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Article Contents

Introduction, why patient journey mapping, how is patient journey mapping conducted, use of technology in patient journey mapping, future implications for patient journey mapping, conclusions, patient journey mapping: emerging methods for understanding and improving patient experiences of health systems and services.

Lemma N Bulto and Ellen Davies Shared first authorship.

Conflict of interest: none declared.

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Lemma N Bulto, Ellen Davies, Janet Kelly, Jeroen M Hendriks, Patient journey mapping: emerging methods for understanding and improving patient experiences of health systems and services, European Journal of Cardiovascular Nursing , 2024;, zvae012, https://doi.org/10.1093/eurjcn/zvae012

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Patient journey mapping is an emerging field of research that uses various methods to map and report evidence relating to patient experiences and interactions with healthcare providers, services, and systems. This research often involves the development of visual, narrative, and descriptive maps or tables, which describe patient journeys and transitions into, through, and out of health services. This methods corner paper presents an overview of how patient journey mapping has been conducted within the health sector, providing cardiovascular examples. It introduces six key steps for conducting patient journey mapping and describes the opportunities and benefits of using patient journey mapping and future implications of using this approach.

Acquire an understanding of patient journey mapping and the methods and steps employed.

Examine practical and clinical examples in which patient journey mapping has been adopted in cardiac care to explore the perspectives and experiences of patients, family members, and healthcare professionals.

Quality and safety guidelines in healthcare services are increasingly encouraging and mandating engagement of patients, clients, and consumers in partnerships. 1 The aim of many of these partnerships is to consider how health services can be improved, in relation to accessibility, service delivery, discharge, and referral. 2 , 3 Patient journey mapping is a research approach increasingly being adopted to explore these experiences in healthcare. 3

a patient-oriented project that has been undertaken to better understand barriers, facilitators, experiences, interactions with services and/or outcomes for individuals and/or their carers, and family members as they enter, navigate, experience and exit one or more services in a health system by documenting elements of the journey to produce a visual or descriptive map. 3

It is an emerging field with a clear patient-centred focus, as opposed to studies that track patient flow, demand, and movement. As a general principle, patient journey mapping projects will provide evidence of patient perspectives and highlight experiences through the patient and consumer lens.

Patient journey mapping can provide significant insights that enable responsive and context-specific strategies for improving patient healthcare experiences and outcomes to be designed and implemented. 3–6 These improvements can occur at the individual patient, model of care, and/or health system level. As with other emerging methodologies, questions have been raised regarding exactly how patient journey mapping projects can best be designed, conducted, and reported. 3

In this methods paper, we provide an overview of patient journey mapping as an emergent field of research, including reasons that mapping patient journeys might be considered, methods that can be adopted, the principles that can guide patient journey mapping data collection and analysis, and considerations for reporting findings and recognizing the implications of findings. We summarize and draw on five cardiovascular patient journey mapping projects, as examples.

One of the most appealing elements of the patient journey mapping field of research is its focus on illuminating the lived experiences of patients and/or their family members, and the health professionals caring for them, methodically and purposefully. Patient journey mapping has an ability to provide detailed information about patient experiences, gaps in health services, and barriers and facilitators for access to health services. This information can be used independently, or alongside information from larger data sets, to adapt and improve models of care relevant to the population that is being investigated. 3

To date, the most frequent reason for adopting this approach is to inform health service redesign and improvement. 3 , 7 , 8 Other reasons have included: (i) to develop a deeper understanding of a person’s entire journey through health systems; 3 (ii) to identify delays in diagnosis or treatment (often described as bottlenecks); 9 (iii) to identify gaps in care and unmet needs; (iv) to evaluate continuity of care across health services and regions; 10 (v) to understand and evaluate the comprehensiveness of care; 11 (vi) to understand how people are navigating health systems and services; and (vii) to compare patient experiences with practice guidelines and standards of care.

Patient journey mapping approaches frequently use six broad steps that help facilitate the preparation and execution of research projects. These are outlined in the Central illustration . We acknowledge that not all patient journey mapping approaches will follow the order outlined in the Central illustration , but all steps need to be considered at some point throughout each project to ensure that research is undertaken rigorously, appropriately, and in alignment with best practice research principles.

Steps for conducing patient journey mapping.

Five cardiovascular patient journey mapping research examples have been included in Figure 1 , 12–16 to provide specific context and illustrate these six steps. For each of these examples, the problem or gap in practice or research, consultation processes, research question or aim, type of mapping, methods, and reporting of findings have been extracted. Each of these steps is then discussed, using these cardiovascular examples.

Examples of patient journey mapping projects.

Define the problem or gap in practice or research

Developing an understanding of a problem or gap in practice is essential for facilitating the design and development of quality research projects. In the examples outlined in Figure 1 , it is evident that clinical variation or system gaps have been explored using patient journey mapping. In the first two examples, populations known to have health vulnerabilities were explored—in Example 1, this related to comorbid substance use and physical illness, 13 and in Example 2, this related to geographical location. 13 Broader systems and societal gaps were explored in Examples 4 and 5, respectively, 15 , 16 and in Example 3, a new technologically driven solution for an existing model of care was tested for its ability to improve patient outcomes relating to hypertension. 14

Consultation, engagement, and partnership

Ideally, consultation with heathcare providers and/or patients would occur when the problem or gap in practice or research is being defined. This is a key principle of co-designed research. 17 Numerous existing frameworks for supporting patient involvement in research have been designed and were recently documented and explored in a systematic review by Greenhalgh et al . 18 While none of the five example studies included this step in the initial phase of the project, it is increasingly being undertaken in patient partnership projects internationally (e.g. in renal care). 17 If not in the project conceptualization phase, consultation may occur during the data collection or analysis phase, as demonstrated in Example 3, where a care pathway was co-created with participants. 14 We refer readers to Greenhalgh’s systematic review as a starting point for considering suitable frameworks for engaging participants in consultation, partnership, and co-design of patient journey mapping projects. 18

Design the research question/project aim

Conducting patient journey mapping research requires a thoughtful and systematic approach to adequately capture the complexity of the healthcare experience. First, the research objectives and questions should be clearly defined. Aspects of the patient journey that will be explored need to be identified. Then, a robust approach must be developed, taking into account whether qualitative, quantitative, or mixed methods are more appropriate for the objectives of the study.

For example, in the cardiac examples in Figure 1 , the broad aims included mapping existing pathways through health services where there were known problems 12 , 13 , 15 , 16 and documenting the co-creation of a new care pathway using quantitative, qualitative, or mixed methods. 14

In traditional studies, questions that might be addressed in the area of patient movement in health systems include data collected through the health systems databases, such as ‘What is the length of stay for x population’, or ‘What is the door to balloon time in this hospital?’ In contrast, patient mapping journey studies will approach asking questions about experiences that require data from patients and their family members, e.g. ‘What is the impact on you of your length of stay?’, ‘What was your experience in being assessed and undergoing treatment for your chest pain?’, ‘What was your experience supporting this patient during their cardiac admission and discharge?’

Select appropriate type of mapping

The methods chosen for mapping need to align with the identified purpose for mapping and the aim or question that was designed in Step 3. A range of research methods have been used in patient journey mapping projects involving various qualitative, quantitative, and mixed methods techniques and tools. 4 Some approaches use traditional forms of data collection, such as short-form and long-form patient interviews, focus groups, and direct patient observations. 18 , 19 Other approaches use patient journey mapping tools, designed and used with specific cultural groups, such as First Nations peoples using artwork, paintings, sand trays, and photovoice. 17 , 20 In the cardiovascular examples presented in Figure 1 , both qualitative and quantitative methods have been used, with interviews, patient record reviews, and observational techniques adopted to map patient journeys.

In a recent scoping review investigating patient journey mapping across all health care settings and specialities, six types of patient journey mapping were identified. 3 These included (i) mapping key experiences throughout a period of illness; (ii) mapping by location of health service; (iii) mapping by events that occurred throughout a period of illness; (iv) mapping roles, input, and experiences of key stakeholders throughout patient journeys; (v) mapping a journey from multiple perspectives; and (vi) mapping a timeline of events. 3 Combinations or variations of these may be used in cardiovascular settings in the future, depending on the research question, and the reasons mapping is being undertaken.

Recruit, collect data, and analyse data

The majority of health-focused patient journey mapping projects published to date have recruited <50 participants. 3 Projects with fewer participants tend to be qualitative in nature. In the cardiovascular examples provided in Figure 1 , participant numbers range from 7 14 to 260. 15 The 3 studies with <20 participants were qualitative, 12 , 14 , 16 and the 2 with 95 and 260 participants, respectively, were quantitative. 13 , 15 As seen in these and wider patient journey mapping examples, 3 participants may include patients, relatives, carers, healthcare professionals, or other stakeholders, as required, to meet the study objectives. These different participant perspectives may be analysed within each participant group and/or across the wider cohort to provide insights into experiences, and the contextual factors that shape these experiences.

The approach chosen for data collection and analysis will vary and depends on the research question. What differentiates data analysis in patient journey mapping studies from other qualitative or quantitative studies is the focus on describing, defining, or exploring the journey from a patient’s, rather than a health service, perspective. Dimensions that may, therefore, be highlighted in the analysis include timing of service access, duration of delays to service access, physical location of services relative to a patient’s home, comparison of care received vs. benchmarked care, placing focus on the patient perspective.

The mapping of individual patient journeys may take place during data collection with the use of mapping templates (tables, diagrams, and figures) and/or later in the analysis phase with the use of inductive or deductive analysis, mapping tables, or frameworks. These have been characterized and visually represented in a recent scoping review. 3 Representations of patient journeys can also be constructed through a secondary analysis of previously collected data. In these instances, qualitative data (i.e. interviews and focus group transcripts) have been re-analysed to understand whether a patient journey narrative can be extracted and reported. Undertaking these projects triggers a new research cycle involving the six steps outlined in the Central illustration . The difference in these instances is that the data are already collected for Step 5.

Report findings, disseminate findings, and take action on findings

A standardized, formal reporting guideline for patient journey mapping research does not currently exist. As argued in Davies et al ., 3 a dedicated reporting guide for patient journey mapping would be ill-advised, given the diversity of approaches and methods that have been adopted in this field. Our recommendation is for projects to be reported in accordance with formal guidelines that best align with the research methods that have been adopted. For example, COREQ may be used for patient journey mapping where qualitative methods have been used. 20 STROBE may be used for patient journey mapping where quantitative methods have been used. 21 Whichever methods have been adopted, reporting of projects should be transparent, rigorous, and contain enough detail to the extent that the principles of transparency, trustworthiness, and reproducibility are upheld. 3

Dissemination of research findings needs to include the research, healthcare, and broader communities. Dissemination methods may include academic publications, conference presentations, and communication with relevant stakeholders including healthcare professionals, policymakers, and patient advocacy groups. Based on the findings and identified insights, stakeholders can collaboratively design and implement interventions, programmes, or improvements in healthcare delivery that overcome the identified challenges directly and address and improve the overall patient experience. This cyclical process can hopefully produce research that not only informs but also leads to tangible improvements in healthcare practice and policy.

Patient journey mapping is typically a hands-on process, relying on surveys, interviews, and observational research. The technology that supports this research has, to date, included word processing software, and data analysis packages, such as NVivo, SPSS, and Stata. With the advent of more sophisticated technological tools, such as electronic health records, data analytics programmes, and patient tracking systems, healthcare providers and researchers can potentially use this technology to complement and enhance patient journey mapping research. 19 , 20 , 22 There are existing examples where technology has been harnessed in patient journey. Lee et al . used patient journey mapping to verify disease treatment data from the perspective of the patient, and then the authors developed a mobile prototype that organizes and visualizes personal health information according to the patient-centred journey map. They used a visualization approach for analysing medical information in personal health management and examined the medical information representation of seven mobile health apps that were used by patients and individuals. The apps provide easy access to patient health information; they primarily import data from the hospital database, without the need for patients to create their own medical records and information. 23

In another example, Wauben et al. 19 used radio frequency identification technology (a wireless system that is able to track a patient journey), as a component of their patient journey mapping project, to track surgical day care patients to increase patient flow, reduce wait times, and improve patient and staff satisfaction.

Patient journey mapping has emerged as a valuable research methodology in healthcare, providing a comprehensive and patient-centric approach to understanding the entire spectrum of a patient’s experience within the healthcare system. Future implications of this methodology are promising, particularly for transforming and redesigning healthcare delivery and improving patient outcomes. The impact may be most profound in the following key areas:

Personalized, patient-centred care : The methodology allows healthcare providers to gain deep insights into individual patient experiences. This information can be leveraged to deliver personalized, patient-centric care, based on the needs, values, and preferences of each patient, and aligned with guideline recommendations, healthcare professionals can tailor interventions and treatment plans to optimize patient and clinical outcomes.

Enhanced communication, collaboration, and co-design : Mapping patient interactions with health professionals and journeys within and across health services enables specific gaps in communication and collaboration to be highlighted and potentially informs responsive strategies for improvement. Ideally, these strategies would be co-designed with patients and health professionals, leading to improved care co-ordination and healthcare experience and outcomes.

Patient engagement and empowerment : When patients are invited to share their health journey experiences, and see visual or written representations of their journeys, they may come to understand their own health situation more deeply. Potentially, this may lead to increased health literacy, renewed adherence to treatment plans, and/or self-management of chronic conditions such as cardiovascular disease. Given these benefits, we recommend that patients be provided with the findings of research and quality improvement projects with which they are involved, to close the loop, and to ensure that the findings are appropriately disseminated.

Patient journey mapping is an emerging field of research. Methods used in patient journey mapping projects have varied quite significantly; however, there are common research processes that can be followed to produce high-quality, insightful, and valuable research outputs. Insights gained from patient journey mapping can facilitate the identification of areas for enhancement within healthcare systems and inform the design of patient-centric solutions that prioritize the quality of care and patient outcomes, and patient satisfaction. Using patient journey mapping research can enable healthcare providers to forge stronger patient–provider relationships and co-design improved health service quality, patient experiences, and outcomes.

None declared.

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Patient journey mapping: what it is, its benefits, and how to do it

We've all been patients at some point, but our journeys were not the same. Patient journey mapping holds the key to unraveling this mystery, providing a strategic lens into the diverse pathways individuals tread throughout their healthcare experiences.

In this article, we'll explore the pivotal role of patient journey mapping in the healthcare industry, uncovering its profound benefits for both providers and patients. From amplifying patient satisfaction to streamlining operational processes, the impact is transformative.

But how does one embark on this journey of understanding and improvement? We'll guide you through the essential steps and considerations, offering insights into the art of crafting a meaningful healthcare patient journey map.

Join us as we peel back the layers of patient experience journey mapping. This powerful tool not only illuminates the complexities of healthcare but also empowers providers to reshape and enhance the patient experience.

• 1.1 Difference from other customer journeys
• 2 Patient journey mapping benefits
• 3 Patient journey stages
• 4.1 Clinical journey maps
• 4.2 Service delivery maps
• 4.3 Digital journey maps
• 4.4 Chronic disease management maps
• 4.5 Emergency care journey maps
• 4.6 Pediatric patient journey maps
• 4.7 Palliative care maps
• 5 How to do patient journey mapping?
• 6.1 Patient-centered care
• 6.2 Streamlined access to care
• 6.3 Effective communication
• 6.4 Education and empowerment
• 6.5 Care coordination
• 6.6 Technology integration
• 6.7 Feedback and continuous improvement
• 6.8 Cultural competency
• 6.9 Emotional support
• 6.10 Efficient billing and financial assistance
• 7 Templates
• 8 Wrapping up 

What is a patient journey?

A patient journey is the entire process a person goes through when seeking and receiving a healthcare service. It covers everything from first noticing symptoms or realizing the need for care and medical attention to finally resolving the health issue. The journey involves patient interactions with healthcare professionals, diagnostic procedures, treatment activities, and follow-up care.

Mapping and understanding the patient journey can help boost the quality of hospital care and improve patient satisfaction. By pinpointing challenges, patient communication gaps, and areas for enhancement, care providers can refine their services to better cater to patients' needs. It also contributes to promoting patient-centered care, shifting the focus beyond just treating diseases to considering the overall well-being and experience of the patient.

Difference from other customer journeys

While the concept of patient journey mapping is similar to customer journey mapping , there are unique aspects specific to the healthcare domain. This is how a patient journey differs from any other customer journey:

• Emotional intensity. Health-related experiences often involve heightened emotions, including fear, anxiety, uncertainty, a sense of losing control, and a dependence on others. The emotional aspect is more pronounced in patient journeys compared to customer journeys in most industries.
• Complexity and uncertainty. Healthcare journeys often involve multiple stakeholders, various diagnostic and treatment options, and inherent uncertainties. Navigating these complexities requires a different approach compared to more straightforward consumer experiences. Comparing buying eyeglasses online and visiting a doctor — both are experiences, but how different they are!
• Regulatory and ethical considerations. Healthcare is heavily regulated, and ethical considerations play a significant role there. Patient journeys must align with regulatory standards and ethical principles that other industries don’t have.

• Clinical decision points. Patient journeys involve critical clinical decision points, such as diagnosis and treatment choices. These decisions not only impact the patient's health but also influence the overall trajectory of the journey.
• Care continuum. Patient journeys often extend beyond a single episode of care. They may involve long-term management, follow-up appointments, and ongoing support, creating a continuous care continuum.
• Interdisciplinary collaboration. Healthcare is often delivered by a team of professionals from different disciplines. The patient journey may involve collaboration among physicians, nurses, specialists, and other healthcare providers.

Patient journey mapping benefits

Mapping a patient journey offers a range of benefits that contribute to improving the overall quality of healthcare delivery. Here are some key advantages:

• Visualization of the entire patient journey helps healthcare providers identify critical patient journey touchpoints that impact patient satisfaction and experience and require immediate attention. By paying more attention to these touchpoints, you ensure a more positive overall journey.
• Gaps in care and challenges are highlighted among healthcare professionals. Addressing these issues ensures a more seamless and collaborative approach to patient care.
• Pain points and barriers become evident, enabling healthcare providers to proactively address issues that may hinder effective care delivery.
• Understanding individual patient journeys allows for more personalized ongoing care plans. Tailoring interventions to specific needs and preferences improves patient engagement and outcomes.
• By mapping a patient journey, you can identify resource-intensive stages and areas where efficiency can be improved, enabling a healthcare organization to allocate resources more effectively.
• It's a great way to identify opportunities for smoother transitions between different stages of care, ensuring continuity and preventing gaps in treatment.
• It becomes clear where patient involvement in the decision-making process can contribute to their healthcare journey.

Example: Tom, recovering from surgery, feels more empowered as his healthcare team provides clear post-operative care instructions, making him an active participant in his recovery.

In summary, patient journey mapping provides a comprehensive framework for healthcare improvement, addressing specific challenges at each stage and leading to tangible enhancements in patient experience, communication, and overall care delivery.

Patient journey stages

Patient journeys can differ, and if we take a broad perspective, some key stages would include:

Awareness 

This stage involves the patient recognizing symptoms and becoming aware of a potential health issue.

• Key considerations: Pay attention to how patients identify and interpret their symptoms, as well as the information sources they consult.

Example: John notices persistent joint pain and, through online research, suspects it might be arthritis. His journey begins with a heightened awareness of his symptoms.

Seeking information

Patients actively look for information to understand their symptoms, potential causes, and the importance of consulting a healthcare professional.

• Key considerations: Review the information sources patients use and how well they understand the need for professional medical advice.
• Example: Emily researches her persistent cough online, learning about various respiratory conditions and recognizing the importance of seeing a doctor for an accurate diagnosis.

First contact

This marks the initial interaction with the healthcare system, typically through scheduling an appointment with a primary care physician.

• Key considerations: Assess the ease of access to healthcare services and the patient's initial experience with medical professionals.
• Example: Alex schedules an appointment with his family doctor to discuss recent changes in his vision, initiating his journey within the healthcare system.

Diagnostic process

Patients undergo diagnostic tests to identify the root cause of their symptoms.

• Key considerations: Examine the efficiency of the diagnostic process and the clarity of communication about the tests.
• Example: Maria undergoes blood tests and imaging to determine the cause of her abdominal pain, marking the diagnostic phase of her journey.

Treatment planning

Patients receive a diagnosis, and healthcare providers collaborate on creating a personalized treatment plan.

• Key considerations: Evaluate how well the diagnosis is communicated and involve patients in treatment decisions.
• Example: Emily receives a diagnosis of rheumatoid arthritis. Her healthcare team takes the time to explain the condition, discusses various treatment options, and actively involves her in deciding on a comprehensive plan that combines medication, physical therapy, and lifestyle adjustments.

Treatment and clinical care service

Patients initiate the recommended treatment plan, experiencing the day-to-day challenges and improvements associated with their patient journey in a hospital.

• Key considerations: Monitor treatment adherence, side effects, and the patient's overall experience during this active phase.
• Example: Sarah starts chemotherapy for her cancer, navigating the treatment process with the support of her healthcare team.

Psychological support

Patients deal with the emotional toll of managing a health condition, including anxiety, frustration, or isolation.

• Key considerations: Acknowledge and address the emotional aspects of the journey, providing resources for mental health support.
• Example: James copes with the emotional challenges of managing chronic pain, seeking counseling to navigate the psychological impact.

Regular checkups

Patients undergo routine checkups to monitor their health status and adjust treatment plans as needed.

• Key considerations: Ensure consistent communication and scheduling of regular checkups to track progress and address any emerging issues.
• Example: Sarah, diagnosed with hypertension, attends regular checkups where the healthcare team monitors blood pressure, discusses lifestyle adjustments, and ensures medication efficacy. The routine checkups create a proactive approach to managing her condition.

Patients provide feedback on their experiences, allowing healthcare providers to refine and tailor their care.

• Key considerations: Establish mechanisms for patients to share feedback easily and transparently, encouraging an open dialogue.
• Example: John shares his experiences with a new treatment plan, providing feedback on its effectiveness, side effects, and overall impact on his daily life. This feedback loop allows the healthcare team to make timely adjustments and improve the patient's journey.

The stages may vary based on diverse scenarios and individual health circumstances. For instance, when a patient undergoes surgery or faces an acute medical event, the trajectory of their journey can diverge significantly from a more routine healthcare experience. 

Factors such as the need for emergency care, hospitalization, and specialized interventions can introduce unique stages and considerations. Additionally, variations may arise due to the specific nature of medical conditions, treatments, and the individual preferences and needs of patients. 

Recognizing this variability is crucial for comprehensive journey mapping, allowing for a more nuanced understanding of the patient experience across different healthcare contexts.

Types of healthcare journey maps

Healthcare journey maps can take various forms depending on their focus, purpose, and the specific aspects of the patient experience they aim to understand. 

Here are a few types of healthcare journey maps:

Clinical journey maps

Focus: Emphasize the clinical aspects of a patient's experience, including diagnosis, treatment, and recovery.

Purpose: Help healthcare providers understand the medical processes and interventions involved in the patient's journey.

Example: A clinical journey map for a cancer patient would detail the steps from initial symptoms to diagnosis, treatment modalities, and post-treatment care.

