Patient Pathway TODO#

The Patient Tracker is designed to identify as many potentially ‘missing’ or ‘lost’ needs of patients as possible - providing a holistic view of all activity and requests for care for a patient.

The App therefore includes as much information as possible, and the number of data sources and inclusions will grow with development over time.

Currently every referral on a hospital system starts a pathway in the patient tracker. We then exclude pathways from being viewed/counted where:

the logged status for the referral (where the referral status is logged as ‘cancelled’ or ‘completed’)
the latest RTT status of the pathway, we excluded using the filters overview below:

S No	Rule name	Patient Tracker Updated Definition	Patient Tracker function
	Total Pathways at start
1	Referral Status		drop_referrals_by_status
2	PTL Status	PTL statuses implying a stop. for Alpha release this EXCLUDES Watchful waits (32,31,91)	drop_referrals_by_PTL_status
3	Patient Deceased	Patient is deceased	drop_pathways_with_date_of_death
4	Consultant Discharges	Where outcome of most recent appointment is ‘Discharge from consultant’s care.	remove_discharged_appointments
5	Last Appointment Outcome	Outcome DNA, Appointment Later date, No Outcome, Another Appointment and where last Appointment date before 1/1/2020 QUESTION: PT now has access to other events (e.g diagnostic & orders). What if these exist for the pathway after 1/1/2020	filter_by_appointment_outcome_and_date
6	Referral with no appointment	Where Request Received Date is before 01/01/2020 (updated to reflect extending 12 month period for covid)	filter_no_appointments
7	Duplicate Referrals	Where multiple open Outpatient Referrals exist under the same consultant and specialty, only keep open the one with the most recent or future appointment date.	N/A

Fuootnotes

number	note
1	PTL status with most recent activity date that isn’t “Not Set”.
2	Stop (34) - Decision Not to Treat/No Further Contact Required, Stop (33) - DNA NEW Appt - Discharged To Referrer, Stop (35) - Patient Declined Offered Treatment, Stop (21) - (IPT) Refer To Other Provider - Same Condition, Stop (36) - Patient Died Before Treatment, Inactive (91) - Continue Watchful Wait/Discharge Watchful Wait, Stop (32) - Start Watchful Wait - CARE PROFESSIONAL Initiated, Stop (31) - Start Watchful Wait - PATIENT Initiated
3	“DNA New Appointment - Discharged To Referrer”, “DNA New Appointment At Later Date”, “DNA New Appointment - Further Appointment Booked”, “DNA New Appointment - Further Appointment Telephone”, “DNA New Appointment - Further Appointment Face to Face”, “DNA New Appointment - Further Appointment My Online Care”, “DNA New Appointment - Further Appointment Video”, “Appointment To Be Made At A Later Date”, “No Outcome”, “Another Appointment Given”, “DNA Follow Up - Appointment to be Made at a Later Date”, “DNA Follow Up - Further Appointment Face to Face”, “DNA Follow Up - Further Appointment Booked”, “DNA Follow Up Appointment - Discharged To Referrer”, “DNA Follow Up - Further Appointment Telephone”, “DNA Follow Up - Further Appointment My Online Care”, “DNA Follow Up - Further Appointment Video”, “DNA Outcome”,

the death of a patient is recorded in the PAS without the associated RTT status update having been applied

In future releases we would like to fully include patients currently undergoing ‘active monitoring / watchful wait’.

First / Subsequent treatment TODO#

The assignment of a patient pathway into either awaiting/undergoing their first or subsequent treatment is achieved by splitting included RTT statuses into these two categories, as below.

If at ANY point in a patient’s pathway a subsequent treatment status has been logged for this pathway - we assign them into subsequent treatment.

Patients will only be moved into a subsequent treatment status if they have at least one closed treatment event

RTT statuses	ALPHA Status Split
‘Ongoing (20) - Patient Not Yet Treated’,	First Treatment
‘Start (11) - End Of Watchful Wait - Decision to Treat Following Watchful Wait’,	First Treatment
‘(99) Unknown/Not Yet Known’,	First Treatment
‘Start (12) - Internal Cons To Cons Referral For Separate Condition’	First Treatment
‘Start (10) - Referral To Treatment Begins/Decision to Start New Treatment’,	First Treatment
‘Inactive (98) - Non 18WW’,	Subsequent treatment
‘Inactive (90) - Patient Already Treated’,	Subsequent treatment
‘Inactive (91) - Continue Watchful Wait/Discharge Watchful Wait’,	Subsequent treatment
‘Stop (30) - Patient Treated; First Definitive Treatment Complete’,	Subsequent treatment
‘Inactive (92) - Direct Access Diagnostic’,	Subsequent treatment
‘Stop (33a) - DNA NEW Appt - Further Appt Booked’,	First Treatment
‘Stop (33c) - DNA NEW Appt - Appt At Later Date’,	First Treatment