3 tips for building the future care pathway

What is a care pathway?

A care pathway is defined as the sequential treatment steps carried out by health professionals between the city, the hospital, and the patient’s home.
The challenge of efficiency to guarantee equal access to care and the quality of the care, all in the setting of economic sustainability for the healthcare system, is not new. However, the organization is still one of the main concerns of health insurance, of which increasing efficiency is around 50% of its risk management program for 2024 ^[1]. Optimizing and reinforcing the care and prevention pathways is therefore a priority for meeting the associated challenges.

What are the main challenges for care pathways in France?

Relieving the hospital’s burden as the historical center for care

Taking advantage of new facilities for care (multidisciplinary healthcare centers, care access services, home hospitalization, coordination support systems, distance health consultations, etc.) and urban players (general practitioners and specialists, pharmacists, paramedic professionals, patient associations, etc.) could help relieve the burden on hospital services. With these transformations will come new training requirements and enhanced coordination of healthcare professionals, as well as a larger involvement of the patients and their loved ones.

Guaranteeing equal healthcare access

Today, equal healthcare access is undermined by tension in medical demographics of certain professions and the inequality of territorial distribution. In addition, innovations in organizations, therapies, and technologies, such as gene and cell therapies (CAR-T cell, etc.), e-Health, diagnostic help tools or medical devices for therapeutic usage, are important levers that will aid patients and healthcare professionals and change the care practices. To manage the implications linked to the arrival of these innovations and promote their integration in current practices, it will be essential to guarantee that they respond to the needs of the health ecosystem, and then build the associated modes of care.

Reducing the environmental impact of care pathways

Integrating the environmental component into the relative choices of therapies – whether it’s in the design of the pathway, the manner in which the care is given, or the choice of the intervention – will be key for reducing the carbon footprint of the healthcare system (which contributes 8% of the greenhouse gas emissions in France ^[2]). For example, nutritional and hygiene education programs that aim to reduce the occurrence of type 2 diabetes also have the potential to reduce more than 30% of the emissions linked to the patient pathway ^[3].

3 tips for building the care pathways of the future at the local level:

To face these challenges, it is necessary to understand them and imagine building new pathways, by starting from the context of each local ecosystem. Three tips can help healthcare professionals to contribute to this effort:

Tip 1: lead a multidisciplinary work process

Organizing and leading multidisciplinary work meetings centered on the patient pathway and their associated challenges is a first step for questioning the current organization and imagining ways for improving it.

The starting point of these meetings is typically to identify the challenge(s) or the intuition of certain issues which hinder the quality of the therapy for patients, which could be improved and are agreed upon by all of the stakeholders in the ecosystem. These first observations could concern for example the need to develop a local management protocol to reduce the therapeutic inertia in regions which are difficult to access and which have trouble changing their practices.

Based on these findings, these meetings bring together the concerned stakeholders and create a setting conducive to exchanges, for example concerning:

• The state of affairs of a local/regional situation, based on the data available and current practices of healthcare professionals implicated in the pathway
• Real-world examples (patient stories, models observed in other regions, etc.) for identifying good practices and imagining their integration into current practices
• Indicators and tools that exist or should be developed in response to the identified points of improvement

These changes will not happen overnight. Such meetings should thus be modulated and viewed as the first step of a long-term process whose purpose is to build the foundation that will help implement concrete measures of optimization.

Tip 2 : prioritize an innovative health care organization

Capitalizing on the results of solutions that are already in place and putting them in the spotlight is an important step in inspiring and progressively deploying this transformation at a larger level. An example of this is the model of remote monitoring oncology patients in coordination between hospital teams and primary care physicians (such as the model of the Onco’Link project). This can also be accomplished in several ways:

• Drawing up and tracking key impact and success indicators of these measures in order to draw learnings from them, notably: the key success factors, barriers to anticipate, and context factors. Next, at the local level and beyond, valuing the benefits obtained will help with their deployment in the other centers and/or on the other territories.
• Creation of content and/or supports of visual communication dedicated to patient pathways (scientific publications around good practices, posters, patient brochures, etc.) to raise awareness of the medical community and the general public, and to drive action by illustrating the expected results of this change through concrete examples. This content could equally be used, both internally and externally, to grow an engagement communication plan all along the pathway and to support the teams on their discussions with healthcare professionals.

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Tip 3: investigate the pathway and co-build an action plan at the local level

Finally, supporting the evolution of an organized ecosystem can involve the co-construction of a plan of action for improvement that is pragmatic and adapted to the constraints and resources of the local ecosystem. This approach involves two critical steps:

1. First step : investigate the pathway at the local level and identify the blockers that prevent the expected objectives and/or the reference situation from being reached, such as those recommended by learned societies. This diagnostic can be done through individual interviews with stakeholders in the pathway, observations, data analysis (PMSI data, environmental impact data, etc.), analysis of patient cases, and other means.
2. Second step : prioritize the improvement points in multidisciplinary teams, and imagine simple and realistic measures to put in place (directory of local care centers, referral checklist, community of practice, etc.) and the associated plans of action to implement.

In order to guarantee the plan’s success, this approach requires the engagement of motivated and influential local players who position themselves as supporters of the initiative and motivate other stakeholders to follow suit.

Accompanying the changes linked to care pathways provides an opportunity for healthcare professionals to generate value for the health system and for health management players in addition to the therapies that they make available. These solutions reinforce the ecosystem knowledge and the engagement of stakeholders, create a differentiating experience in the interactions with healthcare professionals, and lay the foundations of an innovative and collaborative project with a strong societal impact. Further, it represents a unique opportunity to re-think the place and experience of the patient in their own treatment and to contribute to the solutions, at a time when the needs and desires of healthcare professionals are rapidly evolving.

With strong expertise in more than 60 projects in optimizing pathways related to multiple therapeutic and geographic areas, we can support you in your projects around patient pathways. Contact our team to learn more!

[1] Assurance Maladie (2023). Synthèse du rapport de propositions de l’assurance maladie pour 2024
[2] The Shift Project (2023). Décarboner la santé pour soigner durablement
[3] Health Systems Taskforce. Sustainable Markets Initiative. https://www.sustainable-markets.org/taskforces/health-systems-taskforce/

About the author, 

Céline, Project manager in Alcimed’s Healthcare team in France