A Process-Centered Approach to the Description of Clinical Pathways-Forms and Determinants

Int J Environ Res Public Health. 2019 Jul 24;16(15):2638. doi: 10.3390/ijerph16152638.


The aim of the study is to indicate the need for variability in the presentation of clinical pathways, in various phases of their implementation, and to define the forms of presentation of clinical pathways required by physicians in both the Hospital Information Systems (HIS) and Electronic Medical Records (EMR) Systems, as well as the determinants of the selection of the forms of description, in relation to the performed medical actions. The results of the study are a significant lead-in towards further research on the required form of the user interface in systems supporting dynamic business process management (dynamic BPM). The research is a pilot of a survey study, conducted to ascertain the usefulness and feasibility of the adopted methodology, for a wider project on the determinants of the form of description of clinical pathways. An exploratory pilot survey, in a large multi-specialization hospital in Poland, was conducted. The survey sample consisted of 28 purposely selected heads of all hospital departments, and the medical team of the pediatric ward. Descriptive analysis was carried out on the data collected. The results of the study have unambiguously supported the claim that physicians require the form of presentation of clinical pathways to change, depending on the particular phase of the diagnostic-therapeutic process, as well as establishing the main determinants thereof. This pilot study is one of the first attempts to establish the factors determining the choice of clinical pathway presentation in HIS/EMR systems. While not conclusively decisive in terms of the forms of presentation or the determinants of their choice, it indicates the directions of further research, both from the point of view of ergonomics and the usability of HIS/EMR systems, as well as the management of medical knowledge, as part of the dynamic management of clinical pathways.

Keywords: business process management; clinical pathways; dynamic business process management; knowledge management.

MeSH terms

  • Critical Pathways*
  • Electronic Health Records*
  • Hospital Information Systems*
  • Hospitals
  • Humans
  • Physicians
  • Pilot Projects
  • Poland
  • Records
  • Surveys and Questionnaires