HealthPathways Research Network

Western Victoria Primary Health Network developed a COVID-19 online Community of Practice comprising general practitioners, practice nurses, pharmacists, aged care and disability workers, health administrators, public health experts, medical specialists and consumers. This paper describes progress toward a durable organisational learning health system model through the COVID-19 pandemic and beyond, and the role HealthPathways played in embedding learning into clinical practice.

A case study highlighting the value and impact of HealthPathways during the COVID-19 response. The study finds that HealthPathways played an important role by providing frontline clinicians with trusted, reliable and up-to-date information at a time of rapidly changing information and advice. Developing the COVID-19 pathways also required significant collaboration, which strengthened relationships, trust and respect between government, local health systems, community health providers and colleges.

A case study that describes the implementation of HealthPathways in the Australian state of Queensland. Queensland is an interesting case because HealthPathways was implemented in a policy context of addressing equity of access to care, within a wider state Outpatient Strategy and Clinical Prioritisation Criteria (CPC). HealthPathways has played an important role in delivering the CPC across a number of diverse localities in Queensland, gaining the support of frontline clinicians for a change that could otherwise have been confronting and controversial. It is an example of managing consistency in health services while allowing for local variation where appropriate.

A report from The King’s Fund that provides an overview of the transformation process the Canterbury Health System undertook. It follows up The King’s Fund’s 2013 report.

A journal article that provides an overview of HealthPathways, including the background, evolution and development of the HealthPathways platform.

A report from The King’s Fund that provides an overview of the transformation process the Canterbury Health System undertook.

This white paper describes an economic model of the value of HealthPathways, to help HealthPathways Community members understand the value of their HealthPathways programme and justify sustained investment. The model suggests a potential return on investment of $9.76 for every $1 invested in HealthPathways.

This paper shows the impact of HealthPathways on musculoskeletal radiological referrals at a single institution within Cardiff and Vale University Health Board. It finds that HealthPathways is an effective way of reducing referral rates for musculoskeletal radiological investigations, and that the financial savings are significant and recurrent.

Key findings
• MRI knee scans decreased by 82% following HealthPathways implementation.
• MRI lumbar spine scans decreased by 70%.
• Ultrasound shoulder scans decreased by 92%.
• Estimated annual savings of £374,424 were achieved through reduced imaging.
• There was no increase in referrals to physiotherapy or orthopaedic services, except for a small rise in spinal referrals.

HealthPathways was used to embed models of acute care in the community that led to 30% fewer acute medical hospital bed days in Canterbury compared with the national average.

Key findings
• Results showed a flattening of acute medical admission rates per 1,000 population, with 30% fewer acute medical hospital bed days used in 2017 compared with the national average.
• Between 2000 and 2018, Canterbury’s Acute Demand Management Service (ADMS) supported over 34,000 patients a year, contributing to a sustained reduction in emergency department attendances and acute medical admissions, particularly among patients aged 65 and over.
• The Canterbury Health System achieved a sustained reduction in acute medical admissions per head of population, despite a growing and ageing population, through a focus on integration and primary care enablement.
• HealthPathways was a critical enabler, giving GPs agreed local guidance on management and referral for over 550 clinical conditions, supporting safe and consistent decision-making in the community.
• Community-based services such as ADMS, supported by HealthPathways, allowed GPs to treat patients at home who would otherwise have needed hospital care.
• The integrated model relied on a culture of trust, shared clinical leadership, flexible funding and strong relationships across sectors, highlighting the importance of alignment beyond technology.
• Relevance to HealthPathways: this study shows how HealthPathways can support systemic change by enabling community-based care and reducing hospital pressure through better coordination and guidance.

A case study that used a pre-post study design to investigate the impact of HealthPathways. The study suggests that HealthPathways has likely reduced costs for diabetes patients in Mackay by reducing unnecessary referrals. Economic analysis indicated the diabetes pathways could potentially save the health system approximately $74,240 a year in avoidable referrals.

A journal article that demonstrated the value of explicit advice in a pancreatitis clinical pathway. Compliance improved by 13 percentage points (from 65% to 78%), resulting in 54 fewer amylase tests over the six-month period.

A journal article that describes a project to improve radiology referral and identifies its outcomes. The project led to a sustained improvement in the quality and value of primary care radiology referrals in Canterbury. Referral quality improved (acceptance rates rose from 78% to 88%, and urgent referrals fell from 59% to 22%), as did value (plain film volumes fell by 40%).

HealthPathways was used to embed the Western Sydney Integrated Care Program (WSICP), which was associated with a 34% reduction in hospital admissions among enrolled patients.

A journal article that describes a skin cancer programme and identifies its outcomes. The programme improved skin cancer management, resulting in more skin cancers being treated by the public health system, shorter waiting times for treatment, and fewer minor skin lesions being referred to secondary care. Developing the programme also improved working relationships between primary and secondary care clinicians.

A journal article that describes the results of an online survey of healthcare professionals in Canterbury about their perceptions of HealthPathways. It found that 90% to 95% of GP teams thought HealthPathways was easy to use and improved patient care. Most hospital clinicians (87%) considered the website had contributed to better patient management in primary care and had improved all stages of referral and follow-up of patients.

The South Tyneside HealthPathways team ran its first annual user survey in late 2023 to understand more about how HealthPathways is used in the region and the benefits it provides. The simple online survey produced very positive results, with 97% of respondents saying they use HealthPathways at least once a week, and almost half saying they use it daily. Clinicians also reported that HealthPathways makes them more confident assessing and managing the patient in front of them, identifying and accessing services, and understanding and following local referral processes.

Key findings
• 97% of respondents reported using HealthPathways at least once a week, and 47% reported using it daily.
• Users reported that HealthPathways saves them approximately 1 hour a week on average.
• 80% of clinicians agreed that HealthPathways helps them assess the patient in front of them.
• 91% of respondents stated that HealthPathways helps them understand and follow local referral processes.
• 86% of clinicians said that HealthPathways helps them identify and access services they would otherwise not be aware of.
• 87% of respondents reported that HealthPathways makes them feel more confident in managing the patient in front of them.

This article summarises the background and benefits of Community HealthPathways and provides tips to support decision-making in the consulting room. It highlights the influence a community of clinicians can have on service redesign through developing and publishing HealthPathways.

HealthPathways was used to embed an advance care planning programme that corresponded with a 13% reduction in people aged 75 and over dying in hospital between 2013 and 2017.

A journal article that describes the development of a supportive education programme and online information about tongue-tie for health professionals and consumers. The programme contributed to successful uptake of the new clinical pathway and a reduction in the frenotomy rate from 11.3% in 2015 to 3.5% by mid-2017.