Why is Patient Pathway Plus better than our own in-house built systems?

Steve Jobs stated that the difference between a good product or service and a bad product or service (e.g. cars, taxis, etc) is at most a factor of 2. He continued to say that, in software the difference between a good software product and a bad software product can be a factor as great as 50 or potentially 100.

The differences in software come from functionality, ergonomics, the quality of the code used to generate it, the coding standards, architectural standards, the management of the software development, version control, release processes and supporting documentation. And the list goes on.

The reality is that while a trust’s technology teams may have the vision to develop applications, they don’t have the full software development environment needed to produce enterprise-grade software.

Our information department says they can develop a similar system. Can they?

The information department’s role is focused on working with data to produce and interpret output data and information, which is important for the trust.

While Patient Pathway Plus produces output and analytics from the core system as well as having an analytics module, it is fundamentally an operational transaction processing system, complete with sophisticated in-built workflow. It would be outside the remit and resources of an information department to expect them to develop a system of this type and complexity.

Information departments are not geared up with the requisite capacity, skills and resources to undertake a development project of this nature. Therefore, you would have to wait long periods for a system to be developed, and it would not be reasonable to expect an information department to produce something of comparable capability and robustness, in comparison to commercially developed software.

Insource market themselves as a data management company. What does that have to do with RTT and patient pathway management?

Good data management is instrumental to managing RTT and patient pathways generally.

Accurate data allows you to see your true capacity, find inefficiencies and bottlenecks in your processes, and measure the success of any interventions.

To be confident in your position it’s absolutely crucial that you’re confident in your data. Thus, gaining and retaining control of your pathway estate is inextricably linked to data quality and auditability, and this is made possible by Patient Pathway Plus’ underlying Data Academy architecture.

Isn’t Patient Pathway Plus just a reporting and information tool?

Absolutely not.

It’s a comprehensive, sophisticated workflow and management system that requires incredibly large amounts of data to deliver its full functionality. It has a very comprehensive analytics and reporting capability via respective modules, but the core system is an enterprise-grade transaction processing system, with workflow.

How can I be confident in what Patient Pathway Plus is telling me?

The data flowing through Patient Pathway Plus will have been validated and checked by our implementation consultants against both the front end of your PAS/EPR and your current PTL.

Your validation/data quality manager will also have approved it for completeness and accuracy.

How can I be sure that the data provided by Patient Pathway Plus is correct?

The software’s transparency, together with functions like data lineage and the Management Information Console, provide you with comprehensive evidence for every single data item. You therefore have the ability to validate data provenance.

Patient Pathway Plus is an enterprise-grade application that has been developed by a substantial team of highly skilled and experienced data management and system development experts. It leverages our revolutionary product development platforms and our extensive experience of the NHS.

We constructed Patient Pathway Plus against guidelines published by the NHS while giving you the flexibility to address local requirements. The continued release of new updates ensures it remains current and aligned to changing NHS guidelines.

How much does Patient Pathway Plus cost?

The cost depends on many factors, but the primary factor is the amount of data being processed. This means cost is driven by factors such as the number of patients processed and the number of modules used.

We offer a number of procurement options including capital purchase, rental, hosting and SaaS. Let us know your requirements and we will be happy to quote you.

Is there a minimum term for the rental option?

You can rent Patient Pathway Plus for as little as one month. However, there is the set-up cost to take into consideration along with the monthly rental fee.

Patient Pathway Management Implementation Questions IMPLEMENTATION QUESTIONS

What are the minimum server requirements?

Our recommended minimum sever specification to achieve a respectable level of performance is a 2xQuad core Xeon processor server with 64GB RAM and hard disk space that’s 4 times larger than the data source required.

A higher spec will provide improved performance; a lower specification server will result in slower performance.

We also offer a hosting solution in which we manage the server specification for you.

Please do not rely on this information as the sole basis of a procurement or implementation; please check with us to validate the latest specification applicable to you.

What if I can’t provide a minimum specification server?

You will have to accept that the performance of the system may not be as you would ideally like.

You can also consider our hosting option, in which your solution is hosted in a secure, N3-compliant data centre. If you choose our hosting option you don’t need to provide any hardware.

What are the minimum software requirements of the server for installation of Patient Pathway Plus?

