Pathscription logoPathscription
Prototype — not for clinical use — simulated data
Pathscription architecture

Healthcare does not only have a knowledge problem.
It has a completion problem.

Pathscription helps turn important clinical signals and decisions into completed, owned and auditable workflows.

Hear. Know. Own. Act. Tell. Check.

The Pathscription loop

Hear · Know · Own · Act · Tell · Check

HEAR1/6

Has the important signal been captured?

Capture what matters.

  • · patient concern
  • · clinician observation
  • · result
  • · request
  • · preference
  • · referral
  • · task
  • · decision
KNOW2/6

Does the right person have the context?

Bring the right context forward.

  • · history
  • · current plan
  • · relevant patient preferences
  • · previous decisions
  • · outstanding concerns
  • · previous team handover
OWN3/6

Does somebody know they are responsible?

Make responsibility clear.

  • · named owner
  • · responsible clinical team
  • · acknowledged task
  • · escalation owner
  • · follow-up owner
ACT4/6

Did the required next action happen?

Make the next action visible.

  • · review
  • · discussion
  • · referral
  • · calculation
  • · prescription
  • · reassessment
  • · documentation
TELL5/6

Does the patient and/or next team know what happened?

Close the communication gap.

  • · patient updated
  • · next step explained
  • · care plan updated
  • · receiving team informed
  • · instructions provided
CHECK6/6

Did the action actually resolve the workflow?

Confirm what happened next.

  • · concern resolved?
  • · referral confirmed?
  • · reassessment completed?
  • · patient understands?
  • · follow-up arranged?
  • · next team acknowledged?
Workflow issue categories

  • HEAR GAP

    Important information has not been captured or acknowledged.

  • KNOW GAP

    Relevant context is unavailable, fragmented or not reviewed.

  • OWN GAP

    No responsible owner or team has acknowledged the next action.

  • ACT GAP

    Required action remains outstanding.

  • TELL GAP

    Relevant patient/team communication remains incomplete.

  • CHECK GAP

    The action happened, but completion or resolution has not been confirmed.

Every workflow uses the same six stages

Fictional examples across maternity, tell us once, waiting, handover, referrals, results, care-plan changes and prescribing.

Maternity — patient concern

Frightened about the anaesthetic

Sophie James · fictional demonstration data

“I am frightened about the anaesthetic.”

CHECK GAP
  • HEARConcern recorded
  • KNOWPrevious traumatic birth context available
  • OWNAnaesthetic team assigned
  • ACTAnaesthetic clinician discussed concerns
  • TELLSophie updated about what happens next
  • CHECK“Did that address what you were worried about?” — Patient: PARTLY
Workflow statusOPEN· Next action: Further discussion required

Why is this here?
This item appears because the patient has confirmed the concern was only partly addressed, so the loop cannot yet be closed.

Tell us once — important care context

Important care context

Sophie James · fictional demonstration data

KNOW GAP
  • HEARPatient history recorded
  • KNOWIncoming team has not reviewed context
  • OWNAwaiting context review owner
  • ACTNot started
  • TELLNot started
  • CHECKNot started
Workflow statusOPEN· Next action: Review care context

Why is this here?
This item appears because the workflow has reached the KNOW stage, but relevant context is unavailable, fragmented or not reviewed.

Waiting / promise made

Told someone would come back

Amara Okafor · fictional demonstration data

“I was told someone would come back.”

ACT GAP
  • HEARWaiting item recorded
  • KNOWTeam knows what patient is waiting for
  • OWNObstetric team assigned
  • ACTSenior review not yet completed
  • TELLPatient has not received update
  • CHECKNot started
Workflow statusOPEN· Next action: Complete senior review

Why is this here?
This item appears because the workflow has reached the ACT stage, but required action remains outstanding.

Shift handover

Shift handover — incoming team

Simulated unit · fictional demonstration data

OWN GAP
  • HEARHandover items captured
  • KNOWHandover received · important care context available
  • OWNTwo actions have no incoming owner
  • ACTOutstanding
  • TELLPatient informed new team has taken over
  • CHECKNot confirmed
Workflow statusOPEN· Next action: Assign incoming owners

Why is this here?
This item appears because the workflow has reached the OWN stage, but no responsible owner or team has acknowledged the next action.

Referral

Perinatal support referral

Leah Bennett · fictional demonstration data

CHECK GAP
  • HEARNeed identified
  • KNOWReferral context available
  • OWNReferring clinician assigned
  • ACTReferral sent
  • TELLPatient informed
  • CHECKReceiving service acknowledgement: not confirmed · follow-up owner: not assigned
Workflow statusOPEN· Next action: Confirm receiving service next step

Why is this here?
This item appears because the action has been completed, but Pathscription cannot yet confirm that the next step has happened.

