The classes into which you're deserializing are incorrect. You are missing the "Patients" class.
When I have JSON and am trying to deserialize it I like to use http://json2csharp.com to generate a first cut at the deserialization classes. It's more accurate than trying to do it by hand.
var jsonobject = JsonConvert.DeserializeObject<RootObject>(json);
public class Patient
{
public string patientid { get; set; }
public string name { get; set; }
public string status { get; set; }
public string start { get; set; }
public string last { get; set; }
public string engagement { get; set; }
public string drug { get; set; }
public string adherence { get; set; }
public string vitals { get; set; }
public string last_appointment { get; set; }
public string next_appointment { get; set; }
}
public class Patients
{
public List<Patient> patient { get; set; }
}
public class Pathway
{
public Patients patients { get; set; }
}
public class RootObject
{
public Pathway pathway { get; set; }
}
P.S. The exception you were getting is usually a really good clue that there's something wrong with the way you've defined the deserialization classes.
Cannot deserialize the current JSON object (e.g. {"name":"value"}) into type 'System.Collections.Generic.List`1[ConsoleApplication1.Program+patient]' because the type requires a JSON array (e.g. [1,2,3]) to deserialize correctly.
To fix this error either change the JSON to a JSON array (e.g. [1,2,3]) or change the deserialized type so that it is a normal .NET type (e.g. not a primitive type like integer, not a collection type like an array or List) that can be deserialized from a JSON object. JsonObjectAttribute can also be added to the type to force it to deserialize from a JSON object.