Service delivery maps

Focus: Highlight the various touchpoints and services a patient encounters throughout their healthcare journey. Then, detail the back and front processes your team does or has to do during each stage. 

Purpose: Enable healthcare organizations to assess the efficiency and effectiveness of service delivery.

Example: Mapping the service delivery for a patient undergoing surgery, including preoperative consultations, surgical procedures, and post-operative care.

Digital journey maps

Focus: Examine the patient's interaction with digital tools and technologies, such as online portals, mobile apps, and telehealth platforms.

Purpose: Help improve the digital aspects of patient engagement and communication.

Example: Mapping the patient's journey when using a telehealth platform for virtual consultations, prescription refills, and accessing medical records.

Chronic disease management maps

Focus: Explore the long-term journey of patients managing chronic conditions.

Purpose: Aid in understanding the challenges and opportunities for supporting patients in their ongoing self-management.

Example: A journey map for a diabetes patient would encompass regular monitoring, medication management, lifestyle adjustments, and periodic checkups.

Emergency care journey maps

Focus: Examine the patient’s experience during emergencies, from the onset of symptoms to emergency room admission and follow-up care.

Purpose: Help optimize response times, communication, and the overall emergency care process.

Example: Mapping the journey of a patient experiencing chest pain, from the initial call to emergency services to the triage process and subsequent cardiac care.

Pediatric patient journey maps

Focus: Tailored specifically for the unique needs and considerations of pediatric patients and their families.

Purpose: Address the emotional and practical aspects of pediatric healthcare experiences.

Example: Such a map is good for a child undergoing surgery to consider the role of parents, age-appropriate communication, and post-operative care.

Palliative care maps

Focus: Center on the patient's journey when facing serious illness, with a focus on providing comfort and support.

Purpose: Enhance the quality of life for patients and their families during end-of-life care.

Example: This kind of journey map suits a patient receiving palliative care when considering symptom management, emotional support, and coordination of services.

The mentioned types of maps cover different patient scenarios and clinical cases. There can also be "AS-IS" and "TO-BE" maps, reflecting the current state of the journey and the desired one, respectively.

All these types of healthcare journey maps offer a nuanced understanding of the diverse aspects of patient experiences, allowing healthcare providers and organizations to tailor their services to meet the unique needs of different patient populations.

How to do patient journey mapping?

Mapping a patient's journey is a thorough process that needs careful planning, teamwork, and analysis. Here's a guide on how to do it:

• Define the objectives

Clearly articulate the goals of the patient journey mapping exercise. Determine what aspects of the patient experience you want to understand and improve. All involved parties should be aware of these goals and agree with them.

• Assemble a cross-functional team

Form a team that includes representatives from various departments, including healthcare providers, administrative staff, patient advocates, and anyone involved in the patient experience.

• Do research

Conduct thorough research to gather quantitative and qualitative data related to the patient experience. This may involve analyzing patient records, studying existing feedback, diving into analytics and market research, and reviewing relevant literature on best practices in healthcare.

• Select a patient segment

Identify a specific patient segment or persona to focus on. This could be based on demographics, health conditions, or specific healthcare services. 

Tip: You can leverage your segments or patient personas to craft an empathy map , which is particularly valuable in healthcare.

• Conduct stakeholder interviews

Interview stakeholders, including healthcare professionals and administrative staff. Gather insights into their perspectives on the patient journey, pain points, and opportunities for improvement.

• Define the stages

Outline the patient journey by mapping out each stage and interaction with the healthcare system. This can include pre-visit, during a visit, and post-visit experiences.

Tip: To speed up the process, run a journey mapping workshop with your team. It will help with the next step, too. 

• Create the patient journey map

Develop a visual representation of the patient journey. This can be a timeline or infographic that illustrates each stage, touchpoint, and the emotional experience of the patient.

• Identify pain points and opportunities

Analyze the collected data to pinpoint pain points, areas of friction, and opportunities for improvement. Consider emotional, logistical, and clinical aspects of the patient experience.

• Review and validate

Consider collaborative journey mapping . Share the draft patient journey map with stakeholders, including frontline staff and patients, to validate its accuracy. Incorporate feedback to ensure a comprehensive and realistic representation.

• Develop actionable plans

Generate specific, actionable plans based on the identified pain points and opportunities. Each initiative should be feasible, considering resources and organizational constraints.

• Prioritize and implement changes

Prioritize the recommendations based on impact and feasibility. Begin implementing changes that address the identified issues, whether they involve process improvements, staff training, or technology enhancements.

• Monitor and iterate

Continuously monitor the impact of implemented changes. Gather feedback from both staff and patients to understand the effectiveness of the improvements. Iterate on the patient journey map and make recommendations as needed.

• Measure your success 

You can also establish KPIs to measure the success of any improvements made based on the patient journey mapping insights. These could include patient satisfaction scores, reduced wait times, or improved communication metrics.

•  Document insights (optional)

And keep a record of the lessons learned during the patient journey mapping process. This documentation can inform future initiatives and contribute to ongoing efforts to enhance the patient experience.

• Promote a culture of continuous improvement

Foster a culture within the organization that values continuous improvement in patient care. Encourage ongoing feedback and regularly revisit your journey map to ensure its relevance over time.

By following these steps, healthcare organizations can gain valuable insights into the patient experience, leading to targeted improvements that enhance healthcare quality and patient satisfaction.

How to improve the patient journey?

Striving for a seamless patient journey involves enhancing the overall experience that individuals have when seeking and receiving healthcare services. Here are some strategies to consider:

Patient-centered care

• Prioritize patient needs and preferences.
• Emphasize education and empower patients to actively participate in their healthcare journey.
• Foster open communication and active listening.

Streamlined access to care

• Reduce wait times for appointments and procedures.
• Implement online scheduling and appointment reminders.
• Provide options for virtual consultations when appropriate.

Effective communication

• Ensure clear and understandable communication with patients.
• Provide information about treatment plans, medications, and follow-up care.
• Confirm that patients are well-informed about the potential risks and benefits of treatment options.

Education and empowerment

• Offer educational resources to help patients understand their conditions and treatment options.
• Encourage patients to actively participate in their health management.
• Provide tools for self-monitoring and self-management when possible.

Care coordination

• Improve collaboration and communication among healthcare providers to strengthen care coordination, ensuring a more cohesive and seamless experience for patients throughout their healthcare journey.
• Define and implement standardized protocols for communication and handovers between care teams, reducing the risk of errors and ensuring continuity of care.
• Implement remote monitoring technologies to track patients' health remotely, enabling timely interventions and reducing the need for frequent in-person visits.

Technology integration

• Adopt electronic health records (EHRs) for efficient information sharing.
• Use telemedicine to enhance accessibility and convenience.
• Implement mobile health apps for appointment reminders, medication management, and health tracking.

Feedback and continuous improvement

• Conduct regular surveys to gather specific insights into patient satisfaction, allowing for a more nuanced understanding of their experiences.
• Establish easily accessible channels for patients to provide real-time feedback, ensuring that their voices are heard promptly.
• Respond promptly to patient feedback, address concerns, and communicate any changes or resolutions, fostering a sense of responsiveness and accountability.

Cultural competency

• Train healthcare staff to be culturally competent and sensitive to diverse patient needs.
• Promote diversity in healthcare staff to reflect the communities served, fostering a more inclusive and culturally sensitive environment.
• Recognize and celebrate cultural awareness events within the healthcare setting, fostering an inclusive atmosphere that appreciates the richness of diverse traditions.

Emotional support

• Address the emotional and psychological aspects of healthcare.
• Provide resources for mental health and emotional well-being.
• Consider support groups or counseling services.

Efficient billing and financial assistance

• Simplify billing processes and provide clear information about costs.
• Offer financial assistance programs for patients in need.
• Communicate transparently about insurance coverage and out-of-pocket expenses.

Staff training:

• Train healthcare staff in patient-centered communication and empathy.
• Ensure staff is knowledgeable about the resources available to patients.
• Foster a culture of empathy and compassion in the healthcare environment.

By focusing on these aspects, healthcare providers can contribute to a more positive and effective patient journey. Regularly reassessing and adapting strategies based on feedback and evolving healthcare trends is crucial for ongoing improvement.

UXPressia already has some healthcare journey map examples: 

• Surgical patient journey

This map focuses on the healthcare journey of a patient persona, Robin, from the moment when the patient understands that something is wrong to the recovery period. This journey is long and very detailed.

• Non-surgical patient journey

This map visualizes the journey of a patient, Lotta, who decides to undergo a checkup at a hospital. She schedules a visit, gets a consultation, takes some tests, and starts taking some medicine prescribed by her doctor.

More healthcare and well-being templates are available in our library.

Wrapping up 

In wrapping up, think of patient journey mapping as a powerful tool reshaping the healthcare landscape, with the patient's experience taking center stage. It's like creating a roadmap that intricately traces every step of a patient's interaction within the healthcare system. 

This deliberate mapping isn't just a plan; it's a compass guiding healthcare organizations toward key points where they can enhance patient satisfaction, simplify access to care, and cultivate a more compassionate and patient-focused healthcare environment. Investing in patient journey mapping is more than a strategy—it's a dedication to raising the bar in care quality, amplifying the patient's voice, and ensuring that every leg of the healthcare journey is characterized by empathy, understanding, and an unwavering pursuit of excellence in patient experience.

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• Published: 04 December 2019

“Patient Journeys”: improving care by patient involvement

• Matt Bolz-Johnson 1 ,
• Jelena Meek 2 &
• Nicoline Hoogerbrugge 2  

European Journal of Human Genetics volume  28 ,  pages 141–143 ( 2020 ) Cite this article

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“I will not be ashamed to say ‘ I don’t know’ , nor will I fail to call in my colleagues…”. For centuries this quotation from the Hippocratic oath, has been taken by medical doctors. But what if there are no other healthcare professionals to call in, and the person with the most experience of the disease is sitting right in front of you: ‘ your patient ’.

This scenario is uncomfortably common for patients living with a rare disease when seeking out health care. They are fraught by many hurdles along their health care pathway. From diagnosis to treatment and follow-up, their healthcare pathway is defined by a fog of uncertainties, lack of effective treatments and a multitude of dead-ends. This is the prevailing situation for many because for rare diseases expertise is limited and knowledge is scarce. Currently different initiatives to involve patients in developing clinical guidelines have been taken [ 1 ], however there is no common method that successfully integrates their experience and needs of living with a rare disease into development of healthcare services.

Even though listening to the expertise of a single patient is valuable and important, this will not resolve the uncertainties most rare disease patients are currently facing. To improve care for rare diseases we must draw on all the available knowledge, both from professional experts and patients, in order to improve care for every single patient in the world.

Patient experience and satisfaction have been demonstrated to be the single most important aspect in assessing the quality of healthcare [ 2 ], and has even been shown to be a predictor of survival rates [ 3 ]. Studies have evidenced that patient involvement in the design, evaluation and designation of healthcare services, improves the relevance and quality of the services, as well as improves their ability to meet patient needs [ 4 , 5 , 6 ]. Essentially, to be able to involve patients, the hurdles in communication and initial preconceptions between medical doctors and their patients need to be resolved [ 7 ].

To tackle the current hurdles in complex or rare diseases, European Reference Networks (ERN) have been implemented since March 2017. The goal of these networks is to connect experts across Europe, harnessing their collective experience and expertise, facilitating the knowledge to travel instead of the patient. ERN GENTURIS is the Network leading on genetic tumour risk syndromes (genturis), which are inherited disorders which strongly predispose to the development of tumours [ 8 ]. They share similar challenges: delay in diagnosis, lack of cancer prevention for patients and healthy relatives, and therapeutic. To overcome the hurdles every patient faces, ERN GENTURIS ( www.genturis.eu ) has developed an innovative visual approach for patient input into the Network, to share their expertise and experience: “Patient Journeys” (Fig.  1 ).

Example of a Patient Journey: PTEN Hamartoma Tumour Syndrome (also called Cowden Syndrome), including legend page ( www.genturis.eu )

The “Patient Journey” seeks to identify the needs that are common for all ‘ genturis syndromes ’, and those that are specific to individual syndromes. To achieve this, patient representatives completed a mapping exercise of the needs of each rare inherited syndrome they represent, across the different stages of the Patient Journey. The “Patient Journey” connects professional expert guidelines—with foreseen medical interventions, screening, treatment—with patient needs –both medical and psychological. Each “Patient Journey” is divided in several stages that are considered inherent to the specific disease. Each stage in the journey is referenced under three levels: clinical presentation, challenges and needs identified by patients, and their goal to improve care. The final Patient Journey is reviewed by both patients and professional experts. By visualizing this in a comprehensive manner, patients and their caregivers are able to discuss the individual needs of the patient, while keeping in mind the expertise of both professional and patient leads. Together they seek to achieve the same goal: improving care for every patient with a genetic tumour risk syndrome.

The Patient Journeys encourage experts to look into national guidelines. In addition, they identify a great need for evidence-based European guidelines, facilitating equal care to all rare patients. ERN GENTURIS has already developed Patient Journeys for the following rare diseases ( www.genturis.eu ):

PTEN hamartoma tumour syndrome (PHTS) (Fig.  1 )

Hereditary breast and ovarian cancer (HBOC)

Lynch syndrome

Neurofibromatosis Type 1

Neurofibromatosis Type 2

Schwannomatosis

A “Patient Journey” is a personal testimony that reflects the needs of patients in two key reference documents—an accessible visual overview, supported by a detailed information matrix. The journey shows in a comprehensive way the goals that are recognized by both patients and clinical experts. Therefore, it can be used by both these parties to explain the clinical pathway: professional experts can explain to newly identified patients how the clinical pathway generally looks like, whereas their patients can identify their specific needs within these pathways. Moreover, the Patient Journeys could serve as a guide for patients who may want to write, in collaboration with local clinicians, diaries of their journeys. Subsequently, these clinical diaries can be discussed with the clinician and patient representatives. Professionals coming across medical obstacles during the patient journey can contact professional experts in the ERN GENTURIS, while patients can contact the expert patient representatives from this ERN ( www.genturis.eu ). Finally, the “Patient Journeys” will be valuable in sharing knowledge with the clinical community as a whole.

Our aim is that medical doctors confronted with rare diseases, by using Patient Journeys, can also rely on the knowledge of the much broader community of expert professionals and expert patients.

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Acknowledgements

This work is generated within the European Reference Network on Genetic Tumour Risk Syndromes – FPA No. 739547. The authors thank all ERN GENTURIS Members and patient representatives for their work on the Patient Journeys (see www.genturis.eu ).

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Matt Bolz-Johnson

Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands

Jelena Meek & Nicoline Hoogerbrugge

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Bolz-Johnson, M., Meek, J. & Hoogerbrugge, N. “Patient Journeys”: improving care by patient involvement. Eur J Hum Genet 28 , 141–143 (2020). https://doi.org/10.1038/s41431-019-0555-6

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DOI : https://doi.org/10.1038/s41431-019-0555-6

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Patient Journey Mapping: What it is and Why it Matters

How can healthcare organizations make every stage of the patient journey better?

How was your last experience in a healthcare facility? Think about every step of that patient care journey - the phone calls, in person meetings, wait times, communication and all of the healthcare professional/ patient interactions. It’s a lot.

Healthcare organizations are working diligently to improve patient satisfaction and quality of care by asking, “How can we make the patient experience better?” But that’s no mean feat, trying to capture the multitude of challenges patients face when navigating a healthcare journey. That makes improving it even more difficult.

A first, fundamental step to improving patient experience is understanding what that experience looks like today. This is where patient journey mapping comes into play. You can use patient journey maps to understand the highs and lows, pain points and gaps to begin pinpointing which interventions will be most impactful. Then you can assess which changes you have the power to make.

As a result, you’ll be better able to manage your patient’s journey, improve care pathways and meet—and exceed—patient expectations, needs, and wants.

What is Patient Journey Mapping?

Patient journey mapping works to identify and understand the details of all patient touchpoints within a specific healthcare experience. It helps you visualize the process patients go through to receive care, complete a treatment plan, and/or reach a desired outcome. When done correctly, patient journey maps make it easier for you to identify pain points, discover opportunities and re-align treatment and care approaches across the entire healthcare system.

What makes up a patient’s journey?

A patient’s journey represents the entire sequence of events or touchpoints that a patient experiences within a given health system, with a specific provider, or within a specific facility. These touchpoints are either virtual or in-person. They range from the mundane to the nerve-wracking or life-changing. They comprise events from scheduling an appointment online to reviewing post-surgery instructions with a doctor.

It’s key for healthcare professionals and clinicians to recognize the patient journey extends well beyond the most obvious in-person interactions at a treatment facility. The patient journey happens before, during and after a healthcare service: pre-visit, during-visit, and post-visit. These include but are not limited to:

• Finding the right service or practitioner
• Scheduling an appointment
• Submitting a list of current medications
• Arriving at the medical facility
• Identifying where to check-in.

These experiences can instil a sense of reassurance or unease before a patient even receives care. In essence, they set the tone and expectations for the physical visit. A frustrating or confusing experience during the pre-visit stage will impact the emotional state of the patient and family for the rest of their interactions.

During-visit

• Checking in at the front desk
• Waiting in the lobby to be called
• Discussion with nurses before speaking to a doctor
• Family waiting for updates in the lobby during a procedure
• Care from doctor and staff.

There are an infinite number of touchpoints during the delivery of healthcare. Each one will have a different level of impact on the patient’s experience.

• Post-care instructions at hospital
• Hospital discharge process
• Completing a patient feedback survey
• Paying for the medical treatment
• Post-surgery calls or online messages from the nurse or doctor.

The patient experience after a hospital visit plays a vital role in either reinforcing a positive experience or mitigating a negative one. Actions such as post-appointment follow-ups extend the care relationship and may help the likelihood of the patient sticking to the treatment plan

All these individual touchpoints are crucial to understand. Altogether, these positive and negative experiences — no matter how big or small — comprise the patient journey.

Who are the stakeholders?

The healthcare ecosystem is complex, involving multiple stakeholders and a wide range of internal and external factors, including:

• People (patients, their families and caregivers, doctors, nurses, administration, parking attendants, volunteers)
• Technology and systems (online registration, parking tickets, surgery updates, mobile app, website, social media)
• Facilities (hospital campus navigation, parking availability, building accessibility).

Investigation of all players and systems involved is essential to seeing the multidimensional layers impacting the experience. To do this, patient journey maps should include the perspectives of patients, providers, and staff - and those perspectives must be of the same journey. Often, an interaction that occurs from one point of view will show only one reality. However, further investigation will show the many contributing factors across the care delivery process. This is only apparent by examining multiple perspectives.

Once you understand the entire journey, with pain points, you’ll be able to identify patterns across patient personas and different demographics, and any gaps within the healthcare process. You can then begin asking important questions like:

• Which moments are most painful?
• Why do they happen?
• What must we change in order to improve the experience?
• Who must we impact?
• Which do we have the power to change?

Benefits of patient journey mapping

Patient journey mapping provides the opportunity to turn the healthcare experience from a primarily reactive experience to a proactive one. By building out care journeys for your patients, you can close any gaps in provision and establish robust preventative routines that ultimately help your patients stay healthier for as long as possible. Engaging consumers and patients based on where they are and what they want, builds trust and confidence. That retains patients in your system and encourages them to make friends and family referrals.

But how does the process work?

• Streamline patient processes and workflows: upgrading the usability and functionality of online patient portals, websites and mobile apps can put more control in the patients’ hands, increasing patient flow and cutting operational expenses.
• Increase staff efficiency : enhancing internal online tools and creating automation within systems can assist hospital staff in implementing protocols and schedules and help them anticipate and solve problems more easily. It can help to align the expected service delivery with the actual one.
• Clear routes and direction across medical facilities: hospitals can be incredibly complicated to navigate - whether it’s using the right entrance, finding parking or making your way to the cafeteria for a snack. Improving signage, making visible pathways, and using landmarks to help orient users can help patients and families readily access the resources they need.
• Improve communication between patients and providers: exchanging patient information and coordinating care can be a challenge for providers and a frustration for patients. This misalignment can be due to silos within organizations, incompatible technology systems or many other factors. Working to bridge the appropriate organizational or technological gap can help alleviate stress and anxiety.
• Develop seamless and timely patient and family updates: waiting while a family member is in surgery or communicating with a doctor to secure care for a child is typically an extremely stressful process. Families wait anxiously for updates which can be infrequent and lacking detail. Implementing a seamless system for families to communicate directly and receive regular updates, through an app or text, can help ease these pain points.
• Better ‘in-between visit’ care and check-ins with patients and families: communication between patients, including families and caregivers and providers can feel ‘hit or miss.’ Patients may be scrambling to answer phone calls or missing phone calls only to find themselves unable to get hold of the provider when they call back. Alternatively, providers are challenged to communicate critical information to a wide range of patients. Establishing better communication systems can improve patient engagement, build the patient’s confidence in the care they receive, and ease the care provider’s job.

In short, we’re talking happier patients who experience better communication and levels of empathy at every stage of the patient journey.

What tools and methods are used for creating a patient journey map in healthcare?

There are many ways to undertake patient journey mapping, but doing it well isn’t always as simple as it may seem. It’s not a single exercise, moving from A to B. It’s more complex, involving a series of tools.

Our team at Highland has helped a lot of our clients create their first journey map . Grab a bunch of sticky notes and pens to start your map. Our process tends to go like this:

• Chart the course -work out what you want to achieve (your goal); determine whose journey you’re mapping, the start and end points; create the persona(s); think about what the stages of the journey may be.
• Prepare to interview - list your potential questions being mindful that you want the interviewee to recount events rather than share opinions. Schedule interviews with a tool like Calendly. Look into other available data (such as patient feedback).
• Interviews and coding - we interview in pairs so that one can speak whilst the other takes notes. With permission, record the interviews. Afterwards, code the responses according to thoughts, actions, experience etc. We use a simple Google Sheet to do this.
• Building blocks - go through the interviews and notes. Start mapping. Use a specific color of sticky note for each Building Block and add points to the wall in their themes.
• Identify opportunities - “mine” the wall for opportunities, presenting ideas to the team. Together, prioritise the top three or four to tackle.

Repeat this whole process with another persona or goal to examine.

Explore this journey mapping process in more detail

The outcome of this process should be that healthcare professionals can look after patients better. Using patient data collection to underpin your decision-making can transform your organization’s culture to one of continuous improvement. By referring constantly to patient data, you can identify the key areas to amend and improve to better the patient experience. Satisfied customers, those who’ve experienced a near seamless patient journey, will rate your facility highly and they’ll be more likely to generate new referrals.

Improve your customer experience with Highland Solutions’ help

You may know your healthcare facility like the back of your hand, but you only know it from your informed perspective. Getting a 360º view of the patient experience is the first step to improving it. A huge challenge for healthcare leaders like you is to recognize, understand and address the fact that the overall experience is created by the cumulative interactions across the various touchpoints in the healthcare journey: pre-visit, during-visit, and post-visit.

