share critical information regarding post-operative care and collect and disseminate Real-Time Patient Feedback (PREMs).

• Post-discharge Care Transition

May include re-admission prevention pathways, post-op phone calls (day procedures), and Patient-Reported Outcomes (PROMs) care models and collect Patient Reported Experience Measures (PREMs).

Combining these clinical and administrative workflows (including PREMs and PROMs) you’re also able to ask patients simple questions to ensure preparedness and post-operative care. For example, here are some clarifying questions to ask patients:

• Do you know where you're going?
• Do you know what time you need to be at the clinic/hospital/appointment?
• Do you know your procedure preparation requirements?
• Do you know what you need to do postdischarge?
   

As we defined earlier, the impact of patient preparedness and progress on the healthcare system is significant and including simple questions into the wider Digital Patient Pathway can have a dramatic impact on success indicators.

How to design patient-centric Digital Patient Pathways AND keep health teams in control.

Once patients are through the (digital) front door, they need to know what to do next. Whether in preparation for a treatment or procedure or as part of their recovery — we call that a “Digital Patient Pathway”.

For patients, it answers the daily questions of; What do I need to do today? What information do I need to be aware of? What actions do I need to take right now? Based on my procedure or treatment, my underlying risk factors and my progress against the clinical guidelines defined by my clinician, nurse and broader healthcare team.

The key is to define this digital experience based on the existing clinical workflows within specialty areas. This significantly reduces the burden on frontline staff (circa 70–80%) and avoids the "who's going to deal with all the online messages from patients" challenge.

Those same frontline staff can continue to have the same clinically-specific conversations against their defined clinical pathways via a secure digital channel. Rather than through very inefficient analogue channels (letters, hand-outs, forms, phone calls) because we haven’t yet connected the digital front door to the clinical preparation and recovery for the patient.

Top tips for creating a digital experience that help unlock critical care staff:

• Start with the problem you’re trying to solve, and for whom
• Focus on a simple patient experience that doesn't overwhelm frontline staff
• Don't use technology to introduce changes to clinical workflows.
• Think big. Start small. Move fast this is not the moment to try and "fix healthcare" by "boiling the ocean"
• Winning formula = Patientcentered + clinically controlled + IT supported

Want to learn more and start freeing up clinical time?

To help you navigate the move to digital pathways, we've created a practical guide that outlines how other leading healthcare organisations have enabled their frontline staff to spend more of their time on high-value care.

In this latest guide, you'll discover how to rapidly solve these problems for your frontline team in days or weeks:

• Simple patient experiences that don't overwhelm frontline staff
• Clinically-specific digital patient pathways that meet both patient expectations and keep clinicians in control
• Digital experiences based on existing clinical workflows that support different specialty areas, patient cohorts, and locations — that also respond to the increasing complexity of a patient conditions
• Help healthcare teams easily answer one simple question for patients, what do I need to do today?
   

Download your copy of the 2022 Guide to Digital Patient Pathways here.

Taking the steps outlined in this guide will help you free up clinical time for high-value care for the patients in most need of support or intervention.

Alternatively, if you're interested we'd love to connect and share more about our novel approach to digital patient pathways. We've shared our upcoming availability here.

Image credit: ©stock.adobe.com/au/Khunatorn