The following minimum software is required for Patient Pathway Plus:

  • Microsoft Windows Server 2008 Enterprise or DataCenter Edition
  • Microsoft SQL Server 2008 64-bit R2 Standard Edition or better (i) with
    • Microsoft SQL Server 2008 Integration Services
    • Microsoft SQL Server 2008 Analysis Services
    • Microsoft SQL Server 2008 Reporting Services
    • Microsoft Internet Information Services (IIS) 6 (or later) (ii)
    • SMTP Mail Server with no authentication, or Database Mail (included in SQL Server setup) (iii)
    • Microsoft  .NET 3.5 (installed after IIS)
    • Microsoft  .NET 4
    • Microsoft ADOMD.NET 11.0 (iv)
    • Microsoft Internet Explorer 6.0 SP1 (or later) with JavaScript enabled

Client PCs require:

* Microsoft Internet Explorer 6.0 SP1 (or later) with JavaScript enabled


(i) SQL Server should not be installed with binary collation

(ii) If you have IIS 7 (the version that comes with Windows Server 2008 and Vista) then you must enable the IIS6 management capabilities from the Role Features

(iii) Only required if email is to be used.

(iv) Only required if Analyzer BI reporting tool chosen

Please do not rely on this information as the sole basis of a procurement or implementation; please check with us to validate the latest specification applicable to you.

(Click here for the minimum hardware specification.)

Does Patient Pathway Plus have to connect to a PAS/EPR?

Your PAS/EPR is the place where your data is stored and where your pathways are most likely to be stored.

A direct connection, or the most direct connection, guarantees that Patient Pathway Plus is working with your actual data. It also ensures lineage will be accurate back to your PAS/EPR.

We hold our pathways statuses in a data warehouse. Can I connect Patient Pathway Plus to the data warehouse?


Patient Pathway Plus is designed to be flexible and is able to take the relevant data from any number of sources.

If your RTT pathway status data is held in a data warehouse outside of the PAS/EPR, then it can be brought into Patient Pathway Plus via the data mapping component.

The important consideration is that Patient Pathway Plus is working with your actual data, which ensures lineage will be accurate.

How long does it take to install Patient Pathway Plus?

Installation can be achieved in a matter of hours as long as the prerequisites have been met in setting up the server and operating systems.

This is also true of upgrades to Patient Pathway Plus. You’ll be able to run with the latest enhancements as soon as they’re available, and you can implement upgrades yourself by using a simple product installation application.

How long does it take to configure Patient Pathway Plus?

Configuring and testing the application after installation involves making sure the output from the system matches expected results.

There is an implementation process (configuration) where our engineers assist you to ensure a quick and smooth outcome. Trusts have installed, configured and tested the system such that it is fully operational in a week.

How quickly can a vanilla installation of Patient Pathway Plus be implemented, so we get a transparent view of our current position to provide us with robust assurance?

As long as you have a server that that satisfies the prerequisites, an installation can be in place and processing data as quickly as 2 or 3 days.

However, to get a robust assurance of the trust’s current position, you need user acceptance testing and some configuration to local trust rules. This is achievable within a week.

What information do I get at the end of the implementation phase?

You will be given a snapshot of your trust’s current performance, e.g. current total PTL broken down by division, directorate, specialty, consultant and wait band.

This data will have been thoroughly validated against the front end of your PAS/EPR, as well as approved by your data quality/RTT lead.

This will provide you with assurance that it’s an accurate, robust dataset you can use to benchmark performance.

Does Patient Pathway Plus accommodate any future changes to the national guidelines change and/or the UNIFY/ISD MMI reporting requirements?

Any changes in these rules or guidelines will be incorporated through updates. New versions of the software will immediately be made available to you as they’re released.

Patient Pathway Management Technical Questions TECHNICAL QUESTIONS

How does the information team extract and use data from Patient Pathway Plus?

At its core, Patient Pathway Plus is an operational transaction processing system that processes and manages the extremely large volumes of data associated with your patients and their pathways.

Its output is presented via a comprehensive data output layer called the UDL® (Unified Data Layer). This is the source of all the data that will be used for reporting and analytics purposes.

Additionally, metrics relating to the data itself are also available, so information teams are able to evidence data quality and data provenance.

