This paper refers to a project for development and optimization of a clinical pathway for the Lumbar Nerve Root Compression Syndrome. A special focus is taken on computer support for pathway development and implementation. An innovative combination of "rapid prototyping" of a workflow model and a 2 level approach using round robin methods in a large group and individual semi-structured interviews is presented. The method focuses on process optimization instead of process modeling and concentrates on areas of the workflow which may be optimized. Critical parts of the optimized clinical workflow have been implemented inside a commercial electronic patient record system.