Multi-center disease-specific management system: toward standardized and harmonized clinical pathways in integrated...

West China Hospital of Sichuan University leads the largest regional medical alliance in Western China, coordinating complex referrals and continuity of care. However, variability in clinical practices and the absence of a unified digital infrastructure have limited standardized disease-specific management across member institutions. This study aimed to develop and implement a standardized digital platform to support interoperable disease-specific management within the medical alliance.

A total of 293 patients were enrolled in the early implementation phase. The system demonstrated feasibility in multicenter data integration, standardized pathway execution, and privacy-compliant cross-institutional data sharing. Preliminary deployment confirmed stable interoperability across participating institutions.

The results indicate that perceptions of increasing extreme weather are widespread among older adults in Austria, pointing to a broadly shared awareness of climate-related change. At the same time, perceptions are socially and spatially differentiated. Environmental awareness emerges as the strongest correlate of perceived increases, underscoring the importance of cognitive and informational factors in shaping climate-related interpretations. Urban residence is associated with stronger perceptions compared to town and rural living, suggesting the relevance of geographic context and everyday exposure. Higher education and financial hardship are also positively associated with perceived increases. In contrast, subjective health and loneliness show no significant associations.

The W-SDM System provides a scalable and standardized digital framework for pathway-based disease management within a medical alliance. This early-stage implementation establishes a foundation for future evaluation of clinical effectiveness, workflow optimization, and long-term outcome assessment.