Impact and outcome evaluation of HealthPathways: a scoping review of published methodologies.

INTRODUCTION The HealthPathways programme is an online health information system used mainly in primary health care to promote a consistent and integrated approach to patient care. AIM The aim of this study is to perform a scoping review of the methodologies used in published impact and outcomes evaluations of HealthPathways programmes. METHODS The review included qualitative, quantitative or mixed-methods evaluations of the impact or outcome of HealthPathways. MEDLINE, Embase, CINAHL and Web of Science databases were searched. Seven programme aims were identified in the impact and outcome evaluation: (1) increased awareness and use of HealthPathways; (2) general practitioners are supported to adopt best practice, patient-centred care; (3) increased appropriate use of resources and services; (4) improved quality of referrals; (5) enhanced consistent care and management of health conditions; (6) improved patient journeys through the local health system; and (7) reduction in health-care cost and increased value for money. RESULTS Twenty-one studies were included in the final review; 15 were research papers and six were reports. 'Increased awareness and use of HealthPathways' was the most frequent programme aim evaluated (n = 12). Quantitative and qualitative research methodologies, as well as prospective and retrospective data collections, have been adopted to evaluate the impact and outcome of HealthPathways. DISCUSSION Assessing the impacts and outcomes of HealthPathways may be challenging due to limitations in primary data and the interconnectedness of change across the measured aims. Each aim may therefore require specific methodologies sensitive enough to capture the impact that HealthPathways are making over time.

Integrated GP and allied health care for patients with type 2 diabetes.

BACKGROUND: Integrated general practitioner and allied health chronic disease management (CDM) has been supported by Australian Government Medicare initiatives since 2005. Practical ways of implementing CDM have been slow to develop. METHODS: An integrated CDM program for patients with type 2 diabetes was piloted in 2006 by Central Northern Adelaide Health Service (South Australia), in conjunction with four divisions of general practice. Health providers included GPs, practice nurses, credentialed diabetes educators, dieticians and podiatrists. Eligible patients with Medicare approved Team Care Arrangements (TCAs) received allied health care for the Medicare Plus rebate only. This article reports on GP and staff perspectives of the processes, and the effectiveness and sustainability of the pilot. RESULTS: Chronic disease management improved with integrated health care, reflected by appropriate allied health referrals and better quality TCAs, interprofessional communication, and patient satisfaction. DISCUSSION: There are benefits for interested GPs, their staff, co-located allied health providers and diabetic patients if integrated multidisciplinary care is provided in the manner of this Enhanced Primary Care CDM model.