Background and Objective: Most healthcare institutions are reorganizing their healthcare delivery systems based on Clinical Pathways (CPs). CPs are novel medical management plans to standardize medical activities, reduce cost, optimize resource usage, and improve the quality of service. However, most CPs are still paper-based and not fully integrated with Health Information Systems (HIS). More CP computerization research is therefore needed to fully benefit from CP’s practical potentials. A major contribution of this research is the vision that CP systems deserve to be placed at the centre of HIS, because within CPs lies the very heart of medical planning, treatment and impressions, including healthcare quality and cost factors.

Methods: An important contribution to the realization of this vision is to fully standardize and digitize CPs so that they become machine-readable and smoothly linkable across various HIS. To achieve this goal, this research proposes a framework for (i) CP knowledge representation and sharing using ontologies, (ii) CP standardization based on SNOMED CT and HL7, and (iii) CP digitization based on a novel coding system to encode CP data. To show the feasibility of the proposed framework we developed a prototype clinical pathway management system (CPMS) based on CPs currently in use at hospitals.

Results: The results show that CPs can be fully standardized and digitized using SNOMED CT terms and codes, and the CPMS can work as an independent system, performing novel CP-related functions, including useful data analytics. CPs can be compared easily for auditing and quality management. Furthermore, the CPMS was smoothly linked to a hospital EMR and CP data were captured in EMR without any loss. Conclusion: The proposed framework is promising and contributes toward solving major challenges related to CP standardization, digitization, and inclusion in today’s modern computerized hospitals.

背景与目标：大多数医疗机构都在根据临床途径（CP）重组其医疗提供系统。CPs是新颖的医疗管理计划，旨在规范医疗活动，降低成本，优化资源使用并提高服务质量。但是，大多数CP仍然是基于纸张的，并且没有与健康信息系统（HIS）完全集成。因此，需要进行更多的CP计算机化研究，以充分利用CP的实际潜力。这项研究的主要贡献在于，应该将CP系统放置在HIS的中心，因为CP内蕴藏着医疗计划，治疗和印象的核心，包括医疗质量和成本因素。

方法：实现此愿景的重要贡献是对CP进行了完全标准化和数字化，以使它们在各种HIS中变得机器可读且可平滑链接。为实现此目标，本研究提出了一个框架，用于（i）使用本体论进行CP知识表示和共享，（ii）基于SNOMED CT和HL7的CP标准化，以及（iii）基于新型编码系统对CP数据进行编码的CP数字化。为了展示所提出框架的可行性，我们基于医院当前使用的CP开发了原型临床途径管理系统（CPMS）。

结果：结果表明，可以使用SNOMED CT术语和代码对CP进行完全标准化和数字化，并且CPMS可以作为独立系统工作，执行新颖的CP相关功能，包括有用的数据分析。CP可以轻松进行比较以进行审核和质量管理。此外，CPMS与医院的EMR平滑链接，并且在EMR中捕获了CP数据而没有任何损失。结论：拟议的框架很有希望，并有助于解决与CP标准化，数字化和纳入当今现代计算机医院有关的重大挑战。