Recording some 2 million annual outpatient visits, Geisinger Health System encounters practically every chronic condition under the sun. To manage this massive patient flow, the Danville, Pa.-based delivery system has developed electronically enabled clinical pathways for 15 diseases it treats most frequently.

The pathways-a set of protocol that defines responsibilities across the continuum of care-were built one disease at a time, says Jim Walker, M.D., the chief health information officer at the 900-physician integrated delivery system. Care delivery is supported by an EHR, from Epic, and adjoining systems which Geisinger designed internally. Serving both inpatient and outpatient settings, the EHR works in tandem with a data warehouse and clinical decision support engine. Both remain invisible to providers, Walker says.

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