Care Paths
Care Paths are an advanced form of clinical decision support available in the Connect Care clinical information system. They promote integrated multidisciplinary care through shared coordination of a patient’s healthcare goals across settings, including acute, community and primary care. They guide goal-based management of health conditions by exposing key information, personalizing recommendations and promoting evidence-informed care.
Care Paths aid in clinical workflow with simple and intuitive supports accessed via Best Practice Advisories (BPAs) based on results, medications, investigations and diagnosis. Targeted recommendations based on clinical criteria are provided to clinicians, which allow for key actions to be visible within a single view (e.g., order management, note writing).
The first Care Paths developed in Connect Care are for Heart Failure (HF), Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) and Liver Cirrhosis, with more planned in the near future for other disease conditions.
Care Path Essentials (click to expand/collapse)
Initiating a Care Path
The Care Path will start with an “automatic pop-up” that asks the prescriber to place the patient on the Care Path. It will be triggered by either admitting diagnosis or adding a principal diagnosis in the Problem List.
Managing a Patient on a Care Path
Once a patient is added to a Care Path, ongoing support and recommended key actions will be visible by clicking the Care Path BPA from the Storyboard.
Admission Order Sets are easily accessible from within the Care Path.
A "Summary" tab, consolidating valuable patient information, is included to support day-to-day patient care (assessments, labs, vitals, medications, rapid rounds, expected date of discharge [EDD]).
A Care Path can be stopped (resolved) at any time if conditions for its use change, and will be automatically resolved when a patient is discharged.
Care Paths move the patient through several phases, including initiation and access to Admission Order Set, Acute Management, Optimization of Treatment and Preparing for Discharge.
Patients move along a Care Path automatically based on specific criteria being met (e.g., clinical condition or length-of-stay data), or may be moved manually based on prescriber discretion and clinical judgement.
Supports in Place
Care Paths are supported by a number of provincial teams, including the Care Path Project Team, Cardiovascular Health & Stroke Strategic Clinical Network™ (SCN), Medicine SCN™, IT, Clinical Knowledge & Content Management (CKCM) and the EPIC developers.
Help, feedback and requests can be submitted though the standard processes:
If immediate assistance is required, contact the IT Solution Centre at 1-877-311-4300.
For non-urgent issues, submit a ticket via the Connect Care support page.
Care Path Utilization (click to expand/collapse)
Care Paths have been shown to reduce unhelpful practice variation, prescribing errors, length of stay, readmission rates, patient mortality, and healthcare costs. They also improve patient follow-up with primary care providers, specialists, and specialty clinics.
Note that, for optimal Care Path use, including correct medication recommendations, HF Baseline data (Weight and Ejection Fraction) and HF/COPD Care Path Daily Assessments must be entered. See the below link for more information.
Care Path feedback metrics are designed to help clinicians recognize missed opportunities for leveraging the potential positive impact of these tools.
Available metrics are found in Meaningful Use Dashboards:
Education Modules (click to expand/collapse)
Education modules are available for prescribers, allied health clinicians and nurses through MyLearningLink (MLL), as well as accredited modules for physicians to receive RCPSC MOC and CFPC MAINPRO.
Available Care Path courses in MLL:
EPIC - Care Paths - Allied Health/Nursing (15 min)
EPIC - Care Paths - Prescribers (20 min) (Note: This course is also inserted into the accredited modules below.)
Accredited courses in MLL:
Heart Failure Disease Care Path Integration: Evidenced-Based Guideline Recommended Best Care
RCPSC MOC 3 – SAP 1.5 hrs
CFPC Mainpro+ 3-credits-per-hour for 1.5 hrs (4.5 credits)
Acute Exacerbation of Chronic Obstructive Pulmonary Disease Care Path Integration - Evidenced-Based Guideline Recommended Best Care
RCPSC MOC 3 – SAP 1.0 hr
CFPC Mainpro+ 3-credits-per-hour for 1.0 hr (3.0 credits)