Introduction The pressure on the health care industry is ever rising. While trying to maintain and improve the safety, effectiveness, patient centeredness, and timeliness the costs of health care must be kept from rising. Amongst others standardisation, skill-mix change, and information technology are all presented as the solution to health care’s problems. Clinical pathways, considered a form of standardisation, will evidently bring skill-mix change, and information technology support seems promising. There is however little known about the relationship between these concepts. This study tried to, describe recent insights concerning clinical pathways and the concepts of standardisation, skill-mix change and information technology in the literature, study how clinical pathways change practice by performing a case study, and investigate how information technology can help implement and use clinical pathways. Literature study Although generally accepted definitions of clinical pathways do not exist, there is general understanding that clinical pathways will not suffice on their own in changing health care by for instance bringing evidence into practice. Several authors identify therefore additional design principles, which can be summarised by Berg’s (2005) four additional design principles: (1) a thorough restructuring and delegation of tasks, (2) the application of integrated planning, (3) the use of indicators about the functioning of the care programs, and (4) implementing process-supporting information technology. These principles link clinical pathways with standardisation, skill-mix change and information technology. Concluding it seems evident that (introducing) clinical pathways comes with skill-mix change in the health care workforce while standardising health care delivery. Information technology can play an important role in facilitating these processes and vice versa. Case study Clinical pathways were studied in practice in the NHS setting in England at an independent sector treatment centre and two NHS Foundation Trusts by site visits and interviews. The nursing staff’s role was empowered by the clinical pathways and it gave them more control over the journey of the patient. Fear for “cookbook” medicine seems unfounded; in effect evidence-based practice can maximise the effect of clinical judgement and does not eliminate the need for professional judgement. To what extent clinical pathways are really evidence-based is a point of discussion, for instance clinical pathways are rarely tested empirically. Another point of interest is the fact that clinical pathways are often developed by professionals extracted from the primary process, which may lead to medically effective, but unpractical standards. The relationship between information technology and clinical pathways including additional changes that come with implementing and using pathways (e.g. standardisation, skill-mix) works both ways. For information technology to work it requires a standardisation of work processes and clinical pathways require information technology in order to standardise health care as information technology requires standardised use.