Conformance Analysis of Clinical Pathway Using Electronic Health Record Data

Area of Science:

• Health Informatics
• Clinical Process Improvement
• Healthcare Management

Background:

• Clinical pathways (CPs) aim to standardize care but real-world adherence can vary.
• Electronic Health Records (EHRs) offer valuable data for assessing CP usage.
• Optimizing CPs requires understanding actual clinical practice.

Purpose of the Study:

• To evaluate the conformance rate of actual clinical pathway (CP) usage.
• To utilize Electronic Health Record (EHR) log data for assessing CP adherence.
• To identify areas for CP improvement based on real-world care processes.

Main Methods:

• Analysis of EHR log data from 164 appendectomy patients.
• Assessment of clinician order application and matching rates against predefined CP order sets.
• Statistical analysis of patient information, medication orders, operations, diagnoses, and transfers.

Main Results:

• Actual CP order application rates ranged from 0.75 to 0.89.
• Application rates varied by order type, with intra-operative orders showing higher adherence.
• Routine and discharge orders demonstrated lower application rates compared to other CP components.

Conclusions:

• EHR data analysis enables the assessment and improvement of CP application and matching rates.
• Updating CP order sets, particularly for routine and discharge orders, can enhance adherence.
• Further research is needed to correlate CP adherence rates with patient care outcomes.