QPATH4MS

The project has been successfully completed.

The QPATH4MS project has concluded: Treatment pathways and quality indicators now facilitate targeted and efficient management in the continuous specialist care of patients with multiple sclerosis (MS). These new indicators, defined to meet the needs of comprehensive digitalization, enable pathway-based quality management.

With the completion of the Saxon project "Pathway-Based Quality Management in MS Care" (QPATH4MS), a set of treatment pathways and associated quality indicators has been developed, forming the foundation for a digital module for MS patient care that is now nearing market readiness. The project, funded since September 2020 by the European Regional Development Fund (ERDF) and the Free State of Saxony, is led by Carus Consilium Sachsen GmbH, the University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, MedicalSyn GmbH, and Symate GmbH.

"With our QPATH4MS project, we have created the first nationwide quality management concept for MS treatment that consistently considers the perspectives of both treating physicians and patients through cross-institutional, consensus-based treatment pathways. This can play a significant role in care quality, especially concerning the outpatient specialized medical care (ASV) for multiple sclerosis recently approved by the Federal Joint Committee (G-BA)," says Prof. Tjalf Ziemssen, Head of the MS Center and the Center for Clinical Neurosciences at Dresden University Hospital. "This marks another significant step toward personalized and digital MS management."

Prof. Michael Albrecht, Medical Director of Dresden University Hospital, emphasizes the project's advancement in integrating MS patients: "With QPATH4MS, we are proactively utilizing digitalization to redefine the roles of patients, enabling them to engage competently and actively in the treatment process. The transparency achieved through the project sets new standards and will hopefully serve as a model for the care of other chronic diseases."

Established standards, such as MS guidelines and other works, do not reflect the multidimensional management process of MS patients, as they typically focus on specific areas and therapeutic measures. Meaningful quality indicators for consistent and comprehensive care of affected individuals were previously lacking. Therefore, the goal of QPATH4MS was to define a set of quality indicators based on the clinical treatment pathways developed in the project, which can be assigned to various processes in MS management, including diagnosis, monitoring, and therapy.

One of the challenges was to design these treatment pathways in a way that allows for documenting, monitoring, and ideally further improving the quality of treatment for individuals with multiple sclerosis. They need to be measurable and, ideally, easily processable digitally, while also being formulated and structured to ensure ease of handling in daily medical practice. Relevant quality indicators were extracted from existing literature and categorized, summarized, rephrased, and assigned to the clinical pathways of the processes with the help of experts.

Based on an online survey, selected MS experts from Germany, Austria, and Switzerland evaluated the quality indicators formed for the monitoring process. The evaluation showed that the approach received a very positive response. "These feedbacks further confirm that the QPATH4MS initiative resonated with physicians," says Prof. Ziemssen. This is also due to the absence of consensus-based clinical pathways and measurable quality indicators for MS care. The quality indicators developed in the project are structured in a way that provides physicians with a scientifically grounded set of criteria while allowing for straightforward documentation of the parameters to be queried or measured.

The project's challenge was not only to identify treatment pathways and indicators based on the current state of scientific knowledge and develop corresponding criteria for their collection but also to prepare the findings and data collected in such a way that they remain easily transferable and analyzable in a digital environment. While the medical expertise of the Multiple Sclerosis Center at the Department of Neurology at Dresden University Hospital was essential for the first step, the subsequent tasks involved the Digital Health Research Group at Technische Universität Dresden. The business informatics team acted as an intermediary between medicine and IT technology. In this role, it developed interfaces that can process and present patient data obtained from treatment pathways and quality indicators in a manner comprehensible to both healthcare providers and MS patients and their families. For this target group, the Digital Health Research Group designed and created a user-friendly portal as part of the QPATH4MS project.

Additionally, clear and situation-oriented recommendations for action were developed to help patients contribute to maintaining or even improving their health status. This portal thus enhances the health literacy of patients, empowers them as active participants, and allows them to be more involved in important therapeutic decisions. They are given the opportunity to manage the quality of their own therapy.

To achieve this ambitious goal, an all-in-one solution was developed that actively and consistently integrates the treatment management of MS patients into an electronic platform for the first time. The aim is to significantly improve care quality, patient satisfaction, and information transparency. This is achieved by considering as many aspects of diagnostics and therapy as possible: from appointment scheduling to various values and documents to an overview of medications. In the future, clinical processes can be made more efficient, and communication with patients can be significantly improved.

The advantage of the transparency created by the digital tool becomes evident in the example of regular disease progression monitoring based on quality indicators: MS patients receive not only a well-captured overview of their current condition but also information on changes. However, this monitoring is only meaningful if all examinations occur within the intervals defined by guidelines and indicators. The digital tool developed within QPATH4MS displays upcoming appointments, helping to avoid duplicate examinations and facilitating appointment planning for practices and outpatient clinics. From the perspective of individuals with multiple sclerosis, the advantage lies in gaining a clear overview of the treatment course and being able to remind themselves of pending examinations if necessary.

The project's approach aims to ensure transparency across institutions, allowing all involved entities to access or input data related to MS care according to their role. This helps avoid temporal, personnel, and spatial bottlenecks, creating opportunities to expand time slots for doctor-patient conversations. This tool also enables comprehensive data collection for further analyses and "MS Management 2.0."

Thanks to the tool developed within QPATH4MS, both parties—patients and medical staff—can assess care quality at any time. Patients can better understand their condition and thus support therapies more comprehensively than before.

Germany's Largest Academic MS Center as the Hub of QPATH4MS

The central hub for the QPATH4MS project was the Multiple Sclerosis Center (MSZ) at the Department of Neurology at Dresden University Hospital. With approximately 1,500 MS patients per month, it is one of Germany's largest academic MS centers. The facility not only represents comprehensive clinical-interdisciplinary care for MS patients but has also committed to patient-centered research and digitalization. In addition to numerous studies on diagnostics and therapy, including the evaluation of innovative medications, Digital Health is a focal point: For over 20 years, the center has been testing and then routinely implementing MS-specific patient documentation systems and the application of digital concepts in everyday care. MS patients also benefit from this. Examples include digitized tests and questionnaires that capture subjectively perceived limitations due to the disease. In this way, patients can independently or with guidance from center staff document their condition. The results of the QPATH4MS project contribute to perfecting this approach.

On behalf of the Saxon State Ministry for Social Affairs and Social Cohesion, the University Hospital Carl Gustav Carus Dresden, Carus Consilium Sachsen GmbH, MedicalSyn GmbH, and Symate GmbH implemented the innovative project “Pathway-Based Quality Management in MS Care.” The project was carried out from June 3, 2020, to December 31, 2022, and was co-financed by the European Regional Development Fund (ERDF) and the Free State of Saxony.

More information: www.qpath4ms.de

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Raimund Böhle

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