Medical Specialties
Help Patients Navigate Liver Disease.
Liver disease can remain quiet, then create a complex set of needs.
PATHS helps healthcare organizations turn clinical expertise into actionable patient journeys, giving patients and caregivers clear guidance while providing care teams with visibility into engagement, understanding, and progress.
Liver Care Depends on What Happens After the Visit.
Liver disease can remain quiet, then create a complex set of needs. Patients and families need to understand their care plan and how to raise concerns as those needs change.
52,2741
U.S. deaths from chronic liver disease and cirrhosis in 2024
33.8%3
30-day readmission rate in a trial of 240 adults with decompensated cirrhosis
32.1%3
Of first readmissions in that trial involved hepatic encephalopathy
The Cost to Care Teams
In a U.S. cirrhosis trial, case managers called patients weekly for a month. The intervention added coordination of hepatology follow-up, medication use and outpatient fluid-drainage procedures when needed, illustrating the work involved in discharge support.3
When Advanced Disease Becomes Unstable
In that single-center study, 81 of 240 patients with decompensated cirrhosis were readmitted within 30 days. Hepatic encephalopathy, a complication affecting brain function, was recorded in 32.1% of first readmissions. These rates describe a high-risk study group, not all liver disease.3
What Better Support Can Do
The trial did not significantly lower overall 30-day readmissions. An encephalopathy-related result favored the intervention, but the study did not reach its planned sample size. The useful lesson is to make follow-up and escalation clear while treating admission reduction and cost savings as unproven.3
Sources
- 1.CDC/NCHS. FastStats: Chronic Liver Disease and Cirrhosis. Mortality: National Vital Statistics System, 2024.
- 2.NIDDK. Cirrhosis. Overview, symptoms and complications.
- 3.Pusateri AJ, et al. Randomized intervention and outpatient follow-up lowers 30-d readmissions for patients with hepatic encephalopathy, decompensated cirrhosis. World Journal of Hepatology 2023;15:826.
Healthcare teams have a critical responsibility to educate and prepare patients for that journey. But once patients leave the clinical setting, how do we know they're ready?
Do they understand their care plan? Can they apply what they've learned? Are they following through? Where do they need additional support?
Preparing patients for the journey is essential. Knowing how they're managing it creates the opportunity to improve care.
Liver Disease: From Clinical Expertise to Actionable Guidance.
Understand
Education and knowledge
Explain the person's liver condition using information selected by their clinical team.
Take Action
Tasks, decisions, follow-through
Prepare patients and caregivers to ask questions and follow the team's instructions for getting help.
Manage Care
Medications, appointments, self-care
Organize guidance about the agreed treatment plan, daily care and follow-up appointments.
Demonstrate
Assessments and engagement evidence
Use assessments to identify questions and gaps in understanding for clinical review.
Meet Victor.He Starts the Understanding My Cirrhosis Diagnosis Path.
Follow Victor through an illustrative seven-Step Path as he starts care for a cirrhosis diagnosis made during a hospital stay. A hospital could use this structure to organize the education its liver care team repeats with every newly diagnosed patient, from what the diagnosis means to his follow-up plan.
Illustrative person (AI-generated). Illustrative educational Path. Completion does not establish a clinical outcome.
Read the Path Steps
- Video: Understand his diagnosis
What his cirrhosis diagnosis means: scar tissue has replaced healthy liver tissue, so his liver cannot work normally, as his liver care team explains.
- Document: Understand the cause
The cause or causes his team found, such as alcohol, fatty liver disease or hepatitis, explained without blame, and why not drinking alcohol protects his liver, with support his team can offer.
- Audio: Use medicines safely
Why his team prescribed each new medicine, how to take it as directed, and why to ask his team before taking any other medicine, pain reliever, sleep aid, supplement or herbal product.
- Image: Eat to support his liver
A picture guide to the eating plan his team or dietitian advises, such as enough protein, regular meals and a bedtime snack, less salt if advised, and no raw shellfish.
- Quiz: Know when to get help
Practice which changes to report to his team, such as more swelling in his belly or legs, and which need help right away: vomiting blood or black stools mean going to a hospital, and new confusion means calling his team at once, as his team instructs.
- Form: Prepare his questions
Victor and his wife write down questions for his first visit after the hospital, such as how advanced his cirrhosis is and which changes matter most.
- Link: See his follow-up plan
His follow-up plan: his hepatology visit, the tests and procedures his team schedules, such as a liver ultrasound every six months and an endoscopy if advised, and the vaccines his team recommends.
Every Workflow Should Save the Health System Time and Money.
Assign a value to the Understanding My Cirrhosis Diagnosis Path and see the results.
Path Value Estimation
minutes
per year
How many times your team already does this workflow each year.
per hour
65.5staff hours saved per year
$2,291estimated value per year
Change the assumptions above to see your estimate of time and money saved.
CREATE
The care team builds a Understanding My Cirrhosis Diagnosis Path once.
Liver care clinicians turn the cirrhosis education they repeat with every patient into a structured Path and assign it a value of 21 minutes of staff education time saved per patient.
ENGAGE
Patients like Victor learn and act.
Each year, 187 patients like Victor learn about cirrhosis after a hospital stay with the Understanding My Cirrhosis Diagnosis Path, saving 21 minutes of education time each.
KNOW
Data shows the impact.
That adds up to 3,927 minutes (65.5 hours) of staff time, worth an estimated $2,291 a year at $35.00 an hour.
IMPROVE
Insights improve the next Path.
Engagement, knowledge checks and questions show where cirrhosis education was clear or confusing, so the care team can refine it for the next patient.
Every Liver Disease Journey Creates an Opportunity to Improve the Next.
Estimates are illustrative and use the assumptions above. They are not measured results.
Victor's Care Leads to More Than One Path.
What begins with a cirrhosis diagnosis leads to more than one Path. From understanding his diagnosis to his medicines, going home, his nutrition, an endoscopy, symptoms to discuss, liver cancer screening and his hepatology review, Victor needs guidance at every stage. PATHS connects multiple Paths into an experience tailored to his changing needs, and each Path could save the care team time, not only the first. This journey is illustrative.
Victor's Experience Becomes Health System Intelligence.
Victor's care doesn't stop at one Path. After his hospital stay, the hospital provides a Path for each part of his recovery: understanding his diagnosis, his discharge plan, his medicines, appointments and procedures, symptoms to discuss, and nutrition. Each Path Victor completes also shows his care team what he engaged with, what he understood and what he still had questions about.
Medicine Education Path
Victor can return to his prescribing team's instructions whenever he needs them. The questions patients ask show which instructions need work.
Symptoms to Discuss Path
Victor's family knows which changes need attention. The questions families raise show the team where the guidance can be clearer.
Hepatology Review Path
Victor arrives at his review with his questions and practical obstacles ready. That helps the team focus the visit on his care.
The more the health system knows about each patient's experience and journey, the better it can make its workflows. What Victor and every other patient engage with, understand and ask about becomes health system intelligence: the team learns from every patient and refines each Path, so the next patient's experience is better. Clearer Paths mean fewer repeat calls and less time re-teaching the same education, and that saves time and money across the health system.
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Start With One Journey. Learn From Every Experience.
Improving liver care doesn't require changing every workflow at once.
Start with a patient journey that matters to your organization. Build a structured approach, understand how patients and caregivers engage, and use what you learn to improve the experience.