Despite years of expertise, it’s easy for healthcare providers and leaders to develop blind spots for persistent issues in the care process. Partnering with a knowledgeable research team to conduct patient journey mapping will bring expertise and a fresh perspective to your quality of care. It’s not only about uncovering in-depth insights via patient journey maps, but also translating them into actionable strategies to help you bridge any gaps between current and emerging patient needs and the present state of your healthcare organization.

Once on the right track, you’ll be enabled to manage and grow relationships at every stage of the patient journey. The more patient-centric you become, the better experience you build, reaching a higher quality of patient care, patient retention and loyalty, and improved health outcomes and overall well-being.

Get in touch to find out more about how we can help you with patient journey mapping

“Working with Highland is a really powerful experience for a company to be able to gain insights. To have real conversations with patients unlocks new pathways, ones that may be uncomfortable and uncover change, but they empower you to move forward in a way that feels really constructive.”

Chris Whitworth, Vice President, Treatment

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Unpacking the Patient Journey : Challenges and Opportunities

For people who’ve worked at least a few years in the U.S. healthcare industry, it can be difficult to reflect on the busiest and hardest days of COVID-19 – and near impossible to consider ever again facing the existential threats the pandemic posed. Hospitals and other facilities were packed to the brim. Operational leaders had to innovate simply to maintain industry standards. And forget carpe diem – most care teams strived to simply survive the day.  

All of this culminated in an unfortunate turn for the worse: declines in patient experience across just about all hospitals. But these difficult times? Sadly, they aren’t just going away. The industry is still dealing with outdated infrastructure, strained resources, and historic labor shortages, resulting in a dim outlook several years after the pandemic’s onset.  

As many healthcare organizations look for the light at the end of this public health emergency, what lessons can they carry into the future? And what solutions are best suited for closing gaps in the patient journey ?  

Challenges to a seamless care experience

1. Extended wait times – Waiting for an appointment doesn’t just feel like it’s taking longer. One source cites a 2022 survey that found it now takes 26 days (nearly an entire month!) to schedule a doctor visit — a 24% jump from 2004.   

2. Communication gaps – Ensuring clear and compassionate communication in the healthcare setting is difficult for even the most seasoned providers. Almost two-thirds of patients forget to ask important questions during their visits. And most medical terms clinicians use baffle the people they treat, creating a potentially confusing patient journey .  

3. Burned-out healthcare workers – Simply put, the healthcare workforce is not okay. Medical professionals are burned out, stretched thin, and leaving the field as a result. One of the main contributors to record burnout  is unreasonable workloads. And as clinicians are overburdened by stress, their engagement declines — possibly impacting the care they deliver and patient experience measures .  

The emergence of healthcare consumerism and the patient voice

Prioritizing patient experience is essential as healthcare organizations seek to improve the patient journey and incorporate the patient voice into improvements. And a logical starting point has been to understand how to better reach patients where they are, when they need assistance the most.   

One primary trend is digital consumerism . Patients increasingly expect a digital-first care experience when interacting with providers. For example, an Experian Health report found that most patients crave digital platforms for appointment setting, paying bills, and navigating their care journeys.   

Going hand-in-hand with an increasing preference for digital-first care are higher standards for providers. EHRs undoubtedly streamlined clinical workflows. But they’ve also put pressure on care teams to collect more patient data, meaning more time looking at a computer screen and less time looking at patients in the eye. Recent research found 61% of patients want better engagement from their medical professionals.  

Delivering patient-first care in a digital world

There’s no question that evolving consumerism trends have influenced patient expectations of care. Patients increasingly are demanding more seamless, convenient, and personalized experiences from their providers across the patient journey .  

Here are some notable features to look for:  

1. Real-time feedback – Taking a manual approach to a digital healthcare landscape is no longer an option. Organizations must embrace digital patient engagement solutions that gauge patient experience measures in the moment to truly empower care teams with the right data to deliver best-in-class care.  

2. User-centric digital interfaces – It’s not enough to embrace digitization. Healthcare organizations must consider the impact of their digital technology choices on user experience. For example, most patients want to use one platform for navigating their care experience, so providers should restrict the amount of fragmented point solutions they put in front of those they treat.  

3. Rapid resolutions to subpar experiences – Beyond understanding patient concerns in real time, providers must also act upon this data quickly to meet higher expectations of care. This means that digital tools for collecting and organizing patient-reported information must also be accessible and understandable to care teams that need to use them.  

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Feedtrail’s experts have developed a comprehensive solution that streamlines patient engagement, service recovery, and medical reputation management , so your staff aren’t burdened by another fragmented platform and they’re able to keep an eye on concerns across the entire patient journey . Contact us today to learn more about how Feedtrail’s real-time healthcare experience management technology and digital patient engagement tools can help you unlock new levels of patient satisfaction.   

About Mallory Magelli McKeown, Customer Success: Meet Mallory, a healthcare professional dedicated to improving the patient experience. With a background in roles like chaplain and family advocate, Mallory’s mission is simplifying healthcare for patients and families. From advisory councils to patient advocacy, she amplifies the patient’s voice. At Feedtrail, she redefines the patient-provider relationship, asking vital questions to guide healthcare leaders toward patient-centered changes. Her goal: revolutionizing healthcare by putting patients’ needs first.

A Narrative Review of the Patient Journey Through the Lens of Non-communicable Diseases in Low- and Middle-Income Countries

• Open access
• Published: 14 October 2020
• Volume 37 , pages 4808–4830, ( 2020 )

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• Ratna Devi   ORCID: orcid.org/0000-0002-9817-3836 1 , 2 ,
• Komal Kanitkar 3 ,
• R. Narendhar 4 ,
• Kawaldip Sehmi 2 &
• Kannan Subramaniam   ORCID: orcid.org/0000-0001-5551-4103 5  

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Low- and middle-income countries (LMICs) are challenged with a disproportionately high burden of noncommunicable diseases (NCDs) and limited healthcare resources at their disposal to tackle the NCD epidemic. Understanding the patient journey for NCDs from the patients’ perspective can help healthcare systems in these settings evolve their NCD care models to address the unmet needs of patients, enhance patient participation in their management, and progress towards better outcomes and quality of life. This paper aims to provide a theoretical framework outlining common touchpoints along the patient journey for NCDs in LMICs. It further aims to review influencing factors and recommend strategies to improve patient experience, satisfaction, and disease outcomes at each touchpoint. The co-occurrence of major NCDs makes it possible to structure the patient journey for NCDs into five broad touchpoints: awareness, screening, diagnosis, treatment, and adherence, with integration of palliative care along the care continuum pathway. The patients’ perspective must be considered at each touchpoint in order to inform interventions as they experience first-hand the impact of NCDs on their quality of life and physical function and participate substantially in their disease management. Collaboratively designed health communication programs, shared decision-making, use of appropriate risk assessment tools, therapeutic alliances between the patient and provider for treatment planning, self-management tools, and improved access to palliative care are some strategies to help improve the patient journeys in LMICs. Long-term management of NCDs entails substantial self-management by patients, which can be augmented by pharmacists and nurse-led interventions. The digital healthcare revolution has heralded an increase in patient engagement, support of home monitoring of patients, optimized accurate diagnosis, personalized care plans, and facilitated timely intervention. There is an opportunity to integrate digital technology into each touchpoint of the patient journey, while ensuring minimal interruption to patients’ care in the face of global health emergencies.

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Plain Language Summary

In low- and middle-income countries, patients living with noncommunicable diseases face several challenges due to limited healthcare resources, access to accurate information, and prevailing social, economic, and cultural conditions. These factors influence care pathways, patient behavior, and consequently the patient journey. A patient journey is defined as the sequence of steps beginning with a patient’s awareness that something is not right or they are not feeling well and seeking interaction with hospital, healthcare professional, or other stakeholders in a healthcare system. Understanding these interactions can provide many insights into patient experience and the outcomes of their disease. In the context of patients suffering from noncommunicable diseases, these interactions can be broadly categorized as (1) awareness of disease and knowledge of associated risk factors; (2) screening and risk assessment; (3) diagnosis and treatment decision; (4) treatment experience and access to care; and (5) adherence to treatment for long-term management. The examination of these key patient journey touchpoints highlights opportunities in noncommunicable disease management and can help in prioritizing interventions for improving prevention and control. Strategies to improve the patient journey must integrate the patients’ perspective at each touchpoint. Digital health technologies and widespread use of mobile phones in low- and middle-income countries allow patients to actively participate in their care through home monitoring devices, healthcare apps, wearable technology, and telehealth services.

Introduction

Noncommunicable diseases (NCDs) are the leading cause of deaths globally, particularly in low- and middle-income countries (LMICs) [ 1 ]. The NCD mortality burden is disproportionately higher in LMICs, with over 75% of global NCD-related deaths [ 1 ]. Apart from the impact on health and well-being, NCDs also pose high financial burden on the national healthcare systems and often lead to catastrophic expenditure by households, particularly the poor who are the most affected [ 2 ]. Research on the major NCDs, i.e., cardiovascular (CV) diseases, diabetes, cancer, chronic respiratory diseases, and mental health disorders, informs that these conditions are associated with modifiable risk factors (tobacco and excessive alcohol use, unhealthy diet, and physical inactivity) that are common to them, and contribute to the disease onset [ 3 ]. Despite global commitment to reduce NCD-related premature mortality, progress is slow particularly in the LMICs [ 4 ]. This highlights the need to recalibrate the existing NCD care model.

Patient Journey Mapping

Patient journey mapping—also called healthcare process mapping—is an exercise used by healthcare leaders for viewing the management of specific conditions from the patients’ perspective, as a series of consecutive events or activities between patients and healthcare systems that shape the patient experience [ 5 , 6 ]. From a hospital or healthcare system perspective, most patient journeys typically comprise six sequential stages as described in Table  1 . Mapping reveals every facet of interaction between the patient and the health system, including appointment reminders, phone calls with admitting staff, prescription reminders, physical care, and with adequate surveillance, even points in the clinical journey that happen out-of-network [ 5 ]. This exercise helps locate any gaps in the patient care experience, lending the opportunity to redesign patient pathways to maximize clinical efficiency by focusing on activities most valued by patients [ 6 ]. To get the most out of the patient journey mapping exercise, it is important to identify various elements of the patient and health system interaction, as listed in Table  2 . Despite their usefulness, there is no consensus on a universally accepted definition of the patient journey ratified by patients or patient organizations, varying between disease conditions, regions, and mapping process employed [ 7 , 8 ].

Published studies have attempted to map patient journeys for individual NCDs in multiple countries and regions (Table  3 ) [ 9 , 10 , 11 , 12 , 13 , 14 ]. As expected, most evidence comes from high-income countries and the corresponding data for LMICs is sparse. Notably, most patient journeys for NCDs begin long before the “trigger” or point of access into the health system [ 9 ]—a fact that is commonly missed by healthcare providers and results in remedial counselling at or after the trigger. Being “aware” of NCD risk factors and adopting healthy lifestyles can prevent or delay the onset of a disease [ 15 ]. It is also important to recognize that NCDs do not occur in silos; many patients face multimorbidity, with each morbidity prompting its own unique journey [ 16 ]. Patients’ perspectives and value-added inclusion can provide both unique and critical insights to healthcare delivery teams in journey mapping. Patients living with NCDs (PLWNCDs) have direct, extensive experience of living with the disease and understand first-hand the impact of the disease on their quality of life and physical function. Chronically ill patients are expected to participate substantially through self-care in managing their adherence to therapy and the safe use of prescribed medicines based on labelling and other information provided to them [ 17 ].

Barriers to NCD Care Pathways in LMICs

Patient journeys are context-specific and reliant on national healthcare systems and investments. Since LMICs tend to have fragmented health service delivery, uneven quality of care, and a large informal healthcare sector providing substantial chronic healthcare, the patient journey from initial outreach to continued care is rarely seamless [ 18 ]. Equitable access to health services is far from optimal in many LMICs, as evident from poor patient-to-provider ratios and high out-of-pocket (OOP) expenditure on healthcare [ 19 , 20 ]. Whereas in developed nations the OOP expenditure for complete healthcare (data for NCD OOP expenditure is not reported separately) is about 20–25%, it rises to a massive 60% in developing countries like India [ 21 , 22 ]. Contributing to the burden, most LMICs invest only a small proportion of their gross domestic product into healthcare expenditure (ca. 4%), much lower than what is needed [ 23 ].

In LMICs, several factors outside the health system also influence decisions to enter or exit the patient journey, and often these choices influence the disease trajectory. Poor health literacy and lack of awareness about risk factors and appropriate entry points into the healthcare system contribute to poor patient outcomes [ 24 , 25 ]. In resource-limited settings, unauthorized practitioners propagate ignorance, misconceptions, and misleading guidance that complicate patient pathways further [ 26 ]. Health and morbidity are influenced by behavioral decisions of individuals or their families, genetically inherited health endowments, or the health environment in which people reside. Illness is, therefore, systematically linked to household- and community-level factors [ 27 ]. Other factors shaping health-seeking behavior include age, socioeconomic conditions, presence of comorbidities, perceived family support, duration of disease, and history of early treatment at diagnosis [ 28 ]. The social determinants of health in LMICs, governed by the policy choices and the amount of money, power, and resources that people have, are key to discerning care pathways followed by patients when accessing healthcare [ 29 ]. The differences in healthcare systems, socioeconomic and cultural factors, and population health literacy warrant the need for examining patient journeys independently in the LMIC setting.

Scope of the Study

NCDs often co-occur and share common behavioral and environmental risk factors. The World Health Organization (WHO) has long advocated for an integrated approach for prevention and control of NCDs both at system and service levels, rather than in disease-specific silos [ 30 ]. Therefore, this paper aims to provide a theoretical framework outlining the shared patient journey touchpoints for people living with the major NCDs, particularly CV diseases, diabetes, and mental health disorders, as the leading contributors of NCD-related mortality and morbidity in LMICs [ 1 ]. It further aims to draw upon published literature and secondary sources to review influencing factors and recommend patient-centered strategies to improve the patient journey at each touchpoint.

The PubMed database was searched to identify relevant literature using the search terms "patient-centered care", “patient journey”, "noncommunicable diseases", “cardiovascular diseases”, “diabetes”, “hypertension”, “dyslipidemia”, “mental health”, “depression”, “anxiety”, “awareness”, “health promotion”, “health literacy”, “patient education”, “screening”, “risk assessment”, “diagnosis”, “treatment decision”, “treatment experience”, “treatment monitoring”, “treatment access”, “adherence”, “compliance”. As a result of the sparse availability of peer-reviewed literature on the topic in LMICs, additionally, relevant articles and reports curated by the authors from the Google database and gray literature were also utilized in this study.

This article is based on previously reported studies and does not contain any studies with human participants or animals conducted by any of the authors.

Common Touchpoints of the Patient Journey for NCD in LMICs

Suffice to say that patient journeys are not similar for all diseases; however, there are commonalities in patient journeys of closely linked groups of diseases and specific needs for individual conditions [ 31 ]. The WHO recommends integrated management of NCDs with equitable access to a nationally determined set of promotive, preventive, curative, rehabilitative, and palliative basic health services [ 32 ]. Aligned with the WHO recommendation and common risk factors linking the major NCDs [ 33 ], the patient journey for NCDs can be structured into five broad touchpoints: awareness, screening, diagnosis, treatment, and adherence with integration of palliative care along the care continuum pathway (Fig.  1 ).

Key touchpoints of the patient journey for noncommunicable disease. HCP healthcare professional

The importance of the concept of primordial prevention, which focuses on health education even before risk factors arise, cannot be downplayed in the context of NCDs [ 34 ]. Awareness of health-promoting habits and knowledge of disease form the first stage of the patient journey, before the onset of NCDs [ 35 ]. Periodic or opportunistic screening for risk factors and co-occurring NCDs is an effective strategy for lowering the morbidity and mortality due to these diseases by detecting undiagnosed cases and initiating early treatment [ 36 ]. At the remedial phase, the treatment decision following diagnosis, treatment experience influenced by treatment goals, access to services, follow-up, and adherence to the recommended therapeutic or lifestyle modification interventions determine the course of the patient journey for NCDs and the outcomes. Palliative care is recognized as an integral component of universal health coverage and must be available throughout the life course of PLWNCDs particularly in LMICs, where approximately 80% of the global population in need of palliative care resides [ 37 , 38 ]. Palliative care is essential for better control of symptoms and an improved quality of life for patients and also improves the physical and psychosocial well-being of families and caregivers [ 38 ].

The patient’s touchpoints with healthcare systems along their journey is further influenced by the accessibility of services across five dimensions, i.e., approachability, acceptability, availability and accommodation, affordability, and appropriateness (Fig.  2 ) [ 39 ]. These dimensions in access to care are in turn governed by the patient’s ability to perceive, ability to seek, ability to reach, ability to pay, and ability to engage, respectively [ 39 ]. Strategies designed to improve the patient journey must consider these factors to ensure a patient-centered perspective.

[Copyright © 2013, Springer Nature] published under license to BioMed Central Ltd. as indicated under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/2.0 )

A conceptual framework of barriers and facilitators in access to healthcare. Reprinted from “Levesque, J., Harris, M.F. and Russell, G. Patient-centered access to health care: conceptualizing access at the interface of health systems and populations. Int J Equity Health 12, 18 (2013)”

Strategies to Improve the Patient Journey for NCDs Along Common Touchpoints

Improving the patient journey for NCDs requires cost-effective and efficient solutions customized to LMIC settings [ 40 ]. It is important to review problems and prospects of influencing factors at the micro, meso, and macro levels of healthcare, i.e., at the level of individuals, their households, and communities, as well as at the policy level [ 41 ]. Some recommendations are listed in Table  4 .

Disease Awareness and Knowledge of Associated Risk Factors: Effective Health Communication

The limited impact of the medical monologue between the doctor and the patient, guised as medical communication, has necessitated the development of health communication strategies that are collaboratively designed, implemented, and comprehensively evaluated to ensure sustainable health improvements [ 42 , 43 ]. The overarching component of an effective health communication program remains a powerful, well-articulated, long-term vision. In chronic conditions like heart failure, transition from home to hospital can be high risk. Preventing rehospitalization requires integration of care across hospitals, home care agencies, and outpatient clinics and patient education [ 44 ]. Evidence suggests that increasing “patient activation” interventions—the skills and confidence that equip patients to become actively engaged in their healthcare—is linked to improved outcomes and reduced relapses and rehospitalizations [ 45 ].

Although physicians report attempts to educate patients on the causes of their disease and the importance of adhering to secondary prophylaxis, patients in LMICs still have very low levels of understanding of their disease [ 46 ]. There is potential to address the underlying issues by involving caregivers during consultation, use of native language while providing therapy or counselling, observing cultural nuances and levels of literacy. Awareness of the patients’ needs and cultural background should take precedence in the conversation around expectations of adherence of follow-up; physicians explanations and the level of patients’ understanding significantly affect treatment adherence, treatment outcome, and patients’ satisfaction [ 47 ]. Healthcare providers need to be critically aware of these issues when communicating with patients and their caregivers, select health information that is appropriate to the patients’ level of understanding, and employ a systematic approach using a basket of tools (e.g., printed material, displays, videos, and discussions) to educate and improve awareness and stress motivating principles, cultural relevance, and feasibility [ 47 ].

Screening and Risk Assessment: Integrated Assessment Tools for NCDs

Screening for risk factors is a cost-effective method for early diagnosis and further prevention of complications. As a result of limited knowledge on the prevention aspects of CV diseases, people living in LMICs often delay visiting hospitals at the first sign/symptom [ 48 ]. CV risk screening and stratification of high-CV-risk individuals, based on multiple risk factors (age, sex, blood pressure, blood lipids, smoking, diabetes), can detect subclinical CV diseases and avert future CV events [ 49 ]. The WHO PEN package tools provide specific guidance for screening, risk stratification, and management of patients with the main NCDs in low-resource settings [ 49 ]. Notably, failure to detect underlying mental illnesses leads to underestimation of overall CV risk, deters prognosis and adherence to treatment, and can impact the patient journey [ 50 ]. Mental health issues often co-occur with other NCDs [ 33 ]. People with debilitating neurological disorders like stroke, Parkinson’s disease, and epilepsy are often treated for the disease alone and the mental health aspect is excluded. On the other hand, mental health issues like depression are often hidden and overlooked during routine checkups. Primary care clinics are an ideal setting to identify and address mental health problems early, although integration of mental health services within primary care and in community-based settings remains low [ 51 ].

Age-appropriate screening is important to understand the best fit for treatment options and care pathways. A pediatric patient with cancer would need a different approach compared with an elderly patient with stroke. The guidance provided, choice of treatment plans, and discharge advice should be based on the age and fitness of the patient, which is often overlooked in busy clinical practice. For senior citizens, a geriatric assessment is a valid strategy to stratify patients and prepare them for care pathways. A variety of fitness/frailty scores are available to appropriately assess the status of elderly patients [ 52 ].

Diagnosis and Treatment Decision: Shared Decision-Making

The true extent of those at risk for NCDs or those who have NCDs is likely underestimated, given that many persons with raised blood pressure and diabetes remain undiagnosed [ 53 , 54 ]. Early diagnosis is critical to prevent complications and ensure optimal treatment outcomes. However, this is based on several critical factors of access, awareness, and affordability. Clinician–patient risk discussions must follow the approach of shared decision-making in which the patient and physician consider the potential benefits of treatment, risk of adverse events, and patient preferences before making a final decision to initiate treatment [ 55 ].

Shared decision-making and self-directed support have the potential for being effective tools for recovery [ 56 ]. It is important to consider patients and their families as critical partners in the diagnostic process. Their engagement will result in a valuable contribution to facilitate an accurate and timely diagnosis and improve shared decision-making on treatment and continued care [ 57 ]. In conditions like advanced heart failure, the treatment goal is to improve quality of life and prolong survival [ 56 ]. Shared decision-making for advanced therapies in these conditions must be considered in the context of the caregivers’ ability to manage tailored treatment [ 56 ]. For patients who are unable to make decisions themselves or independently follow the treatment and care pathways, clinicians need to effectively engage with caregivers and family [ 56 ].

Decision aids can facilitate shared decision-making and improve decision-related outcomes, particularly involving multiple treatment choices [ 58 ]. Often the choice of treatment is weighed down heavily by the patients’ ability to pay at the time of treatment. However, the benefit of choosing a seemingly expensive option with better outcomes that saves on long-term treatment and fewer complications is often not explained well enough to the patient [ 59 ]. Use of decision aids reduced decisional conflict, and increased knowledge and satisfaction without any change in anxiety or depression, in many studies [ 58 , 59 ]. Additionally, the utility of clinical practice guidelines to aid diagnosis and treatment cannot be ignored. The guidelines contain recommendations that are based on evidence from rigorous systematic reviews and synthesis of the published medical literature [ 60 ].

The importance of integrated primary healthcare services and management of chronic diseases is gaining momentum and the artificial dichotomy between diseases is slowly receding in favor of a combined approach that benefits all conditions [ 61 ]. This integration of comprehensive services, especially within existing and established primary and secondary healthcare structures, should be strongly encouraged by clinicians, policy makers, and the community.

