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The eClinical Care Pathway Framework: a novel structure for creation of online complex clinical care pathways and its application in the management of sexually transmitted infections.

Gibbs, J; Sutcliffe, LJ; Gkatzidou, V; Hone, K; Ashcroft, RE; Harding-Esch, EM; Lowndes, CM; Sadiq, ST; Sonnenberg, P; Estcourt, CS (2016) The eClinical Care Pathway Framework: a novel structure for creation of online complex clinical care pathways and its application in the management of sexually transmitted infections. BMC Med Inform Decis Mak, 16. p. 98. ISSN 1472-6947 https://doi.org/10.1186/s12911-016-0338-8
SGUL Authors: Sadiq, Syed Tariq Harding-Esch, Emma Michele

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Abstract

BACKGROUND: Despite considerable international eHealth impetus, there is no guidance on the development of online clinical care pathways. Advances in diagnostics now enable self-testing with home diagnosis, to which comprehensive online clinical care could be linked, facilitating completely self-directed, remote care. We describe a new framework for developing complex online clinical care pathways and its application to clinical management of people with genital chlamydia infection, the commonest sexually transmitted infection (STI) in England. METHODS: Using the existing evidence-base, guidelines and examples from contemporary clinical practice, we developed the eClinical Care Pathway Framework, a nine-step iterative process. Step 1: define the aims of the online pathway; Step 2: define the functional units; Step 3: draft the clinical consultation; Step 4: expert review; Step 5: cognitive testing; Step 6: user-centred interface testing; Step 7: specification development; Step 8: software testing, usability testing and further comprehension testing; Step 9: piloting. We then applied the Framework to create a chlamydia online clinical care pathway (Online Chlamydia Pathway). RESULTS: Use of the Framework elucidated content and structure of the care pathway and identified the need for significant changes in sequences of care (Traditional: history, diagnosis, information versus Online: diagnosis, information, history) and prescribing safety assessment. The Framework met the needs of complex STI management and enabled development of a multi-faceted, fully-automated consultation. CONCLUSION: The Framework provides a comprehensive structure on which complex online care pathways such as those needed for STI management, which involve clinical services, public health surveillance functions and third party (sexual partner) management, can be developed to meet national clinical and public health standards. The Online Chlamydia Pathway's standardised method of collecting data on demographics and sexual behaviour, with potential for interoperability with surveillance systems, could be a powerful tool for public health and clinical management.

Item Type: Article
Additional Information: © 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Chlamydia trachomatis, Framework, Online clinical care pathway, Sexual health, Sexually transmitted infections, eHealth, Online clinical care pathway, Framework, eHealth, Sexual health, Sexually transmitted infections, Chlamydia trachomatis, Medical Informatics, 0806 Information Systems, 1103 Clinical Sciences, 0909 Geomatic Engineering
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: BMC Med Inform Decis Mak
ISSN: 1472-6947
Language: eng
Dates:
DateEvent
22 July 2016Published
13 July 2016Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
G0901608Medical Research CouncilUNSPECIFIED
PubMed ID: 27448797
Web of Science ID: WOS:000380334500001
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108918
Publisher's version: https://doi.org/10.1186/s12911-016-0338-8

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