Improving the quality of health care through an integrated clinical pathway management approach and a digital platform

In addition to China's large (1.4 billion) and ageing population, shortages in critical health and care workers have compounded the demand for health care, in a country where major hospitals can have over 4,000 beds, with outpatient volumes of four million patients per year. Within this context, long term research conducted by members of the Informatics Research Centre at Henley Business School, the University of Reading, has addressed how the quality, efficiency and safety of hospital services can be significantly improved through the effective use of information, data and clinical pathway knowledge. Prior to this, there was limited research on integrating best-practice clinical pathways with local hospital practices and existing technical information systems. Although digital systems are increasingly used in hospitals, they form information silos; thus, their effectiveness has been limited, owing to a lack of alignment with clinical pathways. By developing an integrated clinical pathway platform, the research has addressed the lack of connection between best practice clinical pathways, local hospital practices and existing hospital information systems.

Responding to the challenge of rapidly increasing health-care demand in China, research at the Informatics Research Centre in Henley has underpinned a major change in hospital practice across the country. In addition to improving clinical outcomes, it has brought significant benefit to the quality of the patient experience prior to, during and after a hospital visit. Through the development of a digital integrated clinical pathway management approach, and a digital platform linked to existing hospital information systems, the research has enabled up-to-date clinical pathway knowledge and healthcare data to be readily accessible through mobile technology by the patient, clinician and hospital management. In so doing, it has considerably improved hospital service capacity, and reduced medical error, patient waiting time, length of hospital stay, and unnecessary tests. At the same time, it has increased patient surgery and patient referrals. The integrated clinical pathway approach has also been responsible for improved diagnoses, resulting in the saving of lives. .

The novel approach was co-developed by the team led by Dr Weizi Li, as well as clinicians and technical teams from hospitals, and was demonstrated through successful pilots in collaboration with Chinese hospitals. By 2018, research from Dr Li’s team had underpinned the delivery of bespoke digital platforms and integrated clinical pathway management systems across 2,400 hospitals in China ; this includes 1,000 major public hospitals (over 400 Grade A hospitals) and 1,400 suburban hospitals, covering 31 provinces and 200 cities.

According to statistics from 100 major hospitals that applied this research, it has on average reduced medical error by 30% (from an average of 252 adverse events and prescribing errors on six disease pathways during six months before implementation to 168 adverse events and prescribing errors after implementation), and reduced waiting times by 50%, patient record and treatment data accessing times by 90%, and admission/discharge/referral times by 85%, with a total reduction of average length of stay from 12 days to 10 days.