Treatment Experience and Access: Patient-Centered Approach

Once diagnosed, PLWNCDs face many challenges in accessing treatment due to availability and affordability of essential NCD medicines in these settings. Governments must commit to long-term strategies to address access-related issues pertaining to regulatory (ensure good quality of medicines in circulation and acceptance of affordable generic medicines), healthcare financing (inclusion of priority NCD medicines in benefits packages and reduce OOP expenditure), and supply chain matters (efficient procurement and distribution of medicines) [ 62 ].

Many experts have indicated that “chronic diseases are managed most effectively when patients take an active role in this themselves” [ 63 ]. Empowerment is the result of effective communication in healthcare and determines consequent participation and self-management [ 64 ]. “Therapeutic alliance” is a concept in the field of psychiatry that refers to the relationship between a healthcare provider and patient [ 65 ]. An optimal therapeutic alliance is achieved when the patient and the therapist share beliefs in the relevance of treatment goals and efficacy of the strategies to achieve those goals. A positive therapeutic alliance is a predictor of patient activation and positive clinical outcomes [ 65 , 66 ].

Patient-centered care (PCC) identifies patients as partners with their healthcare providers and recognizes an individual’s specific health needs and preferences as the driving force in all healthcare decisions [ 63 ]. PCC encourages the presence of family members in care settings and respects their values, cultural traditions, and socioeconomic conditions. PCC has the benefit of improving patient satisfaction levels, improving the productivity of clinicians and ancillary staff, and reduces expenses across the continuum of care. Management of chronic conditions is moving toward an individualized therapy approach; personalized treatment goals for conditions such as diabetes can be valuable in providing effective care and also combating negative long-term outcomes [ 67 ].

Adherence for Long-Term Management: Self-Management Tools

The medication adherence rate, defined as the extent to which patients take medication as prescribed by their healthcare professionals, among patients in LMICs suffering from chronic diseases is about 50%, a worrisome statistic [ 68 ]. Evidence has demonstrated that interventions led by clinical pharmacists encompassing services such as education, counselling, and assessing each medication and medication-related problem for patients with diabetes are effective in increasing adherence to clinical guidelines and medications leading to improved outcomes [ 69 ]. Older adults often face adherence issues following hospital discharge due to complex treatment plans and poor communication with the patient. Nurses are well placed to follow-up with these patients and keep them adherent to their therapies. Additionally, frontline community health workers and patient support groups can be instrumental in driving patient health literacy, empowerment, and ultimately medication adherence [ 70 , 71 ]. Developing “expert patient” programs imparting peer education, training, and skill development can be a cost-effective strategy for driving adherence in LMICs [ 18 ]. Other tools applying innovative e-health technologies combined with pill counts can improve medication adherence among the vulnerable and older patients [ 68 ].

Palliative Care: Integrating with Health Services

Palliative care is still in its nascent stages in most developing countries. Pain and respiratory issues are the main complaints from patients in need of palliative care. As per the WHO, access to palliative care is a human right and national health systems must include palliative care in the continuum of care linking it to prevention, early detection, and treatment programs for chronic and life-threatening conditions [ 38 ]. The immediate actions include integrating palliative care into national health policy or action plans and ensuring funding and affordability of palliative care service delivery; building the capacity of health workforce to delivery palliative care through training and updating medical curricula; and ensuring the availability of essential medicines including opioids for pain relief [ 38 , 72 ]. Choice of palliative care service delivery models must be based on the cultural, spiritual, and economic needs of the people. Home-based palliative care is the most common service delivery model in LMICs [ 72 ]. Other models include outpatient clinics and day care where patients visit a palliative care facility for services [ 72 , 73 ]. However, these models need involvement of families and volunteers for managing essential symptoms supplemented with healthcare professionals for necessary medicines and backup support [ 72 , 73 ].

Integrating Digital Technologies into the Patient Journey

With the advent of smart phones, tablets, nimble wearables relying on big data, health informatics, and analytics, digital technologies have afforded the opportunity to monitor the complete patient journey in real time and provide patients with tools to better manage their journey [ 74 , 75 ]. The penetration of mobile telephones in LMICs has exceeded that of developed nations, leading to new possibilities in the field of healthcare [ 76 ]. This rise in technology adoption is shaping the medical ecosystems in many ways; within the NCD arena it provides health systems the opportunity to shift the balance from secondary to preventative care [ 77 ]. In the near future, physicians will have access to electronic medical records, real-world data, and patient-reported outcomes at their fingertips, which will restore patient-centricity within personalized healthcare. Recognizing this imminent transformation in healthcare, the WHO released guidelines on evidence-based digital health interventions for health system strengthening [ 78 ].

In the digital health age, the start of the new patient journey should ideally begin with the merging of patients’ social media, geo-location, and other digital footprints with their biomarkers. Merging these digital footprints with biomarkers like blood pressure, glucose levels, and body mass index can predict raised risk levels [ 79 ]. Following that, a revised schedule of physical activity, diet and nutrition, and other routines drawn up with the health professional and fed into the patient’s smart phones could drive the appropriate lifestyle changes.

Good personalized healthcare involves home-based supported self-care [ 80 ]. Digital solutions allow patients to benefit from home-based self-care while still being attached to their healthcare team through a “digital umbilical cord”. Secondary prevention in self-care entails patients maintaining their blood pressure, blood glucose, lipids, and other endocrinal markers within a safe level either through prophylactic therapies or through lifestyle modifications [ 81 ]. With advances in home monitoring devices, these markers can be easily monitored by patients and the results transmitted to their health teams for analysis and treatment optimization. Use of simple finger-prick tests or automated machine learning solutions such as the flash glucose monitor or the continuous glucose monitor for diabetes mellitus and home blood pressure monitoring devices for hypertension have reported better outcomes for patients [ 82 , 83 ]. These technologies provide a high resolution view of each patient and can facilitate the choice of individual optimal therapy.

As with all technological advancements, there is an expected lag in the adoption of digital developments by healthcare professional communities due to a lack of awareness, lack of understanding, resistance to digital technologies, and working within protected silos that discourage information sharing. Lastly, there are concerns from the patient community regarding data privacy and ownership, and fear of discrimination against certain genetic diseases [ 84 ].

The growing number of people living with chronic diseases is both a measure of success, an outcome of increased life expectancy, and a challenge for healthcare systems in LMICs [ 85 ]. Despite international commitment, the momentum for impeding NCD-related morbidity and mortality has waned since 2010 [ 86 ]. In contrast to developed countries where healthcare delivery remains relatively accessible and inclusive, LMICs require substantial improvements in healthcare delivery to meet the Sustainable Development Goals and achieve Universal Healthcare Coverage [ 87 ]. To effectively alter the current trajectory of NCDs, it is important to review problems and prospects of influencing factors at the micro, meso, and macro levels of healthcare, i.e., at the level of individuals, their households, and communities, as well as at the policy level [ 41 ]. Evidence suggests that patient experience is a key pillar of healthcare quality; therefore, instead of limiting it to in-person interactions between the patient and physician, mapping the entire patient journey is the best way to understand the patient experience and identify existing lacunae [ 88 ].

Traditionally, a patient journey is viewed from the perspective of healthcare providers. It is often perceived to be linear, following a sequential process in a care continuum pathway with a single entry and exit point. The entry point or the start of the patient journey is believed to begin after a “trigger”—an onset of a sign or symptom of a disease. Redesigning of patient pathways based on journey mapping is often undertaken with the purpose of improving healthcare system performance or meeting regulatory constraints [ 6 ]. Traditional patient journey maps also miss the impact of medical protocols followed in patient care [ 6 ].

The patient journey for NCDs starts well before an episode of care and continues after discharge [ 89 , 90 ]. The patient journey is also complex with multiple entry and exit points. In practice, care provided to patients with multimorbidity is fragmented, resulting in innumerable hospital appointments with different specialists and concurrent use of multiple medications or polypharmacy. The “treatment-in-silos” approach impacts patients’ lifelong compliance to treatment and further incapacitates patients with advancing age and disability. There is a need to reframe the patient journey as one with touchpoints, where a patient may enter at any one point but often may need support and care at other points. For example, in the framework presented in Fig.  1 , the NCD patient’s first touchpoint may well be at “Diagnosis” during an encounter with the health system. They will benefit from education to increase their “Awareness” to help them understand and participate in their care; they may benefit from “Screening” for comorbidity; and enriched monitoring and counselling for “Adherence”.

The concept of “healthcare” has been delineated from “medical care” years ago; still, most healthcare systems today subject PLWNCDs to only physical and laboratory evaluations without properly assessing their mental, social, and emotional well-being [ 91 ]. Following diagnosis, treatment modalities are tailored to the disease rather than the person, leading to altered lifestyle to suit protocols set up for the condition. There is a strong call to action in LMICs to integrate the management of NCDs combined with the “holistic medicine” concept that follows the approach of putting patients’ perceived needs first in providing care not just for physical but also mental, emotional, and spiritual needs [ 71 ].

This can only be achieved through critical assessment of the underlying complexities in patient journeys for NCDs—awareness levels, screening opportunities, treatment protocols, access to care, issues with compliance—to avoid missteps in providing timely and optimal intervention.

It is increasingly evident that many PLWNCDs have specialized expertise and can play a crucial role in identifying what is most meaningful to them and their conditions. The “expert patient” concept where patients with significant knowledge about their disease and treatment take on a larger role in self-management has been explored in the West with noted improvements in symptoms, quality of life, and adherence [ 18 ]. Many healthcare systems in developed countries have found value in moving towards a self-management approach for chronic diseases, utilizing the knowledge and expertise held by “expert patients” [ 18 , 92 , 93 ]. Replication of this approach in LMICs has seen some success in positively impacting the patient journey. A diabetes peer education program (MoPoTsyo) initiated in rural and urban slum areas of Cambodia trained patients from local communities as peer educators who could then coach other patients in self-management, counsel them on lifestyle changes, and conduct follow-ups [ 94 ]. MoPoTsyo patients had better health outcomes in terms of a higher proportion of patients achieving target glycosated hemoglobin (HbA1C) levels, lower systolic blood pressure, and reduced presence of diabetes foot lesions and also had lower diabetes-related healthcare expenditure compared with diabetes care programs in two other LMICs, Democratic Republic of Congo and the Philippines [ 95 ]. Access to more external resources and a stronger focus on self-management and chronic illness may have contributed to the success of MoPoTsyo [ 95 ]. Meaningfully involving PLWNCDs along common touchpoints in the patient journey for NCDs will help inform the value assessment in healthcare, provide better outcomes, and increase adherence to therapy, leading to a happier and more rewarding patient experience.

Use of mobile- and web-based computing can help in educating individuals at the level of prevention by emphasizing the control of NCD risk factors and, once made aware of their conditions, aids in self-management and adherence to their treatment. A systematic review identified that mobile solutions are more widely available than other technology-based solutions for education on NCDs owing to ease of access, convenient delivery of educational content, and potential to gamify educational learning for chronic illnesses [ 96 ]. Another review from developed countries demonstrated that the use of information and communication technology (ICT) in health promotion behavior resulted in increased physical activity, reduced weight, and healthy behavior change among the participants [ 97 ]. However, there is a dearth of data on the long-term effectiveness of ICT on health-promoting behaviors in LMICs. There is an urgent need to build evidence for ICT use in promoting health behaviors among healthy adults in LMICs and move towards personalized assistance supported by ubiquitous learning [ 96 , 97 ].

Social environments have a significant influence on an individual’s health and, in this digital age, online social networks play an important role in health as they control access to resources and opportunities to model one’s behavior [ 98 ]. Several models have been developed and evaluated the use of social media to foster better health behaviors among populations. For example, the Pompilos model was developed to enhance healthcare applications with social media content and ascertain to what extent a person’s health behavior influences the health of others in their social network [ 98 ]. Preliminary evaluation of the model indicated that NCD prevention messages directed to users correlated with increased access to the application and warrants further research [ 98 ]. Most LMICs are progressing towards an ageing population that will accompany a rise in chronic conditions and increased healthcare costs [ 99 ]. From an elderly patient setting in LMICs, technology must prioritize patient-facing innovations that improve quality of life, facilitate communication with providers, and provide decision-support [ 99 ]. Redesigning healthcare models to sustain increased self-management will improve outcomes and reduce healthcare costs. Healthcare applications can be further enhanced by integrating them into “smart city” infrastructures, e.g., the U’Ductor architecture developed in Brazil can increase social collaboration by integrating with city information systems to guide users to hospitals on the basis of the availability of beds, provide traffic updates in medical emergencies, recommend modes of transport on the basis of real-time air quality data, etc. [ 100 ].

Future Perspectives

The COVID-19 pandemic accelerated the digitization of healthcare services as health systems had to adopt telemedicine and other technologies to flatten the curve and help patients in self-isolation receive access to healthcare [ 101 ]. A WHO survey of 194 countries in May 2020 reported severe disruption to prevention and treatment services for NCDs since the beginning of the COVID-19 pandemic [ 102 ]. Preexisting inequities in LMIC health systems will likely exacerbate the effects of the COVID-19 pandemic among vulnerable populations and the care for chronic diseases will likely further worsen along with health outcomes. This may be the result of health system capacity being exceeded, redeployment of health personnel to the frontline of COVID-19 infection, or because of measures placed to address the spread of the pandemic such as lockdowns and restrictions on people’s movement [ 103 ]. A prescient insight into the patient journey for NCDs can help with adopting the WHO guidance to maintain essential services for NCDs. The guidance offers programs of activities across chronic disease management including awareness; prevention and screening; diagnosis; specialist treatment; rehabilitation; and palliative care [ 104 ]. Increase in home-based service support by appropriately trained community health volunteers helps promote self-care, risk assessment, and referral for uncomplicated patients, a cost-effective strategy for prioritizing NCD management [ 105 ]. Being readily accessible healthcare practitioners in LMICs during the pandemic, community pharmacists are well positioned to help manage chronic conditions, promote medication adherence, and help ease the burden on already strained health systems [ 103 ].

Setting healthcare priorities is of particular importance in the LMICs in order to allocate their limited resources toward the most effective interventions. Evidence-based decision-making for NCD prevention and control policies requires reliable and timely data [ 106 ]. The lack of mechanisms to collect high-quality data is a major barrier to successful implementation and monitoring of NCD programs in LMICs [ 107 ]. As a result, NCD policy recommendations at the national and local levels in LMICs are based on evidence from communicable diseases or from studies conducted in high-income countries, which can potentially impact the outcomes of these policies [ 107 ]. Similarly, mapping patient journey for NCDs will require local evidence generation and continual monitoring of evidence to inform strategies to improve the patient journeys in LMICs.

The mounting mental health burden is a growing concern in LMICs, as poverty is known to be associated with increased risk of mental illness. Limited access to psychiatrists and mental health facilities in many LMICs has triggered the pursuit for innovative solutions such as employing community-based health workers to deliver psychosocial therapies supported remotely by specialists [ 108 ]. Additionally, technology-based solutions are being explored in the domain of mental health education and information dissemination, digital screening tools and diagnosis, self-management programs, and system-level efforts to improve mental health [ 108 ]. Several models of ubiquitous computing have been proposed to inform psychotherapeutic practice, often used in the treatment of depression and anxiety disorders [ 109 ]. Mobile and wearable technologies can be utilized to collect an individual’s physiological and environmental measurements and provide psychophysiological insights [ 110 ]. Patient engagement and adherence to online programs in psychotherapeutic treatment can be improved by employing gamification techniques [ 109 ]. Applications monitoring social activities of people with depression can contact caregivers as needed and aid providers in patient follow-up [ 111 ].

Concluding Remarks

In the past, the patient journey for chronic diseases was marred with late diagnosis, “one-size-fits-all” treatment, and access issues creating bottlenecks in the health system. Treatment was often location bound and the patient’s life oscillated between hospitals, providers, and healthcare facilities. Unlike in developed countries, healthcare systems in LMICs continue to follow the traditional, provider-driven, disease-focused approach which must move towards person-centered care integrating patient preferences, needs, and experiences into every phase of the patient journey [ 112 ]. In order to create, implement, and support successful patient journey maps, healthcare organizations must have a deep understanding of the populations they serve—as well as those they wish to serve in the future. The patient needs to be recognized as an integral part of this journey and involved in all stages embracing the “nothing for us without us” sentiment [ 113 ].

Health systems in LMICs must recognize that the patient journey for NCDs starts long before the onset of symptoms and signs. Strategies designed to improve the patient journey must incorporate the patient-centered perspective at each touchpoint of their journey in the healthcare system: awareness, screening, diagnosis, treatment, and adherence. Effective communication strategies for improving health literacy, patient activation, and incorporation of narrative medicine in physician education positively impact the awareness of patients. Use of appropriate risk assessment tools to tailor therapies, integrated management of chronic illness in primary healthcare, shared decision-making, and decision aids ensure timely and accurate diagnosis. Improved access to NCD treatments, embodying the principles of person-centered care and positive therapeutic alliance, requires commitment at a policy level to deliver safe, affordable, and effective care equitably. Long-term management of NCDs entails substantial self-management of their conditions by patients, which can be augmented by pharmacists and nurse-led interventions. The NCD care continuum pathway needs to move from the traditional acute incident management protocol to a public health approach of prevention and delay of disease onset through early identification and management of risk factors; early diagnosis and appropriate management; and good adherence through effective communication and follow-up. In addition, comprehensive palliative care models must be evaluated and integrated into national health policy and action plans.

Digitization has heralded a healthcare revolution with a patient-centric and user-friendly framework that will undoubtedly increase patient engagement. eCare pathways allow better management of patient journeys by facilitating early and accurate diagnosis at the outset and then on the progress of the disease; aiding in personalized care plans tailored to the patient’s genomic makeup and lifestyle; and remote monitoring of patients via digital algorithms to optimize timely treatment interventions. The reduced dependence of digital health on healthcare facilities for care-seeking is an encouraging prospect for LMICs to help bridge gaps in the patient journey for NCDs through empowering patients, improving access to healthcare services, and enhancing efficiency of health systems with innovative, cost-effective, and localized solutions.

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Devi, R., Kanitkar, K., Narendhar, R. et al. A Narrative Review of the Patient Journey Through the Lens of Non-communicable Diseases in Low- and Middle-Income Countries. Adv Ther 37 , 4808–4830 (2020). https://doi.org/10.1007/s12325-020-01519-3

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Patient Journey Mapping: What it is, Benefits and 5 Steps to Do it

In the rapidly evolving landscape of healthcare, patient-centered care has emerged as a crucial paradigm shift. As hospitals strive to deliver exceptional patient experiences and improve outcomes, understanding the patient journey has become paramount. 

A customer journey map is a powerful tool that shares patients’ path from their first encounter with a healthcare facility to their final discharge. By visualizing this complex expedition, hospitals can gain invaluable insights into patient needs, pain points, and opportunities for enhancement, thereby revolutionizing the delivery of care. 

The following article delves into the significance of patient journey maps for hospitals and their importance in optimizing patient experiences, streamlining processes, and ultimately elevating the standard of healthcare.

What is a Patient Journey Map?

A patient journey is a methodology that enables the analysis of a healthcare provider’s processes and value chain but from the patient’s viewpoint. This includes their possible solutions, pain points, emotions, touchpoints and user actions throughout the journey.

The patient journey map employs visual representation to gain deeper insights into how patients engage with a healthcare facility throughout their care journey. This unique approach is an evolution of the customer journey map , tailored specifically to the healthcare context. By employing this method, healthcare providers can unravel the intricacies of patient interactions, uncovering valuable information to enhance the quality of care provided.

The concept of the Patient Journey Map mirrors that of the Customer Journey Map, seeking to uncover areas of enhancement in patient care across various healthcare providers, including hospitals, fertility centers, and more.

Just as a skilled cartographer carefully crafts a map to navigate uncharted territories, patient journey maps chart the course of a patient’s experience, revealing hidden insights, unveiling opportunities for improvement, and ultimately guiding healthcare providers toward a destination of unparalleled patient satisfaction . 

What are the benefits of implementing a Patient Journey Map?

Engaging in the patient journey proves immensely valuable as it enables us to provide patients with an optimal experience, meeting the very expectations that arise when seeking healthcare services. 

The emotional aspect tied to the Patient Journey Map can be profoundly impactful, considering the inherent uncertainties often associated with visiting a healthcare facility.

Considering the unique personalities, fears, behaviors, and attitudes of different patient archetypes play a pivotal role in creating a tailored and pleasant experience for them. Thus, the patient journey map becomes a valuable tool benefiting both patients and healthcare service providers.

● Enhanced Communication with Patients:

By understanding the patient journey, healthcare providers can establish effective and continuous communication throughout the entire care process, addressing any doubts or uncertainties. Keeping patients well-informed and updated through appropriate channels reinforces the quality of care provided.

● Elimination of Blind Spots:

Clear comprehension of each stage of the patient journey helps bridge the gaps between patients and services. From the initial appointment request to discharge and follow-up, identifying and addressing potential blind spots ensures consistent and satisfactory solutions tailored to each patient’s unique situation.

● Streamlined Resolution of Pain Points:

Mapping the patient journey and defining archetypes enables a deeper understanding of patient concerns, particularly identifying which aspects of the service have the most negative impact. Pain points such as waiting times, unclear explanations, lack of empathy, or impersonalized treatments can be simplified and resolved more effectively.

Learn About: Complaint Resolution

● Process Optimization:

A well-defined patient journey optimizes workflow and allows for more efficient handling of all processes. Staff members become better equipped to anticipate and address patient issues promptly, offering alternatives that instill confidence and satisfaction.

● Continuous Improvement:

Implementing a Patient Experience model involves measuring patient experiences through a feedback system . Continuously updating the database with relevant information about patient journeys and their experiences leads to ongoing improvement in response times, customer service processes, and overall service quality .

What is a Patient Persona?

The patient persona represents an imaginary profile that encapsulates potential patients’ needs, goals, illnesses, conditions, emotions, behaviors, and knowledge. 

By creating patient personas, healthcare providers can enhance the accuracy and anticipation of care and diagnosis processes, ultimately improving the experience of individuals seeking healthcare services.

5 Steps to Build Your Own Patient Journey Map

1. define the experience to map:.

Before diving into the Patient Journey Map, it is crucial to determine the specific experience you intend to outline. By establishing your objectives and identifying the type of information you seek to gather and how it will be utilized, you can ensure a more efficient mapping process right from the start.

2. Identify your Ideal Patient:

The majority of data used to construct the customer patient care journey will come directly from patient-clients. Thus, a key step is identifying the patient persona, which can be singular or multiple. You must decide whether the map will encompass various patient profiles or if separate maps will be created for each target patient.

To create the patient persona(s), gather feedback directly from patients and analyze their behaviors and data. Pose questions such as:

• What initially led the patient to seek your services?
• Which competitors did they research?
• How did they discover your website or company?
• What factors differentiated your brand from others? What influenced their decision (or lack thereof) to choose your services?
• What are their expectations when interacting with your company?
• Can they articulate what they appreciate about your company and what frustrates them?
• Have they ever contacted customer service? If so, how was their experience?

