A customer journey map is a very simple idea: a diagram that illustrates the steps your customer goes through in engaging with your company, whether it be a product, an online experience, a retail experience, or a service, or any combination. The concept of customer journey mapping comes from the business world with respect to a better understanding how customers interact with a product or service.
The patient journey is the sequence of events that begins when a patient first develops a need for care. Journey map findings emphasized the daily challenge of integrating self-care recommendations and disease knowledge of everyday life. Healthcare organizations can increase patient retention and improve patient satisfaction with patient journey mapping (PJM). Examining the patient journey is essential to improving the patient experience. Patient journey mapping can help you to visualize all of the steps patients take throughout the entire process of seeking, receiving, and continuing care.
Patient journey mapping helps stakeholders to assess the patient experience from multiple perspectives. A journey map provides a way to visualize the internal and external factors affecting patient flow and the different paths patients must take in order to reach their care goals.
The approach used in Mapping the Patient Journey Towards Actionable Beyond Pill Solutions (MAPS) is designed to quantitatively map different stages of the patient journey. The key touchpoints along the patient journey include awareness, screening, diagnosis, treatment, adherence, and control or remission. When applied at touchpoints along the patient journey, these solutions can improve awareness to better engage patients to predict and prevent risk factors that lead to negative health consequences.
Noncommunicable diseases (NCD) are varied and complex and require solutions that balance a variety of issues, including the prevention of risk factors and the delivery of quality, cost-effective health care. To achieve desired health outcomes, there is a need for a patient-centric approach that shifts the focus from the disease to what is needed along the patient journey, from the prevention of risk factors to the control of established illness.
Awareness plays an important role in disease prevention, especially in chronic Diseases like Heart Failure, Chronic Kidney Disease, Diabetes, and COPD. Diagnosis, treatment, and adherence are basic parts of prevention of Disease progression. Patients in LMICs (low- and middle-income countries) are becoming increasingly engaged with their healthcare decisions with enhanced access to healthcare information and the requirement to pay significant out-of-pocket costs for healthcare. A patient-centric approach involves and enables participation of the patient in their own care. Also referred to as person-centric or people-centric, this integrated approach combines the expertise of HCPs with feedback from patients and their families.
The concept of patient-centered care extends to the treatments and therapies clinicians provide. Not only are care plans customized, but medications are often customized as well. A patient’s individual genetics, metabolism, biomarkers, immune system, and other signatures can now be harnessed in many disease states, especially cancer, to create personalized medications and therapies, as well as companion diagnostics that help clinicians better predict the best drug for each patient.
The WHO (World Health Organization) has developed a framework on people-centered health that shifts the focus from diseases to the needs of people at the center of the health systems. The WHO notes that such a framework can result in improved access to care, improved outcomes, better health literacy and self-care, increased satisfaction with care, improved job satisfaction for health workers, and reduced costs. The intent of patient-centered care is to reduce healthcare costs, improve health outcomes, and enhance patient experience. The primary goal and benefit of patient-centered care is to improve individual health outcomes, not just population health outcomes, although population outcomes may also improve. This patient-centric approach is being progressively recognized as a way to make evidence-based decisions for the patient that are responsive to the patient’s preferences, needs, and values, which will result in the best outcomes. Therefore, a key step in the direction of patient centricity is to create a framework to gather, assess, and validate data anchored around the patient journey.
Patient journey mapping benefits include:
- Creating shared ownership of the patient experience
- Refining your patient listening strategy
- Aligning your organization with a common view of the patient experience
- Measuring gaps between the intended experience for your patients versus the actual experience
- Identifying and resolving common pain points for patients
There are several stages along the patient journey. When gathering patient feedback, you should make sure to capture insights at each of these stages.
Awareness
Consideration
Access
Service delivery
Ongoing care
Figure1. Main stages of patient journey
Patient journey mapping: getting started
Before you get started, it’s a good idea to engage individuals across all departments and include input from multiple stakeholders. Once you’re ready, follow these steps to begin creating an effective patient journey map.
Identify your target audience
What type of patient journey will you be mapping? There may be varying patient journeys within your organization; for instance, an oncology patient’s journey will look very different from that of an expectant mother. The journey of a patient with health insurance will differ from that of a patient without insurance. To map the patient journey, you’ll want to create robust patient profiles you can use to segment and track like populations throughout the healthcare experience.
