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Your complete guide to patient journey mapping.

15 min read Healthcare organizations can increase patient retention and improve patient satisfaction with patient journey mapping. Discover how to create a patient journey map and how you can use it to improve your organization’s bottom line.

What is the patient journey?

The patient journey is the sequence of events that begins when a patient first develops a need for care. Rather than focusing on service delivery, the patient journey encompasses all touchpoints of a patient’s healthcare experience–from locating healthcare providers and scheduling appointments, to paying the bill and continuing their care after treatment.

Examining the patient journey is essential to improving the patient experience. Not all interactions a patient has with your organization are weighted the same. Gathering patient feedback and understanding perceptions all along the patient journey can help you to identify moments of truth : the touchpoints that have the biggest impact on patient loyalty.

Download eBook: The 3 steps to driving human-centered healthcare experiences

The patient journey vs. the patient experience

Unlike traditional patient experience measurement, the patient journey looks not only at service delivery but also at the steps the patient takes before and after they engage directly with your organization. It recognizes that patient interactions with a healthcare system go well beyond the walls of the medical facility itself.

What are the stages of the patient journey?

There are several stages along the patient journey. When gathering patient feedback, you should make sure to capture insights at each of these stages.

Stage 1: Awareness

The patient journey starts with awareness. In this stage, the patient identifies a need for care and begins searching for care providers. Examples of how patients learn about healthcare providers include online searches, review sites, marketing campaigns, networking, and community involvement.

Stage 2: Consideration

In the consideration stage, the patient weighs their options to determine if your health system can meet their needs. Factors patients consider include referrals, coverage and benefits, recommendations, access, and ratings and reviews. Often in this stage, patients interact with your website or social media pages or contact you via phone or email during this stage.

Stage 3: Access

The access stage is where the patient decides to schedule services with your healthcare organization. Direct patient engagement with your organization increases during this stage. You’ll engage with patients in a variety of ways including phone calls, the patient portal, text messages, and emails as part of the scheduling and new patient acquisition process.

Stage 4: Service delivery

The service delivery stage relates to the clinical care provided to your patients. Encompassed in this stage are the clinical visit itself, check-in and check-out, admission and discharge, and billing. Traditional patient satisfaction measurement centers around this stage of the patient journey.

Stage 5: Ongoing care

The ongoing care stage of the patient journey involves patient engagement that occurs after the interactions directly related to service delivery. In addition to wellness and care management, this stage may address social determinants of health and population health.

What is a patient journey map?

The best way to utilize the patient journey to enhance patient experiences is by journey mapping. A patient journey map is a visual tool that illustrates the relationship a patient has with a healthcare organization over time.

Patient journey mapping helps stakeholders to assess the patient experience from multiple perspectives. Journey maps provide 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.

What are the benefits of patient journey mapping?

Patient journey mapping can help you to visualize all of the steps patients take throughout the entire process of seeking, receiving, and continuing care. Creating a patient journey map is useful to identify pain points and gaps in care. Mapping the patient journey makes it easier to develop solutions that make a more seamless experience within your healthcare system.

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 your patients

Four types of patient journey maps

When creating a patient journey map, there are four types to consider. Each type of map has an intended purpose. You might start your patient journey mapping with only one type and incorporate the others as your efforts progress.

Current state

A current state journey map tells the story of what patients do, think, and feel as they interact with your organization today. This type of patient journey map is ideally created using patient data and observational data.

The current state journey map is best for driving incremental improvements to enhance the patient experience.

Future state

A future state patient journey map tells the story of what you want your patients to do, think, and feel as they interact with your organization in the future. This type of map should capture the ideal journey you’d like to see for your patients.

The future state journey map is an effective tool to drive strategy, align teams, and communicate your visions for new services, processes, and experiences.

Day in the life

A day in the life patient journey map illustrates what your patients do, think, and feel today, within a specific area of focus. Patient personas are particularly useful when creating day in the life maps; these are discussed in greater detail below.

This type of patient journey map is intended to capture what your patients experience both inside and outside of the healthcare system. Day in the life maps are valuable to address unmet needs and determine how and when you can better engage your patients.

Service blueprint

A service blueprint is a simplified diagram of a current state or future state patient journey map. In the service blueprint, you add layers to illustrate the systems of people, processes, policies, and technologies surrounding each patient touchpoint.

For current state patient journey maps, the service blueprint can help to identify root causes of pain points. For future state, the service blueprint is helpful to visualize the systems or processes that can be put in place to support the intended patient experience.

How do you create a patient journey map?

Now that you know about the different types of patient journey maps and their roles in driving patient experience improvement, how do you get started on creating your own?

The most useful maps are those which can expound upon each touchpoint of the healthcare journey with operational data, such as patient demographics, as well as real patient insights and perspectives. Using a platform that can capture this data will aid significantly in your patient journey mapping process.

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 personas 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

Specify a goal for the patient’s journey

The patient personas you create will all have unique goals within the care journey. The patient has a specific goal in mind when they initiate contact with your organization, whether it is treatment of symptoms, a diagnosis for chronic issues, or surgery.

Every interaction along the patient journey influences how successful the patient feels about achieving this goal. When mapping the patient journey, you’ll want to consider how the various touchpoints affect the patient’s ability to meet this goal.

Identify the patient’s steps to accomplish their target goal

This step is about how the patient views their care journey within your health system–not about the actual processes and systems your organization has in place. Effective patient journey mapping requires you to see how the patient navigates the journey through their point of view.

Omni-channel listening is a valuable strategy in this step of journey mapping. Listening to your patients across all the channels can provide a clearer picture of their perceptions and behaviors as they engage with your organization.

Some steps the patient takes may not even include your organization, but might still affect how they are interacting with you directly. For example, if a patient logs into their health insurance portal to check coverage for healthcare services, they are not engaging with your organization but this is still a part of their care journey that may feed into their interactions with your organization later on.

Uncover perceptions along the journey

Gather patient feedback along the touchpoints of the care journey to identify key emotional moments that may disproportionately shape attitudes. These insights shed light on what’s working and what’s not; they can also be used to highlight the moments of truth that contribute to patient loyalty.

Patient perceptions are an important piece of patient journey mapping; it will be difficult to drive action without them.

Additional tips for creating the ideal patient journey map

Patient journey mapping is a continuous process. Creating the map is the first step, but the true value is dependent upon maintaining the map as you continue to gather insights and refine processes.

This leads to the second tip: be ready to take action! You can use a patient journey map to draw conclusions about your patients’ experiences within your organization, but awareness alone will yield no benefits. The journey map is a valuable tool to be used in your wider improvement efforts.

How do you drive action using a patient journey map?

Once your patient journey mapping is complete, it’s time to put it to good use. Here are five ways patient journey maps can be used to drive action.

Identify and fix problems

The visual layout of a journey map makes it ideal to identify gaps and potential pain points in your patient journeys. This will give you a better understanding of what’s working and what’s not. It will also help you to visualize where and how improvements can be made.

Build a patient mindset

Patient journey mapping enables you to incorporate more patient-centric thinking into your processes and systems. Use your map to challenge internal ideas of what patients want or need. Invite stakeholders to navigate the touchpoints along the healthcare journey to gain perspective.

Uncover unmet patient needs

By mapping the patient journey, you can build stronger patient relationships by listening across all channels to determine where experiences are falling short or where unmet needs emerge. This enables you to look for opportunities to expand alternatives, streamline initiatives, and create new, engaging ways for your patients to share feedback.

Create strategic alignment

Utilize your patient journey map to prioritize projects or improvement efforts. It can also help you to better engage interdepartmental staff to better understand policies and work together toward patient experience goals.

Refine measurement

Patient journey mapping is a great resource to use when defining patient satisfaction metrics and identifying gaps in how you currently gather insights.

How does patient journey mapping increase your bottom line?

Patient journey mapping can increase your bottom line by laying the foundation for improved patient satisfaction and higher retention.

Organizations across all industries are looking to understand customer journeys in order to attract and retain customers by gaining deeper insights into what drives the consumer experience.

As healthcare becomes more consumer-driven, health systems must similarly map the patient journey to improve the patient experience and boost retention. The cost of patient acquisition, combined with the fact that patients are willing to shop around for the best healthcare experience, means success depends on creating the most seamless patient journey possible.

The tools for success

For the most impactful patient journey mapping experience, you’ll want the ability to link your operational and experience data to your journey map’s touchpoints. Insights about what has happened at each touchpoint, as well as why it is happening, empower you to create experiences that meet patient expectations and drive up satisfaction.

Here are some best practice considerations as you develop your patient journey mapping strategy:

• Create a shared understanding throughout your health system of how your patients interact with your organization, and you’ll know the roles and responsibilities of your different teams
• Design a unique patient journey based on multichannel, real-time feedback from the patient
• Consider the frequency with which topics emerge in feedback, as well as the emotional intensity behind them to zero in on what improvements can drive the greatest impact
• Develop empathy and collaboration between teams, working together to achieve the same outcome
• Drive a patient-centric culture by developing a shared sense of ownership of the patient experience
• Connect your operational patient data with your patient experience feedback in one system
• Leverage a closed-loop feedback system that triggers actions for immediate responses to patient concerns

Qualtrics’ XM Platform™ is designed to support all of these actions throughout the journey mapping process.

The 3 steps to driving human-centered healthcare experiences

Related resources

Patient feedback 15 min read, healthcare branding 13 min read, patient journey 10 min read, patient experience 12 min read, symptoms survey 10 min read, nurse satisfaction survey 11 min read, cahps surveys 6 min read, request demo.

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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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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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• [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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The 1-2-3 Guide to Patient Journey Mapping [Template Inside]

by Gaine Solutions | Feb 28, 2024 | Healthcare , Life Sciences , Master Data Management

Patient journeys in today’s healthcare landscape are complex, spanning a number of platforms, systems, touchpoints, and interactions. As patients engage with healthcare providers through diverse channels, both digital and physical, the need for a structured and comprehensive approach to managing the patient journeys is evident. Patient journey mapping is the solution.

Patient journey mapping creates a high-level and holistic view of the patient journey that empowers healthcare providers to make the most informed and impactful decisions possible about how to enhance operations and care.

In this guide, we’ll walk step-by-step through the process of creating and implementing a patient journey map that drives better performance results and patient outcomes for your healthcare organization.

Key Takeaways:

• Patient journey mapping is crucial for understanding and enhancing the patient experience.
• Patient journey mapping leads to improved patient satisfaction, better clinical outcomes, and increased operational efficiency.
• Developing a patient journey map requires clear objectives, a cross-functional team, and data-driven approaches to gaining insight.
• Improvement strategies should be developed for each critical moment and touchpoint, with changes implemented and continuously monitored for effectiveness over time.

What is Patient Journey Mapping and Why Is It Important?

Patient journey mapping is the process of creating a detailed visualization of a patient’s healthcare journey, from initial contact through treatment and follow-up care, identifying every touchpoint along the way. This methodical approach helps healthcare providers see the care process from the patient perspective, including the highs, lows, and gaps in the patient experience.

The example below is from the U.S. Department of Veteran Affairs, and shows how intricate and complex the patient journey is once it’s mapped completely. This drives home the importance of documenting the journey visually in order to see it in a holistic way.

Image Source

When done effectively, patient journey mapping is a valuable tool driving more seamless, integrated, and patient-centered care. Journey mapping also helps healthcare organizations make informed decisions about where to allocate resources, how to streamline operations, and ways to personalize care to meet the unique needs of each patient.

In the end, the benefits of patient journey mapping are threefold:

• Improved Patient Satisfaction : Enhances the overall patient experience by addressing specific needs and preferences, leading to higher satisfaction rates.
• Better Clinical Outcomes : Identifies opportunities for early intervention and personalized care plans, contributing to improved health results.
• Increased Operational Efficiency : Streamlines healthcare processes by pinpointing inefficiencies and redundancies, leading to more effective use of resources.

It leads to 360-degree improvements that enhance clinical, administrative, and operational aspects of both the healthcare system and the patient experience. In the next section, we’ll walk through the steps you can take to develop a patient journey map for your organization.

Your Step-by-Step Patient Journey Mapping Template

1. identify the goals and scope of your map.

Begin by d eve loping a clear vision of what you aim to achieve through patient journey mapping. Whether it’s to enhance patient satisfaction, streamline healthcare delivery, or identify gaps in service, setting specific objectives will direct your mapping efforts. During this step, you should also determine the scope of your map (i.e. whether it focuses on a particular service line or the entire healthcare experience).

2. Gather a Cross-Functional Team

Assemble a team that represents a broad spectrum of roles within your organization, including clinicians, administrative staff, IT professionals, and cust ome r service representatives. Diverse perspectives ensure a holistic view of the patient journey, capturing insights from every facet of patient interaction. 

3. Map the Patient Touchpoints

Systematically list every interaction point between the patient and your healthcare system. This includes digital touchpoints like website visits, appointment scheduling portals, and social media interactions, as well as physical touchpoints like clinic visits, phone calls, and direct mail communication. Mapping these touchpoints requires a detailed understanding of the patient’s path through your system, from initial awareness through treatment and follow-up care.

4. Collect and Analyze Data

Leverage diverse data sources to understand patient experiences at each touchpoint. Collect patient feedback through cha nne ls like surveys, interviews, and comment cards. Analyze staff insights and review operational data. Look for patterns in behavior and satisfaction levels, and identify bottlenecks or pain points in the patient journey.

Having a centralized data management platform in place is crucial for this step—it provides a central repository for the data you collect as part of your patient journey mapping exercise, while also giving you seamless access to historical data in one location.

5. Visualize the Journey

Develop a visual representation of the patient journey. Use flowcharts, storyboards, or diagrams to depict the sequence of touchpoints and the patient’s experience at each stage. This visualization should be from the patient’s perspective, highlighting critical interactions, emotions, and decision points.

Tools like customer journey mapping software can facilitate this process, but even simple graphical tools or whiteboards can be effective.

6. Identify Moments of Truth

Highlight key moments in the journey that significantly impact the patient’s perception of care—things like first contact, diagnosis communication, wait times, and billing support. These are opportunities to make a lasting impression on the patient, and identifying them allows your team to prioritize areas for immediate improvement or innovation.

7. Develop Improvement Strategies

For each critical moment and touchpoint, evaluate what’s working effectively as well as areas for potential improvements. Call out specific gaps and pain points that may exist for the patient at every stage on your journey map. Then, brainstorm how to resolve them.

