Literature to real world data
From published pathways to the claims logic that tests them.
PathwayMapper takes the treatment pathway a disease should follow, turns every stage into US claims code logic, and carries the care gaps, biomarkers, physician behaviours and costs through to the analysis. The result is a specification an analytics team can run, and a set of charts you can put straight into a deck.
How it works
01
Start with the papers
Add the PMIDs that describe how the disease is actually managed. Each abstract sits in the project and every later decision points back to it.
02
Draw the pathway
Stages, timing, setting and who acts, with the routes between them carrying probabilities and time ranges taken from the literature.
03
Write the claims logic
Diagnosis, procedure, drug, revenue and taxonomy codes attached to each stage, ready for an analytics team to run against a real claims database.
04
Test the gaps
Every care gap becomes a measurable indicator with a numerator, a denominator and a window. Enter the observed rates and the whole model updates.
What is inside every project
Evidence library
PMIDs with full abstracts, linked to the pathway stages they support, so nothing in the model is unattributed.
Pathway builder
The patient journey stage by stage, with branches, timing and the provider responsible at each step.
Pathway views
Flow diagrams, decision trees with probabilities, cohort simulation, funnels and a care gap heat map, all exportable as images.
Claims code logic
Hundreds of codes per disease mapped to stages, with the operator rules that define each measure.
Biomarkers
The tests that gate each decision, their thresholds, the codes that capture them and how often they should be repeated.
Physician behaviours
Each care gap turned into what clinicians do today, what should happen instead, and how big a change that is.
Cost model
Cost per stage and per type of care, so the gaps can be argued in money as well as in clinical terms.
Physician libraries
Every provider type involved, with taxonomy codes so referring and rendering providers can be found in claims.
Start a disease area pre-filled, then make it yours.
New projects arrive with the stages, codes, care gaps, indicators, biomarkers, provider types, behaviours and costs for the disease already in place. Every row is editable, and everything exports to CSV or JSON.
Create your first project