Abstract
HealthPathways is an online decision support tool available at no cost to local healthcare workers, with primary usage aimed at local General Practitioners (GPs). HealthPathways programs are made of multiple ‘pathways’ containing practical, concise, evidence-based information intended to be used during a patient consult. The main types of pathways are clinical or referral pathways, they guide GPs on patient assessment, management and when and where to refer. In New South Wales (NSW) there are 13 HealthPathways programs covering all geographical areas of the state. The larger community of HealthPathways programs span Australia, New Zealand and the United Kingdom, with over 40 programs in total (Streamliners, 2023).
Pathway development is resource intensive and it takes considerable time to produce quality pathways that reflect local care arrangements. Prior to the COVID-19 pandemic HealthPathways teams leveraged the work of others when developing pathways for their local area. This occurred through HealthPathways teams looking to the work of other teams who had already developed the particular pathway, then using the best pathways as their template to start from. Then the team would ‘localise’ the information to make sure it reflected local ways of working. The NSW programs worked closely together and were proactive in informing other NSW programs when they had a pathway that was significant or appropriate for sharing across the state.
During the pandemic there became a need for a more efficient and effective way of sharing pathways, particularly the pathways containing public health information that needed to be rapidly disseminated to local GPs. A method was developed whereby one team would develop for the state individual or small groups of pathways with state level input and governance. The efficiency was that these pathways could be spread to other teams with little to no changes, generally in a rapid, efficient manner. The program itself spread to the remaining geographical area in NSW where a team had not been implemented prior. The pathways developed were spread across the NSW teams, helping to scale up each of the programs. Usage of HealthPathways increased dramatically as HealthPathways was intentionally chosen at the state level as only place GPs should go for information targeted specifically for them. This increase in usage also scaled up many of the programs. These state pathways were kept up to date with changes in guidance and services at the state level and teams could decide if they wanted the changes automatically or if they just wanted notification and ability to incorporate the changes individually.
The learning for the international audience is that HealthPathways is spreading and scaling as an integrated care initiative. Although resourcing the programs is intensive, value is seen in functions and outputs which will help make it sustainable. To become more sustainable the program requires research to prove the value it provides health systems. The practice of sharing pathways in the state-wide format is a large efficiency making the program more sustainable.
The next steps are to continue researching HealthPathways, particularly around spread and scale.