This may happen by introducing new technologies, optimizing existing processes, providing additional training for your staff, enhancing communication strategies, and more.

8. Implement Changes

Prioritize the identified improvements based on their potential impact and feasibility. Create a detailed implementation plan, assigning clear responsibilities and deadlines. Ensure there is a mechanism for tracking progress and measuring the impact of these changes on the patient experience and other goals and objectives you set at the start of the process.

9. Monitor and Adjust

Establish a continuous feedback loop to monitor the effectiveness of implemented changes. Use patient feedback, staff input, and performance metrics to assess progress. Be prepared to make iterative adjustments to your strategies based on this feedback, fostering a culture of continuous improvement.

Putting it All Together

Embarking on patient journey mapping is more than a strategic exercise—it’s a commitment to elevating the standard of care through a deep understanding of the patient’s experience. It represents a pivotal shift toward a more empathetic, patient-centric approach in healthcare, where decisions are informed by the nuanced needs and experiences of those we serve.

Gaine’s Coperor platform is a scalable, ecosystem-wide master data management solution designed for the unique challenges of the healthcare and life sciences industries. It creates a single source of data truth within an organization that makes initiatives like journey mapping possible. Learn more here or start your real-time Coperer demo today.

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Patient journey 101: Definition, benefits, and strategies

Last updated

22 August 2023

Reviewed by

Melissa Udekwu, BSN., RN., LNC

Today’s patients are highly informed and empowered. They know they have choices in their healthcare, which can put healthcare providers under a lot of pressure to provide solutions and meet their patients’ expectations.

Just like any customer, patients embark on a journey that begins before they ever contact the provider. This makes understanding the journey and where improvements can be made extremely important. Mapping the patient journey can help practitioners provide better care, retain a solid customer base, and ultimately identify ways to improve patient health.

• What is the patient journey?

The patient journey is best described as the sequence of experiences a patient has from admission to discharge. This includes all the touchpoints between the patient and provider from beginning to end.

The patient journey continues through consultation, where they meet the potential caregiver. That portion of the journey includes interactions with a doctor and support staff, how long they wait to be seen, and the steps taken for diagnosis and treatment.

The patient’s post-care journey includes follow-ups from the healthcare provider, post-treatment care, and billing. For example, if the patient has questions about post-surgery care or how to read their invoice, how quickly their questions are answered and their problems resolved will impact their satisfaction.

Mapping the patient journey helps healthcare providers improve patient satisfaction at every step of the way. By collecting data at each stage and conducting an in-depth analysis, providers can identify patient concerns and make the necessary improvements to meet their patient satisfaction goals.

What is another name for the patient journey?

The term “patient funnel” describes the journey patients take from first learning about a healthcare provider or healthcare product to actually making an appointment or purchase. This “funnel” can be applied to any type of business, describing the stages a customer goes through to obtain a service.

• Understanding the stages of the patient journey

Each stage of the patient journey is essential to a positive patient experience . Gathering and analyzing data can alert healthcare providers to potential issues throughout the journey.

Data collection at each of the following stages will give healthcare providers the information they need to make the necessary improvements:

1. Awareness

Awareness is where the patient journey begins. This is when they first research symptoms and identify the need to see a medical professional.

They may consider at-home remedies and get advice from friends, social media, or websites. Once they identify the need for a healthcare provider, they continue their research via review sites, advertising campaigns, and seeking referrals from friends and family.

Determining the way patients become aware they need healthcare and the sources they use for research is important. The data collected at this stage could suggest your organization has an insufficient social media presence, inadequate advertising, or a website in need of an update.

To remedy these shortcomings, you might consider adding informational blogs to your website, performing a social media analysis, or closely monitoring customer reviews.

This stage in the patient journey is where the patient schedules services with the healthcare provider.

This engagement is essential for acquiring new patients and retaining current patients. Patients will contact you in several ways to schedule an appointment or get information. Most will call on the first attempt to schedule an appointment.

This is a crucial touchpoint in the journey. A new patient may become frustrated and move on if they find it difficult to access your services or are placed on hold for a long period or transferred numerous times.

Patient engagement occurs in other ways, such as your online patient portal, text messages, and emails. Your patients may interact differently, so it’s important to gather data that represents their preferred means of communication. Work to make the improvements required to correct access issues and ensure efficient communication.

The care stage can include everything from your patient’s interaction with the front desk to how long they have to wait in the examination room to see a doctor.

Check-in, check-out, admissions, discharge, billing, and of course, the actual visit with the healthcare provider are other touchpoints in the care stage.

There are a couple of ways to gather and analyze this data. Most organizations choose to analyze it holistically, even if it’s collected separately. For example, you might gather data about the patient’s interaction with the front desk, the clinical visit, and the discharge process, but you may want to analyze the care segment as a whole.

4. Treatment

Treatment may be administered in the office. For example, a patient diagnosed with hypertension may have medication prescribed. That medication is the treatment. Gathering information at this stage is critical to see how your patient views the healthcare provider’s follow-up or responses to inquiries.

In most cases, treatment extends beyond the initial clinical visit. For example, a patient might require additional tests to get a diagnosis. Providing the next steps to a patient in a timely manner and letting them know the test results is crucial to patient satisfaction .

5. Long term

A satisfied patient results in a long-term relationship and referrals to friends and family. Most of the data collected at this stage will be positive since the patient is continuing to use your services.

Gathering data after the treatment stage allows you to expand on the qualities that keep patients returning for your services in the long term.

• Benefits of patient journey mapping

The patient benefits from their healthcare provider understanding their journey and taking steps to improve it. Healthcare providers also reap several benefits, including the following:

1. Efficient patient care

When they understand the patient journey, healthcare providers can provide care more efficiently and spend less time and money on unnecessary, unwanted communications.

2. Proactive patient care

Proactive patient care is aimed at preventing rather than treating disease. For example, women who are over a certain age should have an annual mammogram, smokers may be tested for lung disease, and elderly women may need a bone density study. These preventative measures can help keep disease at bay, improve health outcomes, and build trust with patients.

3. Value-based patient care

Patients don’t want to feel they are being charged unfairly for their healthcare. Focusing on the individual patient promotes satisfaction and yields positive outcomes.

The Center for Medicare and Medicaid Services (CMS) has issued recent guidelines for participants that help offset the costs of high-quality care through a reward system.

4. Retention and referrals

Patients who are happy with their journey will keep returning for healthcare, and happy patients equal voluntary referrals. Many providers offer rewards to incentify referrals.

• How to get started with patient journey mapping

Follow the steps below to start the patient journey mapping process:

Establish your patient personas

Journey mapping is a great way to identify your patient’s characteristics so that their experience can be further enhanced.

Some of the following determinations can help you pinpoint your patient’s persona and establish protocols to provide a better service:

How do your patients prefer to communicate? Are they more comfortable with phone calls, texts, or other methods?

How are most patients finding your services? Are they being referred by friends or family members, or are they seeing advertisements?

Would the patient prefer in-person communication or telecommunication?

What are the patient’s expectations of care?

This data can be complex and widespread, but it can give you the information you need to more effectively and efficiently communicate with your patients.

Understand the entire patient lifecycle

Each patient is unique. Understanding the patient lifecycle can avoid confusion and miscommunication.

To positively engage the patient, you’ll need to gather data not only about communication methods but where they are in the patient journey, their health issue, and their familiarity with the healthcare provider’s procedures and treatment options.

Understand the moments of truth

With a few exceptions, most people seek healthcare services when they are ill or have a healthcare issue. These situations can cause patients to feel stressed and anxious. It’s these moments of interaction where compassion, knowledge, and understanding can provide relief and reassurance.

When patients see their healthcare provider, they are looking for solutions to problems. It’s the provider’s opportunity to identify these moments of truth and capitalize on them.

Get the data you need

Healthcare providers can collect vast amounts of data from patients, but the data collected rarely goes far enough in analyzing and determining solutions.

Your patients have high expectations regarding personalized treatment based on data. They want personalized, easy access to medical information and records, responsive treatments and follow-up, and communication in their preferred format.

You need more than clinical data to give patients what they want. You also need personal data that sets each patient apart and ensures a tailored experience.

For example, it might be challenging for parents of small children to contact the clinic and schedule appointments at certain times of the day. As a healthcare provider, you’ll need to be aware of the best times to contact this individual and offer simple methods for scheduling appointments.

Another example is patients with physical disabilities. You can take steps to improve their access to and experience at the healthcare facility.

Encourage referrals and loyalty

Although engagement on social media and online forums is becoming more and more common, the best way for new patients to find you is through referrals. Referrals stem from satisfactory experiences and trust.

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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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Nursing and the Patient Journey

• First Online: 22 September 2023

Cite this chapter

• Barbara Sassen   ORCID: orcid.org/0000-0001-8354-7885 2  

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Patient mapping or patient journey, a tool used to visualize the patient journey, is beneficial in understanding the patient’s experience with healthcare. It highlights what contributes to good care and what does not from the patient’s perspective.

Additionally, the concept of the patient journey is used in the context of quality of care to refer to the path a patient takes through the healthcare system. By viewing the journey from the patient’s perspective, the effectiveness and efficiency of care can be improved by eliminating ineffective or unnecessary treatments. This can lead to a redesign of the patient’s journey with the goal of increasing patient satisfaction and improving the quality of care. Achieving this requires healthcare providers to align care with the patient’s perceptions, preferences, and expectations.

Understanding the patient experience within the healthcare system is important particularly using patient journey mapping. This involves mapping out the process a patient goes through, from diagnosis to discharge, to identify areas for improvement and to make care more efficient and effective. The focus should be on activities valued by patients to improve patient satisfaction. Process mapping is also used to optimize care processes, but it often lacks a patient-centered approach. The text emphasizes the importance of incorporating patient satisfaction into medical protocols, guidelines, and ethical standards. A care continuum is also preferable from a patient perspective, where care providers maintain continuous contact with their patients to avoid gaps in care and ensure effective care outcomes.

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Sassen, B. (2023). Nursing and the Patient Journey. In: Improving Person-Centered Innovation of Nursing Care. Springer, Cham. https://doi.org/10.1007/978-3-031-35048-1_26

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• What is Patient Experience & Why It Is Importance ?

A Comprehensive Guide to Patient Journey Mapping

• Author: Wavetec
• Published: January 26, 2024

Is regulating patient experience at your healthcare service a challenging task? If your patients leave the hospital unsatisfied with the service, we have a solution for you!

Patient journey mapping is vital in understanding your patient’s experience at every step of interaction with the hospital, whether virtual or physical. This allows you to empathize with your patients, facilitate their experience, and contribute in uncertain and stressful times.

Parallel to the patient’s journey, healthcare systems face increasing challenges in patient management, regulating space constraints, limiting healthcare providers, and budgeting. By mapping the patient journey , you can pinpoint the shortfalls in your management services, improve facilities, and increase patient turnout.

The patient journey map must be curated in detail, accounting for various touchpoints and patient perceptions. The most accurate method of measuring healthcare quality is pairing patient journey maps with patient satisfaction scores, such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPHPS) and a Net Promoter Score (NPS) .

Higher scores speak volumes about your healthcare services, increase patient retention, and promise returns.

What is Patient Journey Mapping?

Patient Journey Mapping is a strategic tool in healthcare that visually illustrates the entire patient experience, from initial contact to post-treatment follow-up. It involves mapping out key touchpoints and stages, such as appointment scheduling, diagnosis, treatment, and aftercare.

This process allows healthcare providers to understand the patient’s pathway through the healthcare system comprehensively.

Amidst the changing landscape of the healthcare industry, patients look for service providers that offer a personalized experience. Besides renowned healthcare providers, patients look for a human-centric environment that provides timely and efficient services.

Moreover, modern consumer requirements demand a digital transformation of healthcare services.

Healthcare managers can use patient journey maps to visualize the blind spots and pain points in a patient’s experience. A distinguished healthcare service sees journey mapping as a powerful tool that tells about a patient’s well-being and connects care providers with their emotional journeys.

You can make your practices to be more empathetic and make a difficult journey seamless.

The Benefits of Patient Journey Mapping

Investing in patient experience mapping carries benefits for both parties, care providers and patients. We have highlighted some benefits of journey mapping below:

Improved patient communication

Identifying unaddressed patient issues helps build a connection with the patient. Keeping them at the model’s center and informing them of changes before their visit reduces frustration and confusion.

Continuous patient care

With a streamlined workflow, staff members and care providers can remove uncertainties from a patient’s care journey. An integrated healthcare system removes loopholes, such as overbooked appointments, which otherwise lead to negative patient feelings.

Personalized care

Given the nature of the treatment plans and services offered by the healthcare industry, a one-shoe-fits-all theory does not apply to the consumers. By integrating patient data with business models, you can provide a customized experience to the patients.

Turn-out increases when patients receive automated appointment reminders and physician availability updates.

Improved Efficiency

Patient journey maps identify the demand for time management and sensitivity in healthcare. Feasibility arrangements such as pre-booking appointments, receiving digital laboratory reports, and online consultations boost patient satisfaction.

Patient retention and profitability

Patient feedback is crucial to introducing or revising policies, growth opportunities, and consistent revenues.

Seamless Patient Journey

With our intuitive interface, patients can easily register, check-in, and monitor their queue status. This reduces their anxiety, improves their overall experience, and fosters a positive perception of your healthcare facility.

7 Key Stages in the Patient Journey

Patient journey mapping differs for each hospital or clinic, depending on the care level. Most tertiary care hospitals identify three key stages when patients experience mapping .

Touchpoints of each step may differ slightly in pregnancies, emergency services, and outpatient departments.

Let’s read about the details of each stage below:

1. Awareness:

• This stage often begins with recognizing symptoms, changes in health, or routine checkups revealing potential issues.
• Patients may notice something is amiss, prompting them to seek further information or professional advice.

2. Consideration:

• Information gathering kicks into high gear. Patients may research their symptoms, explore potential causes, and consider various treatment options.
• Seeking advice from healthcare professionals, friends, or family members becomes a key part of this stage.

3. Decision:

• Armed with information, patients make decisions about their course of action. This could involve choosing a specific healthcare provider, deciding on a treatment plan, or committing to lifestyle changes.
• The decision-making process may also involve discussions with healthcare professionals to ensure alignment with the patient’s values and preferences.

4. Engagement:

• This is the active phase, where patients interact with healthcare providers, undergo diagnostic tests, and initiate the chosen treatment plan.
• Open communication between the patient and the healthcare team is crucial during this stage to address concerns, clarify expectations, and ensure a collaborative approach.

