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Study topic
Evaluation of HealthPathways Sydney, focusing on its uptake, impact on clinical practice, and integration into the local health system.

Study type
Multi-phase mixed-methods evaluation including quantitative, qualitative, and systems-level analysis using the NASSS Framework.

Key findings

• Use of HealthPathways Sydney increased steadily between 2014 and 2018, but most general practitioners used it infrequently, with a small number of users responsible for the majority of pageviews.
• HealthPathways was particularly useful for new GPs and for conditions with recent policy changes or detailed local protocols, such as antenatal care and cervical cancer screening.
• Most users reported that HealthPathways supported decision-making, reduced uncertainty, and clarified referral processes, particularly in managing less familiar conditions or navigating local service access.
• Stakeholders valued the platform’s potential for building cross-sector understanding and consistency, with hospital clinicians increasingly engaging in pathway development and review.
• HealthPathways was used as a tool to surface system gaps and inconsistencies, acting as a platform for dialogue between primary and secondary care on service access, referral criteria, and shared care models.
• Referral trends suggest HealthPathways contributed to increased referrals to several outpatient clinics, especially at Royal Prince Alfred Hospital.
• A slight improvement in referral completeness was observed for haematology and renal medicine, but no significant change in appropriateness, partly due to already high baseline standards.
• Participation in pathway development workgroups improved knowledge and relationships between primary and secondary care providers and helped identify service redesign opportunities.
• Engagement with HealthPathways was uneven across the district, with lower uptake in areas of higher social disadvantage and bulk-billing practices.
• Barriers to uptake included login requirements, lack of integration with practice software, and limited visibility of referral information for services outside the district.