JMIR Publications

ABSTRACT

Objective:

The aim of this study is to examine the implementation and impact of digital care pathways specifically designed to reduce or replace physical contacts or phone consultations in specialised healthcare.

Methods:

We analysed the ten most widely used digital care pathways by user volume. The selection criteria were 1) the number of digital care pathway users (> 1500 users) and 2) the digital care pathway is aiming at replacing or decreasing physical contacts. Descriptive analyses quantified digital contact volumes, average contacts and costs per patient, and inflation adjusted expenditures using the Consumer Price Index, both overall and by patient group. Ecological group level correlations were examined to assess whether the 2024 proportion of digital contacts was associated with changes in physical contacts and total costs from 2018 to 2024.

Results:

Digital care pathways were progressively adopted between 2018 and 2024, increasing from no use to accounting for 19% of all outpatient contacts among the studied patient groups. Physical visits declined from 75% to 54%, while total contact volume rose by 8%. Conditions with the highest uptake of digital pathways showed the strongest reductions in physical visits, with declines of up to 45%. Average outpatient costs per patient decreased by 18% in real terms, with a 40% reduction in the costs of physical contacts and a 15% increase in the costs of phone visits. Digital pathway contacts accounted for 12.6% of total outpatient costs in 2024; however, only 8.8% of the variance in total cost levels was explained by digital pathway adoption, suggesting that the shift toward digital care pathways did not substantially drive overall cost changes. Conclusion: Digital care pathways expanded rapidly, reaching nearly one-fifth of all outpatient contacts by 2024 in the included patient groups and contributing to a notable reduction in physical visits. However, their overall cost impact remains uncertain, as there have been also other factors impacting the development of the outpatient costs.