5. Treatment and Recovery:

• The chosen treatment plan is implemented, whether it’s medication, surgery, therapy, or a combination of interventions.
• Recovery involves monitoring progress, managing potential side effects, and adapting the treatment plan as needed.

6. Follow-Up and Maintenance:

• Post-treatment, patients often enter a phase of follow-up care. This can include regular check-ups, monitoring for recurrence, and adjusting treatment plans as necessary.
• Lifestyle changes and ongoing self-care may be emphasized to maintain health and prevent future issues.

7. End-of-Life Care (if applicable):

• In cases of terminal illness, this stage involves compassionate and supportive care. Palliative care aims to enhance quality of life, manage symptoms, and provide emotional and spiritual support.
• This stage emphasizes open communication about end-of-life preferences and ensures a dignified and comfortable experience for the patient and their loved ones.

Analyzing the Patient Journey Map

Once you have designed a patient journey map for your service, the correct way of utilizing the maps is to identify the pain points. Next, we enlist and discuss some common hurdles patients face that delay prompt care, including internal and external factors or barriers to healthcare.

1- Pre-visit

• The patient feels anxious about the medical condition.
• The website needs more information about the healthcare facility to make patients satisfied. Your website must be SEO-friendly and listed on Google to regulate patient management.
• During this stage, missed phone calls and confusing appointment scheduling tasks lead to care provision delays.
• Limited communication with consultants before visiting

2- At the healthcare facility

• Filling out the pre-appointment questionnaire is time-consuming and makes patients uneasy.
• Lengthy waiting times and mismanaged queues for appointments reduces patient satisfaction. Patients waiting at the facility can be guided using digital signage that communicates announcements, turns, and navigates around the healthcare facility.
• Explaining old symptoms and information to the same care provider at every visit frustrates patients.

3- Post-treatment plan

• Billing and initiating the hospital discharge process is often tedious.
• Receiving feedback from patients to measure patient satisfaction.
• Unable to monitor the patient at home and set up follow-up appointments creates mistrust between the patient and the doctor.

Gain valuable insights

Leverage our healthcare queue management system’s data to make informed decisions to improve the patient experience. We have seen up to a 35% increase in patient satisfaction.

Patient Journey Mapping Template

We have designed templates of patient journey maps to help you make the best one for your hospital system. As shown in the samples, patients visiting different departments have specific touchpoints. For example, a patient scheduling his appointment for the outpatient department will research the clinic and the primary caregiver.

However, the primary concern for patients requiring urgent care will be prompt ambulance services and treatment. Despite the differences, all patient journey maps are based on three key stages: pre-hospital care, in-hospital care, and post-treatment plans.

Patient Journey Improvement Solutions

If you want to enhance patient flow management and boost patient satisfaction at your hospital, we recommend using pre-engineered solutions. There are many ways to improve the quality of service you provide to your patients.

One such solution is the Wavetec patient flow system. Adopting a digital healthcare system can optimize patient-doctor interaction and improve investment returns.

We have put together the most impactful solutions your facility can sign-up for each stage of the patient journey map. Here’s what they are:

• Online appointment and booking
• Queue management – People counting, WhatsApp Queuing, Queue management applications, Digital Signage
• Patient application
• Self-check-in kiosks
• Integrated manager dashboards and analytics
• Customer feedback reports
• Curbside pickups

Let’s learn about each solution and how it will benefit your healthcare center.

1. Simplify Online Appointment Booking

Before visiting the facility, patients can schedule online appointments and ticketing on the website or patient application with their preferred physician. This service allows your patients to book seamlessly, check-in and receive wait time or canceled appointment notifications. Satisfying your customer before they arrive mitigates their already-high worry levels.

2. Patient Management

Waiting in queues for examination rooms and healthcare providers is a major source of concern for patients. You can reduce perceived wait times by giving patients a virtual waiting room. This can be done by signing up for WhatsApp Queuing and the Queue Management Mobile App. These services give patients virtual tickets and wait time notifications, allowing them to manage time effectively.

Walk-in patients and patients with pre-booked appointments can also use automated, self-service kiosks at the facility to check in or reschedule appointments. Patients can scan the displayed QR code or use biometrics technology to receive tickets via SMS, Email or WhatsApp.

You can manage the patient count in the waiting area using a real-time counter and digital signage . This helps emergency case patients to navigate the hospital without confusion.

3. Promoting Patient Satisfaction

Many patients must visit the healthcare facility multiple times to collect laboratory reports, prescriptions, and medications. You can facilitate this tedious process by providing delivery and curbside pickup options. This regulates unnecessary traffic at your hospital and saves time for patients.

Investing in Patient Applications is a great marketing tool and a one-stop solution to patient worries. Individuals can learn more about your facility’s services, access laboratory reports, initiate billing, and receive updates and reminder notifications. This is particularly useful in conducting telehealth rotations with expecting mothers and palliative care patients who cannot visit the facility often.

4. Patient Feedback

Receiving your consumer’s feedback and solving their queries ensures a successful approach to patient journey mapping. Wavetec has designed a customer feedback solution to measure customer satisfaction and follow up on your staff’s performance.

Additionally, you can get a management portal for the hospital staff and care providers. This can be integrated with patient data to give healthcare providers complete information.

Softwares such as Spectra include dashboard analytics and reports on the performance of each department to help you identify the shortfalls. This will help you build a congregated team that runs operations smoothly in the patient’s best interest.

Studies have shown that facilities using solution experience up to a 50% decrease in missed appointments, optimizing resource utilization and increasing revenue.

The modern healthcare system requires providers to be more involved in providing a seamless patient experience. In this blog, we highlight the role of patient journey mapping to help you identify touchpoints in a patient’s journey. Before, during, and after treatment, it is crucial to comprehend the patient’s viewpoint to ensure proper care.

Patient journey solutions are, therefore, integral in distinguishing your healthcare facility. Investing in patient applications, queue management software, receiving customer feedback, and analyzing it is vital in improving your standing.

Adopt our solutions, transform the healthcare industry, and make your approach more empathetic!

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Healthcare and Life Sciences

The essential guide to patient journey mapping

By Jim Burke

The healthcare industry is experiencing a paradigm shift towards patient-centric care. This shift is driven by the realization that the quality and effectiveness of healthcare services greatly depend on understanding each patient’s unique journey.

At the heart of this transformation lies the concept of patient journey mapping, which aims to capture and analyze a patient’s interactions—from their first point of contact to the final stage of their encounter and their ongoing engagement thereafter.

In this blog, we’ll explore:

• The significance of the patient journey in healthcare.
• The various stages of patient journey mapping.
• How healthcare organizations can leverage Talkdesk tools to map the patient journey effectively.

What is a patient journey?

A healthcare patient journey delineates a patient’s experiences from initial symptom recognition to the final treatment outcome and their ongoing engagement. It includes several stages—awareness, consideration, access, service and care delivery, and ongoing care and engagement.

Patient journey mapping is a strategic tool that helps visualize this process, allowing healthcare providers to better understand their patient needs and identify improvement opportunities.

Why is the patient journey important in healthcare?

Understanding the healthcare patient journey is critical for enhancing patient satisfaction and improving healthcare outcomes. Here are some of the ways patient journey mapping contributes:

It allows you to measure and monitor patient satisfaction.

Patient journey mapping measures patient satisfaction throughout their healthcare experience. This allows healthcare providers to assess the quality of patient interactions at every stage, from the initial consultation to follow-up care after treatment. Healthcare providers can make quick adjustments to their services and touchpoints, leading to continual improvement and high levels of patient satisfaction.

It reduces wait times.

Long waiting times are a very common source of dissatisfaction among patients. Patient journey mapping helps healthcare providers identify factors contributing to these prolonged wait times. With this insight, they can streamline their processes and optimize operations, significantly reducing wait times and enhancing patient satisfaction. 

It helps you identify pain points in the patient experience.

A patient journey map can identify pain points in the patient’s experience. These could range from administrative complexities, low appointment availability, and billing confusion to insufficient follow-up care. Identifying and addressing these issues provides a smoother patient journey, increasing patient satisfaction and improving healthcare outcomes.

The eight steps in the patient journey.

The healthcare patient journey is a comprehensive sequence that encapsulates a patient’s healthcare experience from start to finish. It’s an indispensable tool for healthcare providers striving to enhance patient satisfaction and outcomes. Here are eight critical stages of this journey.

1. Awareness. 

This initial stage is when a patient first recognizes a health issue and begins to seek information about it. They might turn to internet searches, personal knowledge, or advice from friends and family. Healthcare providers can play a crucial role here by offering reliable, easily accessible information and interactive symptom checkers about various health conditions and guiding patients toward appropriate care.

2. Consideration. 

At this stage, patients are actively researching potential healthcare providers and comparing them based on expertise, location, cost, and reputation. Providers can stand out by clearly communicating their unique approach to care or their expertise in treating a specific condition or community, and ensuring positive online reviews and testimonials are readily available for prospective patients.

3. Access. 

This involves patients making their first contact with the healthcare provider, often through booking an appointment or consultation. This process needs to be as seamless and convenient as possible and could include offering flexible scheduling options and streamlined registration processes. Patients expect synchronized and convenient access experiences, similar to what they receive in other industries. Providers who enable self-service and EHR-integrated patient access tools can meet and exceed these expectations and capture patients that might otherwise be frustrated waiting on hold or for normal business hours to get an appointment scheduled or changed.

4. Education. 

As patients learn about their diagnosis and treatment options, healthcare providers must communicate clearly, concisely, and compassionately. This helps patients understand their situation so they can make informed decisions. This might include providing resources like post-visit instructions and condition information  or links to reputable online information. Giving patients easy and consistent access to information helps keep them engaged with their care plan and builds trust with the health system before and in between encounters.

5. Service delivery. 

This is the actual provision of medical care. Whether through routine check-ups, surgical procedures, or ongoing treatments, healthcare providers must offer high-quality, patient-centered care. Efficient service delivery also ensures the healthcare environment is clean, safe, and comfortable for patients.

6. Ongoing care. 

This stage involves follow-up appointments, medication management, and long-term health maintenance. Regular communication and support from healthcare providers are essential to ensure patients adhere to their treatment plans and manage their health effectively. This might include regular check-ins, medication or appointment reminders, and providing self-care resources.

7. New patient referrals. 

Patients who have had a positive experience may recommend the healthcare provider to others. This word-of-mouth marketing is incredibly valuable and often a testament to the high-quality care and service patients have received. Providers can encourage referrals by offering exceptional care and occasionally reminding satisfied patients that referrals are appreciated.

8. Loyalty. 

The final stage of the patient journey is loyalty, where patients choose the same provider for future healthcare needs. This is the ultimate goal for healthcare providers and is achieved through consistent, high-quality patient experiences throughout the journey. Successful loyalty building also involves responding promptly and compassionately to issues or concerns.

Patient experience reimagined by Ed Marx

Ed Marx, author of “Healthcare Digital Transformation” and former CIO of the Cleveland Clinic, shares his thinking on how organizations can make the patient experience a priority.

How to facilitate successful patient journey mapping.

Patient journey mapping allows healthcare organizations to visualize the healthcare experience from the patient’s perspective. This helps providers identify opportunities for improvement and enhance the overall patient experience .

Identify stakeholders.

The first step is identifying the key stakeholders, such as doctors, nurses, patient access center and revenue cycle staff, administrative staff, and even patients and their family members. Involving diverse perspectives can help ensure a more comprehensive understanding of the patient’s journey.

For example, in a hospital, stakeholders might include the access team who schedules appointments, the nurse who takes vitals, the doctor who provides treatment, and the billing department who handles payment in addition to the patient and possibly their caregiver.

Define objectives.

Next, it’s important to clearly define what you hope to achieve with your patient journey map. This could involve improving patient satisfaction, reducing wait times, or improving communication between staff and patients.

An objective could be reducing patient wait times in the health system’s primary care clinics by streamlining the scheduling process.

Map touchpoints.

A touchpoint is any point of interaction between the patient and the healthcare provider. Mapping these touchpoints can help you visualize the patient’s experience and identify any areas of friction or dissatisfaction.

For example, in a typical doctor’s visit, touchpoints include accessing scheduling options and information, scheduling the appointment itself, confirming, rescheduling, or canceling the appointment, checking in at the reception desk, waiting in the waiting room, interacting with the nurse and doctor, receiving a prescription, offering feedback or a review, and paying for the visit .

Provide staff training.

After creating the healthcare patient journey map, training staff on its findings and implications is important. This can ensure everyone understands their role in improving the patient experience and is equipped with the tools and knowledge to make necessary changes.

Staff training might involve role-playing exercises based on the journey map, workshops on improving patient communication, or seminars on implementing new procedures.

Benefits of using Talkdesk tools to gather actionable data.

Talkdesk contact center and patient experience tools help healthcare organizations enhance customer experiences and elevate operational efficiency:Amplifying customer insights.

Customer experience (CX) analytics sheds light on patient behaviors, preferences, and pain points, acting as a compass, guiding healthcare organizations to understand their patients’ needs better.

For instance, CX analytics can reveal patterns in how patients seek help or the common issues they face during their healthcare journey when they interact with key teams like patient access or billing. These insights enable healthcare providers to tailor their services, operations, and support mechanisms to align more closely with patient needs, improving the overall patient experience.

Crafting personalized customer experiences.

Personalization is no longer a luxury, but a necessity in today’s healthcare scenario. Talkdesk CX analytics enables healthcare organizations to personalize patient interactions.

It uses generative AI to draw insights from customer interactions, helping contact centers understand and resolve customer service issues efficiently. This ensures patients receive the most relevant care and assistance. Armed with data-driven insights, healthcare providers can offer targeted recommendations, enhancing the patient experience.

Generative AI and the healthcare contact center of the future

Find out how this exciting new technology will change everything from patient self-service to the role of the healthcare contact center agent.

Boosting operational efficiency.

Operational efficiency is crucial in the healthcare sector, where every minute counts. Analyzing CX data helps identify operational bottlenecks and inefficiencies that could slow down service delivery or affect patient satisfaction.

For example, if data indicates that patients are experiencing long wait times to schedule radiology appointments during certain hours, healthcare organizations can adjust staffing levels or streamline processes during these peak times. Similarly, if certain procedures or systems are causing confusion or dissatisfaction among patients, changes can be implemented to address these issues.

This insight-driven approach enables healthcare organizations to make strategic decisions that improve process flow and operational efficiency. Ultimately, Talkdesk tools empower healthcare providers to deliver a more efficient, seamless, and satisfying patient journey.