Patient Pathway Plus also has a comprehensive analytics module consisting of pre-built, but highly customisable, star schemas and OLAP cubes. Information teams can access these for analytics purposes.

Can Patient Pathway Plus provide me with much-needed assurance of our RTT position?


It reconstructs your pathways from the pathway events, status codes and associated data from your source system. It does this with complete transparency, so you can be sure the pathway data it presents is accurate and absolutely reflective of your current position.

Nothing is overlooked or missed, and any additions or changes to the state of a pathway are captured.

Patient Pathway Plus is based on national RTT guidelines and supports local configuration to accommodate any local access policies you may have implemented.

Can the information recorded in Patient Pathway Plus, e.g. breach reason, be recorded back into the source system?

Patient Pathway Plus works by loading information from your PAS/EPR and holding this information with other inputted data such as breach reasons. All data stored with Patient Pathway Plus is highly visible and available for a multitude of purposes.

If the source PAS/EPR can record the breach reason (or other information), then the relevant information held in Patient Pathway Plus can be used to inject back into the PAS as a custom piece of functionality.

Can I generate my RTT return from Patient Pathway Plus?

Yes. Patient Pathway Plus is an integrated system that provides trusts with the ability to generate their return to UNIFY/ISD MMI based on a trusted dataset, which you also use to support patient tracking and pathway validation.

Using a simple, web-based interface, you can interact with a weekly or monthly snapshot of data to ensure the position accurately reflects the current situation. You can then export it to a format that the UNIFY/ISD MMI template can import.

The process of generating your return is completely automatic, meaning you save significant time and effort. This allows you to focus on supporting operational services and, ultimately, improving the timeliness of care delivered to patients.

We need a solution to be flexible, as we may need to modify the UNIFY/ISD MMI return prior to submission. Can I do this with Patient Pathway Plus?

Patient Pathway Plus automatically generates an accurate UNIFY/ISD MMI return from the data held within the application, and the return is complete in all aspects.

However, you can modify it (for example, due to recent changes in specific pathways that have not yet been reflected in the PAS or Patient Pathway Plus).

Any changes you make are logged and audited to ensure you maintain full compliance and governance.

How does Patient Pathway Plus support the external audits of our incomplete pathways?

Patient Pathway Plus provides an immediate, clear, structured history of each pathway for easy analysis – and it’s supported by a full and completely evidenced audit trail for every pathway and pathway event.

This removes the laborious and time-consuming exercise of have to manually wade through the front or back end of your PAS/EPR.

Can I see RTT projections based on historical information?

Yes, the analytics module of Patient Pathway Plus enables you to forecast future performance based on a historical trend.

This will, however, only be meaningful once Patient Pathway Plus has been operational for some time. This is because Patient Pathway Plus needs a few months’ worth of data to be able to make accurate predictions.

Am I able to manage cancer pathways in Patient Pathway Plus?

Patient Pathway Plus can alert you to 2WW referrals where an appointment has not been booked within the 2-week standard, as well as pathways which are likely to breach the 2WW target.

Full support for all aspects of a cancer pathway is part of our roadmap for Patient Pathway Plus, and will be announced as part of a further version release.

Can the application be used as a PTL?

Patient Pathway Plus provides a PTL capability that includes very basic pathway information. You can also use its workflow capability to ensure no required actions against any individual pathway are ever lost.

Since a trust’s and a specialty’s requirements for PTL content can differ, you can create a custom PTL by trust or specialty based on any of the product’s comprehensive data content.

Patient Pathway Plus has been designed specifically so that the PTL can be supplemented with additional data content if required.

Our patient pathway validation process is partly centralised and partly distributed to certain specialties. Can Patient Pathway Plus accommodate this way of working?

Patient Pathway Plus fully supports multiple ways of working, including the validation of patient backlogs concurrently with tracking and validating current patient tracking.

You do this by using a simple web-based interface that both administrative and clinical staff can access. This significantly reduces the amount of duplicated effort because the solution highlights to users whether a pathway has been validated previously, when and by whom.

Does Patient Pathway Plus offer online, context-sensitive support?

Patient Pathway Plus has a comprehensive wiki and in-depth training documentation, which are available to all clients.

Quick to implement