Acute heart failure pathway
A seven-layer pathway, from admission to discharge, taken from national guidance down to the level an EHR team would configure. Built to demonstrate the translation step that usually gets missed.
At a glance
- ✓ Seven implementation layers
- ✓ Mapped to NICE NG106, ESC 2021, GIRFT
- ✓ SNOMED CT and dm+d coded elements
- ✓ Vendor-agnostic design
- ✓ DCB0160 hazard considerations
The problem
Heart failure accounts for a significant share of emergency hospital admissions in England, with high 30-day mortality and readmission rates. NICE, ESC, and GIRFT all publish guidance on what good care looks like. None of them tell you how to configure it in an EHR.
The usual approach is that an informatics team spends months translating clinical guidelines into EHR configuration, starting from scratch, with every organisation doing it independently.
The approach
A single, structured template that bridges the gap between what the guideline says and what the EHR team needs to configure. Seven layers:
Layer detail
Clinical workflow
The patient journey from emergency presentation through diagnosis, acute treatment, stabilisation, and discharge planning. Decision points mapped to clinical criteria.
Data model
Data elements coded in SNOMED CT, medications in dm+d, investigations in OPCS. Ready to import into any SNOMED-capable EHR.
Order sets
Investigation and medication bundles for each pathway stage, with first-line and second-line options, dose ranges, frequencies, and contraindication flags.
Decision support
NEWS2 escalation logic, diuretic response assessment triggers, specialist referral criteria, and HFpEF versus HFrEF pathway branching.
Audit & outcomes
What to measure and what good looks like: length of stay, in-hospital mortality, 30-day readmission, guideline adherence, and medication optimisation at discharge.
Registry alignment
Data capture aligned with NICOR and NHFA requirements, configured once in the pathway rather than re-entered for the registry.
Safety documentation
A starter DCB0160 hazard set for the pathway deployment: common configuration hazards identified, scored, and matched to controls, ready for a Clinical Safety Officer to review.
What this demonstrates
Vendor-agnostic
Not locked to one EHR. Uses SNOMED CT, HL7 FHIR, and standard terminologies that any modern system can consume.
Built to be configured
Not a diagram with boxes and arrows. Every element is specified at the level a configuration team needs: data types, code systems, alert thresholds, and scoring logic.
Evidence-mapped
Each clinical decision point traced back to its source guidance, so a clinical governance team can verify the evidence base.
Need a pathway built for your service?
This is one worked example. The real version is built around your clinical service, your EHR, and your local context. If that is the kind of help you need, get in touch.