Talkdesk makes it simple to map the patient journey. 

The healthcare industry is seeing a range of new, innovative contact center solutions tailored to the unique needs of healthcare providers and payers. These solutions aim to optimize patient experience by facilitating seamless communication across multiple channels, leveraging modern technology.

Talkdesk Healthcare Experience Cloud is the contact center platform built exclusively for healthcare. It allows healthcare organizations to deliver a differentiated patient journey that is connected, personalized, and scalable. This is achieved by integrating AI-powered customer service tools that enhance patient-provider interactions and drive exceptional customer outcomes. Learn more and request a demo of Talkdesk Healthcare Experience Cloud today to see for yourself how we make it simple for you to map, track, and manage patient journeys.

HEALTHCARE & LIFE SCIENCES

The contact center solution built just for healthcare.

Talkdesk Healthcare Experience Cloud™ helps organizations create synchronized, personalized, and radically convenient experiences for healthcare patients, members, and caregivers.

As Talkdesk's Manager for Healthcare and Life Sciences Marketing, Jim Burke is focused on helping healthcare organizations deliver better experiences for their patients and members through thoughtful and transformative technology solutions. He lives in his hometown Los Angeles and is fueled by coffee and Lakers basketball.

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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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Process mapping the patient journey: an introduction

Affiliation.

• 1 Department of Gastroenterology, Portsmouth Hospitals Trust, Portsmouth PO6 3LY. [email protected]
• PMID: 20709715
• DOI: 10.1136/bmj.c4078
• Critical Pathways / organization & administration*
• Critical Pathways / standards
• Data Collection
• Data Interpretation, Statistical
• Diffusion of Innovation
• Patient Care Planning / organization & administration
• Patient Care Planning / standards
• Quality of Health Care

How to Use Process Mapping in Healthcare for Better Patient Care

Process mapping in healthcare isn’t given as much attention even though it can revolutionize the way medical institutions work.

Imagine a world where patient care takes center stage and healthcare processes are finely tuned for efficiency and effectiveness. That’s a world with healthcare process mapping. 

In the ever-evolving landscape of healthcare, optimizing patient care has become paramount. We’re delving into the powerful practice of process mapping and exploring strategies that can revolutionize the way healthcare professionals deliver exceptional care . 

Join us as we unravel the secrets behind enhancing processes, streamlining operations, and ultimately, transforming the patient experience. Get ready to embark on a journey of discovery, where every step counts towards achieving excellence in healthcare process management .

What is process mapping in healthcare? 

Process mapping in healthcare is a visual representation and analysis of the sequential steps and interactions involved in delivering healthcare services to patients. It is a systematic approach that allows healthcare professionals to understand, document, and improve processes within a healthcare setting. 

When done correctly, process mapping offers a comprehensive view of how different activities, departments, and individuals interact to deliver patient care . By mapping out the processes, healthcare organizations can identify:

• Inefficiencies
• Bottlenecks
• Areas for improvement

Examples of how process mapping is used in healthcare

Additional image goes here 

Process mapping is a versatile tool used in various areas of healthcare to improve patient care and operational efficiency. Here are a few examples of how process mapping is utilized:

Patient journey mapping

Through process mapping, users can visualize the entire patient journey, starting from the moment a patient enters the healthcare system to their discharge. This helps identify potential delays, communication gaps, and areas for improvement to enhance the overall patient experience.

Medication management

Process mapping outlines the steps involved in medication administration, from prescription to dispensing and patient education. By identifying potential medication errors or bottlenecks , healthcare providers can implement strategies to ensure safe and efficient medication management .

Surgical process mapping

Surgical procedures and be streamlined with effective process mapping. This ensures smooth coordination among surgical teams, operating rooms, and support services. 

It helps identify opportunities for: 

• Reducing waiting times
• Optimizing resource allocation
• Enhancing patient safety during surgical interventions

Emergency department management

Process mapping is applied to evaluate and improve the efficiency of emergency department workflow templates . 

By visualizing the various stages of patient triage, assessment, treatment, and disposition, healthcare providers can: 

• Identify areas of congestion
• Optimize resource allocation
• Reduce patient waiting times

Electronic health record (EHR) optimization

Another use case for process mapping in healthcare is to analyze the flow of information within an EHR system. It helps identify areas of inefficiency, such as duplicate documentation or data entry, and facilitates the implementation of streamlined processes fo: 

Quality improvement initiatives

Process mapping plays a crucial role in quality improvement projects, such as reducing hospital-acquired infections or improving patient handoffs . 

It allows healthcare teams to: 

• Identify critical process steps
• Potential failure points
• Areas for standardization and training

As a result, enhanced patient safety and care quality is provided.

How healthcare institutions benefit from process mapping

Healthcare institutions benefit in numerous ways from the implementation of process mapping. Some of the key advantages include:

Enhanced patient care

When processes are mapped, healthcare institutions are empowered to identify and eliminate inefficiencies, bottlenecks, and variations in care delivery. By streamlining processes, reducing errors, and improving workflow, healthcare providers can enhance the quality and safety of patient care. 

This leads to:

• Improved patient outcomes
• Increased patient satisfaction
• Better overall healthcare experiences

Operational efficiency

Process mapping helps healthcare institutions identify areas of waste, duplication, and unnecessary steps in their processes. By optimizing workflows , eliminating non-value-added activities, and enhancing resource allocation, healthcare organizations can achieve significant improvements in operational efficiency. 

This can lead to:

• Reduced costs
• Increased productivity
• Improved resource utilization

Standardization and consistency

Healthcare professionals promote standardization of processes across healthcare institutions when they map out this work. By establishing clear guidelines, protocols, and best practices, healthcare providers can ensure consistency in care delivery. This reduces variations in treatment outcomes and improves the reliability and effectiveness of healthcare services.

Identification of improvement opportunities

A visual representation is provided through good process mapping, which makes it easier to identify areas for improvement. By analyzing process maps, healthcare institutions can pinpoint inefficiencies, bottlenecks, and sources of errors. 

This enables them to implement targeted interventions, such as:

• Workflow redesign
• Technology implementation

As a result, healthcare institutions optimize their processes, which enhances patient care.

Team collaboration and communication

Process mapping encourages collaboration and communication among healthcare teams. By involving multiple stakeholders in the process mapping exercise, healthcare institutions can foster a shared understanding of workflows, responsibilities, and handoffs. 

This promotes: 

• Effective teamwork
• Enhances interdepartmental coordination
• Reduces communication gaps

All these factors lead to smoother care transitions and improved patient outcomes.

Continuous improvement culture

Healthcare institutions create a foundation for a culture of continuous improvement when they process map. By regularly reviewing and updating process maps, healthcare providers can identify evolving challenges and opportunities for further process management optimization. 

This ensures that healthcare organizations remain:

• Responsive to change
• Committed to delivering the best possible care to their patients

Top strategies to create a healthcare process map

Creating a healthcare process map requires a systematic approach to accurately capture and analyze the workflow. Here are some top strategies to consider when creating a healthcare process map:

Identify the process

Clearly define the process you want to map. It could be a specific clinical procedure, patient journey, or administrative workflow. Narrow down the scope to ensure focused and accurate mapping.

Include stakeholders

Involve key stakeholders who are directly involved in or impacted by the process. This includes healthcare professionals, administrators, patients, and other relevant staff members. Their input and perspectives will contribute to a comprehensive and accurate process map.

Collect relevant data

Collect relevant data and information about the process. This can be done through observations, interviews, documentation review, and data analysis. Ensure you have a complete understanding of the steps, decision points, interactions, and information flow within the process.

Define any boundaries

Set clear boundaries for the process map to avoid including unrelated activities. Identify the starting and ending points of the process to maintain focus and clarity.

Choose a visualization technique

Select an appropriate visualization technique to represent the process. Common techniques include flowcharts, swimlane diagrams , or value stream maps. Choose a format that best represents the flow and complexity of the process.

Map the steps

Begin mapping the sequential steps involved in the process. Use symbols, shapes, and arrows to represent activities, decisions, handoffs, and information flow. Clearly indicate inputs, outputs, and any decision points or branching paths.

Validate and verify

Validate the process map with the stakeholders involved. Seek feedback and verify the accuracy of the mapped process. Ensure that the map reflects the actual workflow and captures all necessary details.

Analyze and identify improvement opportunities

Analyze the process map to identify areas of waste, inefficiency, bottlenecks, or variation. Look for opportunities to streamline, standardize, automate, or eliminate non-value-added steps. This analysis will help uncover improvement opportunities for better patient care and operational efficiency.

Document and share

Document the process map with clear and concise descriptions. Share it with relevant stakeholders to promote understanding, collaboration, and continuous improvement. Ensure that the process map is easily accessible and updated as needed.

Monitor and update

Regularly review and update the process map to reflect any changes, new insights, or improvement initiatives. Continuously monitor the process for effectiveness and adapt the map accordingly.

Use process tools to standardize and optimize 

Process management software provide medical institutions with a structured and systematic approach to process mapping. These management tools enable standardization, optimization, quality improvement, and compliance, leading to enhanced patient care, operational efficiency, and better overall healthcare outcomes. By utilizing Process Street as a process mapping tool for healthcare, medical professionals are empowered to:

• Streamline workflows
• Optimize processes
• Improve patient care

Process Street’s user-friendly interface, collaboration features, automation capabilities, and visualization options make it an ideal choice for process mapping in the healthcare industry. By leveraging the power of Process Street, healthcare organizations can drive efficiency, enhance patient outcomes, and achieve operational excellence.

Efficiency isn’t a luxury; it can save a life 

Efficient process mapping in healthcare is not just a luxury; it is a necessity for healthcare institutions striving to provide exceptional patient care. By delving into the intricacies of healthcare workflows and visualizing them through process maps, healthcare organizations gain the power to drive positive change and achieve operational excellence.

The importance of efficient process mapping lies in its ability to identify inefficiencies, streamline workflows, and enhance the quality and safety of patient care. It empowers healthcare professionals to uncover areas for improvement, standardize processes, and optimize resource allocation. Through process mapping, healthcare institutions can reduce errors, minimize delays, and increase patient satisfaction.

Regularly reviewing and updating these process maps also guarantees that healthcare institutions remain responsive to evolving challenges and strive for ongoing excellence. In an era where healthcare delivery is complex and dynamic, efficient process mapping equips healthcare organizations with the insights and strategies needed to navigate this landscape successfully. 

Ultimately, efficient process mapping is not just a tool; it is a catalyst for transformation. It empowers healthcare institutions to optimize patient care, improve operational efficiency, and deliver the highest quality of healthcare services. By embracing the power of process mapping, healthcare organizations can revolutionize the way they operate, leading to better outcomes, enhanced patient satisfaction, and a brighter future for healthcare as a whole.

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Take control of your workflows today

Patient Journey Mapping In 2023, Guide + [Examples & Template]

Sliman M. Baghouri

Patient Journey Maps are the secret ingredient to a thriving medical business. Let’s discuss how to implement this strategy for your practice in under 3 days.

Imagine you have the ability to hand-craft the perfect patient experience, tailored specifically to your brand. An experience that skyrockets patient retention, doubles your profit margins and creates cult-like loyalty to your medical business.

This is exactly what I’ll share with you today. We’ll go through what are patient journey maps, how to use them, and how they can catapult your practice to the next level.

Other topics I will discuss are:

What is a Patient Journey?

• What is Patient Journey Mapping?
• What are the benefits of this strategy?
• Step-by-step process to implement your patient journey mapping workshop
• Examples of patient journey mapping
• Free patient journey mapping templates to use
• The secret to a fruitful patient journey map

Let us dive in.

A Patient Journey (A.K.A customer journey) is a series of events the patient goes through from his/her first interaction with your medical business up until post-treatment. It outlines every touchpoint (point of contact) the patient comes across during the whole patient experience.

What is a Patient Journey Mapping?

A Patient Journey Mapping (PJM) is the act of tracking, optimizing, and enhancing all of the events that happen during the patient journey. Think of it as creating a map to the whole patient experience and proactively looking for hidden issues across all of your touchpoints.

What are the benefits of patient journey mapping?

There are endless benefits to patient journey mapping. So let’s check some of the important ones.

1) Lets you uncover the blind-spots in your medical business

The most wicked, money-draining issues we face are the ones that hide in plain sight. It’s easy to get tunnel-versioned on the “obvious” and skip past critical parts of your business. This is where patient journey mapping comes into play. It hones in on the easy-to-miss spots in your practice and extracts the invisible layers of hindrances.

This way you make sure that your practice growth is not held off by small and hard to pinpoint bottlenecks.

2) It allows you to craft a personalized patient experience

A great benefit of patient journey mapping is that it lets you overhaul the whole patient journey the way you want it. It enables you to sketch the perfect patient experience based on what you want the patient to feel, experience, or know. This is an opportunity for you to fully tailor every aspect of your medical business to be personalized and boost their retention.

3) It skyrockets patient retention

Due to the enhanced communication and personalization in the patient experience, patient retention will soar. Patient journey mapping enables you to better connect with the patient and sympathize with their state throughout the treatment experience. This way of communication with the patients shrinks the “psychic distance” between the patient and your medical brand. Therefore building stronger relationships and affinity for your practice.

4) It increases profit and accelerates your medical business growth

According to recent research by Aberdeen Group , businesses that perform customer journeys see exponential growth year after year. Those growth spikes include:

• 18X faster average sales
• 56% up-sell revenue
• 10X improvement in customer service costs
• 5X greater revenue from customer referrals
• 54% greater ROI (return of investment)

These unmatched growth results are the outcome of a great journey mapping. Enhancing your patient experience from start to finish will be a fruitful endeavor in terms of profit-growth.

5) It provides alignment among your staff

Patient journey mapping is a collaborative strategy by nature. Key stakeholders need to attend the workshop to see the bigger picture of the patient experience. This collaborative environment will align all of your team under one umbrella, ensuring that everyone is on the same page and vibrating at the same frequency. This will create consistency and harmony between all of your team which will result in a seamless experience for your patients.

Step-By-Step Process: how to create a patient journey map:

Now that you know the importance of the patient journey, let’s dive into the process of how to implement it with your medical business.

From our experience, the process usually takes between 2 days to 3 days. It shouldn’t take more than 3 days to fully complete your patient journey.

Let’s go through the stages one by one.

