Web-based Clinical Pathway for Reducing Practice Variations in Radical Prostatectomy

Background: A clinical pathway support system on the Internet (CPSSI) has beendesigned for creating and implementing a web-based clinical pathway forradical prostatectomy. This investigation assessed the effects of the webbasedclinical pathway for radical prostatectomy on practice variations.Methods: From June 2002 to Jun 2003, 22 consecutive patients with localized prostatecancer who underwent radical prostatectomy were treated according to theweb-based clinical pathway. The treatment results were compared with anidentically sized sample of patients treated during the year before implementingthe web-based clinical pathway. Variations before and following theimplementation of the web-based clinical pathway for radical prostatectomywere also assessed. The CPSSI automatically measured pathway variationsand length of hospital stay.Results: After implementing the web-based clinical pathway, the average hospitalstay was reduced significantly (p = 0.0001). The mean number of variationsalso differed markedly (p = 0.0002).Conclusion: This study concludes that the CPSSI-based clinical pathway support systemmay provide a good tool for creating and implementing a web-based clinicalpathway. After implementing the web-based clinical pathway for radicalprostatectomy, practice variations and length of stay were reduced considerably.Moreover, automatically assessing the effects of web-based clinicalpathway implementation can enhance the quality of patient care.