Consensus pathways: evidence into practice.

HealthPathways is a website that provides general practice teams with guidance on clinical assessment and management of medical conditions, relevant to local services and resources. The website evolved in 2008 as part of changes towards an integrated healthcare system in the Canterbury region of New Zealand. The website differs from other clinical guidance websites as the clinical pathways are formulated by local healthcare professionals, health managers, and technical writers. This process is facilitated by a proactive group called the Canterbury Initiative. The website now contains over 570 clinical pathways, with access increasing seven-fold since 2009 (visits/mth; 1053 in 2009 vs. 7729 in 2014). HealthPathways has contributed to the delivery of more care in the community (e.g. primary care spirometry; 1443 measurements in 2014 representing one-quarter of the total number). Introduction of the website has been associated with an improvement in referral quality, more equitable referral triage, and more transparent management of demand for secondary care. Because the website provides relevant localised clinical information required during a patient consultation in an easy-to-use standardised format, it has overcome many of the barriers encountered by other online clinical guidance systems. The website has also acted as a change management tool by disseminating information required for successful integration of health services.