Day 1: Preparation Stage

The patient journey map is as good as the preparation behind it. On the first day, you’ll need to finish the following critical tasks:

1) Gather Insights and information

In this phase, you’ll start by collecting important data points that will help you during your patient journey mapping workshop. If you’re not sure what insights to gather, consider the following:

• Who’s the target patient your practice or hospital attracts? E,g: middle-aged moms, C-suite executives, or maybe you’re cosmetic service and most of your patients are image-aware people like actors, politicians? If you don’t have an exact patient base, you can write down the ideal patients that you want to work with.
• Any relevant data from customer service chat logs, emails, or even anecdotal information from support, marketing team, or about the issues patients usually experience
• If your practice brand is active online, you might want to check data from analytics tools like Google Analytics or Facebook ads if you’re running digital advertising campaigns. That can give you some insight into what is happening across your online touchpoints
• Gather your testimonials from the patients, good and bad. This will help us understand the mind of your patient and what he thinks about your brand.

Don’t get caught up in this phase too much. The aim here is to capture rough ideas about the patients and their thoughts towards your brand. From our experience, we’ve found that large amounts of data do not fundamentally change the first hypothesis about the patient base.

2) Define the goals and the scope of your patient journey map

Defining the goals and objectives of the workshop is key to its success. It ensures that you’re on the right track and everyone is on the same page. It also makes it easy for you to measure the success of the strategy by checking back and seeing the progress that has been made towards the end goals.

Here are some questions to ask yourself when defining the scope of the workshop:

• What are the key aspects of the medical business you want to tackle?
• What are the desired outcomes you want out of this workshop?
• Do you have any hypotheses you want to confirm by performing a patient journey map?
• What are the ultimate results and end goals you’d like to achieve after acting-out on the patient journey map?

Answering these questions should give you a head start to defining the scope of the strategy.

3) Choose your team

Having the right people around when conducting PJM is important to a fruitful workshop. On the other hand, choosing too many people or the wrong team can hurt the outcome of the strategy.

From our experience 2-6 people are a manageable number. Any more than that and it will hinder the process of the workshop.

However, the key element here is to choose one stakeholder from each part of your business. Or if you’re a larger facility, a stakeholder from each department is a great option. Make sure that everyone in the team has gone through the scope and the goals of the PJM.

Day 2: The Workshop Stage

Now that everything is prepared, let’s dive into the details of the PJM and how to run the workshop.

Phase 1: Bring the necessary materials

There are two ways to run the workshop: online or in person. Both are fine but for the sake of convenience, I’ll use digital platforms to perform the PJM.

You can invite your team via Zoom and use collaborative virtual whiteboards like Miro or Mural . These online workplaces will make it easy for your team to join the workshop from the leisure of their homes.

But if you decide you’d like to run the workshop in person, the same principles will apply. But you’ll need to prepare stationery tools like pens, post-its of different colors, masking tape, and large sheets of paper to hang on the wall.

Phase 2: Start the workshop

This is the interactive part of the process. It takes roughly 1.5 to 2 hours to finish the complete first draft of the map.

Introduction ⏰ [5-10 minute]

• Introduce the exercise to the participant and explain why you’re doing this
• Explain the benefits of this exercise and the end goal of the PJM
• Recap the insights you gathered from your data and explain who your patient-base is.

Mapping Exercise ⏰ [60-90 minute]

The first thing to do is to present the patient’s journey map. The map consists of different stages, each stage contains specific steps the patients go through. Our goal here to hone in on these steps and pose questions regarding this particular step

• What are the questions they might be asking
• Are there any happy moments in this step?
• What are the pain points that the patient might experience?
• What opportunities could enhance this particular step?

Here’s roughly how the digital version of the patient journey should look like:

If you’re running the workshop in person, the PJM might look like this:

For each step ask participants to use sticky notes to answer the above questions. At the end of the exercise you should have something like this:

After you finish the first draft of the map, discuss with your team the observation and insights they made. It’s important to create a sense of collaboration during this exercise. Your team should feel involved and invested in the success of the strategy.

Wrap up the workshop ⏰ [5-10 minute]

After everything is said and done, offer a quick recap of what everybody has done today. It is important to inform the participant as to what’s coming next.

Day 3: The Final Stage

Now that the map is finished, all is left is to finalize the Map and provide a concrete plan for the whole team to start acting on.

• If you run the workshop in person, make sure to convert the map, insights, and notes into a digital format. This will make it more accessible for the whole team to go back and see the PJM
• Provide the team with a video or write-up about the strategy and the purpose behind it. Make sure to include how this can benefit the whole team and the brand overall
• Turn the insights and the results you got out of the PJM into an action plan. This plan should include what to do next at each step of the patient journey and what are the things that need to change. This is a critical part of the PJM. You want to act out the strategy to start seeing improvement and profit results for your medical business.

Patient Journey Example

I’ll share with you a recent example of the patient journeys map we conducted with our client so you can see roughly how the first draft of the map should look like.

Hospital Patient Journey

Here is Healthier™ ’s PJM, an Orlando-based community hospital:

For full screen click here or click on see board

The results of performing PJM

• Healthier profit margin nearly doubled from the first year of acting out the PJM
• The hospital start now is acquiring 4X the volume of last year
• The hospital patient retention rate increased from 12% up to 18% within the first year

The secret to a result-driven patient journey map

The Patient Journey Map is as good as the action-plan behind it. The last thing you want is unactionable PJM. You need to provide your team and your stakeholders with an action-based plan that goes through the next steps.

The steps that will redeem the pain-points of your patients, take advantage of the opportunities and make an unforgettable patient experience.

If you’re looking for help to facilitate your workshop or perform a patient journey map, drop me a message . I’d gladly help you.

• what is a patient journey
• what is a patient journey mapping
• what are the benefits of patient journey mapping
• step by step process how to create a patient journey map
• patient journey example
• the secret to a result driven patient journey map

Sliman M. Baghouri, Founder of unnus™, he's the co-author of unnus magazine and regular contributor in the healthcare marketing industry.

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• Published: 09 April 2024

The algorithm journey map: a tangible approach to implementing AI solutions in healthcare

• William Boag 1   na1 ,
• Alifia Hasan   ORCID: orcid.org/0009-0000-1361-3744 1   na1 ,
• Jee Young Kim   ORCID: orcid.org/0000-0003-4850-9757 1 ,
• Mike Revoir 1 ,
• Marshall Nichols   ORCID: orcid.org/0000-0002-0969-1982 1 ,
• William Ratliff   ORCID: orcid.org/0000-0003-4015-3805 1 ,
• Michael Gao 1 ,
• Shira Zilberstein   ORCID: orcid.org/0000-0001-7564-727X 1 , 2 ,
• Zainab Samad 3 ,
• Zahra Hoodbhoy 3 ,
• Mushyada Ali 3 ,
• Nida Saddaf Khan 3 ,
• Manesh Patel 4 ,
• Suresh Balu   ORCID: orcid.org/0000-0003-4929-9130 1 &
• Mark Sendak   ORCID: orcid.org/0000-0001-5828-4497 1  

npj Digital Medicine volume  7 , Article number:  87 ( 2024 ) Cite this article

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• Health care
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When integrating AI tools in healthcare settings, complex interactions between technologies and primary users are not always fully understood or visible. This deficient and ambiguous understanding hampers attempts by healthcare organizations to adopt AI/ML, and it also creates new challenges for researchers to identify opportunities for simplifying adoption and developing best practices for the use of AI-based solutions. Our study fills this gap by documenting the process of designing, building, and maintaining an AI solution called SepsisWatch at Duke University Health System. We conducted 20 interviews with the team of engineers and scientists that led the multi-year effort to build the tool, integrate it into practice, and maintain the solution. This “Algorithm Journey Map” enumerates all social and technical activities throughout the AI solution’s procurement, development, integration, and full lifecycle management. In addition to mapping the “who?” and “what?” of the adoption of the AI tool, we also show several ‘lessons learned’ throughout the algorithm journey maps including modeling assumptions, stakeholder inclusion, and organizational structure. In doing so, we identify generalizable insights about how to recognize and navigate barriers to AI/ML adoption in healthcare settings. We expect that this effort will further the development of best practices for operationalizing and sustaining ethical principles—in algorithmic systems.

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Introduction

In the realm of healthcare and artificial intelligence, there is an abundance of conversations happening at the abstract level. We frequently discuss the potential 1 , policies 2 , and best practices of AI in a somewhat detached, hypothetical manner. While these discussions are important for shaping the future of healthcare, they often lack the crucial element of real-world grounding 3 . Meanwhile, the number of projects that reach the “clinical integration” stage has been growing; a survey of 95 randomized controlled trials (RCTs) of AI software found mixed results of their clinical impact 4 . Several works have provided high-level summaries about how to build ML models in healthcare, with particular emphasis on initial considerations for deployment 5 , ethical implications and considerations for regulation 6 , post-deployment evaluation criteria for projects 7 , legal and governance guidance 8 . As these case studies have developed, researchers have begun identifying “lessons learned” to help increase the adoption of AI software in health systems, including: how to conduct a silent trial 9 , reliability and fairness audits 10 , clinical workflow 11 , and change management and outcome monitoring 12 .

Moreover, when considering the adoption of new technologies in healthcare, historical examples remind us of the significance of moving beyond theoretical discussions. For instance, during the introduction of electronic health records (EHR), the benefits (e.g., flagging issues in medication orders) were carefully weighed against the hypothetical concern of alarm fatigue. However, it was only through the examination of specific case studies that unforeseen, complex scenarios came to light. A notable incident at UCSF serves as a stark reminder. Here, alert fatigue, coupled with a confusing user interface featuring different units for adult (mg) and pediatric (mg/kg) patients, resulted in a doctor accidentally ordering a 39x overdose, which was subsequently administered to a pediatric patient, nearly proving fatal 13 . Such a scenario is the result of a complex interaction of different decisions; no one could foresee that specific event, thus underscoring the value of studying real-world case studies in order to formulate sensible policies and best practices.

For that reason, it is valuable to create a workflow diagram to document the development of an ML-based tool for predicting sepsis in a hospital. Such a diagram serves as a tangible case study that can bridge the gap between theoretical discussions and practical applications of AI in healthcare. Workflow diagrams can empower stakeholders and function as communication tools for knowledge legitimation and diffusion. Sharing operational knowledge, or knowledge of day-to-day operations, allows stakeholders to navigate the organization and gain agency as they understand the outcomes and goals of their roles 14 . Furthermore, documenting on-the-ground processes creates a stable and tangible basis for knowledge building and legitimation 15 . Sharing and documenting knowledge about the full range of roles critical to technological work matches frameworks such as the Data Feminist 16 principle to “Make Labor Visible.”

This study presents a comprehensive algorithm journey map (a set of workflow diagrams), capturing all social and technical activities involved in the procurement, development, integration, and lifecycle management of a health AI tool. Our contributions are as follows:

We present the algorithm journey map of a Sepsis prediction tool at Duke called SepsisWatch and discuss our findings.

We analyze these findings, particularly with an eye toward lessons learned in modeling assumptions, stakeholder recruitment, and organizational structure.

We discuss limitations and future work.

Although this algorithm journey map is highly specific to the Duke SepsisWatch context, the exercise will be very valuable to other researchers both because it provides a blueprint for how one can build their own algorithm journey map and because even if a different organization doesn’t follow the exact same steps, there will be commonalities in the types of stakeholders, challenges, and enablers (e.g., institutional silos, differences in stakeholder priorities, technical barriers).

How to read the algorithm journey map

The algorithm journey map is organized around four stages based on related work defining algorithm adoption stages 17 . The four lifecycle stages are:

Problem identification : How the organization identified sepsis as a problem that needed to be addressed and why a solution that uses AI is the best approach to address the problem. This stage ends with investing resources to build a sepsis AI tool.

Development : The building of the sepsis AI tool, preparing the clinical environment in which it operates, and designing the user interface and user experience. This stage ends with the decision to integrate the AI tool into clinical care. This stage zooms into two sub-stages, which are:

Model build and validation : building and validating a machine learning model on retrospective data

User interface build and user experience design : defining and developing the user interface and user experience.

Integration : Integrating the sepsis AI tool into the clinical environment and ends with a decision to continue using the sepsis AI tool after initial integration. This stage zooms into two sub-stages, which are:

Technical integration : integrating the technology into legacy systems and creating a way for the sepsis AI tool to run on real-time data

Clinical integration : integrating the sepsis AI tool into the clinical workflow

Lifecycle management : This stage describes post-rollout activities to manage, maintain, evaluate, and update the sepsis AI tool. This stage continues for as long as the AI tool is used in clinical care. It also includes monitoring the appropriate use of the tool and ensuring its decommissioning is initiated if it becomes obsolete or irrelevant.

A full list of stakeholders mentioned throughout the algorithm journey map is identified in Table 1 . We use the traditional event shapes from the swimlane literature—start/stop (oval), action (rectangle), and decision (diamond) using their canonical shapes from process maps 18 —and supplement them with some additional markers, all shown in Fig. 1 . We introduce light bulb icons to denote ‘lessons learned’ that were identified by participants during interviews and dotted gray circles to denote “the path not taken” from each decision point. Due to the complexity of the multi-year effort, some processes are broken down into sub-processes; if a sub-process is complex and distinct enough we represent it with a green box and its own standalone map, whereas if it is small enough then we embed it in the original map but with a dotted blue line border.

Symbols used in the algorithm journey map.

An explanation of how we created the algorithm journey map below is provided in the “Methods” section later in the paper.

Algorithm journey map

Figure 2 shows the process of identifying and prioritizing the problem that led to the development and adoption of a sepsis AI tool. This process began in the fall of 2015 when health system leaders launched an innovation competition (i.e. the Request for Applications (RFA) process) that featured a strategic priority to reduce inpatient mortality. A small group of clinicians applied to the innovation competition and proposed to use machine learning to predict sepsis.

Journey map of problem identification phase.

The proposal to develop a sepsis AI tool was selected by health system leaders for funding. Resources were allocated to pursue the opportunity, and staff from an internal innovation team were embedded in the project. In 2016, machine learning expertise within the school of medicine was limited and there was no mechanism for faculty in quantitative sciences departments to directly collaborate on operational health system projects. Health system leaders worked with the vice provost for research to establish a process whereby a statistics faculty and graduate student could dedicate effort to the sepsis AI tool project. The project team featured clinicians across specialties, project management, and statistics and machine learning expertise.

