| Project main goal(s) |
The goal of CARE-PATHS is to set up an intelligent operational
environment for making Clinical Governance effective, to support
Health Professionals, Clinicians and Care Operators, in continually
improving the quality of services and safeguarding high standards
of care:
- Effectiveness: more patients treated in a time frame, less
harm to patients due to faster diagnosis and treatment
- Efficiency: less medical idle time, less useless and/or inappropriate
procedures
- Perceived quality of the medical services for patients: healthcare
performance meets patients' needs
- Overall quality of the medical services for medical personnel:
focus on their professional skills and promote interdisciplinary approach
To enable such improvements, CARE-PATHS leans upon the concept
of Clinical Pathways, also known as care maps, practical
guidelines, coordinated attention, and clinical case handling. A
clinical pathway is a plan of care that is applied to patients
with a known diagnosis and a predictable clinical outcome.
The aim of a clinical pathway is to coordinate and define the extent
and quality of care that is provided. It is directed not only to
the health professionals (the science-technological quality and
the coordination amongst the health professionals), but also to
the patient (information and adjustment of expectations) and all
areas related to efficiency and costs.
Clinical pathways are in fact strategies for handling complex treatment
procedures. These strategies define the essential steps so the strategy
itself is carried out in a detailed manner. Their objective is to
improve the quality and/or reduce the cost of a given product or
service, while ensuring its timely execution.
|
| Key issues |
CARE-PATHS addresses key implementation barriers
to the methodology of Clinical Pathways. Although Clinical Pathways
represent a powerful approach to clinical governance, their implementation
is impeded for a series of reasons:
- Defining Clinical Pathways requires a great deal of skill for
finding and analyzing the "highest quality available evidence".
- With scientific literature having a validity of approximately
3 years, clinical pathways must be brought up to date regularly.
- Even the best clinical pathways do not contain all the answers
that will be needed. It is therefore necessary to maintain the care
giver´s knowledge up to date to be able to respond to any of
the unanswered situations in a reasonable time.
- Indicators must be set up to allow an analysis of how closely
the pathway is being followed, of its results, of deviations, ...
- Once the results and deviations have been analyzed, and the
latest scientific data has been studied, the clinical pathway should
be modified and brought up to date.
- Implementing clinical pathways might also face cultural and/or
organizational challenges, such as resistance from doctors, lack of
group work, and lack of interdisciplinary collaboration
The approach adopted by CARE-PATHS is to exploit emerging technologies
in knowledge management and semantic web for enabling
the methodology of "Clinical Pathways" to function, to
be effective and to succeed. The output of the project will be a
set of intelligent tools for supporting Health Professionals in:
- Putting Clinical Pathways in practice in the everyday treatment
of individual patients,
- Monitoring and managing their variances,
- Authoring conceptual clinical pathways for selected group
of pathologies in specific contexts.
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| Technical approach |
From a technological viewpoint, CARE-PATHS proposes the development
of a Web based solution for healthcare institutions that
combine:
- Decision support tools for care givers to put in practice
clinical pathways, i.e. enabling to develop a specific patient
plan, evaluate a patient's condition, promote the use of alternative
solutions at each stage of the pathway.
These decision support tools will get access to Patient Records
databases and more generally with the workflow of clinical documents
at the specific site, on the basis of messaging using XML and HL7/CDA.
- Monitoring and analytical tools for clinical pathways variance.
Managing clinical pathways requires first to gather historical
data regarding the application of pathways to all patients, in
an original or modified way.
The evaluation of a patient's variance can first be used by the
decision support tools to propose changes in the patient's pathway.
The analysis of patients' variance will also serve to the identification
of needs for pathway redefinition.
- A Semantic based knowledge system enabling the authoring
of clinical pathways. The CARE-PATHS knowledge system will
cover both Clinical Pathways definitions, document repositories
internal to the healthcare institution and access to external
medical document repositories, existing and authorised by accredited
medical organisations and medical profession unions.
|
| User perspective |
Two pilot sites participate in CARE-PATHS and will use
Clinical Pathways both for scientific and administrative purposes.
- The first one is located in Parma and involves the domain of Cardiology/Cardiosurgery
and Peripheral Vascular Surgery.
- The second one is located in Valencia and involves the domain of Pneumology.
|
| Expected achievements / impact |
The CARE-PATHS project will lead to two major results
:
- A Web-based software solution enabling healthcare institutions
to implement and manage clinical pathways, thus covering the whole
cycle of:
- Pathway authoring
- Putting pathways in practice
- Monitoring and managing patients' variance
- 2 "Good Practice" projects demonstrating the
feasibility and benefits for an healthcare institution of setting
up a methodology for managing clinical pathways
The impact of CARE-PATHS, enabled by the Web-based software solution
and demonstrated through 2 pilots, will thus be the set up in
healthcare institutions of a generic method for continuous improvement
of the quality of healthcare services.
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| Co-ordinator contact details |
M. Pierre-James SPY-ANDERSON
AIRIAL Conseil
3 rue Bellini
92806 Puteaux
France
Pierre-James Spy-Anderson - +33 1 41028943
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| This project has been partially
funded by the European Commission under the IST initiative. The content
of this publication is the sole responsibility of the project partners
listed herein, and in no way represents the view of the European Commission
or its services. |
