Improving Pathway Compliance and Clinician Performance by Using Information Technology R Blaser a , M Schnabel b , O Heger a , E Opitz a , R Lenz a , K A Kuhn c a Institute of Medical Informatics, Philipps-University Marburg, Germany b Department of Trauma, Reconstructive and Hand Surgery, Philipps-University Marburg, Germany c Institute of Medical Statistics and Epidemiology, Technical University Munich, Germany Abstract To deliver patient-specific advice at the time and place of a consultation, to improve clinician performance and compliance by using computer-based decision support, and to integrate such IT solutions with the clinical workflow are important strategies for the implementation of clinical pathways. User acceptance plays a critical role: additional effort has to be balanced with enough benefit for the users. Experiences from routine use of an online surgical pathway at Marburg University Medical Center show that it is possible to successfully address this issue by seamlessly integrating patient-specific pathway recommendations with documentation tasks which have to be done anyway and by substantially reusing entered data to accelerate routine tasks (e.g. by automatically generating orders and reports). Keywords: Clinical Pathways; Clinical Decision Support Systems; Systems Integration; User Acceptance 1. Introduction For more than a decade, studies on the incidence and nature of adverse events in medicine have shown that errors in medicine are not rare and may cause severe harm [1-3]. The nature and preventability of adverse events have been studied, and cognitive overload of physicians was found to be among the reasons. Evidence-based clinical guidelines or pathways can reduce variability in practice and improve patient care outcomes [4]. Implementation strategies for guidelines and pathways which deliver patient-specific advice at the time and place of a consultation are most likely to be effective [4, 5]. Computer- based decision support (e.g. reminder systems) can improve clinician performance and guideline compliance [6, 7]. Such a capability depends on the availability of the data to make the appropriate recommendations [8]. Suitable interaction mechanisms for data entry during consultation and for the representation of patient-specific recommendations and warnings are needed. These IT solutions should be integrated with the clinical workflow and give back to the user something of value in order to minimise and to offset the inconvenience of using the system [5, 8]. In 2003 we analysed quality problems with discharge letters at the Department of Trauma, Reconstructive and Hand Surgery at University Medical Center, Marburg, Germany. Based Connecting Medical Informatics and Bio-Informatics R. Engelbrecht et al. (Eds.) ENMI, 2005 199 Section 3: Decision Support and Clinical Guidelines