Abstract
HealthPathways is an online decision support tool aimed primarily at General Practitioners. It contains practical, concise information on patient assessment, management and when and where to refer in the form of ‘pathways’. There are over 40 HealthPathways programs across Australia, New Zealand and the United Kingdom (Streamliners, 2023). Each program’s pathways are developed through local General Practitioners and Subject Matter Experts collaborating on content to ensure the pathways reflect how care looks locally. As part of a larger group of HealthPathways programs, collaboration and sharing of pathways is of central importance.
HealthPathways sits within Integrated Care for multiple reasons including collaborative partnerships and funding, facilitating workforce capacity and capability, local response to population health, and system wide governance and leadership.
Although some HealthPathways programs have been in place for over 10 years and value in the program is seen by the health systems that use the program, there is still limited empirical evidence available. Our scoping review brings together all of the evidence for HealthPathways to make it easy to find and to identify what future research on HealthPathways should aim to achieve. It was undertaken by staff from the University of New South Wales, South Eastern Sydney Local Health District and the Royal College of Surgeons in Ireland.
The JBI scoping review methodology was used to structure the review and relevant databases were searched. At least two reviewers were involved in each step of the article screening using Covidence. Sixteen articles were identified for data extraction from databases. This shows how limited publications on HealthPathways have been since its inception in 2008. The included articles had a variety of focuses, in particular there were multiple on program evaluation, including a recent scoping review on methodologies used in HealthPathways evaluations (Senanayake et al., 2021).
There remains a research gap on whether HealthPathways increases appropriate use of services and resources, whether it reduces costs and is of value for money (Senanayake et al., 2021). Authors have also questioned if it is possible to measure outcomes of HealthPathways independent of other factors (Senanayake et al., 2021). There also needs to be more evidence to show the pathways improve patient care (Stokes et al., 2018).
Some researchers have studied usage of the pathways by General Practitioners as this is key to achieving any of the aims of HealthPathways. Most of the users in the area studied used the program infrequently, but authors conclude HealthPathways ‘improves knowledge of local services, changes clinical management and saves time’ (Gill et al., 2019, p.213).
The learnings for the international audience is that HealthPathways is spreading and scaling as an integrated care initiative due to the value that health systems see in it. However, there needs to be more targeted research to back up these espoused values.
The next steps are to continue researching HealthPathways, with a particular focus on spread and scale.