Once you have defined the patient persona(s), you can identify the distinct stages of the customer journey when engaging with your company.

3. Divide the Phases of the Customer Journey:

Throughout the customer-patient care journey, patient-clients progress through several discernible stages.

Phase #1: Pre-Visit

● DISCOVERY:

The patient journey initiates with a phase characterized by learning and concern. Patients embark on their healthcare journey upon recognizing a need or developing a concern related to a health issue.

For instance, if an individual experiences symptoms associated with being overweight, they may begin researching options for scheduling an appointment with a medical specialist. At this point, potential patients discover their specific needs and commence the process of investigating suitable solutions. They may turn to the internet, seek recommendations from friends and family, or explore other avenues. During this stage, it is recommended healthcare systems should provide educational support to aid individuals on their journey of understanding.

● CONSIDERATION:

Following their research, patients reach the consideration stage, having discovered your service. At this point, they possess some knowledge about your healthcare facility’s location and offerings, leading them to believe it could meet their needs. However, patients have also explored your competitors and are contemplating multiple options.

During the consideration stage, potential patients meticulously assess the information they come across, including service descriptions, pricing, contact pages, online inquiries, and reviews. They also evaluate the ease of accessing relevant information before scheduling an appointment and the availability of operating hours, among other factors.

Phase #3: Visit

● APPOINTMENT & ENGAGEMENT:

Having gathered sufficient information and progressed through the consideration phase, the patient ultimately chooses your service. This marks their first contact with the health center, which can occur in person, over the phone, via chat, email, or other means of communication.

During this stage, the patient schedules their appointment. The company must streamline the application process and maintain effective and proactive communication. It is crucial for this phase to be completed without complications.

● SERVICE DELIVERY:

Within the visit phase is the service delivery stage, where patients interact with various service providers at the health center. From the moment the patient enters the premises, the company must ensure an exceptional service experience.

Service delivery encompasses multiple micro-moments, necessitating comprehensive attention throughout the entire journey. Every interaction matters, from the reception care and waiting times to the core service itself—meeting the patient’s objective of being evaluated by a doctor or specialist.

Phase #3: After the Visit

● RETENTION:

The Patient journey doesn’t conclude after the initial visit. A crucial third phase occurs post-encounter, where efforts should be dedicated to fostering patient retention and encouraging their return for subsequent visits. Building strategies that monitor the patient experience is essential in designing loyalty programs to ensure patients return for future services.

● RECOMMENDATION:

Part of the post-visit phase involves patient recommendations, which heavily depend on the overall patient journey experience provided by the company. If patients have had a positive service encounter, they are likely to recommend it to others, benefiting your business. 

However, it is important to remember that negative experiences are equally shared, and if patients are dissatisfied, they may spread negative feedback. 

Promptly addressing any negative comments is crucial to resolving issues and preventing unfavorable recommendations.

Phase #4: Identify Touchpoints

An additional vital step in mapping the customer-patient care journey is identifying the various touchpoints between the patient and the healthcare facility. These interactions occur at different stages throughout the patient journey, and understanding these touchpoints aids in developing strategies that facilitate effective communication.

• Seeking information about healthcare centers: discovering the existence of the healthcare provider and the services it offers.

Investigation:

• Reviewing patient-client feedback: researching comments and feedback from other patients about their visit experiences at the health center.
• Exploring promotions: searching for economic benefits such as discounts, promotions, and bundled service packages.

Acquisition :

• Appointment Request: Contact or visit the health center to schedule an appointment.
• Provision of Personal Data: The health center will request personal information to finalize the appointment booking.
• Appointment Confirmation: After providing the required data, the appointment for the agreed date and time is confirmed.
• Patient Reception: The patient arrives at the health center at their scheduled appointment time.
• Waiting Room: The staff guides the patient to the designated waiting area.
• Consultation: The patient’s turn to be attended by the specialist.
• Payment: The process of settling the payment for the service, which may occur at any point during the service phase, depending on the health center’s policies.
• Patient Recommendations: Patients offer positive or negative feedback about the health center and its services.
• Loyalty Program: Incentives such as offers, promotions, discounts, or a points system to encourage future visits.

Recommendation:

• Complaint: If the patient has had a negative experience, they may file a complaint with the health center.
• Online Reviews: Patients share comments or criticisms about the service by posting reviews on the internet.

4. Identify Contact Channels

Patients engage with the health center through various channels throughout the patient journey. These channels, such as the health center itself, can be physical or online, including social media, email, applications, websites, and online forms.

Identifying the most utilized contact channels at each stage of the customer-patient care journey is crucial. This allows for the development of tailored strategies for each channel, meeting patient expectations at each phase.

Working on the patient journey is crucial for healthcare providers to deliver a high-quality experience to patients. By mapping their interactions, providers gain a deeper understanding of their patient personas, allowing them better to comprehend patient needs, desires, and circumstances to provide the desired care.

Patient Journey Map Example 

To better understand what a Patient Journey Map is, we have created this fictitious example using one of the most reputable medical institutions in the healthcare sector, the Massachusetts General Hospital, as a reference.

In this example, we have included some generic touchpoints that are usually the most common in the interaction between a hospital and a patient.

Through this example, it would be possible to visualize the points of interaction between both parties and the perception that patients have of them, which can be positive or negative. This serves as a clear indicator for making adjustments and learning from what has been done well.

The Office of Patient Experience plays a vital role in facilitating initiatives to assess and enhance the quality of care experienced by patients and their families. They are responsible for evaluating each of these touchpoints and ensuring that appropriate actions are taken.

The Mass General Hospital is a benchmark not only in terms of service level but also in the implementation of methodologies and actions that guarantee the satisfaction of their patients. A clear example of this can be seen in the results of their annual HCAHPS survey, where they score above the national average in various aspects.

Willingness to Recommend Hospital Scores below show the percentage of patients who would “definitely recommend” Mass General to their friends and family.

To see the complete study, we invite you to visit their website and learn about it.

More Examples of Patient Journey Maps

Seeking inspiration to craft your own Patient Journey Map? Your search ends here!

Explore a collection of remarkable examples from top-notch brands, unveiling their initiatives that delight customers and foster loyalty.

Get set to revolutionize your own Patient Journey!

Mass General Hospital is renowned for providing exceptional care and taking special care in understanding the perspective of its patients. They achieve this through different tools, such as satisfaction surveys, internal and external feedback, and  HCAHPS surveys .

Mayo Clinic is characterized by its focus on patient satisfaction and its extensive technical deployment to gather user and prospect feedback.

Cleveland Clinic is often ranked among the best hospitals in the United States. This recognition is not only due to its incredible facilities, global expansion, and well-prepared staff but also because of its remarkable focus on the experience they provide to its patients and clients.

Singapore General Hospital is one of the largest and oldest hospitals in Singapore. It has been a major healthcare institution providing a wide range of medical services and treatments since 1821.

Johns Hopkins Medicine has long recognized the significance of a positive patient and family experience during hospitalization, which is why they maintain a specific focus on  patient satisfaction  to achieve an optimal experience.

How can you enhance your Patient Journey Map based on your acquired knowledge?

The insights and recommendations shared above are likely to have sparked ideas about the potential impact of these initiatives across various industries, not just healthcare.

The first crucial step is to embrace a customer-centric approach, keeping their needs and expectations at the forefront. By doing so, the actions you take will have a meaningful impact on your customers and yield multiple benefits for your business.

At QuestionPro, we offer a range of tools and features specifically designed to help you achieve this objective.

QuestionPro SuiteCX is a Customer Journey Mapping Software that simplifies the process of creating your customer journey. 

With a vast selection of templates and the ability to personalize user/buyer personas while incorporating your own data, you can conduct precise visual analyses at every touchpoint throughout your patient journey.

Start delighting your customers today!

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• [Download Free Template] How to create a patient journey map

Patient journey mapping is a process that helps you—as healthcare providers—to visualize the complete experience of your patients who seek and use your care services.  

This includes every single touchpoint (whether online or offline) that a patient encounters in the process of finding a care provider, scheduling an appointment, to having the consultation, and even post-care interactions. 

A good understanding of a patient journey map, and all the pitfalls that the patient can encounter while seeking care, can help you pre-emptively improve your operations to deliver a delightful and consistent patient experience . 

In this article, we’ll dive deeper into various aspects of patient journey mapping, stages of a patient journey, how to create a patient journey map and the benefits you can realize by using the right tools. 

If you’d rather jump to the steps to create a patient journey map, you can do that as well. Go to:

What is patient journey mapping? 

Patient journey mapping is the process of visualizing the connection between various interactions and touchpoints patients have during their relationship with a healthcare practice.  

Mapping healthcare journeys helps providers understand:  

• What is the patient going through? 
• What are the patient’s primary concerns? 
• Is the patient able to cope with their diagnosis? 
• Is information regarding the patient’s diagnosis easily accessible? 
• Is the patient able to reach you to book a consultation easily? 
• Is the patient satisfied with the care they’re receiving?   

With this knowledge, providers can spot inconsistencies, find operational bottlenecks, and devise strategies to improve them.

Healthcare providers need to be obsessed with patient journey. The journey begins way before a patient visits the healthcare facility to interact with the provider, and it ends a lot after their treatment. A good patient journey map integrates various virtual and physical touchpoints. Uzodinma Umeh, Chief Medical Officer, Zuri Health

Before we get into the steps to create a journey map, let’s look at the stages a patient goes through before any consultation. 

5 crucial stages of a patient journey 

The 5 stages common in most of the patient journeys are: 

1. Awareness  

The patient recognizes a need for care at this point and starts looking for providers.  

The patient evaluates their symptoms, does research, thinks about potential medical issues that might need treatment, and may even interact with message boards. 

It begins the moment when the patient experiences a symptom. Most of the time, they go online to find a treatment or a solution to their pain. Healthcare providers need to use this opportunity to position themselves virtually by offering a solution, allowing them to research treatments, and book appointments with ease. Uzodinma Umeh, Chief Medical Officer, Zuri Health

Online searches, review websites, advertising initiatives, networking, and friends/family referrals are a few examples of how patients find out about healthcare services.   

However, patients may face certain challenges at this stage. Such as: 

• Lack of information about their condition
• Inability to find a provider nearby who they think could help
• Feelings of fear and anxiety regarding their concerns

The key to reaching patients at this stage lies in your online presence. You can help your patients by: 

• Publishing posts about the treatments you provide
• Publishing educational blogs posts on your website about the conditions and how to manage them 
• Getting yourself listed on GoogleMyBusiness 

It goes without saying, you should monitor the results of your efforts by using website analytics tools and collect patient feedback through surveys . 

Baptist Health South Florida has nailed this stage by introducing an online triage tool on their website. It asks patients a series of questions around their symptoms and accordingly directs them to e-visit, ER, urgent care, or physician’s office.  

2. Consideration  

The patient analyzes their options to see if your healthcare facility can satisfy their needs. Referrals, coverage and perks, suggestions, accessibility, and ratings and reviews are all things that patients take into account during this stage.   

When it comes to healthcare reviews and recommendations, 83% of patients trust their friends and family, while 62% trust reviews online from people they haven’t even met. This is exactly why healthcare businesses need to collect feedback and reviews physically and virtually to bring in patients from referrals. Chantelle Fraser, Vice President – Africa Sales, LeadSquared

Patients frequently interact with your website and social media accounts and call or email you. Additionally, if you are hard to get in touch with, they will go on to the next applicant. 

At this point, you can find out more about your potential patient, specifically about their preferred method of communication, and make sure you provide it. For instance, if a patient prefers communicating via email, you should reach them on this platform.  

Tools you can use to better connect with patients at this stage are:  

• Email marketing solutions that help automate emails that reach the right person at the right time,  
• Tools that help you segment visitors and create targeted ad campaigns,
• Chatbots help you reach patients with concerns in real time and get a deeper understanding of their concerns.   

3. Acquisition 

Direct patient contact with your organization is the first indicator of the acquisition stage.  

As part of the booking and new patient acquisition process, you will interact with patients via phone calls, the user portal, texts, and emails.   

The patient generally arranges a meeting and visits a doctor or takes a telehealth consultation for a preliminary checkup.  

Common challenges patients face at this stage are: 

• Lack of access to appointment booking portals and websites 
• Inability to reach providers at odd hours (e.g., 2 AM in the morning) 
• No-shows because of no reminder communications 
• Lengthy wait times at hospitals
• Extensive paperwork before consultation 

At this point, providers can use software to improve communications with patients. Such as: 

• Appointment scheduling solutions that help providers and patients find convenient timings for consultations.  
• Email automation tools that send notifications to patients before appointments to reduce the chance of no-shows.  
• Patient intake tools help them fill out forms and answer pertinent questions before they visit the facility.   

4. Service  

The stage of service delivery has to do with the medical care you administer to your patients. The medical consultation itself, check-in and check-out, registration and discharge, and payment are all components of this step.   

The type of service you provide will determine the patient’s satisfaction from your practice. 

Common challenges providers face at this stage are: 

• Difficulty locating comprehensive patient information across different touchpoints at the facility.   
• Administering the necessary treatment and meeting patient expectations.  
• In cases where the patient opts for home care, the inability to monitor and track their progress poses a significant challenge to the treatment process.  

The bulk of patient issues is rarely solved in the medical office. The patient’s experience persists into the treatment phase after assessment and any related procedures. They might receive an in-patient or out-patient plan or receive medicine and get discharged.   

At this point, you want to go beyond just calling to see how the patient is doing with their medicine and use the knowledge you have collected about them to deliver personalized care.  

Tools that can help providers at this stage are: 

• Billing and payment software that enables the speedy processing of invoices and collection of money through the patient or insurer.  
• A tool that unifies patient data and offers visual reports on a healthcare dashboard that is easy to use and accurate in its data collection and analysis.  
• A communication tool that allows patients to contact their healthcare provider whenever necessary and update their status as it changes.  
• Feedback collection tools like patient satisfaction surveys and questionnaires to gather information and testimonials for future use.   

5. Loyalty (on-going care) 

The best way to retain and nurture patients over time is to carry out post-visit follow-ups and keep track of their recovery.  

The patient journey also includes post-operation and post-visit care for your patients. You can use technology to take care of your patients by sending visit reminders, notify them of when their next vaccination is due, schedule house calls and much more. Collecting feedback and implementing it on a macro-level is another important post-visit step. Uzodinma Umeh, Chief Medical Officer, Zuri Health

Most healthcare providers often overlook this phase of the patient’s journey. Regardless of whether a patient’s treatment goes well or not, it is still necessary for the provider to follow up with them thereafter.   

Challenges hospitals face at this stage are:   

• Difficulty keeping in touch with patients as they recover or face issues during the aftercare process 
• Measuring patient satisfaction and their response to the treatment  
• Offering the necessary information to speed up recovery and keep patients aware of different reactions they may have when receiving care 

Providers must keep an eye on the patient’s aftercare and monitor their interactions with them. This phase is crucial because it guarantees the patient’s long-term welfare and lowers the likelihood of readmission.  

Tools that can help at this stage are:  

• Tools that track and monitor the patient’s progress, like a healthcare smartwatch or diagnosis tools 
• CRMs that help send notifications to patients to update them on recurring appointments and consultations 

Note that these stages may differ from one patient to another. This is why it is vital to create patient journey maps to understand gaps in your service and meet patient needs.

How to create a patient journey map

Journey maps are mainly of the following four types: 

• Current state : Useful for illustrating what your patients do, think, and feel as they interact with your practice with your present system. 
• Future state : Useful for illustrating your patient experiences with your practice in the future (usually goes well with your plans to implement a new system/technology). 
• Day in the life : This journey map illustrates what your patients do, think, and feel with or without your product or service. 
• Service blueprint : It is generally a roadmap with action items and support processes. 

Creating all four types of journey maps may not be required for your practice, especially when your goal is to understand your current standing. In the following section, we’ll learn how to create a patient journey map using the current state journey map. 

Create a patient journey map in 7 simple steps

FullStory has come up with a simple and easy-to-remember technique for creating journey maps. It includes 7 D’s, which are as follows: 

• Define: business goals 
• Describe: personas or customer attributes 
• Determine: touchpoints 
• Design: the journey (lay out the steps a customer takes while buying a product/service from your brand) 
• Designate: tag milestones, motivations, frustrations 
• Decide: Flag events that need action 
• Deploy: people, process, and technology to act upon 6 

We’ll apply this technique with some modifications to create journey maps for the healthcare sector. 

Step 1: Define your goals  

Why do you want to create a journey map?  

You might be facing certain challenges for which mapping a patient journey seems like a good starting point. For example,  

• To reduce no-shows 
• To increase retention 
• To increase patients from referral sources 
• To increase intake, and so on. 

Answering the “ why ” part will give you clarity on the purpose of creating a patient journey map and help you sketch the journey in a definitive direction. 

Step 2: Define your patient attributes  

You must be getting leads from your outreach, marketing, or referral programs. You’ll need to know whether you’re attracting the right patients to whom you can serve.  

Mapping patient attributes with the services you provide will help you tune your marketing, outreach, and referral programs. Lay out every single bit of information you have about your patients. Such as: 

• Demographic info : location, age, gender, ethnicity, education, employment, etc. 
• Engagement : appointment history, communication channels, feedback/satisfaction score, etc. 
• Health goals : challenges, conditions, treatment history, barriers to getting care, etc. 

Create an ideal patient profile based on the information you have about your patients. You can also use your CRM data to gain insights into how they came to know about you, their interactions with your facility, and more. 

Explore LeadSquared’s Healthcare CRM

Purpose-built to increase patient intake, engagement, and retention.

Note: Create separate journey maps for each patient profile you create. It will help you analyze patient experiences more deeply.   

Step 3: Determine touchpoints  

Touchpoints are the ways in which patients interact with your practice. They can be online like scheduling apps, websites, ads, etc., or offline interactions like phone calls, OPD walk-ins, etc. 

Some of the common touchpoints in the healthcare patient journey are: 

• Appointment scheduling : WhatsApp, text messaging, phone calls, patient portals, mhealth platforms, provider’s healthcare apps, etc. 
• Pre-check-in : appointment confirmations and reminders on email, WhatsApp, app notifications, text messages, phone calls 
• Check-in and during care : intake process (digital or physical), video consultation, telehealth, insurance verification, etc. 
• Post-visit : diagnosis notes, follow-up consultation scheduling, reminders, feedback via email, WhatsApp, app notifications, and text messages.  

Depending on the nature of your practice the touchpoints will vary. The idea is to note down all the possible sources of interactions with your patients. 

Step 4: Design a visual journey  

Once you’ve identified the touchpoints, it’s time to create a visual journey that your team can easily understand. 

You can plot: 

• Journey stages 
• Customer interactions and actions 
• Your patient’s needs and pains 
• Touchpoints 
• Their sentiments during those interactions 

Concurrently, mark the areas of improvement and who can own them.  

Also, keep your ideal patient profile and goal cards side by side to ensure you’re moving in the right direction. 

You can bookmark this page or download an editable PDF patient journey mapping template: 

Step 5: Designate milestones, motivations, frustrations  

This step of a patient journey highlights various kinds of friction a patient may encounter while contacting you for your product/service. 

For example, patients may not book an appointment because of one of the following reasons: 

• UI issues – If the interface through which they’re trying to schedule a consultation is not working at that time, patients may not be able to book an appointment. 
• Cognitive load – If the UI (User Interface) is not intuitive enough or too complex to understand, or the patients find it difficult to navigate to the services they see, they may drop off.  
• Emotional friction – What patients are feeling at that moment will determine their action on opting for your services. 

This exercise helps the admin understand what to fix and how to fix it. 

Step 6: Decide on the actions you need to take  

Until step 5, the journey was looked upon through the patient’s lens. Now that there’s better clarity on patient experiences and hesitations, it’s time to look at the back-office tasks that can be improved. 

It involves identifying the areas of improvement and how that can be done.  

Step 7: Deploy people, process, and technology to achieve your goals  

In this final step of creating a patient journey map, you assign roles, delegate tasks, and procure tools to act on the areas of improvement identified. 

Best practices to follow while creating a patient journey map 

When you’re just starting off, learn the journey mapping fundamentals and research existing journey maps for healthcare. 

Here are some helpful resources: 

• Neilsen Norman Group’s Journey Mapping 101  
• Atlassian’s team playbook on Customer Journey Mapping  
• Understanding Patient Journey webinar by LeadSquared 

Once you’ve understood the basics, follow these best practices to create a patient journey map. 

• Set clear goals . Define what you wish to achieve from your patient journey map. 
• Do not mix all the information in one map. Create different journey maps for different patient profiles . 
• Involve different stakeholders. Do not restrict it to one team or department for sharing their inputs. 
• Keep it simple . You may not need fancy tools or lots of graphics and colors; a simple spreadsheet can do the work. 
• Make it an iterative process. You may not have perfect journey mapping from the very first time. Take feedback, act on it, and improve all the way up.  

Benefits you can realize by mapping patient journeys correctly 

The goal of patient journey mapping is to improve patient experience across all touchpoints and derive better outcomes. In a nutshell, 

Investing in patient experience essentially takes away the cost of advertising and acquisition. It also boosts referrals, recommendations, and NPS at the same time. Uzodinma Umeh, Chief Medical Officer, Zuri Health

Here’s the drill-down of benefits you get by mapping patient journeys efficiently. 

1. Spot inefficiencies

Every time a patient expresses frustration or uncertainty about her next steps toward recovery, it’s an obvious sign that there are friction spots or unmet gaps in the healthcare system. A patient journey map can effectively battle such challenges and create a clear path for a patient’s progress.   

2. Improve communication

By mapping patient journeys providers can understand the drop-offs occurring because of communication gaps and take measures to rectify their strategies. 

3. Increase profitability 

Net margins for hospitals that provide “excellent” patient care are typically 50% higher than those for hospitals that offer “average” patient care. 

With a patient journey map, practitioners can identify the scope of improvement in operations and help their staff focus more on interacting with patients and caregivers. 

4. Reduce wait time for patients 

The average ER wait time in America is 145 minutes (even higher in some states; e.g., 228 minutes in Maryland, 195 minutes in Delaware, 176 minutes in Arizona, and so on). In India and other countries as well, it may take hours to get emergency admissions . These delays happen due to one or more of the following reasons: 

• Examination of patient 
• Time taken for consultation 
• Emergency investigations or imagining 
• Unavailability of vehicles for transport 
• Lengthy admission procedures 

By knowing what exactly is causing the delays and taking steps to correct them, providers can reduce waiting times for patients to a great extent. 

5. Improve patient outcomes 

A healthcare journey map can help identify the touchpoints where essential and relevant information can be shared with patients. Educating patients and keeping them abreast of their illnesses can lower their anxiety and bring better outcomes 

Tools to create a patient journey map 

As a matter of fact, you can use any UI design tool (e.g., Figma , Sketch , FullStory , etc.) to create a journey map.  

However, there are dedicated tools to create journey maps with ready-to-use templates to make your work faster and easier. Some of which are: 

• Creately  
• TheyDo  
• Custellence  
• Miro  
• LeadSquared  

On a final note, you’ll be able to map your patient’s journey effectively when you’ve ample information about their interactions with your practice.  