Figure 3 shows the development stage. The innovation team project manager, in consultation with the clinical champion, guided the project through the many steps. During this stage, the clinical champions defined project goals and requirements, including:

How is sepsis defined (e.g. CDC criteria, CMS criteria, presence of an ICD code)?

What data elements are important for the predictive model?

Who is the user (e.g. attending, resident, bedside nurse, rapid response team)?

Which patients is the model run on (e.g. emergency department, all floors of main hospital, main hospital and regional partner hospital, ICU, non-ICU)?

Journey map of the development phase.

The IRB reviewed the project to approve the development of the algorithm on retrospective data and granted a waiver of consent to use patient data for model development.

As will be described in the following sections, the above decisions guided the design and development of the sepsis AI tool and had significant downstream implications. Once it was decided that the rapid response team (RRT) nurse would be the primary user of the tool, the project team needed to ensure that organizational priorities would incentivize the tool to actually be used. RRT nurses were historically cardiac critical care nurses who supported care in the cardiac ICU when not responding to urgent events. These nurses reported to the cardiology service line, which was not primarily responsible for sepsis care quality. The project team worked with hospital leaders to create a new structure–the patient response program–that would house the RRT nurses and become responsible for sepsis care quality. During this restructuring, the clinical champion for the project became the patient response program director. These changes aligned RRT nurse management incentives with the objectives of the sepsis AI tool to improve sepsis care.

Figures 4 and 5 detail the development of the sepsis predictive model and UI design, respectively. These processes are described in more detail below. Once these prototypes were built, department physician leadership reviewed the progress and approved moving forward with the integration process.

Journey map of model build and validation sub-phase of development.

Journey map of the development of user interface and user experience.

Figure 4 details the steps involved in building a machine-learning model on retrospective data. These steps are likely very familiar to machine learning model developers. After the team received cuts of historical data, the project manager worked with the clinical champions to clean the raw data. This included both grouping related raw elements (e.g., arterial blood pressure, blood pressure measured from left arm cuff) and performing quality checks to ensure the data aligns with clinical expectations. The data quality activities conducted for this project in 2016 - 2017 laid the foundation for a data quality assurance framework that was formally validated at a later date 19 .

Once the data engineer grouped and cleaned the data, the statisticians on the team built a machine-learning model, evaluating and refining it until it achieved sufficient performance on unseen data. The statistician then reviewed the output of the model with the clinical champion, both with summary statistics and chart reviews to assess whether the model was ready to move forward.

In parallel to the model building and validation sub-phase, Fig. 5 outlines the development of the UI design. This was an iterative process that began with scoping what the tool can help with based on the status quo workflow for delivery of care (i.e., reacting to sepsis once the patient already starts to deteriorate) and the general capabilities for what the tool can do (i.e., forecast who is at risk for deteriorating in the next N hours).

Next, there was an iterative design process where the UI designer would prototype ideas and discuss them with the end user (RRT nurses) for refinement. For instance, the original goal of the tool was just to flag high-risk patients in a dashboard, but the RRT nurses communicated that it would be even better if the tool helped them not just detect but also manage interventions to treat sepsis. That feedback resulted in reconceptualizing the AI tool as a “workflow tool” and not a dashboard. The UI designer and RRT nurse agreed on a workflow with four patient states (Triage, Screened, Monitoring, and Treatment) and the user would move the patients through the process as sepsis is detected and managed. This functionality could not be implemented in the hospital’s electronic health record at the time, so the team made the decision to develop an initial UI as a custom web application.

Another such example of iterative feedback involved model output visualization. Initially, a given patient’s predicted probability of sepsis was going to be plotted over time (to help remind the user of the patients they were keeping an eye on). However, after some feedback sessions with users, the UI designers began to worry that the users would use the trajectory/trend as an indicator, itself, and begin to over-rely on it. They concluded that such a scenario would require additional training for users to understand how to interpret time-based plots, so instead they focused on point-in-time visualizations to more closely match the setting the model was trained on without as large a risk of user misconceptions.

Once the iterative feedback was incorporated into the design, the prototype was presented to the clinical champion to ensure that the tool would be aligned with the project’s goals. In this case, the goal was both early identification of sepsis as well as timely treatment once identified. Treatment was to be measured based on sepsis bundle compliance as defined by SEP-1 sepsis bundle regulations issued by CMS 20 .

Figure 6 visualizes the next stage, integration. Integration contains two sub-stages, technical integration, and clinical integration, which are described in more detail below.

Journey map of the integration phase.

Figure 7 displays the process for technical Integration. It begins with extensive collaboration between the innovation team and the health system IT department. The teams navigated the tension between developing a fully customized solution, which would have higher maintenance and ownership costs and relying fully on existing tools, which would have lower maintenance and ownership costs. A major question that had to be addressed was whether the model could be integrated into Epic via its Cognitive Computing Platform ( https://www.healthcareitnews.com/news/epic-cognitive-computing-platform-primer ). Over a period of 6 months, the two teams conducted due diligence on the Epic solution and determined it was not able to run the sepsis AI tool. The teams agreed to develop a custom solution that extracts data from the EHR, pipes it to a server that runs the model, and sends those predictions to a database that displays results on a custom web application.

Journey map of technical integration sub-phase.

The IT and innovation teams built a data pipeline to extract data out of Epic’s Chronicles database in real-time. This required IT to build web endpoints to supply Epic data and the innovation team to build a schema for organizing the data that was received. Additionally, there needed to be resources for the server and database. A few months of testing were done to ensure the system could handle the volume of data being extracted, particularly because vitals are collected very frequently. Once IT signed off on the data pipeline, the sepsis AI tool was configured to pull real-time data once every 5 min. In addition, the innovation team built monitoring tools to regularly test the input/output connections and measure the volume of inputs.

Once the data pipeline was functioning, the innovation team submitted another study proposal to run a ‘silent trial’ to enable end-to-end system monitoring and testing. During this IRB review, the innovation team met repeatedly with regulatory affairs leadership to ensure that the sepsis AI tool aligned with the FDA’s definition of clinical decision support (CDS). Specifically, the relevant standards were based on the FDA’s “Clinical and Patient Decision Support Software” draft guidance which was posted in December 2017 ( https://www.regulations.gov/document/FDA-2017-D-6569-0002 ). Because the tool did not make clinical decisions or treatment recommendations and supported independent review by clinicians, regulatory leaders determined that the technology qualified as non-device CDS. Once the ‘silent trial’ was approved, the innovation team conducted user testing to get feedback about the UI and the performance of the model. Once the user was satisfied with the changes, the innovation team presented the functioning tool to department physician leadership for approval. The clinical integration process began after approval.

Figure 8 visualizes the clinical integration process. This involved fine-tuning the workflow and user interface, developing training material, and assembling a governance committee. This began with two parallel processes, one for physicians and one for nurses.

Journey map of clinical integration sub-phase.

The ED physician leadership finalized some decision points that hadn’t been fully specified, such as who the RRT nurse should call when the model predicts a high risk of sepsis (call the attending, not the resident), who will administer treatment (the bedside nurse, not the RRT nurse), etc. Additionally, there were some final suggestions for marketing and communications, such as removing any reference to a “code sepsis.”

At this stage, the innovation team met with the chief nursing officer for the health system to discuss the rollout of the sepsis AI tool. During this initial meeting, it became clear that there were additional stakeholders who needed to be engaged before the AI tool could be launched. Up until this point, the project team had been working primarily with physician leaders at both the hospital and department levels. Unfortunately, this left out nurse leaders at the health system level and within relevant service lines (e.g., emergency department) who needed to deploy resources to support the rollout. To address this lack of communication, the chief nursing officer convened a meeting with the innovation team, hospital nurse leaders, ED nurse leaders, and certified nurse educators (CNEs) to map out steps leading up to roll-out. Working closely with nurse stakeholders, several adaptations were made to the workflow, including direct communication between the RRT nurse and bedside nurses in the ED.

The innovation team worked with CNEs to develop training material, particularly for RRT nurses, to equip new users to appropriately use the sepsis AI tool. Finally, a governance committee was established including stakeholders from both physician and nursing leadership to meet monthly during the initial rollout in order to resolve any emergent issues.

Unlike prior stages, post-rollout lifecycle management is not a linear-flow process. Some tasks are predictable whereas others are responsive to events that occur (e.g., user requests, technical failures, etc). Instead of employing a swimlane-oriented diagram to convey lifecycle management, Fig. 9 shows a variety of different activities, categorized by both type of task (monitoring, updates, and operational management) and frequency (one-off, semi-recurring, recurring, and event-based). These activities also involve many stakeholders, principally driven by the project manager and clinical champion.

Different tasks that arise throughout post-rollout lifecycle management.

Monitoring involves both regular dev-ops duties (e.g., is the system still up? Were there large changes in data volume?) as well as periodic, thorough data science analysis (e.g., does the model still perform well? Have clinical outcomes improved?). Monitoring and evaluation are a technical component of system audits, assessing model performance as clinical outcomes, and process measures over time. These audits have also involved user research, such as shadowing the RRT nurses who use the tool. Additionally, CMS requires hospitals to conduct external auditing of bundle compliance in order to maintain eligibility for Medicare payments.

Updates are performed both as needed (event-based, semi-regularly) and on a regular schedule (recurring) in order to ensure the robust performance of the sepsis AI tool. An example of a recurring update that occurs every 6 months is a coordinated effort between the innovation team and clinical champions to refresh data element “groupers.” This process ensures that any new medications, vital sign monitors, or laboratory equipment are accounted for in the data pipeline. An example of a one-off update responding to a user request was adding new functionality to automatically identify treatment bundle compliance in real-time. Although there is no formal process, when users request new features, the project team must categorize the feature as either an ‘update to the existing product’ or a ‘new project that needs separate, dedicated effort.’ An example of a task that spun off into a standalone product is the alert notification system that now supports many AI tools.

Operational management involves ongoing ownership and accountability. The sepsis AI tool has 2 “owners”—the clinical champion and the innovation team project manager—who communicate with each other and liaise with additional members to support the sepsis AI tool as needed. They periodically need to secure funding and resources for the project and assess how well the solution is addressing the original objective. The project owners also ensure that existing and new staff are appropriately trained and that training material is maintained to reflect evolving standards of care for sepsis. Additional entities also play an active role, such as how institutional leaders are now seeking input from the FDA to ensure that the use of the tool continues to comply with the intention of non-device CDS in light of the 2022 final CDS guidance (https: // www.fda.gov/regulatory-information/search-fda-guidance-documents ).

Interviewee-identified opportunities for improvement

Throughout the construction of the algorithm journey map, we asked interviewees to identify not just what happened but also what they might have done differently in retrospect. This includes both narrow/technical and broader opportunities, and such reflections were indicated in the algorithm journey maps with lightbulb icons. The icons were separated into three categories: modeling assumptions (red), stakeholder inclusion (yellow), and organizational structure (blue). Below, we highlight specific learnings from the journey map and also abstract generalizable insights that can inform other efforts to develop and integrate AI into clinical care.

Modeling assumptions

There were multiple areas where technical decisions about the model hampered the project. Most of these decisions occurred early in the algorithm journey:

[Development] Scoping the solution : Early on, clinical collaborators at that time felt the sepsis AI tool would not be used in the ICU, so data was thus truncated at the time of ICU transfer. This single decision limited the future ability to expand the use of the sepsis AI tool beyond the ED to general inpatient wards. When a user requested to expand the use of the AI tool to inpatient wards, a new “2.0” project had to be initiated. Generalizable insight: Carefully consider the downstream impact of inclusion and exclusion criteria applied at the level of patients and individual data values. If the use of an AI tool may extend to adjacent use cases, make sure that relevant data is included in model training and evaluation.

[Model Building] Outcome definition : The project team did not initially appreciate the difficulty in finding the “right” definition of sepsis. Physicians had differing opinions about which outcome to use, and the published literature didn’t show consensus. Modeling became easier once the outcome definition was modularized, allowing for easily changing the criteria and retraining the model. Generalizable insight: Do not limit outcome labels to single sets of criteria and develop (and validate) models for multiple types of definitions. Even if there is a professional consensus today on how a disease is defined, anticipate future changes.

[Model Building] Real-time access to model inputs : When determining which data elements to include as inputs for the model, the team had not initially considered that any data for the model needed to not just be captured in the EHR but also available in real-time. Epic’s backend databases involve both a real-time feed of the current day and a historical archive, and access to real-time data requires the IT department to build specific data endpoints for each kind of element. Generalizable insight: Only include data elements in an AI tool if the data is available and robustly captured at the time predictions need to be made.

[Model Building] Environment constraints on model : Initial versions of the model involved a technically complex Multi-task Gaussian Process for data imputation, followed by an LSTM classifier. The plan had been to integrate this model into production, but during technical integration, the team realized this approach required matrix inversion and significant computation. Eventually, the team used fill-forward data imputation for the LSTM, but it should have been knowable at the time that the runtime environment would limit expensive model architectures and decisions. Generalizable insight: Plan for ablation studies that evaluate the impact of removing model components or input features. When building an AI tool for integration, reduce unnecessary complexity.

Stakeholder inclusion

Beyond technical lessons, there was another ‘obvious’ insight from the mapping exercise. Many decision points throughout the process (e.g., problem formulation, workflow design, signing off with integration) were shaped and approved by hospital and department leaders who were physicians, but not nurses. This culminated in the clinical integration stage being nontrivially complex and stressful. This oversight also created tension between different clinical stakeholders that needed to be addressed leading up to a large project launch.

Although the RRT nurse users were included in the early designs, it was not well understood that physicians and nursing leaders within service lines and hospitals manage separate activities. The innovation team needed to be directly engaging leaders across both chains of command, rather than expect communication between the two groups. As a result of this oversight, the clinical integration stage involved meeting many levels of nursing leadership (health system-level, hospital-level, and department-level) as well as directly engaging certified nurse educators to finalize programmatic decisions and develop training material.

The yellow light bulb icons indicate all of the opportunities where nurse leadership could be (or eventually was) involved in the project approval.

The generalizable insight from this lesson is to identify up-front the reporting structures, training requirements, and communication channels for all clinical professions affected by an AI tool put into practice. Even if clinicians across professions appear to work closely together in the same unit, reporting, training, and communication channels may be distinct. Project leaders also cannot assume that information shared with front-line workers or business-unit leaders is shared upwards within reporting structures. Executive leaders need to be informed and have their concerns addressed prior to the integration of new AI tools.

