The role of pathways in SmartCare

The SmartCare high-level pathways were developed through an iterative collaboration approach. An initial version of the pathways was created in the kick-off phase of the project, on the basis of a review of existing integrated services and literature research. Members of the project team then visited the SmartCare regions, speaking with both front-line staff and decision makers about how health and social care are organized in the region, how different work processes are structured and how both types of services co-operate currently. They brought with them large-scale print-outs of the pathways that were presented and discussed, passed around and written upon. The results of each visit were fed back into the project and discussed with a wide range of stakeholders, resulting in ever more developed versions of the pathways. Ultimately, a final version of the pathways was agreed between all partners and used as a tool for the development and implementation of the SmartCare services.

In the course of this work, the pathways fulfilled a number of functions. They served as an instrument for strategic planning on the decision maker-level. They helped the various stakeholders in the regions to join forces and formulate objectives and concrete work tasks to achieve them. They also proved to be an invaluable dissemination tool, both for the regions and SmartCare as a whole, to communicate what the project is about to both expert and non-expert audiences.

The pathways also fulfilled a success-critical function in SmartCare's service development and implementation process. SmartCare follows a deployment cycle consisting of five steps leading from initial requirements analysis to service deployment (Meyer, Müller et al. 2011). The SmartCare regions went through this cycle in two iterations in order to arrive at the services that were ultimately being piloted. The pathways were developed and refined on the basis of the requirements analysis and from there on served as a structuring and guiding instrument in the design of detailed service processes, the specification of the IT systems and the SmartCare architecture, as well as the development and testing of service prototypes.

During requirements analysis, the initial pathways versions helped people in the regions to identify gaps in their own service provision that would have to be filled, as well as to point out to SmartCare gaps in the service concept that had up that point been missed.

The service processes – detailed flowcharts of action sequences – were developed as an expansion of the pathways into a more detailed definition of the activities and roles in the service.

The IT specifications define information recording systems, ICT infrastructure components and information sharing mechanisms for each step of the pathway.

Service prototypes were built on the basis of processes and specifications for initial testing and improvement, prior to the deployment of the systems and services for the evaluated pilots.


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