Healthcare CRM software is the best tool to collect and manage patient interaction data and make them accessible for various purposes like creating a journey map. 

If you’re looking for one such tool, 

A patient journey is the series of steps patients take to book an appointment, consult a physician, and pursue treatment with your practice. It involves both online and physical interactions.

Patient journey mapping helps you understand your customers’ experiences while interacting with your practice. With this exercise, you get to know their pain points, identify opportunities for improvement, and take measures to improve your services.

Padma is a Content Writer at Leadsquared. She enjoys reading and writing about various financial and educational topics. You can connect with her on LinkedIn or write to her at [email protected].

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Home > Resources > Articles > Bridging the Gaps in Complex Patient Journeys by Enriching Data

Bridging the Gaps in Complex Patient Journeys by Enriching Data

September 1, 2021 | 711 views

• Finding and understanding potential patients, or tracking patients enrolled on a treatment, but subsequently dropped, can be a challenge as well as understanding comorbidities or concomitant therapies.
• Targeting HCPs is difficult as prescriber volume across datasets can be unclear and can limit the ability to prioritize healthcare professionals by patient mix, practice, specialty, and treatment dynamics.
•  Aligning pricing, contracting and access, and determining incentives and return on investment (ROI)promotional metrics represent challenges.
• When in the patient journey is treatment prescribed?
• Who is prescribing it?
• Which tests, physician appointments, or medical events precede diagnosis?
• How long are patients typically adherent and what typically complicates adherence or causes a stop?
• Is the product being used as part of a combination therapy?
• What triggers the transition to a new line of therapy?
• What impact do copay assistance, nurse educator services, and other value-added programs have on the patient and physician experience?
• When pharmaceutical companies can combine the answers to these questions, they gain clarity into the critical milestones that define the patient experience.

Grupa HASCO

Hasco-Lek SA is a leading manufacturer of medicines, dietary supplements and medical products manufactured in two modern factories in the capital of Lower Silesia and in the suburbs of Siechnice. PPF Hasco-Lek SA has been operating on the Polish market since 1984, combining over 30 years of experience with state-of-the-art technology.

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Pharma Tech

Emergence of crm in pharmaceutical: types & features.

Article | July 20, 2022

Introduction In the past, the pharmaceutical industry was solely concerned with the development of new drugs and medical devices, along with improving their clinical efficacy, safety, usability, and superiority over alternatives. However, the rapid transformation of the life science industry from product-based to customer-based has presented pharmaceutical companies with various obstacles, driving them to enhance their customer relationship management (CRM). Due to the proliferation of the medical and life-science industries, customer-focused solutions are becoming increasingly crucial for pharmaceutical enterprises to remain afloat. With the increasing complexity of the industry, the emergence of new business models, and the introduction of cutting-edge technologies, the pharmaceutical industry is under intense pressure to deliver superior products and services to stay on edge. In addition, the Internet has made it possible for new technologies to spread rapidly, giving consumers greater freedom to select products and services that match their individual requirements. Thus, rather than emphasizing product differentiation, drug and medical aid manufacturing companies are focusing on embracing innovative customer-centric solutions, such as pharma CRM software, to assist them in analyzing and prioritizing the wants and needs of consumers. Pharma CRM Solution Types: Roads from Product to Customer Experience As the world turns toward the dictum "the customer is king," superior customer service is no longer a luxury. In addition, as a result of increased digitalization, life science organizations are dealing with vast quantities of data. A study shows that the pharmaceutical industry generates twice as much data every five months. This is because of the increased need to capture and store a plethora of information, such as patient data and insights, HCP interests, prescription writing patterns, sensitive patient program information, and segmentation analysis, among others. CRMs assist pharmaceutical companies in accurately collecting and tracking customer information, decreasing marketing costs, increasing sales, improving customer support, and organizing data collection and storage. With all-time high competitiveness in the pharmaceutical industry, every drug and medical equipment provider is investing huge sums of money to explore new audiences before anyone else in order to get a competitive edge. In response to this, pharma CRM solutions are gaining tremendous traction across the life science industry for building solid relationships with High Lifetime Value (LTV)customers. There are different types of pharma CRM solutions available for pharma organizations to collect, store, and analyze data related to customers. Let’s look at a few: Operational Pharma CRM Operational pharma CRM solutions are ideal for assisting teams in gaining a deeper understanding of customers through the acquisition and management of customer relationships and connections, as well as improving the company's perspective on customers and sales. These systems aid pharmaceutical companies with lead generation and contact conversion. By streamlining numerous business activities such as marketing, sales, customer service, and others, they assist in creating the solid service foundation needed to retain customers and improve customer relationships. Operational pharma CRM solutions capture customer details and use them to automate sales, marketing, and other operations for providing services throughout the customer lifecycle. In addition, the system tracks and stores data related to employees, customers, and leads using a centralized platform to support existing and potential customers in an efficient manner. Analytical Pharma CRM With the increasing significance of understanding the needs of patients and customers, analytical pharma CRM systems are gaining massive popularity among mid-sized and large pharmaceutical enterprises. It is increasingly being used to accumulate and analyze large amounts of data, including sales, marketing, and financial data, and filter this data into trends and insights. Throughout the pharmaceutical industry, analytical pharma CRM solutions are making deeper inroads as they aid in the development of strategies to generate new leads, improve customer satisfaction, boost customer retention, and increase sales and marketing department efficiency. Collaborative Pharma CRM Collaborative pharma CRM enables pharmaceutical organizations to create and improve communication between various company divisions involved in customer service. These departments include marketing, sales, customer service, technical support, external customers, vendors, and distributors. The idea of collaboration in the workforce is not new, but it is one that is constantly being redefined in light of new technological innovations. It assists life-science spaces in automating their back-office operations, customer interactions, and business management, resulting in enhanced transparency among the organization’s teams. As the teams often operate independently, particularly in large pharma enterprises, the adoption of collaborative pharma CRM solutions can aid them in breaking down several communication silos to address fast-changing customer needs and effectively manage customer relationships. Pharmaceutical Customer Relationship Management Solutions: The Features List Constantly rising business expenditures and budgets, along with the emergence of new challenges and issues related to generating revenue, are compelling medical product developers to embrace modern solutions, such as pharma CRM software, for increasing sales and improving customer retention. As complexity in the pharma industry increases and competition in fields such as immunology and oncology continues to intensify, enhancing customer experiences is becoming even more important. With the "one size fits all" approach no longer delivering results, the implementation of robust and resilient tech systems for understanding customer needs and supervising medical operations is becoming necessary for pharmaceutical companies. While extensively focusing on the clinical value of the medication or medical equipment, firms operating in the pharmaceutical sector often overlook a prominent driver for success: the customer experience. By addressing critical pain points across patients’ and prescribers’ journeys, pharma CRM technology assists these companies in increasing customer satisfaction, improving adherence, and boosting revenues. Apart from this, here are some features of pharma CRM that are vital for organizations’ success Provide Integrated Customer Database Workflow Automation Management of Customers’ Accounts Cycle Activity Planning Customization Real-time data and CRM analytics Sales forecasting Why Are Life Science Companies Leveraging Pharma CRM Solutions? Today, the company's success is predominantly determined by its relationship management with customers and potential leads. With the fast-changing life science landscape and increased competitiveness, the need for pharmaceutical firms to manage customer interactions and improve customer engagement is surfacing at a robust pace to build a better brand reputation. It is crucial in the pharmaceutical industry to acquire patients' trust and maintain a stellar reputation for generating revenue and sustaining in a highly regulated environment. Using customer relationship management solutions is an excellent strategy for accomplishing this objective. According to a survey, a CRM system can enhance customer retention rates by 5%. Depending on the industry, this can then result in a profit gain ranging from 25% to 85%. (Source – PharmaVoice) Let’s see some of the reasons why pharma companies are emphasizing embracing customer relationship management solutions: Creates a Strong Connection with Customers Today, it is imperative for pharmaceutical firms to have a better understanding of their customers and their needs. Deploying pharma CRM software assists these companies in accumulating critical data and insights related to customer and patient behavior to comprehend the past, present, and future of their clients’ relationship with the organization. This aids them in creating a stronger connection with their customers. Promotes Efficiency in the Organization Automated procedures are designed to increase efficiency and enhance productivity without compromising operational accuracy. The use of CRM in pharma companies enables the automation of various consumer-facing business operations such as campaign management, marketing, customer service, and sales, among others. This assists medication manufacturers in enhancing the efficiency of their tasks. These solutions also aid in optimizing communication between the different departments, which in turn results in boosting the productivity of the business as a whole. Enhances Business Accessibility from Anywhere Remote access from anywhere is emerging as one of the essential modern needs for businesses today. For example, pharmaceutical CRM executives need to visit hospitals, chemists, warehouse staff, doctors, and stockists for sales meetings and operations. Cloud pharma CRM systems enable these representatives to access clients' and customers' vital information on the go, thus enhancing business accessibility. Improves Customer Service With the rising importance of improving customer service across the life science industry, it is becoming essential for pharma companies to respond to customer queries within the shortest possible time. Deployment of pharma CRM solutions can provide them with easy access to information stored in the database for resolving the query without causing any inconvenience to the customer or client, thereby offering better customer service. From Lead to Customer: Tracks Complete Journey Based on the current industry conditions and purchasing patterns of customers, the need to identify targeted audiences and potential leads is imperative. To get a complete picture of a customer's purchasing behavior, it is crucial for pharmaceutical firms to follow a customer from their initial interest to being a customer. Pharma CRM software enables these companies to track the complete journey of the customer, starting from being a prospective lead to a lifetime paying client. It can also assist in creating new strategies for future objectives. What Says the Future? With the emergence of new regulations, laws, and policies, the procedures and processes widely employed by pharmaceutical organizations have become more rigorous and rigid in the absence of technological assistance. In addition, intense market competition and rising company expenditures are pushing life-science firms to embrace innovative solutions to boost revenue generation, such as pharma CRM software. As the implementation of customer relationship management solutions assists pharmaceutical businesses in countering these obstacles along with optimizing processes, including customer retention, segmentation, behavior analysis, and many others, these solutions are expected to take center stage in the pharma world over the coming years. FAQ What is Pharma Customer Relationship Management Software? Pharma CRM is a tool that enables life science companies to gain sales and marketing efficiency, complete sales campaigns, adhere to compliance requirements, and efficiently monitor customer relationships. How Does CRM work for Pharma Companies? CRM is used to reduce the workload of pharma companies. Here are the steps showcasing how CRM for the pharmaceutical industry works. Capture the leads Optimize lead management Personalize the pitch Generate more customer value Personalize cross-sell and upsell Help customers help themselves What are the 3 main elements of pharma CRM software? These are the three key elements of pharma CRM solutions. Component #1 – Marketing Automation. Component #2 – Sales Force Automation. Component #3 – Customer Service Solutions.

Pharma CRM: Fostering Customer Engagement in the Life Science Industry

Article | July 13, 2022

Introduction The pharmaceutical industry is becoming more competitive day-by-day with the proliferation of novel technologies and the increasing introduction of new drug-developing companies. As a result, a significant number of pharmaceutical companies are facing difficulties securing solid financial returns. This has left no other choice for life science organizations than to move to digital-AI-based customer-centric systems to stand out. In addition, unexpected circumstances, such as the lack of in-person interaction with customers, have compelled pharma businesses to invest in cutting-edge, conversion-oriented CRM tools. As CRM in pharma provides a centralized platform for managing all the pharmaceutical data and monitoring relationships with customers, it is increasingly being sought in the industry. This strategy is getting a lot of attention in the pharmaceutical industry as a way to build and keep customer loyalty while moving toward supremacy in its respective segment. How Are CRM Solutions Assisting Pharma Companies to Become Customer-Centric? Several pharmaceutical organizations are looking for new strategies to stay competitive and improve their financial returns. The emergence of the pharma CRM trend has presented pharma businesses with a lucrative opportunity to develop new market approaches by transforming into customer-centric organizations. With real-time reports and analytics, any-time data access, and data availability in one place, novel CRM solutions are assisting pharma businesses in developing solid relationships with pharmacies, health care providers, distributors, suppliers, and even end patients. As the trend of improved customer experience and customer relationships spreads throughout the industry, many companies aiming to stay ahead are leveraging pharma CRM solutions to become more customer-centric and improve their financial returns. What are the key pharma CRM features that assist organizations to become customer centric? Let’s find out. Optimizes Products and Services As more and more businesses enter the pharmaceutical market, existing ones are looking for new ways to cut costs without compromising quality in order to survive and thrive in the respective domain. CRM software assists businesses in optimizing their products and services by creating detailed profiles of patients and potential customers, thereby declining costs and adding customer centricity. This also enables them to provide more tailored drugs, faster treatment delivery, and reduce wastage. Enables Integration with Customer Database It is important for drug manufacturing companies to maintain customer databases as they contain crucial information related to customers, such as customer buying behavior, purchasing patterns, usability, and others. Implementing cloud pharma CRM software enables integration with customer data, providing centralized access to organizations and assisting them to become customer-centric. Redefines the Customer Journey Customers and technologies are constantly evolving, and so are customer expectations. Hence, it is becoming crucial for pharma companies to track customers' journeys and analyze if the customer is in the sales cycle. Pharma CRM software assists these firms in determining whether customers are dissatisfied or are interested in an upsell, thereby making them customer-centric and increasing their revenue. Engages Customers in the Marketing Process Engaging customers within their sales and marketing strategies is of great significance for medical aid-providing enterprises to increase their ROI. As CRM for pharma helps in collecting valuable insights on what works and what does not, it assists these firms in constructing innovative marketing and sales campaigns and strategies as per customers’ interests and needs. This results in engaging customers in the marketing process. The Final Word In an intense competitive environment, it is critical for pharmaceutical organizations to engage the customers and build a better brand reputation to improve sales and ROI. As pharma CRM solutions helps in developing customer-centric services by allowing optimization of processes such as production, marketing, and sales, these solutions are ex

How long will the world wait for the next pandemic of antimicrobial resistance before we act?

Article | August 9, 2022

Antimicrobial resistance (AMR) has become an increasingly serious global health problem in recent years. World Health Organization (WHO) estimates that more than 700,000 people die each year due to drug-resistant infections, and the number is expected to increase in the coming years. How does antimicrobial resistance emerge? Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines. It makes infections harder to treat and increases the risk of disease, severe illness, and death. When we use antibiotics, some bacteria die, but resistant bacteria can survive and even multiply. The overuse of antibiotics and substandard antibiotics make resistant bacteria more common. So, the more we use antibiotics, the more chances bacteria have to become resistant to them. The rise in AMR is caused by multiple factors including the misuse and overuse of antibiotics by humans as well as in livestock and agriculture. Although these are the main drivers in the development of drug-resistant pathogens, the emergence of substandard and falsified antibiotics is another lesser-known, huge contributory factor. Even though AMR is a leading cause of death around the world, it is tracked most closely in clinical high-income settings and developed countries. Unfortunately, this is not the case in low and middle-income countries, where the highest burden is in low-resource settings and low-and middle-income countries (LMICs). These countries are disproportionately affected, in part due to the high burden of communicable diseases. Consequences to human health of AMR AMR poses significant risks to human health, resulting in prolonged and more severe infections, extended hospitalizations, and increased healthcare expenses. It can also lead to an increased risk of death, as an infection may become untreatable. Additionally, it can reduce the effectiveness of medicines and treatments, making it more difficult to manage existing medical conditions. It is even more concerning that it can lead to the emergence of new, more dangerous strains of bacteria, viruses, and other microbes. This would mean medical procedures, such as surgery, including caesarean sections or hip replacements, cancer chemotherapy, and organ transplantation, will become riskier. Counterfeit medicines and antibiotics: Antibiotics are the most counterfeited medicines in the world, as they account for 28% of global counterfeit medicines. Substandard and falsified antibiotics are medicines that do not meet the quality standards set by regulatory authorities. Counterfeit antibiotics are estimated at 5% of the global antibiotic market. These medicines are often of inferior quality or contain incorrect ingredients or incorrect amounts of active ingredients. They may also contain toxic contaminants or be expired, posing serious consequences for patients. Sadly, counterfeit antibiotics are mostly found in LMICs due to a lack of regulation and enforcement, as well as a lack of access to quality healthcare. In many of these countries, the demand for antibiotics is higher than the supply, and counterfeit antibiotics are seen as a cheaper and more accessible alternative. Furthermore, there is a lack of awareness around the dangers of taking counterfeit antibiotics, and there is a lack of resources for health authorities to test for the authenticity of these medicines. Why are antibiotics so rife for counterfeit drugs? Counterfeiters of pharmaceuticals succeed in large part by exploiting weaknesses in supply chains, which are often fragmented with poor regulatory frameworks. Antibiotics are often counterfeited because they are in high demand and can be sold for a large profit. To combat the problem of substandard and falsified antibiotics, governments must take a multi-pronged approach. This should encompass enacting laws and regulations to ensure the quality and safety of medicines, conducting surveillance for detecting and removing substandard and falsified products from the market, as well as providing training and education to healthcare professionals and patients regarding the responsible use of antibiotics. In addition, governments must work to strengthen the pharmaceutical supply chain. This includes increasing the transparency of the supply chain, improving the quality control systems, and introducing traceability systems to track the movement of medicines from the manufacturer to the patient. Medical investment in low and middle-income countries Another neglected aspect by international NGOs and governments is investment in building local laboratory capacity in LMICs to combat antimicrobial resistance. Localized laboratory facilities can help identify, track, and prevent the spread of antimicrobial-resistant infections, as well as provide early warnings of emerging drug-resistant strains. Localized microbiology, surveillance, and quality control laboratories can also play an important role in developing new treatments and interventions for combating antimicrobial resistance. In addition, having localized laboratory capacity can provide more accurate standardized data on the prevalence of drug-resistant infections, which can help inform policy decisions and public health interventions. Affordable medicines Finally, governments must work to increase access to high-quality, affordable medicines. This includes improving the availability of generic medicines, which are typically cheaper alternatives to brand-name drugs. They also need to increase access to newer, more effective antibiotics.

4 Tech Trends That Will Shape Pharma in the Coming Years

Article | May 25, 2021

Technological innovations disrupt many industries, but the speeds of their adoption in the pharma industry have become more rampant than ever. A report from global market advisory firm ABI Research predicts that by 2030, the pharma industry will have spent over $4.5 billion on digital transformation. This is due to many things, from the need to optimize production lines to patent protection. A decade from the forecasted market peak there have already been many applications of these rising tech trends. So let’s have a look at some of them: Digital monitoring system Pharma businesses need to comply with certain regulatory requirements before their drugs can be sold on the consumer market. For example, they need to be stored at a certain temperature. The state of the drugs manufactured and used during clinical trials also needs to be monitored. Fortunately, digital monitoring systems created by companies like Aptar Pharma, Primex, and Monnit, have made it easier to provide the reports regulatory boards such as the Food and Drug Administration and Central require. Aptar Pharma, for instance, offers sensors that can monitor and record the patients’ adherence level during ophthalmic clinical trials. Meanwhile, Monnit’s freezer monitoring solution provides data logs that can be filed as proof of compliance. It doesn’t matter what kind of pharma data you need — there will be a digital monitoring system that can help you collect it. Extended reality Extended reality (XR) is used to describe all real-like virtual environments that are generated by computer programs. The two most common types of XR are augmented reality (AR), where digital graphics are overlaid onto the real world, and virtual reality (VR) where the user is “transported” to a digital world through headsets. To create realistic projections, VR and AR technologies are built with complex and densely packed electrical PCB designs. From wiring the schematic to comparing physical validation rules, all of this is carefully done to ensure that the technology has all the 3D features it needs. Pharma has many uses for this kind of technology. For example, one of Augray’s solutions is to allow researchers to better visualize human models using XR. XR can also be used in lab and manufacturing training. Before letting people train onsite, XR solution providers like SoftCover VR and Labrodex Studios can create simulations that let them familiarize themselves with the equipment virtually. This is very important in the pharma industry, as one error can easily contaminate the drugs. Artificial intelligence Whether it’s for drug discovery research or clinical trials, artificial intelligence (AI) can help accelerate the process. AI is a technology that “learns.” AI programs, after they’re made, are immediately trained to detect patterns and features in the data to help collect insights. British startup Pangaea Data helps global pharma companies identify patient cohorts and trials using AI algorithms. AI can also be trained to perform mundane tasks more efficiently, like arrange clinical data for researchers or gather studies. An AI program called Atomwise does this by analyzing thousands of existing medicines and picking out the ones that can be repurposed to treat diseases it wasn’t initially made for. This was even the AI that identified two drugs that could mitigate Ebola’s effects in 2015, saving multiple lives. In the future, AI can be taught more things that will allow them to aid medical research. Additive manufacturing Additive manufacturing, commonly known as 3D printing, is an industrial production process that lets businesses create 3D products using successive layers of a specific material. Since 3D printers will literally print any object with the right blueprints, additive manufacturing has been a big help in the mass production of drugs. However, researchers are now finding more uses for additive manufacturing — one of which is in the field of precision medicine. Precision medicine takes into account the patient’s lifestyle, history record, and even genetics. Eventually, they're given medicine that’s specially tailored for their body. Since blueprints can easily be edited, combining drugs can be done faster and with more accuracy. Of course, additive manufacturing’s application in this field is still at its testing phases, but researchers are hopeful about the results. New discoveries are made in the pharma industry thanks to technology, and more will continue to do so as long as breakthroughs are made. Businesses should always be updated on these emerging trends, lest they want to be left behind by the competition.

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PHARMA TECH

Shl medical partners with steripack group to set up final assembly service.

PR Newswire | January 25, 2024

SHL Medical, a world-leading solutions provider of advanced drug delivery systems and SteriPack Group, renowned global supplier of secondary packing and final assembly services to the pharmaceutical industry, enter a non-exclusive strategic partnership. Together, they aim to establish a pre-validated final assembly service at the SteriPack facility in Poland, enhancing the overall flexibility of supply chain strategies for their customers. In addition to SHL Medical's existing final assembly, labeling, and packaging¬ services in the United States, this collaboration extends high-quality CMO options to Europe. Markus Puusepp, SHL Medical's Chief Growth Officer, expressed enthusiasm about the partnership, stating "This partnership is a significant addition to the Molly platform value proposition. We share common values with SteriPack, from focus on the customer to a commitment to quality, making the decision to collaborate straightforward." Recognizing the importance of flexibility and time-to-market, especially in clinical production, the partnership with SteriPack will offer SHL Medical's customers highly flexible and personalized final assembly and packaging solutions. This is particularly beneficial for small batch handling in clinical supply and niche markets like rare diseases. Emphasizing the comprehensive capabilities of the Molly platform, SHL Medical aims to deliver right-sized solutions that ensure improved service, faster timelines, and a more streamlined supply chain for its diverse customer base. John Ward, SteriPack Group's VP Pharmaceutical Solutions commented "SteriPack Group looks forward to supporting SHL Medical and their customers in providing quality and flexible solutions to a fast- moving market. With an emphasis on creating service solutions designed around specific customer requirements, this partnership will make the process of working with the Molly platform an easy decision." About SHL Medical As a world-leading solutions provider of advanced drug delivery systems, SHL Medical is the partner of choice for many leading pharma and biotech companies. Driven by its company purpose – Enabling Patients' Independence – SHL Medical offers patient-centric solutions for the design, development, and manufacturing of autoinjectors, pen injectors, as well as innovative specialty delivery systems for large-volume and high-viscosity formulations. It also offers final assembly, labeling, and packaging solutions for its drug delivery systems. In response to the rising trend in home therapy, SHL Medical has increased its developmental work in the digital healthcare sector to help improve the drug delivery ecosystem. Located across Switzerland, Taiwan, Sweden, and the US, SHL Medical's global team of experts collaborate seamlessly as one team in utilizing its comprehensive in-house manufacturing capabilities. Its solutions offer customization and optimization for each project while proactively weaving sustainability-driven measures into its designs and processes to contribute to a cleaner earth. About SteriPack Group SteriPack Group is a globally renowned contract packing and manufacturing organisation serving the pharmaceutical and medical device sectors respectively. With a strong emphasis on innovation, quality and compliance, SteriPack's services to the pharmaceutical industry include device design and development, final assembly, labelling, secondary packing, serialisation and aggregation of injectable formats including vials, pre-filled syringes, and autoinjectors. SteriPack's tailored customer-focused solutions make it an ideally suited supplier for small to medium-sized batch volumes required for a growing market of targeted therapies as well as clinical trials. Its proven capabilities in cleanroom assembly and labelling as well as secondary packing services for drug delivery systems and medical devices, combined with significant investment into growing cold chain storage capacity, have helped to make it a trusted partner to top global pharmaceutical companies.

IDBS announces data management partnership with PharmaEssentia Innovation Research Center

PR Newswire | January 24, 2024

IDBS announced today that it has entered into a partnership with Massachusetts-based PharmaEssentia Innovation Research Center (PIRC) on its Polar platform to help digitize data management and facilitate collaboration between the company's global research and development (R&D) teams. The Polar platform will provide PIRC, the newly established U.S. hub of PharmaEssentia's R&D efforts, the ability to electronically collaborate with its team headquartered in Taipei, Taiwan, who have traditionally recorded experimental data on paper. "The IDBS Polar platform provides superior functionality beyond traditional Electronic Laboratory Notebook (ELN) offerings, backed up by our broad customer base and customer support, as well as the ability to support languages like Mandarin," said Pietro Forgione, General Manager at IDBS. "We are proud to help PIRC better capture, structure and interrogate their key data from a single source of truth, thereby making their collaboration more efficient." "We are looking forward to partnering with IDBS, not only to implement the Polar platform to help us manage our data more efficiently and to more seamlessly collaborate with our R&D team in Taipei, but also to work together to further explore ways to bring our innovative therapeutics to market faster," said Lih-Ling Lin, Ph.D., PIRC Founder and Chief Scientific Officer, PharmaEssentia. About IDBS IDBS helps BioPharmaceutical organizations accelerate the discovery, development and manufacturing of the next generation of life-changing therapies that advance human health worldwide. From lab through manufacturing, IDBS leverages its 30+ years of experience working with a diverse list of customers – including 18 of the top 20 global BioPharma companies – and deep expertise in scientific informatics and process data management to tackle today's most complex challenges. Known for its signature IDBS E-WorkBook product, IDBS has extended solutions across the entire value chain for BioPharma Lifecycle Management (BPLM). Built on analytics-centric and cloud-native technology, IDBS Polar and IDBS PIMS platforms are powered by a digital data backbone to drive faster and smarter decisions in drug development and across the supply chain.

Performance Validation Joins ValGenesis Partner Program as Service Partner for the U.S. Market

ValGenesis Inc., the market leader in enterprise validation lifecycle management systems (VLMS), and Performance Validation, Inc. a 100% employee-owned company serving the life sciences industry since 1988, have partnered to deliver unique compliance-focused digital validation solutions for life sciences companies in the US. Performance Validation is an industry leader with over 30 years of experience in analyzing, identifying, and testing the most critical elements of the manufacturing process for FDA-regulated industries. The company provides environmental mapping, commissioning, qualification, computer system validation, and quality system consulting services. ValGenesis is the industry innovator of digitized validation. The company's platform, which includes its flagship VLMS offering, is used in over 100,000 GMP systems worldwide, helping life sciences companies advance their digital transformation strategy, enforce compliance, and enable standardization with 100% digital, risk-based validation software. In this partnership, Performance Validation will implement and manage next-generation digital validation tools developed by ValGenesis, including ValGenesis VLMS and VLMS Express, a simplified cloud-based digital validation solution for startups and midsized companies. ValGenesis and Performance Validation are providing an integrated governance approach to further strengthen risk and compliance across their customers' manufacturing processes. "We are excited to partner with Performance Validation. Their extensive experience and our industry benchmarked digital validation platform can help life sciences companies implement their digitization plans efficiently according to Industry 4.0 standards," says Bo Olsen, ValGenesis' SVP of Partners. "By establishing a clear strategy that addresses their risk and compliance implications upfront, we can assure them of true business transformation." "Performance Validation is thrilled to embark on this collaborative journey with ValGenesis, leveraging our extensive experience and knowledge of digital validation solutions. It's a powerful combination – our hands-on validation experience and their innovative digital tools. For our clients in the life sciences, this means more efficient, streamlined, and compliant solutions. We're not just adapting to Pharma 4.0; we're helping our clients lead the way in digital transformation," says Brad Henry, Vice President of Service Lines at Performance Validation. ABOUT PERFORMANCE VALIDATION Performance Validation (PV) is a global validation partner for pharmaceutical and medical device manufacturers. Headquartered in Indianapolis, IN, we specialize in turning compressed timelines into compliant ones using innovative, adaptive approaches that balance production realities with strict regulatory requirements. Our best-in-class, cGMP-compliant services cover diverse needs from fully managed CQV to on-demand temperature mapping, smoke studies, software assurance, and more. With a dedicated team consisting of more than 95% engineers, we work closely with regulators and equipment suppliers to keep validation ahead of production curves and keep quality moving forward. ABOUT VALGENESIS ValGenesis, Inc. is the creator of an innovative software platform that serves as a foundation for managing compliance-based validation activities in life sciences companies. ValGenesis, Inc. is the provider of the first enterprise application that manages the corporate validation lifecycle process. This solution is fully compliant with U.S. FDA 21 CFR Part 11 and Annex 11 requirements. As the first fully paperless solution for electronic management of validation execution and approval, ValGenesis was selected by an industry peer review committee to receive the Parenteral Drug Association (PDA) New Innovative Technology Award in 2005.

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The Patient Journey: What it is and Why it Matters

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Healthcare is under enormous pressure today.

Patient expectations about their service and experience have changed over the years. Patients have more choices about their care, and they’re more empowered with information about what they want their care experience to be. They expect you to interact with them on their terms, not yours. And with COVID-19 turning so much of our lives digital, this trend has only accelerated.

Having a robust marketing automation approach is critical to addressing these challenges in today’s environment. Meeting — and exceeding — patient expectations comes down to managing your patient’s engagement journey. 

How can patient journeys improve care?

What patient journeys can do is turn the healthcare experience from a primarily reactive experience to a proactive one.

By building out journeys for your patient personas, you can close gaps in care, establishing robust preventative routines that ultimately help your patients stay as healthy as possible for as long as possible.

Engaging consumers and patients where they are builds trust and confidence that keeps patients in the system and encourages them to refer their friends and family to your practice. According to the Beryl Institute , 70% of patients will share a positive experience with others. But your bigger risk is that 76% will share a negative one. And with a negative experience, 43% of patients won’t go back to that provider, with 37% finding a different doctor altogether.

What is the patient journey?

A patient journey represents the entire sequence of events that a patient experiences within a given healthcare system or across providers, from scheduling an appointment for a regular checkup to receiving treatment for an illness or injury. 

A patient journey is an ongoing process that incorporates all parts of the healthcare ecosystem, from hospitals to physicians, specialty care, and outpatient therapy.

While it is easy to think about a patient’s journey as those interactions you have with them before, during, and after an appointment, there are actually many other touchpoints that drive their overall journey. A comprehensive patient engagement strategy touches on all aspects of a patient’s relationship with a healthcare provider, including:

• Onboarding and Access 
• Diagnosis and Treatment
• Adherence to Lifestyle or Behavioral Changes
• Ongoing and Proactive Health (Wellness)
• Referrals and Loyalty

How do I create the patient engagement journey?

Every single interaction with a patient is part of the patient engagement journey and a moment of truth for the health system or provider to add value.

In today’s value-based healthcare world, having that personalized experience is more important than ever. A patient engagement journey organizes those communication touchpoints and ensures you’re delivering the right information at the right time to the right person, and leveraging the appropriate communication channel. Millennials and Generation Z, for example, may be more likely to prefer a text, email, or chat to a phone call.

It’s about knowing your patients’ preferences — like that they prefer to be texted during the day while they’re at work or if they prefer an office vs. telehealth visit — and what’s going to make it easier for them, like sending automatic reminders the week and day before an appointment.

Whether it’s making sure you follow up with cardiac patients about weighing themselves daily after surgery to catch any water retention issues or asking colonoscopy patients whether or not they’ve been following post surgery protocols after discharge, it’s about continuity of care once a patient leaves the office or hospital so they have a quality outcome. From there, patients can more proactively drive their own wellness plan.

Here are important areas to focus on when creating your patient engagement journey:

Establish your patient personas

You need to know the different types of patients that are coming into your organization. You want to figure out:

• What are the most relevant needs of your patients?
• What are their communication and care preferences?
• How do they want to engage with you?
• What information do you already know about them?

To be able to craft the best possible patient experience, you first have to know more about your patients.

For example, there’s a well-known healthcare persona out there called the “Medical Mom” (which can, of course, be any individual taking care of themselves, their kids, their spouses, and may also be the caretaker for aging parents). 

Let’s say this individual has three children, and they book annual physicals at their pediatrician, which happens to have offices in the same building as their own primary care physician. Wouldn’t it be nice if the office sent them one email reminder to schedule all five appointments, rather than five different emails? And when they do call, scheduling those appointments back-to-back so everyone is in and out in one afternoon?

A spreadsheet is not going to be able to do that for you. Collecting and managing the data required to drive complex, interconnected patient journeys requires more than a spreadsheet. In order to succeed, you’ll need to pay close attention to the entire patient lifecycle.

Understand the entire patient lifecycle

An appointment reminder is a great start to engaging a patient, but it’s just one event in an ongoing patient lifecycle that begins with preventative care and includes diagnostics, delivery of care, and post-operations.

For example, how many patients show up for routine blood work at their physician office and you find out they haven’t fasted for the appropriate amount of time? Sending a patient home is frustrating for them and it’s frustrating for you. If the appointment is at 2:00 PM, then that appointment reminder should have been sent at dinnertime the previous evening, reminding them that they can’t eat anything after a 6:00 AM breakfast the next morning.

You’ll want to tailor your communications based on whether the patient is new or existing, what their preferences are, and whether they have any specific or chronic health issues. From there, you need to…

Understand the moments of truth

The healthcare system is complicated, even for those who have been a part of it for decades. The key to building a great foundation for your patient engagement strategy is to put yourself in a typical patient’s shoes. Most patients don’t engage with the healthcare industry unless they’re feeling sick. That means they’re rarely at their best, and they’re not only anxious about getting better, but about the costs associated with that.

The best healthcare providers understand the moments of truth — opportunities for a positive touchpoint that can alleviate their stress and anxiety and help them get on the road to recovery. Every time you interact with a patient is an opportunity for a moment of truth, whether that be in person or via other channels of communication.  It’s not only about establishing accurate moments of truth, but capitalizing on them.

It’s up to you to understand the places people need to be, how you want to communicate to them, and make every one of those touchpoints a positive experience. It doesn’t matter whether they’re physically in your office or not. Your patient engagement journey is what guides your patients to making the best possible decisions on their care so they get better. 

The easier you make it for them to engage with you, the higher quality their care will be.  Ultimately, you want your patients to be evangelists for your services based on their positive experiences. To do that, you’ll need to…

Get the data you need

Your patients expect personalization.

Personalization in healthcare used to mean created tailored treatment plans and clinical protocols. That’s still important, but patients expect more personalization around the entire experience, from access to communication to quality outcomes. It’s like turning on a light switch in your home: a patient just expects the light to turn on. 

Personalization today means being able to see at-a-glance a patient’s healthcare record, communication preferences, and social determinants that may be impacting their overall health to give you a 360-degree picture .

To do this, you need more than clinical data.

You may have patients that constantly miss their appointments. By storing questions that go beyond health risks — say, that they’re a smoker — but to understand that they don’t have a car to get to the appointment in the first place is becoming a more important part of the process. Part of empathetic, compassionate care is understanding these environmental factors that can help patients get the care they need, whether that’s calling a Senior Shuttle, caregiver, or arranging a telehealth appointment instead.

Once you have the data, you can…

Encourage referrals and loyalty

The first place people look for a new doctor isn’t the Internet. It’s their friends and family. In an ideal world, every patient you have should be able to say, “Oh, I loved my experience with…”

Doing that starts with the technology you have. Before a patient ever comes in for treatment, you need to make sure they have a seamless experience that builds trust and encourages referrals and loyalty. 

How do I get started with patient journey mapping?

It’s time to move away from the mindset to simply fill the top of the funnel with as many new potential patients and contacts with caregivers as possible. While this is still a requirement, it is just as crucial for organizations to get better at managing and growing relationships at every phase of the patient journey. Providers must engage with consumers in the marketplace to introduce them to their services of course, but it is of growing importance that they offer support throughout the entire diagnostic and treatment process. 

As a Salesforce Platinum Partner with deep industry expertise, we have created a Foundation for Patient Engagement package — a complete strategy that starts with Health Cloud and facilitates a 360-degree view of the patient , as well as a comprehensive communication strategy, CTI integration, and the use cases driving patient acquisition, engagement, and loyalty.

Learn more about building your patient journey with Silverline.

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The patient journey: What it is and how it’s vital for success

10 min read In the digital age, the patient experience has become more complex but also more critical as it relates to patient retention, reimbursement, and patient satisfaction. In order to thrive in today’s healthcare landscape, it’s important to look at the patient journey when aiming to improve the patient experience.

Does your healthcare organisation ask patients for feedback following clinical encounters? This is a common approach used to improve the patient experience . You may gather key insights about a specific encounter, but you’ll miss out on an untapped system of important patient interactions throughout the care journey.

Improving patient experiences requires looking at the entire healthcare ecosystem. Patients communicate with their healthcare providers through a variety of channels, while interacting with a wide range of departments and individuals along the way.

To stand out in the market and provide an optimal experience for your patients, hospitals and health systems should look beyond clinical service delivery and begin patient journey mapping.

The patient journey is the entire sequence of events that begins when the patient first develops a need for clinical care and engages with your organisation. It follows the patient’s steps as they navigate your healthcare system, from initial scheduling to treatment to continuous care.

Learn how you can collect data and drive action along your patient journey

The patient journey vs. the patient experience

Why is the patient journey important? Each touchpoint of the patient engagement journey, from a simple visit to your website to checking in for an appointment, has downstream effects that can help or hinder meeting patient needs.

As the patient experience evolves, it’s important to expand how you are listening to your patients in order to close gaps and make continuous improvements.

In recent years, emphasis on the patient experience has become the focus of regulatory programs and payment incentives. Many quality measures today center around collecting patient feedback on the healthcare experience.

To satisfy these measures and drive quality improvement efforts, many organizations turn to post-transactional  patient satisfaction surveys. The feedback from these surveys often measures only a limited set of touchpoints while overlooking other critical data from the full patient journey.

A holistic view

Patient experience programs often hone in on clinical service delivery, and many regulatory programs focus solely on numerical scores to measure improvement. These approaches may fail to identify pain points occurring in dozens of patient interactions within a healthcare system.

A holistic view of the patient journey is the key to modernising and strengthening your efforts to meet your patients’ needs. By breaking down silos into separate patient events, you can begin to identify blind spots where hidden challenges exist in your patient experiences.

By the time your patients engage with their care providers, they’ve likely interacted with your organisation a number of times. These interactions can occur digitally, over the phone, or in person. Navigating your website, verifying insurance coverage, and scheduling an appointment are all examples of pain points that may be creating barriers to care.

It’s easy to assume any given touchpoint is more or less important than another. The fact is that each one provides unique value to the patient’s experience. Each of them plays a role in helping the patient achieve their goals.

Patient engagement with your organisation doesn’t begin when the patient is examined by the healthcare provider, or even when they enter your medical facility. From initial awareness  to ongoing care, the patient journey encompasses every separate interaction throughout the process of seeking, receiving, and continuing care within a health system.

There are several stages of the patient journey you should consider.

What triggers the patient’s need for care, and how does the patient learn about your organisation?

• Quality ratings and online reputation
• Campaign management
• Community involvement

Consideration

What drives a patient to choose your organisation over another?

• Coverage and benefits
• Healthcare provider search

What impacts your patient’s ability to receive care or support from your organisation?

• Patient portal
• Call centre
• Price transparency

Service delivery

What is your patient’s experience with their clinical care?

• Interaction with healthcare professionals
• Check-in and check-out
• Discharge process

Ongoing care

What type of patient engagement occurs after a visit?

• Wellness and care management
• Social determinants of health
• Population health

All of these examples influence the way in which your patients make decisions. It’s essential to understand which touchpoints along the patient’s journey are the most impactful or leave the largest gaps in care. There are patient expectations surrounding each type of interaction.

Patient journey mapping

How do you move beyond patient feedback on service delivery and focus instead on the end-to-end patient journey? Patient journey mapping can provide context around what your patients experience as they move through the various channels of your organisation.

A patient journey map is a visual representation of the steps the patient takes as they engage with your organisation in order to receive care. Patient journey maps should capture pre-visit and post-visit touchpoints in addition to those that occur when the patient is onsite at your medical facility.

Your patient journey may be broad and applicable to your entire patient base, or it may be specific to certain specialties, patient personas , demographics, or health events.

Start with an inventory of all the touchpoints for which you currently collect patient feedback. Next, determine what’s missing. Envision moving through your organisation from your patient’s point of view. Your patient journey map should include Interactions that take place pre-visit and post-visit, which are not always captured by traditional or regulatory surveys.

Benefits of patient journey mapping

There are many benefits to capturing key moments along the whole patient journey.

• A patient journey map allows you to walk in your patient’s shoes and think the way they think as they engage with your organisation. Patient journey mapping looks at patient experiences from the outside in.
• Mapping your patient journeys helps you to hone in on the areas where you may not be listening to your patients, but should be.
• You can uncover inconsistencies, gaps in care, and common pain points with patient journey mapping. These are difficult to identify when you collect feedback only on service delivery. Collecting data around these areas can aid in process optimisation and improve patient satisfaction.
• A patient journey map can give you a cross-functional view of your patient experience so you can engage all teams and stakeholders in gathering and understanding patient insights.
• Patient journey mapping provides context around behaviour and attitudes as patients move throughout the channels of your organisation. Are patients having to repeat paperwork? Do patients understand their follow-up care instructions? Are your patients able to easily navigate your patient portal? Patient journey mapping can help to answer these types of questions.
• Mapping the patient journey can transform your patient care approach from a reactive one to a proactive one.

Using patient journey data

Once you can visualise the end-to-end patient journey within your organisation, it’s time to listen to your patients and start gathering data.

Gather the right data

Collect data on all the touchpoints of the patient journey.  Understand how your patients are interacting with every aspect of your organisation, including non-clinical interactions such as your website, scheduling, and billing. Involve multiple stakeholders during this process, including managers, doctors, nurses, other healthcare professionals, and administrative staff.

It’s important to capture all steps involved in each of these stages. For example, when looking for potential pain points surrounding the patient portal, consider how the patient sets up an account, logs in, navigates the interface, gets technical assistance, and so forth.

Also, consider patient expectations and usage–what are they using the portal to accomplish? Look for potential gaps in these experiences, such as paying a bill, contacting the provider with a question, reviewing test results, or scheduling an appointment.

Understanding the patient’s goals and actions along all the different paths of your patient journeys is essential to gathering the data you need to take action.

Understand the data

Gain insights using analytics , benchmarking, and visualisations to identify gaps and discover opportunities at each step of the patient’s journey. Trends along the various touchpoints can help you to discover pain points and identify opportunities.

It’s also important to engage all the right stakeholders when reviewing the data you collect. Involving the right teams and people is essential to understanding gaps and improving experiences.

Take action

Use the insights from all touchpoints along your patient journey to develop solutions to improve your patient experience.

A closed-loop system  is ideal for taking action to close gaps along the patient journey. For example, if a patient gives a low score on a survey for your online scheduling tool, you could follow up with the patient to ensure they were able to schedule an appointment.

Using the data you collect to drive specific actions and feed into processes is vital to creating a seamless patient journey.

Why Qualtrics?

At Qualtrics, we want to enable you to listen to and understand your patients across all aspects of their journey, all within a single platform. Omnichannel distribution lets you gather feedback from patients from where they are at during each touchpoint, with powerful built-in analytics for uncovering meaningful insights.

The Qualtrics XM Platform™ provides a single source for all of your patient journey data. Real-time feedback displayed in role- and location-based dashboards helps deliver pertinent information to the right people, allowing you to take prompt action where needed.

Start collecting data and driving action along your patient journey

Related resources

Patient experience: your complete guide 12 min read, symptoms survey 10 min read, quality improvement in healthcare 11 min read, nurse satisfaction survey 11 min read, cahps surveys 6 min read, patient journey mapping 15 min read, nursing shortages 13 min read, request demo.

Ready to learn more about Qualtrics?

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Donaldson L, Ricciardi W, Sheridan S, et al., editors. Textbook of Patient Safety and Clinical Risk Management [Internet]. Cham (CH): Springer; 2021. doi: 10.1007/978-3-030-59403-9_10

Textbook of Patient Safety and Clinical Risk Management [Internet].

Chapter 10 the patient journey.

Elena Beleffi , Paola Mosconi , and Susan Sheridan .

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Published online: December 15, 2020.

The wide implementation of patient safety improvement efforts continues to face many barriers including insufficient involvement of all stakeholders in healthcare, lack of individual and organizational learning when medical errors occur and scarce investments in patient safety. The promotion of systems-based approaches offers methods and tools to improve the safety of care. A multidisciplinary perspective must include the involvement of patients and citizens as fundamental contributors to the design, implementation, and delivery of health services.

The patient journey is a challenging example of using a systems approach. The inclusion of the patient’s viewpoint and experience about their health journey throughout the time of care and across all the care settings represents a key factor in improving patient safety. Patient engagement ensures that the design of healthcare services are aligned with the values, the preferences, and needs of the patient community and integrates the real-life experience and the skills of the people to enhance patient safety in the patient journey.

The utmost priority to implement patient engagement is the training of patients. Therefore, training for both patients/families/advocates and health professionals is the foundation on which to build active engagement of patients and consequently an effective and efficient patient journey.

