Beyond the billion-dollar builds: Clinical care pathways deliver productivity and integration in healthcare

Despite billions invested in My Health Record and electronic medical records, Australia faces escalating fragmentation, complexity, costs and workforce strain.

At recent CEDA events in Western Australia and Queensland, people called for more efficient, integrated care with improved patient experience, practical workforce support, and streamlined systems.

Meanwhile frontline teams struggle to consistently answer three essential questions: What assessment, management, and supports are required now? What are the shared decision-making options? Who can deliver services close to home?

Clinical care pathways fill that gap with concise, locally agreed “how-we-do-it-here” guidance that makes evidence usable in a 10-minute consult, improves patient flow and connects care across settings.

What are care pathways?

Care pathways are clinician-authored guides that translate evidence into locally agreed steps for assessment, management and handover. They are mapped to local services, referral criteria and consumer resources.

Built for point-of-care use, they complement digital records, are affordable and implementable now, and lift consistency, equity, safety and flow.

More than digital tools, they enable cultural change and clinician empowerment by giving trusted, locally agreed guidance at the frontline.

Care pathways are mandated

Under the National Safety and Quality Health Service (NSQHS) Standards, health services must give clinicians ready access to best-practice guidelines, integrated care pathways, and decision-support tools (Action 1.27 and Action 1.28). Care pathways are a core clinical governance requirement for evidence-based care.

The task is not to justify care pathways, it is to put in place national systems to keep them current, local and useful.

Care pathways improve productivity, safety and equity

Decades of research show roughly 60 per cent of care aligns with evidence-based clinical guidelines, 30 per cent is waste or low value, and 10 per cent causes harm.

Pathways lift the 60, shrink the 30, and reduce the 10: they make best practice easy, curb unnecessary treatment and variation, and give clinicians shared protocols that work in a busy consultation.  

New evidence often takes a decade or more to reach routine care. Care pathways compress that timeline, transforming national guideline updates and local changes into relevant guidance within days or weeks. In crises or during reform, this policy-to-practice bridge converts strategy into consistent clinical action.

For productivity, clinical care pathways streamline diagnostics, cut unnecessary referrals, shorten waiting times and direct scarce resources to higher-value care, delivering measurable efficiency gains with minimal capital outlay.

It is unrealistic to expect junior clinicians, locums or virtual providers to know all new research or every local and culturally appropriate service. Care pathways provide just-in-time guidance to build capability, confidence and wellbeing.

Make technology investments work harder

Care pathways are light-touch technology. Existing alongside electronic medical records, e-referrals and emerging AI tools, they can be embedded through links or application programming interfaces (API) as those systems mature. They don’t compete with national infrastructure; they make it more useful by ensuring the content clinicians act on is current, local and agreed.

As AI assistants emerge, they will still need a reliable, locally agreed source of truth, so pathways remain the critical content layer that AI draws from.

Crucially, pathways act as the practical integrator for primary, secondary and community care teams to work as one.

Hospitals need care pathways

Static intranet documents are inadequate. With aligned primary care and hospital pathways, referrals and discharges improve, duplication drops, and patient flow is streamlined. Teams have current, condition-specific guidance accessible to support sound decisions at all hours.

Clinical care pathways are working locally and internationally

From New Zealand to Australia and Canada, care pathways are delivering better outcomes for patients, staff and systems. Wales has made care pathways the principle of an integrated, learning healthcare system, with national frameworks setting expectations and local teams adapting delivery. Australia can also combine national stewardship with local relevance. 

Leaders have shown how clinician co-creation builds trust and embeds change across services; it is culture as much as structure.  They highlight care pathways’ role in the “left shift” - moving appropriate care out of hospital and into the community while improving referral accuracy and reducing variation.

What governments and boards can do

We need a shared vision for a national care pathways structure that connects Australians to the right care, first time, every time. It empowers clinicians, embeds equity and evidence, and continuously evolves - a learning health system with real-time feedback loops between frontline practice and policy.

Steps to improve healthcare

1. Endorse a national care-pathways framework (purpose, scope, roles, outcomes) co-created with funders, clinicians, consumers and policymakers.
2. Create governance that aligns Commonwealth, state and territory priorities while enabling local tailoring for communities.
3. Secure sustainable funding and system-wide evaluation that track effectiveness, consumer experience, equity and value.
4. Build interoperable digital foundations and data standards so pathways are available at the point of care and produce real-time insights for improvement.
5. Embed a culture of co-design and shared learning so clinicians, consumers, researchers and technical experts continuously refine pathways using evidence and feedback.

Care pathways are the way forward

Pathways won’t replace needed investments in technology. They will ensure those investments translate into better outcomes for healthcare systems and communities. Australia needs to scale what already works and align it to our national reform agenda to deliver productivity, safety and equity gains in healthcare within this term of government.