Establishing patient persona and segments
Not every patient will have the same healthcare goals. Creating patient personas based on behaviors and preferences is a good way to differentiate the needs and more clearly understand the perspectives of the unique populations you serve.
The ideal patient persona will include the following information.
- Demographic information such as age group, gender, or location
- Healthcare-specific goals, conditions, and treatments
- Healthcare-specific challenges/pain points
- Engagement patterns and expressed feedback
- How your services fit into their life
- Barriers to care
As multidisciplinary health stakeholders work towards the WHO Sustainable Development Goal of reducing premature mortality from NCDs by one-third by 2030, we must ensure that we accurately understand the complexity of the patient journey, integrate and amplify the patient voice.
Opportunities from PJM
Virtual visits (VV) include remote visits, in which an audiovisual telecommunication system is used, and e-visits, which are communications between patients and providers through an online portal. A recent statement from the Heart Failure Society of America provides information regarding platforms, workflows, and care models for VV in Heart Failure (HF) patients. Specifically, the potential benefits of VV for HF patients are providing access to care and medical advice that would be otherwise difficult to obtain and reducing in-person exposure to SARS-CoV-2.
The visual tool can help healthcare professionals, policy makers, and researchers improve healthcare provision which is patient-centered and tailored to the preferences of patients. Building the voice of the patient into business innovation. Frequently today, there is a lack of advocacy and failure to represent the patient voice internally—this not only risks the organization not meeting patient needs, but also serves to promote skepticism around pharma motivations within the healthcare ecosystem. Medical affairs have a major opportunity to address this issue by serving as the voice of the customer and patient internally at the highest levels of the company.
The ambition is for Medical Affairs to lead the way in regaining the trust of KOLs, patients, and publicity. Doing this successfully demands new thinking about how to engage with patients. Areas to consider include: how to quantify and reduce patients’ unmet medical needs, how to be patient-centric when designing clinical studies, how to improve patient support programs (PSP), and how to translate insights into opportunities to better help patients.
MSLs are well-positioned to gather insights from the field that can be used to inform internal clinical development, marketing, and market access in developing their strategies. These insights may be based on expert opinion, observations of barriers in the patient journey, or questions that emerge in scientific exchange. Insights may also be gained from advisory board meetings. Also, MSLs are well-positioned to inform people about the safe and appropriate use of therapies. Over time, MSLs have needed to become increasingly versatile given the emergence of new and broader groups of stakeholders, a shift to a more patient-centric model of care where the focus is less on the drug and more on the patient journey and technological advances in diagnostics, devices and treatments.
In conclusion, as the healthcare landscape continues to evolve, MSLs need to keep abreast of advancements and understand how they may impact clinical practice and patient outcomes. To really understand the patient’s journey from diagnosis to treatment, it’s essential to map out all the touchpoints along their paths. This will help you pinpoint key areas where medical and marketing strategies can be used to engage KOLs and patients alike. Consider how KOLs make decisions when prescribing treatments and devices, what information do they rely on? What resources are available to them? Are there any gaps in knowledge that need to be filled?
References:
- Richardson A. Using customer journey maps to improve customer experience. Harvard Business Review. 2010;15(1):2-5.
- Philpot LM. Creation of a Patient-Centered Journey Map to Improve the Patient Experience: A Mixed Methods Approach. Mayo Clin Proc Innov Qual Outcomes. 2019 Sep 24;3(4):466-475.
- Woods L, Representing the patient experience of heart failure through empathy, journey and stakeholder mapping. Patient Experience Journal. 2019; 6(1):55-62.
- Ferreira JP, World Heart Federation Roadmap for Heart Failure. Glob Heart. 2019 Sep;14(3):197-214. doi: 10.1016/j.gheart.2019.07.004.
- https://heartlife.ca/journey-map
About the author:
Omid Salemi, PhD
Currently, Cardiovascular (Heart Failure) and Patient Blood Management (PBM) MSL Lead of the Barsian Darou (Vifor Pharma) in Iran, Tehran. I have worked as an MSL in Hematology, Gastroenterology, and women’s health, for Anemia, Iron Deficiency, and Anemia of Chronic disease therapeutic areas, also the collaboration of implementing International Iron Deficiency Day awareness in Iran.
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