The coordination work takes place on the phone, in the corridor, and in the inbox. The journal record rarely sees any of it – and yet someone is supposed to be able to reconstruct the sequence of events afterwards.

You are calling radiology for the third time this week. You are told that the MRI appointment can be moved forward two days if the patient can come in early Friday. You call the patient, who has to arrange transportation. You send a message to the person presenting the case at the MDT meeting on Monday. You note it in your own overview, the one you made yourself, the one that is not a medical record.

Four phone calls later, the situation is saved. And none of the work exists anywhere else where anyone can find it.

A role that must exist everywhere

The care coordinator is not a local invention. The Directorate of Health is clear in the introduction to the standardized care pathway for diagnosisall hospitals that diagnose and treat cancer must have pathway coordinators. The purpose is an efficient and predictable pathway from the time the referral is received in the specialist healthcare service until treatment starts or the pathway is concluded, with close collaboration between the departments and specialists involved.

The scale is not small. There are 26 different standardized cancer care pathways with associated diagnostic guidelines for general practitioners, in addition to the Pathway Home for cancer patients. All pathways were revised according to a common template, and the new treatment times apply from September 1, 2026.

The pathway coordinator must also be represented in the multidisciplinary meetings. The purpose of MDT meetings is to ensure that clinical decisions are made on the best possible multidisciplinary basis, involving the professional disciplines required by the case. In diagnostic pathways, patients vary so much that permanent teams are often not appropriate—discussions take place ad hoc, involving those who are relevant at that exact time. It is the coordinator who keeps track of who «that exact time» involves.

The work that does not have an obvious medical record field

Here lies the challenge. Much of what a coordinator does is logistics: rescheduling hours, chasing down answers, finding an opening. It is not healthcare in itself, and it does not naturally belong in a clinical note. At the same time, it is crucial to the pathway, and sometimes it is the only explanation for why a deadline was met or missed.

The Patient Journal Regulations provides some indications. Section 5 states that it may be relevant and necessary for the medical record to contain contact information for the patient's regular physician, coordinator, attending physician, and other personnel necessary to facilitate cooperation regarding the healthcare. Section 7 states that the medical record should show whether advice and information have been given to the patient and next of kin – and the main content of that information.

That is exactly where the coordinator's conversations belong. Not as a log of phone calls, but as what the patient was actually told: that the examination has been moved, what happens next, who she can call. The Norwegian Directorate of Health emphasizes that the goal is for the patient and next of kin to receive good information and the opportunity for active participation throughout the entire pathway, adapted to age, language, and needs, with interpreting services when necessary.

When that information only exists in the coordinator's own spreadsheet, it is gone the day the coordinator is sick.

Why custom systems emerge – and what they cost

Most coordinators have built their own overview. It is not sloppiness; it is a rational response to the fact that the electronic health record system is not designed to follow a single patient across eight departments over six weeks. The spreadsheet is faster, and it is yours.

The price is paid later. During vacations, illnesses, handovers to a colleague, or when someone needs to understand afterwards why a process took the time it did. Then the clinical notes are in the medical record and the logistics are in a document no one else has opened. We have written about the same pattern in the transition between the general practitioner and the specialistIt is not in the treatment that it slips, it is in the joints.

The Medivox can do something about it

Medivox transcribes speech to text and structures it according to templates you build yourself. For a coordinator, the latter is often the most important. A coordinator note does not look like a physician's note – it is about who has been contacted, what the patient has been told, what has been agreed upon, and what is pending a response.

You build that template. Then you can dictate the update right after the phone call, while you still remember what was said, and get a draft that is already in the correct fields. It takes the work out of the private spreadsheet and into where others can find it.

All data is pseudonymized before further processing, and all data processing takes place in Norwegian data centers. You own the medical record and make the final assessment. Medivox documents what you have done – it makes no clinical decisions and provides no recommendations regarding the course of treatment.

What remains

The pathway coordinator role is organized very differently from hospital to hospital, ranging from full-time positions to a small fraction of a position on top of everything else. This means that the quality of coordination often relies on individuals who have built up good routines over time.

It is a strength and a vulnerability at the same time. The strength is that whoever knows the process, knows it well. The vulnerability is that the knowledge resides with one person instead of in a system.

If you were gone for three weeks – how much of what you handle could a substitute read up on?

Frequently Asked Questions

What does a pathway coordinator do? The coordinator coordinates activities and resources throughout the standardized care pathway across departments and hospitals, acts as a liaison between the patient and the involved agencies, and must be represented in the multidisciplinary meetings.

Must all hospitals have a pathway coordinator? The Directorate of Health states that all hospitals that diagnose and treat cancer must have pathway coordinators.

Should the coordinator's contact information be included in the medical record? Section 5 of the Medical Records Regulations mentions contact information for the coordinator as something that may be relevant and necessary to have in the medical record, in order to facilitate collaboration between healthcare professionals regarding the patient.

Is logistics work subject to the duty of record-keeping? Pure scheduling is not healthcare. However, the information given to the patient along the way, and what has been agreed upon regarding the further course of treatment, belong in the medical record.

Can speech-to-text be used for coordinator notes? Yes. Dictation is the core function in Medivox, and you decide the template you dictate into yourself – a coordinator note can be set up completely differently than a clinical note.

Use Medivox for free – Get started completely free

Are you a pathway coordinator and wondering how a coordinator note can be set up as a template? Contact us - we review the setup together with you, with no lock-in period.

Sources: