Transforming Patient Experience with end-to-end journey mapping

Technology adoption has lagged quite a bit in health systems, with the initial developments and digitization limited to the internal processes. User experience was often an afterthought, if at all. In recent years though, the healthcare space has seen a renewed emphasis on improving the user experience for patients as well as healthcare staff to optimise costs and improve outcomes.

Patients interact with the healthcare systems across multiple channels and expect interactive, personalised, responsive and cost-effective services. Personalization in healthcare has always been difficult, but it is fast becoming the norm for differentiated experiences and improved outcomes.

Customer Experience Lifecycle Management (CXLM) has gained wide acceptance in this space and is delivering value across multiple disciplines. With more actionable insights now available about the patients, diseases, the quality of care, and the cost associated with any treatment, the CXLM approach leverages business intelligence and advanced analytics to enable providers and administrators to take data-driven decisions that guarantee results.

The challenge is to recognize, understand, and address the fact that the overall experience is created by the cumulative interactions across the various touchpoints in the patient journey. There’s a need to bridge the gap between the emerging needs of the patients and the present state of a healthcare organization. The answer lies in the end-to-end patient journey mapping.

What is Patient Journey Mapping?

Patient Journey Mapping is a visual representation of the sequence of events that emerge from the first contact of the patient with the hospital, including pre-visits, to the final check-up or discharge. It is the interaction of the patient with specific processes across various touchpoints in the complex hospital ecosystem. It allows for the visualization of the patient’s journey through the care system, helping the provider to identify pain-points, discover opportunities, and re-align their treatment and care approaches.

Insights provided by Patient Journey Mapping

• Details of each touchpoint interaction during the journey identify gaps and inconsistencies.
• Patient needs throughout the care and treatment processes.
• Identify security, reliability, and experience issues.
• Holistic view of customer interactions and positive and negative experiences.

Who are the stakeholders?

The healthcare ecosystem is complex, involving many touchpoints and stakeholders. Mapping a patient’s journey must include all the stakeholders, touchpoints, and internal and external factors that influence the patient experience. For the mapping process to be effective, the participation of all those included in the patient journey is essential to gather feedback from everyone involved, collect the right information, and gain meaningful insights into patient and provider needs. These stakeholders are:

• Patients and, often, their family and other close relations.
• The Medical Team – Doctors, nurses, therapists, and other medical professionals.
• Third-Party – A moderator or software and UX designers.

What are the different stages in a patient’s journey through the healthcare ecosystem?

To gain the insights, leverage them to design and create a better patient experience and improve the overall satisfaction with the health system, it is important to understand the stages that a patient goes through in the care experience. Typically, there are six stages in a healthcare consumer journey.

1. Awareness: At this stage, the consumers conduct online research to self-assess the symptoms and learn more about the available health plan options.
2. Help: The patient contacts the health system, mostly to schedule clinical appointments or get more information about the resources and facilities available.
3. Care: The hospital or the medical team performs a health assessment and narrows down on the diagnosis or further investigations needed by the patient.
4. Treatment: After the initial clinical appointments and investigations, the treatment plans are created for the patient in the form of procedures needed, medications, or physical therapy.
5. Behavioral or Lifestyle Changes: Patients ensure that they adapt and be proactive about their health, to avoid further treatment and re-admission to a hospital.
6. Ongoing care/Proactive Health: Patients need to monitor their parameters and may need ongoing care for their health conditions, engaging more with the physician or the hospital resources. At this stage, the goal is to form lasting relationships between the patients and caregivers. 

The role of UX research and design

In the healthcare domain, the patient’s emotional state has a great impact on the adoption rate of technology, the product or solution design, and the subsequent health outcome. It becomes imperative for the UX & UI designers to gain insights into the customer needs and the existing processes at the initial stages of the development and design. Shifting the focus to the illustration of a patient’s journey through a map or a storyboard creates more awareness of the customer needs and the emotions behind their actions.

Patient journey maps expose the pain points, user experience, security, and reliability issues, along the entire user journey. They help provide the stimulus needed for knowledge sharing between the clients and the design teams. Some questions it answers for the UX research teams:

• Who is the end-user?
• What are their motivations?
• What influences their experience – positively and negatively?
• What tools or interfaces do they use?
• What kinds of social interactions influence their decisions and experience?

A journey map differs from the traditional forms of UX deliverables in that it doesn’t look at the patient or the end-user in isolation. It provides a deeper understanding of the user and the life factors that impact their experience and health outcomes. While the underlying design principles and the user-centered approach largely remain the same, it is essential that the research is thorough and covers all the processes and stakeholders involved. [1]The following steps have proven to be instrumental in informing the CJM process by incorporating the research elements.

1. Initial Scenario Outline – The high-level processes and stakeholders that the patient interacts with are plotted. The main stages, their timeline, and stakeholders are outlined in this basic representation.
2. Include Qualitative Data: Additional events and activities that the patient goes through are added to the timeline. The repetitive processes are also added at this stage, along with additional touchpoints, emotional highs and lows, and some symptoms, like pain levels, are also plotted. This information is gathered through research methods, like contextual inquiry, observation, and interviews with personas, when appropriate.
3. Incorporate Quantitative Data: This step requires broader research methods, like surveys, to get the supporting and relevant analytics and statistics (How many? How much?). This data is represented in a separate section, not on the timeline.
4. Final Review and Clean up: The irrelevant steps or touchpoints need to be removed during this step to reduce the clutter and stay focused on the solution. This step requires a few rounds of feedback to review and re-map the journey with only what is pertinent.

Moving ahead

The healthcare sector has taken advantage of new digital technologies and is undergoing a complete transformation. With the increasing number of digital transactions taking place every day, huge volumes of data are being generated. The two data-driven disciplines of data science and process science have made way into the healthcare sector to generate knowledge by turning data into real value and improve the operational processes.

Process mining, a data-oriented sub-discipline of process science, is now being used to identify and analyze typical and non-typical patient journeys and map patients’ experiences. This approach has allowed for a deeper analysis of the touchpoints and the multiple variants that appear in customer journeys, relating it to the patient’s experience.

“The use of process mining to generate customer journey maps has created a powerful analysis tool to understand how processes variants (paths) and touchpoints may affect the customer experience, as well to discover how end-to-end processes look like.”

Int. J. Environ. Res. Public Health 2020, 17, 6586 https://www.mdpi.com/1660-4601/17/18/6586/pdf

More research into the application of mining algorithms and techniques to real-life healthcare processes is needed to achieve the goals of improvements in care quality and patient experience. And while we get there, Patient Journey Mapping provides us with a toolset that works today and can be used for improving patient experience and outcomes.