Understanding the Patient Journey

The renewed focus on patient experience stems from healthcare consumerization and value-based care. The best way to understand the end-to-end experience, and find where to improve it, is to map the entire patient journey.

Journey map vs process map

A journey map is not a process map. The two should run in parallel, but a process focuses on actions undertaken by an organization, while a journey focuses on the patient’s current experience or their ideal future experience.

A patient journey represents the entire sequence of events a patient experiences within a healthcare system or across providers, from scheduling a regular checkup to receiving treatment for an illness or injury. It spans the whole ecosystem: hospitals, physicians, specialty care and outpatient therapy. A comprehensive patient engagement strategy covers every stage:

1. Onboarding and access
2. Awareness
3. Education
4. Diagnosis and treatment
5. Adherence to lifestyle or behavioural changes
6. Ongoing and proactive health (wellness)
7. Referrals and loyalty

Understanding the journey lets providers build targeted experiences that address each patient’s needs and deliver better outcomes. It can also save money, for example by reducing the average time to diagnosis.

Benefits of journey mapping

• Personalized experiences built on a deep understanding of patient needs and preferences.
• Seamless, continuous care, by identifying gaps caused by poorly coordinated technology and resources.
• Fewer pain points, because problems are easier to spot.
• Better pre- and post-clinical engagement through timely, targeted outreach, and stronger long-term relationships.
• Clearer communication between patients and care providers.
• Continuous improvement of the care process, using insights from the journey.

Four ways to support the patient journey

The fourth, practical support, refers to the actual access patients have to treatment.

Example: the rheumatoid arthritis patient journey

Like other diseases, the RA patient’s journey involves distinct stages, each with a measurable delay (lag):

Evidence suggests very early RA (the first 12 weeks) may be a distinct phase of the disease. This creates a “window of opportunity” in which starting DMARDs may prevent erosions and possibly switch off the disease. The strongest predictor of improvement in disease activity was a shorter disease duration at the start of treatment.

Where the delays come from

Gaps in care begin when a person recognizes symptoms and visits a family physician (FP). If RA is suspected, the FP refers the person to a rheumatologist for diagnosis and treatment. Delays combine patient-related and physician-related factors. In one analysis, DMARDs were started within three months of disease onset in only 19% of patients.

Possible interventions

• Spreading knowledge about RA in the general population, and raising awareness among primary care physicians.
• Coordinated local programs linking rheumatologists, FPs and other health professionals.
• GP education sessions with referral guidelines, and reminders to triaging clinicians about key prognostic factors.
• Triage systems and standardized referral forms to prioritize patients with inflammatory arthritis.
• Clinical referral criteria based on examining “target” joints (wrists, 2nd and 3rd MCP and 3rd PIP joints), rheumatoid factor and anti-CCP antibodies, supported by persistent swelling in more than one joint or morning stiffness of 30 minutes or more.

Patient centricity is one of the most important trends in pharma. Providing solutions that benefit brands, physicians and patients alike starts with understanding the patient journey.