Improving health outcomes and value with care pathways: the otolaryngologist's role

With a growing interest in value-based health care, there is an emphasis on establishing best practice, measuring outcomes, and improving clinical efficiencies. Best practice is a challenging concept with our growing knowledge base, and clinical practice guidelines (CPGs) help establish an approach to prioritize care and reduce practice variation. New challenges are emerging with a larger population of insured patients and a mandate to coordinate care with a shared electronic health record, and these are coupled with a massive growth in computing power. Care pathways (also called critical or clinical pathways) structure the implementation of CPGs, stratify high-risk patients, and provide the opportunity to achieve improved value. These are dynamic processes that are supervised by interdisciplinary teams and have the potential to evolve with new information gathered from each of the steps. As we emerge from single to group medical practices and hospitals to health systems, care pathways will be critically needed for optimal population management in health care.