Japanese Society for Clinical Pathway

The Japanese Society for Clinical Pathway was established in 1999 with the objectives of development and diffusion of clinical pathways and providing education on them and is now in its 20th year. As of January 2020, it had 1,400 individual members and 440 facility members, making it the largest clinical pathway research organization in the world. Attended by 2,500 people, the 20th Annual Meeting held in Kumamoto in January 2020 was a great success.

Our society defines clinical pathway as “Means of improving medical care by analyzing variance with a standard medical plan including the patient’s status, goals of clinical practice (outcomes), assessment and recording”. Outcome-oriented pathways involve setting treatment goals as outcomes, and adding assessment to determine whether they are achieved, with the assessment tasks consisting of medical process units. The outcome of “stable circulatory dynamics” may be determined when blood pressure ranges from over 100 to less than 180 mm Hg systolic and over 60 to less than 100 mm Hg diastolic, and pulse from greater than 45 to less than 85/minute; so the tasks of blood pressure and pulse measurement are included. The outcome assessment tasks in the series are minimum medical process units and are called OAT unit (Fig.1 OAT unit).

Since 2005, the society has standardized the terminology of outcomes and assessment, adding the concept of ranking to make them more structured, and published it as BOM (Basic Outcome Master in 2011 (Fig. 2 BOM). The BOM has been certified by JAHIS (Japanese Association of Healthcare Information Systems Industry), an information standards organization. Our society and the Japan Association for Medical Informatics have had several discussions on the structuring of terms in the BOM and the concept of OAT unit, and we are carrying out a development project on electronic clinical pathways for obtaining data. It is currently underway as an ePath project receiving support from AMED. Further details are available on the ePath website（https://e-path.jp/）.

Major objectives of this initiative that we are jointly carrying out with the Japan Association for Medical Informatics include efficiently extracting real world big data from electronic medical records across vendors and medical institutions, and using the data in the analysis of medical processes and development of new drugs as well as in the development of AI-based electronic medical records.

In order to promote the diffusion of clinical pathways and provide education on them, the society established a Certification System of Clinical Pathway Practitioner in 2016 and currently a total of 165 Certified Clinical Pathway Practitioner (CCPP), Certified Clinical Pathway Instructor (CCPI) and Certified Clinical Pathway Advanced Instructor (CCPAI) are engaged in activities nationwide. In addition to annual meetings, we hold educational seminars, and expert meetings in support of clinical pathway activities all over Japan.