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Open Source Pathways
Build free pathways in minuites not months!
Drag and drop builder
Share and copy other's pathways
Integrated decision rules
Web-based collaboration
Add video and other media
An entire pathway system, for free!
Augmented CPOE
CDS that makes easy to do the best thing
Works with Epic (more soon!)
Use built in CDS (dose checking, etc.)
No new software!
Can be up and running in 1-2 months
No additional IT resources needed
ED, inpatient, ambulatory... anywhere!
 
 
Outcomes
Pathway-based CPOE vs. standard ED workflow (n:49)

Pathway-based Control
Adherence to clinical guideline/pathway orders
Expected order was placed
72% (562/780) 45% (311/690)
Overutilization of unnecessary orders
Unnecessary order placed
7% (92/1,326) 10% (117/1,173)
Blinded pilot study that radomized EM physicians and NPs to a simulated Curbside pathway-based CPOE vs. a control CPOE of their current Epic workflow. This model used 5 different disease processes and looked for behavior change in the ordering practices of the provider. Interesting the study was repeated with 20 EM nurses (RNs) who showed even more robust results than the physicians/NPs suggesting that the use of pathway-based CPOE may allow for less trained medical providers to make evidence-based clinical decisions in this setting.
Presented findings
Improving Time to Antibiotics in Fever in Pediatric Oncology Patients
Heather Hickman, RN
Emergency Nurses Association National Conference. Poster: Oct 2017.
Standard model for treating febrile pediatric patients with oncologic processes lead to changes in provider engagement, labs ordered, medications delivered and provider-provider handoff.
Novel Web-Based Algorithm for the Diagnosis and Management of Pediatric Acute Pancreatitis.
Ke-You Zhang, MD, Dan Imler, MD, Zachary M. Sellers, MD, PhD
Stanford University School of Medicine, Pediatric Research Retreat. Poster: Apr 2017.
First treatment algorithm for pediatric acute pancreatitis published in an open access location. Utilized by ~1,000 unique providers from 7 countries in the first 8 months.
Evidence-Based Clinical Pathways Improve Emergency Care For Children.
Dan Imler, MD
Spectrum Innovation Research Symposium Poster: Jan 2016.
Asthma
  • Time to albuterol – ↓ 41.8 min (38.0%)
  • Time to steroids – ↓ 32.2 min (35.6%)
Croup
  • Time to steroids – ↓22.4 min (37.7%)
  • % Receiving albuterol – ↓ 9.6%
Ketamine Sedation
  • % Receiving ondansetron – ↑ 47.7%
  • Length of ED stay – ↓ 75.6 min (17%)
Migraine
  • % Receiving opioids – ↓ 6.7% (30.7%)
  • % Receiving triptans – ↑ 7.6% (58%)
  • Time to headache medication – ↓ 28 min (23.3%)
Febrile Neutropenia
  • Time to antibiotics – ↓ 51.3 min(49.9%)
Neonatal Sepsis
  • Time to antibiotics – ↓ 119.9 min (70.2%)
Provider (MD/NP) survey regarding the value of augmented CPOE (n:81)

In uncomplicated, common medical problems, clinical pathways lead to improved CLINICAL outcomes:
86% Agree (40% strongly agree + 46% agree)

In uncomplicated, common medical problems, clinical pathways lead to improved OPERATIONAL outcomes (length of stay, patient satisfaction, costs, etc.):
88% Agree (41% strongly agree + 47% agree)

Have you ever had a clinical pathway/order set catch a clinical order that you might have otherwise missed?
84% Yes

Where in your workflow do you think the logic from clinical pathways would help you the most in making optimal clinical decisions?
78% Directly integrated into the EHR
 
 
Published Pathways
80
Unique Users
215,314
Countries
95
 
 
The Curbside Mission
We exist to give every patient access to the best clinical decisions for their immediate and long term health.
 
 
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