Result

Blood result returned — review outstanding

Amara Okafor · fictional demonstration data

OWN GAP
  • HEARResult returned
  • KNOWResult visible in workflow
  • OWNNo clinician assigned to review
  • ACTNot started
  • TELLNot started
  • CHECKNot started
Workflow statusOPEN· Next action: Assign review owner

Why is this here?
This item appears because the workflow has reached the OWN stage, but no responsible owner or team has acknowledged the next action.

Care plan change

Care plan change — patient communication outstanding

Ruth Adeyemi · fictional demonstration data

TELL GAP
  • HEARProposed change recorded
  • KNOWPrevious plan and patient preference visible
  • OWNResponsible clinician assigned
  • ACTPlan changed
  • TELLPatient has not yet been updated
  • CHECKPatient understanding unknown
Workflow statusOPEN· Next action: Update patient and confirm understanding

Why is this here?
This item appears because the workflow has reached the TELL stage, but relevant patient/team communication remains incomplete.

Prescribe

Paediatric prescribing workflow

Fictional paediatric demo · fictional demonstration data

LOOP COMPLETE
  • HEARClinical context captured
  • KNOWFictional guidance/context available
  • OWNClinician owns decision
  • ACTDemo calculation / prescription workflow completed
  • TELLPatient instructions generated
  • CHECKClinician approval recorded
Workflow statusLOOP COMPLETE

Why is this here?
This workflow is complete in this simulation.

Sent ≠ complete. Actioned ≠ complete. Pathscription follows the next responsible action until the completion condition is known. Different clinical workflow. Same Pathscription engine.

Where is the loop broken?

Blood result returned — review outstanding

Amara Okafor · Result · fictional demonstration data

HEAR KNOW OWN ACT TELL CHECK

Primary failure: OWNERSHIP GAP

This workflow is currently stalled because no responsible owner has been assigned.

  • Owner: Not yet assigned
  • Next action: Assign review owner
Where is the loop broken?

Frightened about the anaesthetic

Sophie James · Maternity — patient concern · fictional demonstration data

HEAR KNOW OWN ACT TELL CHECK

Primary failure: CHECK GAP

This workflow remains open because the patient has confirmed that her concern was only partly addressed. Further discussion is required before the loop can be considered complete.

  • Owner: Anaesthetic team · Dr Priya Shah
  • Next action: Further discussion required

Where are our open loops?

Simulated prototype data

HEAR gaps

1

KNOW gaps

3

OWN gaps

4

ACT gaps

5

TELL gaps

2

CHECK gaps

6

Total open: 21

Top current failure
CHECK — 6 workflows have been actioned but are not yet confirmed complete.

Pathscription failure patterns — where are loops breaking?

Simulated week · prototype data
  • HEAR8 gapsPatient signals not entering workflow
  • KNOW14 gapsContext not reviewed at transitions
  • OWN22 gapsActions without ownership
  • ACT31 gapsActions overdue
  • TELL17 gapsPatient/team communication incomplete
  • CHECK26 gapsFollow-up/resolution not confirmed

Most common

ACT

Fastest improving

OWN

Recurring issue

Postnatal CHECK gaps

Leadership can drill into each category. All figures are simulated prototype data and are not validated performance measures.

What this feels like for the woman
  • HEAR“I told someone.”
  • KNOW“They understood my history.”
  • OWN“I knew somebody was dealing with it.”
  • ACT“Something actually happened.”
  • TELL“Someone came back and explained.”
  • CHECK“They checked whether I was okay / understood / still needed help.”

This is what “heard & held” looks like as a workflow.

What this feels like for the clinician
  • HEARImportant information arrives in one place.
  • KNOWRelevant context is available.
  • OWNResponsibility is clear.
  • ACTNext work is visible.
  • TELLCommunication is not forgotten.
  • CHECKUnfinished follow-up stays visible.

Pathscription is designed to reduce the amount clinicians must hold in memory.

Common workflow failure examples — fictional

  • HEAR failure

    Patient raises concern but it is not captured.

  • KNOW failure

    Concern is documented but new team does not see relevant context.

  • OWN failure

    Review is required but nobody owns it.

  • ACT failure

    Review is assigned but does not happen.

  • TELL failure

    Decision is made but patient is not told.

  • CHECK failure

    Referral is sent but nobody confirms the next step.

Closed loop — fictional example

Patient: “I don’t feel right.”