Organizational structure

One final set of learning opportunities comes from identifying commonalities around structures and workflows. These events were not about what should have been done differently in the moment but instead flagged organizational changes that took a great deal of effort and could be streamlined. The following learnings are highlighted with blue lightbulb icons:

[Problem Identification] Recruit statisticians : The innovation team partnered with a faculty and Ph.D. student from the statistics department of our organization’s university. However, there was no mechanism for research faculty to dedicate time to health system projects. The Vice Provost for Research at the university helped facilitate the collaboration. Since that time, the innovation team has grown significant internal machine learning expertise in order to move more quickly on projects. Generalizable insight: Ensure senior-level support to engage perceived outsiders in the development of AI tools used in clinical care. Even if technical expertise exists within the organization, trust must be established between senior technical and clinical leaders.

[Development] Create a patient response program : As discussed in greater depth earlier, the project team needed to ensure that organizational incentives enabled RRT nurses to prioritize the use of the tool. This involved working with hospital leaders to move RRT nurses out of cardiology and into a new structure that became responsible for sepsis care quality. This effort was critical to ensure alignment in organizational priorities because otherwise, busy nurses would likely not consistently be able to make time to use (let alone offer feedback about) the sepsis AI tool. Generalizable insight: Invest time and energy in modernizing the organization to most effectively utilize emerging technologies like AI. In cases where an AI tool does not fit seamlessly within workflows or professional roles, the project team may need to be empowered to drive organizational change.

[Clinical Integration] Workflow burden : During the rollout, iPads were prepared for both the RRT nurses and also patient workflow coordinator (PWC) nurses in the ED. However, after a few months post-clinical integration, the innovation team learned that the patient workflow coordinators were too busy with other duties to be using the sepsis AI tool; the model predictions were not as critical to PWC nurses’ immediate priorities. This process could have been streamlined by having regular check-ins with front-line workers, in addition to managers, to surface friction on the ground. Generalizable insight: Adapt the workflow to the needs of front-line workers and build flexibility into early pilots. Being able to respond to feedback also builds trust among front-line workers.

Three major insights derived from our study can inform future work. First, the algorithm journey map captures an extremely messy process that is far from ideal, and the effort required to surface the process is not scalable. In total, the algorithm journey map included 7 components for 4 stages and a separate table to capture all lifecycle management activities. Numerous interviews and co-development workshops were held with individuals who were involved in various stages of AI adoption and our team had to set bounds on the level of detail included in the journey map. Almost every step in the process could go further into detail to further explicate individual sub-steps. While the current study aimed to advance the understanding of traceability and transparency, we do not recommend that algorithm journey maps accompany every single instance of health AI adoption. This conclusion is different from Model Facts labels or data quality assurance documentation, which are recommended for all adopted health AI projects 21 .

Organizations and settings must then determine when concretization of AI adoption is most valuable. Unfortunately, while other organizations may learn from our experience, we do not expect that the algorithm journey map presented in this study maps well to any other setting or use case. By design, this traceability artifact is extremely enmeshed with our particular use case and setting. Other organizations may consider developing their own algorithm journey maps after completing an AI adoption process. We hope that as more groups publicly disseminate traceability artifacts like the algorithm journey map, organizations can learn from each other how to streamline the process and avoid common pitfalls.

The second major insight is the urgent need to standardize the health AI adoption process. The specific path visualized in the sepsis AI tool algorithm journey map is highly circuitous, confusing, and not meant to ever be repeated. Organizations, including ours, must actively streamline the process and define the most relevant and important decision points throughout the lifecycle stages. While developing the algorithm journey map, we did align the structure with 4 stages that can be adopted by other projects. Future work is needed to further align activities across healthcare delivery settings to define a standard process by which health AI tools can be adopted across settings. Hopefully, as different settings align their processes, the complexity of and effort required to develop algorithm journey maps will significantly decrease.

The third major insight is the immediate opportunity to leverage the concrete algorithm journey map to design traceability and transparency artifacts needed to facilitate the adoption of health AI tools. There’s limited understanding of the specific user, knowledge base, context-of-use, and decision made using information contained in the documentation artifact. With the algorithm journey map, researchers can now tailor documentation and transparency artifacts to specific decision points in a process. The user, use case, and implications become clear. While we do not recommend building out documentation for every single decision point, because many decision points are redundant or inefficient, we do expect that documentation efforts can target a small number of key decision points visualized throughout the process.

There are also three primary limitations of the current study. First, we focus on a single algorithm within a single setting. While many machine learning in healthcare studies seek to develop and validate frameworks across multiple models and settings, our objective was different. Rather than contribute additional documentation artifacts or well-organized processes for developing health AI tools, we address a core limitation of existing work. Our study breaks out of common pitfalls that limit visibility into complex sociotechnical processes, but in doing so we are myopically focused on minute details for a single use case. Our study does not address general questions such as the administrative roles, measures of AI tool viability, and form and frequency of communication required for AI tools to be successfully integrated. We address this limitation by identifying generalizable learnings that surfaced within the algorithm journey map, and we present key insights that are immediately informative to other groups.

Second, and relatedly, algorithm journey maps might emphasize a specific perspective, amplifying existing power structures rather than allowing less-powerful stakeholders to have their experiences properly reflected 22 . Further, a given algorithm journey map might not be able to capture all of the relevant context to scale across locations or time periods. Models of innovation are dependent on political, cultural, and institutional factors, requiring a high degree of contextual specificity in each case study 23 , 24 .

The third limitation is a lack of standardization for the amount of detail to include in a journey map. We scoped the journey map to not include any activities prior to problem selection for the sepsis AI tool, even though previous technologies were used to detect sepsis. We also did not include any new sepsis models developed as separate projects during lifecycle management. Within the steps depicted in the algorithm journey map, we included details relevant to the reader, but some may find the level of detail excessive or insufficient. We hope that as more organizations disseminate traceability artifacts, standards emerge for how to best visualize algorithm journey maps.

We hope that in future work, additional organizations can build upon this approach of making these processes more tangible. As more case studies are fleshed out, it will be easier to normatively discuss the best way to operationalize other ethical principles. For instance, the AI sepsis tool adoption captured by this journey map did not include patients at any step, and – unlike for the cases of nurses—that idea did not even come up during the interviews as an opportunity to reflect on where they should have been included. Many projects in this field also have struggled with this question around patient inclusion; as more projects are more tangible, the field will be able to learn from what methods of patient engagement (and other instantiations of ethical computing principles) are more/less meaningful.

Data collection

In this study, we document the effort required to build and integrate an ML-based sepsis detection algorithm in a large health system. The purpose of this study was to identify the stakeholders and decisions that were made throughout the entire effort in order to develop documentation artifacts that would be helpful for people in those roles for future projects. In order to understand this effort, our algorithm journey map is composed of workflow diagrams to track the pre-deployment efforts because of their mostly linear nature and then a table of the post-deployment efforts due to their concurrent and asynchronous nature.

We interviewed every stakeholder on the innovation team (Duke Institute for Health Innovation) who was involved in the project. Six participants with the roles of a clinical data scientist, an innovation program manager, a data engineer, two solutions architects, and an innovation program director were recruited. In total, we conducted 20 unstructured interviews with them to gather information about each stage featured in the algorithm journey map. Although there was no interview guide, each participant was asked to describe:

Which stakeholders were involved in that part of the project?

What work was done (and by whom) for the parts of the project they worked on?

What decisions were made?

What data/information was used to make those decisions?

What decision points weren’t considered but should have been?

During early interviews, we either took detailed notes or interactively built visual schematics using Microsoft Visio, which is a diagramming and vector graphics application. We then met with the sepsis project leaders multiple times to clarify questions and refine the algorithm journey map.

Process mapping

A process map is an artifact that documents a workflow, allowing decision-makers to identify the steps, stakeholders, and decisions made during a given process or activity. There can be many variants of the concept, such as basic flowcharts, customer journey map 25 , value stream map 26 , and more. A recent systematic review that evaluated 105 process mapping manuscripts found that process maps help to support understanding of complex healthcare systems and can guide improvement efforts within their local context 27 . de Ven articulates how a process map’s narrative presentation is well-suited to show the complexities of a workflow, which can be nonlinear and have unexpected twists and turns 28 . Adopting this awareness is especially important to implementing technologies in organizational settings, which often require changes to workers’ roles, relationships, and authority structures 29 , 30 .

To construct the pre-deployment section of the algorithm journey map, we use a visualization technique from the process map literature, namely swimlane diagrams 18 . Damelio describes a swimlane diagram as “a set and series of interrelated work activities and resources that follow a distinct path as work inputs (resources) get transformed into outputs (items) that customer’s value” and such diagrams are used to delineate the various stakeholders and their interactions 26 .

This study was a quality improvement project with minimal risk to the participants. IRB review and approval was not required according to Duke University policy, because the project is not research that is subject to federal human subjects protection regulations 31 . The activities carried out as part of this project can improve the process for algorithm implementation locally, the project evaluates the current practices of clinicians and staff directly involved in the project, and future patients can benefit from improvements in the process. The project followed the ethical principles of research and the privacy, confidentiality, and autonomy of all participants were respected. All participants were informed about the purpose of the project before contributing the information needed, and no harm was anticipated or reported due to participation. All staff who were interviewed for the project provided consent prior to interviews.

Data availability

Much of the materials or information used to inform this study have been previously published or made available on the Duke Institute for Health Innovation website. Requests for material used in this study that is not currently publicly available can be sent to the corresponding author.

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Acknowledgements

We thank the Patrick J. McGovern Foundation for their funding and support of the project. The foundation played no role in the study design, data collection, analysis, and interpretation of data, or the writing of this manuscript. We thank all interview participants for sharing their insights and time with us. We thank Duke Heart Center for helping administer and manage the grant.

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These authors contributed equally: William Boag, Alifia Hasan.

Authors and Affiliations

Duke Institute for Health Innovation, Durham, NC, USA

William Boag, Alifia Hasan, Jee Young Kim, Mike Revoir, Marshall Nichols, William Ratliff, Michael Gao, Shira Zilberstein, Suresh Balu & Mark Sendak

Harvard University, Cambridge, MA, USA

Shira Zilberstein

Aga Khan University, Karachi, Pakistan

Zainab Samad, Zahra Hoodbhoy, Mushyada Ali & Nida Saddaf Khan

Duke University School of Medicine, Durham, NC, USA

Manesh Patel

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Contributions

W.B., A.H. and J.Y.K. designed the study concept, conducted the interviews, collected data, and surfaced the findings; M.R., M.N., W.R. and M.G. provided the data and information needed for the study; S.Z. helped with background and literature review for the study; Z.S., Z.H., M.A. and N.S.K. helped with review and editing of the manuscript critically for important intellectual content; M.P., M.S. and S.B. helped secure the funding for the project; M.S. and S.B. conceived and designed the analysis. All authors were involved in writing and editing the manuscript. All authors approved the final manuscript.

Corresponding author

Correspondence to Mark Sendak .

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M.S., S.B., W.R., M.N., M.R. and M.G. reported co-inventing software at Duke University licensed by Duke University to external commercial entities including Clinetic, Cohere Med, Kela Health, and Fullsteam Health. M.S., S.B., M.N., M.R. and M.G. own equity in Clinetic. No other disclosures were reported.

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Boag, W., Hasan, A., Kim, J.Y. et al. The algorithm journey map: a tangible approach to implementing AI solutions in healthcare. npj Digit. Med. 7 , 87 (2024). https://doi.org/10.1038/s41746-024-01061-4

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• Published: 17 April 2024

Navigating outpatient care of patients with type 2 diabetes after hospital discharge - a qualitative longitudinal study

• Léa Solh Dost 1 , 2 ,
• Giacomo Gastaldi 3 ,
• Marcelo Dos Santos Mamed 4 , 5 &
• Marie P. Schneider 1 , 2  

BMC Health Services Research volume  24 , Article number:  476 ( 2024 ) Cite this article

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The transition from hospital to outpatient care is a particularly vulnerable period for patients as they move from regular health monitoring to self-management. This study aimed to map and investigate the journey of patients with polymorbidities, including type 2 diabetes (T2D), in the 2 months following hospital discharge and examine patients’ encounters with healthcare professionals (HCPs).

Patients discharged with T2D and at least two other comorbidities were recruited during hospitalization. This qualitative longitudinal study consisted of four semi-structured interviews per participant conducted from discharge up to 2 months after discharge. The interviews were based on a guide, transcribed verbatim, and thematically analyzed. Patient journeys through the healthcare system were represented using the patient journey mapping methodology.

Seventy-five interviews with 21 participants were conducted from October 2020 to July 2021. The participants had a median of 11 encounters (min–max: 6–28) with HCPs. The patient journey was categorized into six key steps: hospitalization, discharge, dispensing prescribed medications by the community pharmacist, follow-up calls, the first medical appointment, and outpatient care.

Conclusions

The outpatient journey in the 2 months following discharge is a complex and adaptive process. Despite the active role of numerous HCPs, navigation in outpatient care after discharge relies heavily on the involvement and responsibilities of patients. Preparation for discharge, post-hospitalization follow-up, and the first visit to the pharmacy and general practitioner are key moments for carefully considering patient care. Our findings underline the need for clarified roles and a standardized approach to discharge planning and post-discharge care in partnership with patients, family caregivers, and all stakeholders involved.

Peer Review reports

Care transition is defined as “the movement patients make between healthcare practitioners and settings as their condition and care needs change in the course of a chronic or acute illness” [ 1 ]. The transition from hospital to outpatient care is a particularly vulnerable period for patients as they move from a medical environment with regular health monitoring to self-management, where they must implement a large amount of information received during their hospital stay [ 2 , 3 , 4 , 5 , 6 ]. This transition period can be defined as “the post-hospital syndrome,” which corresponds to a transient period of vulnerability (e.g., 30 days) for various health problems, such as stress, immobility, confusion, and even cognitive decline in older adults, leading to complications [ 7 ]. Furthermore, discharged patients may experience a lack of care coordination, receive incomplete information, and inadequate follow-ups, leading to potential adverse events and hospital readmissions [ 8 , 9 , 10 ].

People with type 2 diabetes mellitus (T2D) represent a high proportion of hospitalized patients, and their condition and medications are associated with a higher rate of hospital readmission [ 11 , 12 , 13 ]. Moreover, T2D is generally associated with multiple comorbidities. This complex disease requires time-consuming self-management tasks such as polypharmacy, adaptations of medication dosages, diet, exercise, and medical follow-up, especially during care transition [ 14 , 15 , 16 ].