The chapter offers examples of successful training courses designed to foster strategic alliances among healthcare professionals and researchers with patients and their organizations. Training of patients constitutes the first step to develop shared knowledge, co-produced projects, and the achievement of active multilevel participation of patients for the implementation of patient safety in the patient journey.

10.1. Introduction

Almost 20 years after publication “To Err is Human: Building a Better Health System” (Kohn et al. 1999), patient safety is still not widely implemented. This report from the Institute of Medicine is the milestone that constituted a turning point for improving quality of care and patient safety identifying the need to rethink healthcare delivery to provide safe, effective, and efficient care.

The barriers of implementing patient safety as a driving force for change towards more effective healthcare include multiple factors: insufficient involvement of all stakeholders contributing to the care process, lack of willingness of organizations and individuals to learn from errors and scarce investments in patient safety improvement and research.

There is a growing need to promote systems approaches to finding solutions in healthcare to improve the safety of care, the quality of healthcare delivery, patients’ health and citizens’ well-being.

The discussion paper “Bringing a Systems Approach to Health” defines the systems approach as one “that applies scientific insights to understand the elements that influence health outcomes; models the relationships between those elements; and alters design, processes, or policies based on the resultant knowledge in order to produce better health at lower cost” [ 1 ].

A multidisciplinary approach must include the involvement of citizens and patients as fundamental contributors to the design, implementation, delivery, and evaluation of health services.

This means that citizen participation plays an essential role, bringing the unique point of view of patients and family members into the debate on patient safety and quality of care.

Patients and more generally citizens, when actively and systematically engaged, bring ideas and experiences which can support a collaborative and reciprocal learning process among the healthcare stakeholders. This produces knowledge that leads to improved practices, a real knowledge creation process where the dynamic participation of all actors in healthcare systems contribute to an active learning environment where the identification, the investigation, and the planning of solutions related to health incidents is a cyclic process enabling healthcare knowledge creation.

The added value of involving patients in healthcare is, respect to other more complex interventions, a low cost opportunity to take into consideration unconventional points of view creating and building knowledge and providing original insights and ideas that otherwise would not be considered.

Health professionals and patients’ skills and knowledge are acquired through individual experience or education and transferred to the health organizations in a perspective of co-production of healthcare. It is a merging of the efforts of those who produce and those who use the solutions to address health problems. It serves to establish a strengthened and long-term relationship in terms of trust and effectiveness and to distribute the responsibilities among all stakeholders [ 2 ].

In light of these arguments, the systems approach—inspired by the fundamentals of ergonomics and human factors (HFE)—creates new alliances between healthcare and engineering, of which patient journey is a challenging example [ 3 ].

Applying the systems approach to patient safety allows the analysis of the factors that characterize the encounters and the interactions between healthcare professionals and patients during the entire course of care. The observation of possible critical issues to the individual and specific encounter between clinician and patient is crucial in widening the scope of observation and research of the entire “journey” of the patient, taking into consideration the complexity of patient, their values and needs, their preferences, the economic and social context in which they live, and language and communication issues.

These observations and research should be carried out considering the interconnections and interactions together with the components of the processes; importance should be given to the context, and to manage the complexity, the value of a holistic approach.

10.2. The Patient Journey

A modern health system looks to the future in the context of the challenges imposed by the real world. It must manage the gap between guidelines and health protocols and what effectively happens and how reality is perceived by patients and family members.

It is more and more necessary to bring the patient’s point of view in the analysis of the care process, in the incident reporting and analysis, in the design and implementation of solutions and guidelines in healthcare.

Vincent and Amalberti in “Safer Healthcare” (2016) [ 4 ] stated that the incident analysis should broaden the class of events having consequences on patient safety. Incidents reported from the patient’s point of view should be included in addition to those suggested by health professionals. Additionally, when analyzing an incident, it should be done in the context of the patient journey rather than a single episode.

Instead of focusing on the individual encounter, it is necessary to extend the observation timeframe by applying the examination of contributing factors to each of the encounters that compose the patient journey (temporal series of encounters with healthcare facilities, a hospital unit, a specialist visit, a primary care clinic, a home health agency), considering both the negative and positive events and the points for improvement that were revealed (Fig. 10.1 ).

Analysis of safety along the patient journey

The adoption of this wider approach is unique in that it incorporates the patient’s perspective of safety and includes new features in the incident analysis such as asking patients to recount the episode of care, including patient and family in the investigation team when possible, asking patients the contributory factors from their point of observation and perception and involving patients and families in the reflections and comments on the disclosure process [ 4 ].

The episodes patients and families can highlight are often different from those that professionals are more accustomed to reporting. However, patients could be involved in further ways in incident reporting and assessment, and today patient-derived information constitutes a free and little used resource.

As per McCarthy’s definition, “patient journey mapping describes the patient experience, including tasks within encounters, the emotional journey, the physical journey, and the various touch points” [ 5 ]. Carayon and Woldridge define “patient journey as the spatio-temporal distribution of patients’ interactions with multiple care settings over time” [ 3 ], where at each point of touch with each healthcare service along the patient journey, the patient interacts with several system elements (task interaction, physical environment, interaction with tools and technologies, organization interaction, interaction with other organizations and other people, interaction with other people and teams within the organization) (Fig. 10.2 ).

The patient journey as a set of interactions and transitions

The patient journey represents the time sequence of what happens to the patient, especially during transitions of care, in particular considering that the health professional who takes care of the patient only sees the portion of care for which he is responsible and in which he has an active role. Conversely, the patient is the only person who has a continuously active and first-hand role during their health journey. They alone are in possession of information that characterizes the entire care experience.

Moreover, when patients navigate their journey, they contact and interface with multiple work systems at several time points, where the sequence of interactions in the work systems determine the outcome experienced by patients and families, healthcare professionals, and health organizations. (Fig. 10.3 ). Each local work system is influenced by a wider socio-organizational context, which can be formal healthcare organization (such as hospital, primary care facility, nursing home) or informal (home).

SEIPS 3.0 model: sociotechnical systems approach to patient journey and patient safety

Every point of the patient journey offers data on health outcomes and patient experience outcomes that should be used as feedback to redesign healthcare work systems in terms of adaptation, learning, improvement.

Patient’s experience represents an important resource in participatory collaborative design, especially in the patient journey where this experience is the result of multiple interactions across space and time.

10.3. Contextualizing Patient Safety in the Patient Journey

Many of the incidents or near-misses during healthcare are not due to serious errors, but to the combination of small failures, such as limited experience of a recently qualified doctor, use of obsolete equipment, an infection difficult to diagnose or inadequate communication within a team.

We know that the analysis of an incident requires looking back to the succession of events that have occurred and that led to the problematic episode, considering both active and latent errors, and all the aspects connected directly or indirectly. It is fundamental to examine the safety of the entire patient journey, all the encounters that make up the entire care process, to study the whole medical history of the patient in an attempt to reconstruct all the elements that characterize the “health journey”, not only from the viewpoint of the health professionals, but also from that of the patient and family.

In light of these arguments, new concepts, tools, models, and methods need to be embraced to support patient safety in the patient journey.

A significant contribution in terms of concepts, frameworks, and models is offered by Industrial and Systems Engineering, and often human factors and systems engineering (HF/SE) have an approach to include the preferences and the needs of stakeholders when designing solutions to address the critical aspects of a health process.

Human factors and ergonomics are described as “the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance. Practitioners of ergonomics and ergonomists contribute to the design and evaluation of tasks, jobs, products, environments and systems in order to make them compatible with the needs, abilities and limitations of people. Ergonomics helps harmonize things that interact with people in terms of people’s needs, abilities and limitations” [ 6 ].

Process models have found widespread use in drug management, visit planning, care transition, to name a few, and can offer tools and methods to investigate interprofessional and physician–patient communication, interruptions and health information handover.

Drawing from the finding of Carayon’s studies [ 3 ], the Systems Engineering Initiative for Patient Safety (SEIPS) model gives a description of five work system elements which when applied to a definite patient journey model should outline who (person) is doing what (tasks) with tool and technologies, taking into consideration the physical and organizational environment where all these activities take place. All these factors have to be examined for both patients and workers and the process analysis and modelling have to consider what patients and families/caregivers, healthcare professionals and workers actually do ( work-as-done versus work-as-imaginated ).

Patients, families, and caregivers are deeply involved in the healthcare process due to the tasks they carry out in the intermediate sectors of care between encounters. Away from direct interactions with professionals, they have to perform multiple actions requiring understanding of what behaviour to adopt, which instructions to follow, how to administer a medication and how to communicate with hospital doctors, general practitioner, and home healthcare professionals [ 3 ].

Taking into account what has been highlighted so far, one of the leading and most challenging keys to success in improving patient safety is to adopt a systems approach to patient safety which includes the patient’s perspective about their health journey throughout the time of care and across all the care settings.

This assumption highlights that patients and their families are valuable resources and can play an important role in patient safety improvement efforts. Viewing health systems as “co-producing systems”, patients can engage as partners in co-producing patient safety improvement activities individually, in groups and collectively. Individual patient and family member participation/co-production of safer care is fundamental. Equally as important is the co-management and co-governance of healthcare services, in addition to the engagement of communities in policy definition and designing activities.

In fact, patient engagement directs the design of healthcare systems towards the preferences, the values, the real-life experiences, and—not less important—the skills of the people to enhance patient safety in the patient journey.

Such a change of perspective involves multiple dimensions of interactions and relationship between patients and professionals, encompassing cooperation, dialogue and listening, trust, reciprocity and peer-to-peer work [ 2 ].

It follows that on the one hand the healthcare organizations have to demonstrate the willingness to support health professionals to effectively engage patients in the patient journey to achieve the common goal of reducing the risk of patient harm or incidents as well as the willingness to integrate patients and family members as partners into quality and safety improvement efforts. On the other hand, it is necessary to motivate and encourage patients and families/caregivers to actively participate during the individual care process for safer care as well as partner in organizational patient safety improvement efforts to ensure safer care for others.

The working group Patient and Family Involvement for the delivery of Safe and Quality Care [ 7 ] stated that the utmost priority to realize the patient involvement is the training of patients, followed by the promotion of interdisciplinary training programmes for healthcare professionals to promote patient and family engagement, the implementation of multilevel structures that allow for participatory processes by patients and smarter allocation of resources in healthcare that supports involving citizens in patient safety improvement efforts for better healthcare.

This working group was part of the activities of the “1st International Meeting about Patient safety for new generations—Florence, 31st August and 1st September 2018” organized by the Centre for Clinical Risk Management and Patient Safety, Tuscany Region—WHO Collaborating Centre for in Human Factors and Communication for the Delivery of Safe and Quality care [ 7 ].

Therefore, training for both patients/families/advocates and health professionals is a pillar on which to build active engagement of patients and consequently an effective and efficient patient journey. From this perspective, the participation of patients (i.e. representatives of patients’ associations and organizations, patient and citizen advocates) in training courses—specifically designed for this target audience of trainees and aimed to encourage co-production of care—is an essential and effective activity to co-produce a better healthcare system in terms of quality and safety of care.

Sharing a common language, promoting citizens’ and patients’ awareness of importance of co-production of care, teaching the key role that patients can play in making treatments safer (investments in health literacy), learning to work together and within a network (locally, regionally, and nationally/internationally) on priority safety and quality of care issues: these are some of the main strengths of training courses aimed to be at the basis of active engagement of patients and citizens.

Examples of successful training courses include “PartecipaSalute” and “Accademia del Cittadino” organized in Italy by Laboratory for Medical Research and Consumers Involvement of the Istituto di Ricerche Farmacologiche Mario Negri IRCCS and the Centre for Clinical Risk Management and Patient Safety, Tuscany Region. The following paragraph describes this educational experience which is specifically designed for citizens and patients to improve their knowledge and skills in patient safety and quality of care, with the aim of co-producing better healthcare services.

10.4. From PartecipaSalute to the Accademia del Cittadino: The Importance of Training Courses to Empower Patients

Over the last few years in the field of health and research and with regard to participation and involvement of citizens and patients, we have witnessed the transition from a paternalist to a partnership model. Individual citizens and those citizens involved in patients’ associations or groups have acquired a new role: no longer passive but actively involved in decision-making regarding health, healthcare, and research in the health field [ 8 , 9 ].

This is a progressive step-by-step process based on the recognition and implementation of the key concepts such as health literacy and empowerment. Health literacy, more properly used at individual level is defined as the capacity to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment [ 10 ]. Empowerment, more used at the community level, is a process that, starting from the acquisition of accurate knowledge and skills, enables groups to express their needs and more actively participate to request better assistance, care, and research. At this level, the availability of organized independent and evidence-based training courses is essential to allow people to be able to critically appraise and use information about the effects of healthcare interventions. Consequently, they will have the skills to participate in the multidisciplinary working groups (composed of researchers, health professionals, patient and citizen advocates, institutional representatives).

In the late 1990s, the Istituto di Ricerche Farmacologiche Mario Negri IRCCS held the first training courses of this kind focused at breast cancer associations. Some years later, within the project PartecipaSalute—a not-for-profit research project designed to foster a strategic alliance among healthcare professionals, patients, and their organizations—an ad hoc training programme for representatives of citizens’ and patients’ organizations was defined with a multimodule format [ 11 , 12 ]. This was an innovative approach, at least in the Italian setting in that period.

PartecipaSalute training programme has combined different experiences: the Mario Negri Institute IRCCS experience in collaborative research activities with patients’ associations, the Italian Cochrane Centre with the activities aimed at promoting the principles of evidence-based medicine, and Zadig long-term experience in health communication. The above promoters jointly developed the PartecipaSalute training programme on the belief that data are more important than opinions, and that every decision should be supported by well-conducted research data.

The spread of this belief to patients and citizens with the purpose of stronger involvement was a key point of PartecipaSalute training courses.

Therefore, patient, family, and community knowledge of the principles of how evidence is developed through clinical research is essential to make or support decisions in the health debate, to promote better clinical research, or to convey correct information. The strength of the PartecipaSalute programme was based on the exchange of experiences in an interactive way aimed at creating opportunities for discussion, overcoming the teacher–learner model. Each session started with an interactive discussion of a real situation—such as a screening, vaccination, therapy—and after sharing data, opinions or articles from media, evidence was presented and discussed, underlining significant methodological aspects. The programme offered the opportunity to debate the value and significance of the methodology offering critical appraisal tools. Each participant was invited to take an active part, starting from direct personal or associative experience. Table 10.1 presents the topics considered in the first three editions of the training programme. The participation was free, and different types of materials were provided including an ad hoc manual published by PartecipaSalute, copies of the PowerPoint presentation and articles.

Topics considered in PartecipaSalute [4] and PartecipaSalute-Accademia del Cittadino training courses

Considering the characteristics of the programme and its modular structure, the PartecipaSalute training programme could be adapted to specific contexts. In fact, the experience of PartecipaSalute was adopted at the regional level by Regione Toscana (Centre for Clinical Risk Management and Patient Safety and the Quality of healthcare and Clinical pathways of Health Department, Tuscany Region) developing a more specific training programme called PartecipaSalute-Accademia del Cittadino (Academy of Citizen), focused on patient safety and risk management. In particular, after some modules on methods related to evidence-based medicine, uncertainties in medicine and information and communication in health, the training was mainly dedicated to regional and local activities on clinical risk management, the role of patients’ associations to improve patient safety and to support the implementation of best practices, the analysis and data of adverse events and risk assessment in terms of quality and safety in the care processes (Table 10.2 ).

Topic integration in the PartecipaSalute-Accademia del Cittadino joint courses

The PartecipaSalute-Accademia del Cittadino joint training programme has been implemented in three editions over the last decade and has trained about 100 members of patient and citizen advocates representing 38 patients’ associations. The courses ranged from 5 to 3 modules of 2 days each in residential mode to allow participants to get to know each other and create a network of associations committed to be engaged in clinical research, quality, and healthcare safety issues.

The entire educational experience was characterized by the use of participatory training methods, based on working groups, practical exercises, lectures from experts with opportunities for discussions. As a result of this training course model, the participants were recognized as “expert patients” and were regularly involved in basic activities for promoting patient safety as auditors on significant events and helping to define policies on patient safety at the Tuscany regional level. In addition, they have participated in patient safety walkarounds in hospitals and in developing eight cartoons intended to promote the education of citizens for the prevention of the most diffused risks (such as prevention of infections, prevention of falls and handovers).

Feedback on the satisfaction on tutors, topics discussed and knowledge gained was regularly requested from participants through questionnaires distributed before and after the programme. In general, positive feedback was received; participants appreciated the interactive methods of work, the clarity of the language, and the effort to make difficult problems easy to understand. An ad hoc questionnaire was provided to the participants regarding the methodology of clinical research, always showing an improvement in the self-evaluated knowledge before and after the course. Feedback of the results of the evaluation was also shared with each participant. Most of participants reported their experience to other members of the organization. In particular, in the case of the Regione Toscana training, the possibility of immediately transferring what was learned in the course in all the activities in collaboration with the health institutions, policy makers, and health professionals—such as working groups on patient safety best practices, participation to audits, development of tools to improve health literacy—was appreciated.

Some limitations emerged from these experiences. The selection of participants is the first issue, not only because the training course is accessible to a small number of participants (in general no more than 30 participants), but also because the groups comprised of middle-aged and retired participants, with few younger ones. Additionally, there were few individual patient or family member representatives from patient associations. The majority of those representing patient associations were in managerial or leadership positions. Furthermore, it is difficult to choose between small, local, or bigger regional associations. Residential training courses also restricted the participation for geographical reasons.

The PartecipaSalute and ParteciaSalute-Accademia del Cittadino training experiences show that patients and citizens are willing to get actively involved in healthcare and the research debate. There is a real desire to improve their knowledge and skills on health and research issues and allow some general considerations regarding the active engagement of citizens representing associations and advocacy groups.

In conclusion, it is very important to invest in a process of empowerment aimed to have well-trained activists involved vigorously and constructively in the debate, design, and assessment of health and research. Switching from tokenism to active participation is necessary to effectively partner with patients and the general population to design, plan, and co-produce safer more effective healthcare, while also supporting better more patient-centred research [ 13 , 14 ].

Also, the training courses are feasible and useful, as has recently been discovered also by pharma or other groups that organize courses mainly focused on drugs and drug development, thus directing the participation of the groups more to market needs than to public health.

Furthermore, this training initiative facilitates the networking among associations in part overcoming the difficulties that derive from personalization and division among the associations representing citizens and patients.

Finally, this illustrates the importance of the design and promotion of training courses with institutions, such as the Regione Toscana, in order to be able to implement projects of real collaboration between institutions, healthcare professionals, and consumers’ and patients’ representatives.

10.5. Recommendations

A systemic approach to health can provide valuable models for wider implementation of patient safety. A multidisciplinary approach includes the involvement of citizens and patients as unique stakeholders in the design, implementation, delivery, and assessment of health services.

Involving patients in healthcare is an opportunity to bring uncommon points of view into policy making and to create shared knowledge between healthcare professionals and patients.

The implementation of patients’ and families’/caregivers’ perspectives in the patient journey is the golden opportunity to leverage crucial input, such as experiential knowledge, safer care, patient motivation, and trust and social cohesion into the co-production of safety solutions in healthcare. This represents a way to get closer to person-centred care, to create opportunities for patients to meet and share information and knowledge, to develop structures and policies for patient involvement at different levels (with healthcare systems, universities, and policy makers).

However, little has been done to overcome some healthcare systems barriers: the power imbalance between the doctor and patient, language differences, the lack of diffusion of non-technical skills and, last but not least, the lack of evidence about the value of patient involvement.

To be widely implemented, patient engagement in the patient journey requires courageous leadership, organizational efforts, a wider culture of safety of care, the implementation of multilevel structures for the engagement of patients and resources from smarter spending in healthcare.

Education is the landmark to integrate meaningful patient and citizen engagement in healthcare. Training of patients is the fundamental starting point to develop shared knowledge, co-produce projects, and implement an active multilevel participation of patients and families for the improvement of quality and safety of care.

Open Access This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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• Cite this Page Beleffi E, Mosconi P, Sheridan S. The Patient Journey. 2020 Dec 15. In: Donaldson L, Ricciardi W, Sheridan S, et al., editors. Textbook of Patient Safety and Clinical Risk Management [Internet]. Cham (CH): Springer; 2021. Chapter 10. doi: 10.1007/978-3-030-59403-9_10
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In this Page

• Introduction
• The Patient Journey
• Contextualizing Patient Safety in the Patient Journey
• From PartecipaSalute to the Accademia del Cittadino: The Importance of Training Courses to Empower Patients
• Recommendations

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Empowering patients to discuss sexual health

I’m sure you can picture it. You’re sitting in an exam room wearing a paper gown, waiting for your health care provider to walk in the room. There are a few colorful posters on the wall about flu season, health screenings, and a discount prescription program available to patients. But all you can think about is the conversation you’re about to have. Will they bring it up? Will you ask? Does it feel awkward, challenging, or shameful to think about? Should you use nicknames for your body parts so it’s not as weird to talk about your symptoms? Let’s be honest. Talking about your sexual health with your clinician can feel difficult to bring up, but it is important no matter who you are.

There is a known gap in medical training when it comes to sexual medicine education, especially in female sexual medicine. There are also stigmas associated with the topics of female sexual health and reproductive health. In society, we’ve been taught from a young age to tip-toe around these topics and to keep any conversation about our “private parts” well … private. And further, the expectations to keep these parts of our lives hidden transcend cultural, religious, and socioeconomic lines. Sexual health is a critical aspect of overall health and well-being that is often overlooked during a patient visit, in the classroom setting, and in medical education. The gap in knowledge between the general public and health care providers continues to perpetuate the negative stigmas attached to female sexual health. Unfortunately, current medical students are still not receiving adequate training to broach topics around the sexual function and experiences of females.

We are writing this letter to you as a group of medical students who have banded together to demand more from the institutions training us so we can become better clinicians for you—our future patients. We want to help create a future in which our patients feel empowered to bring up sexual health concerns and encourage clinicians to normalize these discussions. But how can we do this? How have we done this so far?

We, as medical students, have collaborated to review the medical school clerkship curricula of the seven Chicago-area medical schools for the inclusion of information on female sexual medicine . These findings have been summarized in multiple abstracts, podium presentations, and a published manuscript. Additionally, we have created discussions and lectures, each with a guest expert, for students to learn, exchange ideas, and advocate and collaborate with academic communities to normalize discussing female sexual medicine. We hope that the work we have done and continue to do will encourage and empower you to talk about your body.

There is no such thing as a “stupid question” when it comes to your body. There is no symptom that is “too embarrassing” – your health care providers should have been trained to put you as the patient first, which includes addressing every one of your concerns about your sexual health. If you find that your provider isn’t matching this, reach out to one who will.

You know your body best, and we want to help you continue giving it the best care it deserves. We hear you, we see you, and your concerns matter to us.

Sri Contractor, Suvitha Viswanathan, Olivia Negris, Jen Romanello, and Monica Meyers are medical students.

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