  1. HEARConcern recorded
  2. KNOWRelevant context surfaced
  3. OWNResponsible team assigned
  4. ACTClinical review completed
  5. TELLPatient updated
  6. CHECKPatient says concern addressed / appropriate next step confirmed
LOOP COMPLETE

Illustrative only. Pathscription does not determine clinical urgency, diagnosis or treatment.

Open loop
  • Current stage: OWN
  • Elapsed: Illustrative 12 minutes
  • Escalation status: Team reminder active
  • If still incomplete: Escalated to: simulated senior role

Escalation timing is fictional and configurable in this prototype. No real clinical escalation rules are encoded.

Loop history — fictional example
  1. 10:02HEARPatient concern recorded
  2. 10:04KNOWCare context reviewed
  3. 10:05OWNAssigned to obstetric team
  4. 10:09ACTClinician review completed
  5. 10:13TELLPatient updated
  6. 10:15CHECKPatient says concern partly resolved
  7. 10:16loopWorkflow reopened
  8. 10:22ACTFurther review
  9. 10:28TELLPatient updated
  10. 10:30CHECKPatient confirms concern addressed
  11. 10:30loopLOOP COMPLETE
Reopen loop

Patient concern: previously resolved

Patient now reports: “Something has changed.”

REOPEN LOOP

A new HEAR event is created. Previous history is never silently overwritten.

One signal can create multiple loops

“I am frightened and I still don’t understand the birth plan.”

Loop 1

Emotional support / communication

Current stage OWN

Loop 2

Birth-plan explanation

Current stage TELL

Clinically distinct workflow items are never merged into one vague task.

Open loops

3 open
  1. 1. Birth-plan questionsCurrent stage TELL
  2. 2. Emotional wellbeing supportCurrent stage CHECK
  3. 3. Postnatal referralCurrent stage OWN

Single view of unfinished workflow. Fictional demonstration data.

What happens next?
  • Current open loop: Birth-plan discussion
  • Current stage: ACT
  • What is happening: A senior clinician review is outstanding.
  • Who owns it: Obstetric team
  • After that: The plan should be discussed with you.
  • Then we will check: Whether you understand the plan and whether your questions have been answered.

Simulated example. Not clinical advice and not for clinical use.

One engine. Multiple clinical pathways.

Hear → Know → Own → Act → Tell → Check

Prescribe

  • HEARPatient/context
  • KNOWGuidance/context
  • OWNClinician
  • ACTPrescribing workflow
  • TELLInstructions
  • CHECKApproval/completion

Maternity

  • HEARConcern / care signal
  • KNOWHistory / plan / context
  • OWNResponsible team
  • ACTReview / care action
  • TELLWoman updated
  • CHECKResolved / follow-up confirmed
Future conceptsDischargeReferralResultsMedication reviewFollow-up
Prescribe

Paediatric prescribing workflow

Fictional paediatric demo · fictional demonstration data

LOOP COMPLETE
  • HEARClinical context captured
  • KNOWFictional guidance/context available
  • OWNClinician owns decision
  • ACTDemo calculation / prescription workflow completed
  • TELLPatient instructions generated
  • CHECKClinician approval recorded
Workflow statusLOOP COMPLETE

Why is this here?
This workflow is complete in this simulation.

Architecture language
  • An alert is not a workflow.
  • A note is not a workflow.
  • A referral is not a completed workflow.
  • A conversation is not necessarily a resolved workflow.
  • Pathscription follows the next responsible action until the completion condition is known.

HEAR

What happened?

KNOW

What context matters?

OWN

Who owns this?

ACT

What needs to happen?

TELL

Who still needs to know?

CHECK

How do we know it is actually finished?

Proposed research metrics — not validated clinical outcomes

HEAR

  • · concerns captured
  • · patient-reported concerns acknowledged
  • · waiting items recorded

KNOW

  • · context available at transition
  • · context reviewed by incoming team
  • · duplicated history-taking reported

OWN

  • · time to ownership
  • · unowned actions
  • · ownership transferred at handover

ACT

  • · time to action
  • · overdue actions
  • · workflow completion

TELL

  • · patient informed
  • · next step explained
  • · communication after plan change

CHECK

  • · concern resolution confirmed
  • · referral next step confirmed
  • · reassessment completed
  • · patient understanding confirmed

Pathscription does not just record events.It tracks the journey from signal to completion.

Nothing missed. Nothing unheard. Tell us once. Close the loop.

All patients, timings and metrics on this page are fictional prototype data. Pathscription makes no clinical decision, diagnosis or treatment recommendation, and no NHS approval, clinical validation, regulatory approval or financial saving is claimed.