Various interventions and practices, such as enhanced patient education, discharge counseling, and timely follow-up, have been studied to improve care transition for patients with chronic diseases; however, they have shown mixed results in reducing costs and rehospitalization [ 17 , 18 , 19 , 20 ]. In addition, patient perspectives and patient-reported outcomes are rarely considered; however, their involvement and monitoring are essential for seamless and integrated care [ 21 , 22 ]. Care integration, an approach to strengthening healthcare systems in partnership with people, focuses on patient health needs, the quality of professional services, and interprofessional collaboration. This approach prevents care fragmentation for patients with complex needs [ 23 , 24 ]. Therefore, knowledge of healthcare system practices is essential to ensure integrated, coordinated, and high-quality care. Patient perspectives are critical, considering the lack of literature on how patients perceive their transition from hospital to autonomous care management [ 25 , 26 ].

Patients’ journeys during hospitalization have been described in the literature using various methods such as shadowing, personal diaries, and interviews; however, patients’ experiences after hospital discharge are rarely described [ 26 , 27 ]. Jackson et al. described the complexity of patient journeys in outpatient care after discharge using a multiple case study method to follow three patients with chronic obstructive pulmonary disease from hospitalization to 3 months post-discharge [ 26 ]. The literature does not provide an in-depth understanding of the experiences of patients with comorbidities during care transition upon hospital discharge. The assumption about the patient journey after discharge is that multiple and multi-professional encounters will ensure the transition of care from hospitalization to self-management, but often without care coordination.

This study aimed to investigate the healthcare trajectories of patients with comorbidities, including T2D, during the 2 months following hospital discharge and to examine patients’ encounters with healthcare professionals (HCPs).

While this article focuses on patients’ journeys to outpatient care, another article describes and analyzes patients’ medication management, knowledge, and adherence [ 28 ]. This study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Study design and population

A qualitative longitudinal research approach was adopted, with four individual semi-structured interviews over 2 months after discharge (approximately 3, 10, 30, and 60 days after discharge) that took place at home, by telephone, secured video call, or at the university at the participant’s convenience. Participants were recruited during hospitalization. The inclusion criteria were patients with T2D, with at least two other comorbidities, at least one medication change during hospitalization, hospitalization duration of at least 3 days, and those who returned home after discharge and self-managed their medications. A family caregiver could also participate in the interviews alongside to participants.

Researcher characteristics

All the researchers were trained in qualitative studies. The ward diabetologist and researcher (GG) who enrolled the patients in the study participated in most participants’ care during hospitalization. LS (Ph.D. student and community pharmacist) was unknown to participants and presented herself during hospitalization as a “researcher” rather than a pharmacist to avoid any risk of influencing participants’ answers. MS is a professor in pharmacy, whose research focuses on medication adherence in chronic diseases and aims at better understanding this behavior and its consequences for patients and the healthcare system. MDS is a researcher, linguist, and clinical psychologist, with a particular interest in patients living with chronic conditions such as diabetes and a strong experience in qualitative methodology and verbal data analysis.

Data collection

The interviews were based on four semi-structured interview guides based on existing frameworks and theories: the World Health Organization’s five dimensions for adherence, the Information-Motivation-Behavioral Skills model, and the Social Cognitive Theory [ 29 , 30 , 31 ]. For in-depth documentation of participants’ itinerary in the healthcare system, the interview guides included questions on the type, reason, and moment of the HCP’s encounters and patient relationships with HCPs. Interview guides are available in Supplementary File 1 . During the development phase of the study, the interview guides were reviewed for clarity and validity and adapted by two patient partners from the Geneva University Hospitals’ Patient Partner Platform for Research and Patient and Public Involvement. Thematic saturation was considered reached when no new code or theme emerged and new data repeated previously coded information [ 32 ]. Sociodemographic and clinical data were collected from hospital databases and patient questionnaires. The interviews were audio-recorded, anonymized, and transcribed verbatim.

Data analysis

The sociodemographic and clinical characteristics were descriptively analyzed. Transcriptions were double-coded until similar codes were obtained, and thematic analysis, as described by Braun and Clarke [ 33 , 34 ], was used in a systematic, iterative, and comparative manner. A patient journey mapping methodology was used to illustrate the trajectories of each participant and provide a comprehensive understanding of their experiences. Patient journey mapping is a visual method adapted from the marketing industry that is increasingly used in various health settings and contexts to illustrate and evaluate healthcare services and patient experiences [ 35 ]. In this analysis, we used the term “healthcare professionals” when more than one profession could be involved in participants’ healthcare. Otherwise, when a specific HCP was involved, we used the designated profession (e.g. physicians, pharmacists).

A. Participants description

Twenty-one participants were interviewed between October 2020 and September 2021, generating 75 interviews. All participants took part in Interview 1, 19 participants in Interview 2, 16 participants in Interview 3 and 19 participants in Interview 4, with a median duration of 41 minutes (IQR: 34-49) per interview. Interviews 1,2,3 and 4 took place respectively 5 days (IQR: 4-7), 14 days (13-20), 35 days (33-38), and 63 days (61-68) after discharge. Nine patients were newly diagnosed with T2D, and 12 had a previous diagnosis of T2D, two of whom were untreated. Further information on participants is described in Table 1 . The median number of comorbidities was six (range: 3–11), and participants newly diagnosed with diabetes tended to have fewer comorbidities (median: 4; range: 3–8). More detailed information regarding sociodemographic characteristics and medications has been published previously [ 28 ].

B. Journey mappings

Generic patient journey mapping, presented in Fig. 1 , summarizes the main and usual encounters participants had with their HCPs during the study period. Generic mapping results from all individual patient journey mappings from discharge to 2 months after discharge are available in Supplementary File 2 .

Generic patient journey mapping from hospitalization to two months after discharge

During the 2 months following discharge, the participants had a median number of 10 (range: 6–28) encounters with HCPs. The HCPs met by participants are represented in Fig. 2 . All participants visited their pharmacists at least once, and 16 of the 21 participants met their general practitioners (GPs) at least once. Five participants received home care assistance, four went to an outpatient cardiac rehabilitation program, and five were readmitted during the study period.

Healthcare professionals seen by participants during the study period. left: n=cumulative encounters; right: n=encountered at least once. Abbreviation: S.nurse: specialized nurse; Other physicians: ophthalmologists, neurologists, hematologists, immunologists, addictologists; other HCP: physiotherapists, dietitians, massage therapist

The first HCP encountered was at the community pharmacy on the same day or day after discharge, except for one participant who did not pick up her medication. The first medical appointment with a physician occurred between days 1 and 27 after discharge (median: 8; IQR: 6-14).

Participants newly diagnosed with diabetes had a closer follow-up after discharge than participants with a former diagnosis of T2D (median: 7; IQR: 6–10 vs median: 9; IQR: 5–19), fewer encounters with HCPs (median: 8; IQR: 7–10 vs. 11; IQR: 8–17), and fewer comorbidities (median: 4; IQR: 4–7 vs. 7; IQR: 5–9). Most participants newly diagnosed with T2D or receiving insulin treatment benefited from either a follow-up call, home visit by a nurse, or diabetes care appointment.

C. Qualitative analysis

Transcripts were analyzed longitudinally and categorized into six key steps based on the verbal data. These key steps, shown in Fig. 1 , represent the identified thematic categories and refer to the following elements: 1. Hospitalization, 2. Discharge, 3. Dispensing of prescribed medications at the pharmacy, 4. Possible follow-up call, 5. First medical appointment, and 6. Outpatient care.

Hospitalization: hospital constraints and care organization

Most participants thought they had benefited from adequate medical care by committed and attentive HCPs but highlighted different constraints and gaps. Some participants noted constraints related to the hospital environment, such as loss of autonomy during their stay, lack of privacy, and the large number of hospital staff encountered. This resulted in participants repeating the same information several times, causing frustration, misunderstanding and a lack of coordination for some participants:

“Twenty or thirty staff members come in during the day! So, it's hard to keep track of [what] is bein g said or done. The best thing for me [...] would be to have clear information from just one person.” Participant 8; interview 1 (P18.1)

Participants had different opinions on the hospital’s care organization. Some participants found that care coordination between the wards was well-organized. In contrast, others highlighted poor coordination and communication between the hospital wards, resulting in long waiting times, care fragmentation, and contradictory or unclear information. Some participants felt that they did not benefit from comprehensive and integrated care and that the hospital staff focused on the cause of their hospitalization, neglecting other comorbidities:

“They were not interested [in my diabetes and my sight]. I was there for the heart and that was where [my care] stopped.” P17.1

Patients’ involvement in decision-making regarding medical care varied. Some participants were involved in their care and took part in medical decisions. Written information, adequate communication, and health professionals’ interest in patients were highlighted by some participants:

“They took the information sheet and they explained everything to me. They didn't just come once; they came several times to explain everything to me.” P5.1

Other participants found the information difficult to understand, particularly because of their fatigue and because the information was provided orally.

Discharge: an unclear process

The discharge process was unclear for patients who could not identify a specific related outpatient medical visit or a key step that summarized their hospital stay and prepared them for discharge:

“Well, there's no real preparation [for discharge]. I was waiting for them to give me the go-ahead so I could go home, that’s all...” P7.4

For some participants, outpatient care follow-up was organized before discharge by the hospital team (generally by making an appointment with the patient’s GP before discharge), whereas others had no post-discharge follow-up scheduled during their hospitalization. Approximately half of the participants refused follow-ups during their hospitalization, such as home care services provided by a nurse, or a rehabilitation hospital stay. The main reason for this refusal was that patients did not perceive the need for follow-up:

“It's true that I was offered a lot of services, which I turned down because I didn't realize how I would manage back at home.” P22.2

Dispensing prescribed medications by the community pharmacist: the first HCP seen after discharge

On behalf of half the participants, a family caregiver went to the usual community or hospital outpatient pharmacy to pick up the medications. The main reasons for delegation were tiredness or difficulty moving. In some cases, this missed encounter would have allowed participants to discuss newly prescribed medications with the pharmacist:

“[My husband] went to get the medication. And I thought afterward, […] that I could have asked [the pharmacist]: “But listen, what is this medication for?” I would have asked questions” P2.3

Participants who met their pharmacist after hospital discharge reported a range of pharmaceutical practices, such as checking the prescribed medication against medication history, providing information and explanations, and offering services such as the preparation of pillboxes. For some, the pharmacists’ work at discharge did not differ from regular prescriptions, whereas others found that they received further support and explanations:

“She took the prescription […] checked thoroughly everything and then she wrote how, when, and how much to take on each medication box. She managed it very well and I had good explanations.” P20.3

Some participants experienced problems with generic substitution, the unavailability of medications, or dispensing errors, complicating their journey through the healthcare system.

Possible follow-up call by HCP: an unsystematic practice

Some participants received a call from their GP or hospital physician a few days after discharge to check their health or answer questions. These calls reassured participants and their caregivers, who knew they had a point of contact in case of difficulty. Occasionally, participants received calls from their community pharmacists to ensure proper understanding and validate medication changes issued during hospitalization. Some participants did not receive any calls and were disappointed by the lack of follow-up:

“There is no follow-up! Nobody called me from the hospital to see how I was doing […]” P8.2

First medical appointment: a key step in the transition of care

The first medical appointment was made in advance by the hospital staff or the patient after discharge. For some participants, this first appointment did not differ from usual care. For most, it was a crucial appointment that allowed them to discuss their hospitalization and new medications and organize their follow-up care. Being cared for by a trusted HCP enabled some patients to feel safe, relieved, and well-cared for, as illustrated by the exchange between a patient and her daughter:

Daughter: When [my mom] came back from the GP, she felt much better [...] It was as if a cork had popped. Was it psychological? Patient: Maybe… I just felt better. D: Do you think it was the fact that she paid attention to you as a doctor? P: She took care of me. She did it in a delicate way. [silence] - P23.2

Some participants complained that their physicians did not receive the hospital discharge letter, making it difficult to discuss hospitalization and sometimes resulting in delayed care.

Outpatient care: a multifaceted experience

During the 2 months after hospital discharge, participants visited several physicians (Fig. 2 ), such as their GP and specialist physicians, for follow-ups, routine check-ups, medical examinations, and new prescriptions. Most participants went to their regular pharmacies to renew their prescriptions, for additional medication information, or for health advice.

Some participants had home care nurses providing various services, such as toileting, care, checks on vital functions, or preparing weekly pill boxes. While some participants were satisfied with this service, others complained that home nurses were unreliable about appointment times or that this service was unnecessary. Some participants were reluctant to use these services:

“The [homecare nurse] makes you feel like you're sick... It's a bit humiliating.” P22.2

Specialized nurses, mostly in diabetology, were appreciated by patients who had dedicated time to talk about different issues concerning diabetes and medication and adapted explanations to the patient’s knowledge. Participants who participated in cardiac rehabilitation said that being in a group and talking to people with the same health problems motivated them to undertake lifestyle and dietary changes:

“In the rehabilitation program, I’m part of a team [of healthcare professionals and patients], I have companions who have gone through the same thing as me, so I’m not by myself. That's better for motivation.” P16.2

 Navigating the outpatient healthcare system: the central role of patients

Managing medical appointments is time-consuming and complex for many participants. Some had difficulty knowing with whom to discuss and monitor their health problems. Others had difficulty scheduling medical appointments, especially with specialist physicians or during holidays. A few participants did not attend some of their appointments because of physical or mental vulnerabilities. Restrictions linked to the type of health insurance coverage made navigating the healthcare system difficult for some participants:

“Some medications weren't prescribed by my GP [...] but by the cardiologist. So, I must ask my GP for a delegation to see the cardiologist. And I have to do this for three or four specialists... Well, it’s a bit of a hassle […] it's not always easy or straightforward”. P11.2

Some participants had financial difficulties or constraints, such as expenses from their hospitalization, ambulance transportation, and medications not covered by their health insurance plans. This led to misunderstandings, stress, and anxiety, especially because some participants could not return to work or, to a lesser extent, because of their medical condition.

To ensure continuity of care, some participants were proactive in their case management, for example, by calling to confirm or obtain further information on an appointment or to ensure information transfer. Written convocations for upcoming medical appointments and tailored explanations helped the participants organize their care. Family caregivers were also key in taking participants to various consultations, reminding them, and managing their medical appointments.

 Information transfer: incomplete and missing information

Information transfer between and within settings was occasionally lacking. Even weeks after hospitalization, some documents were not transmitted to outpatient physicians, sometimes delaying medical care. Some participants reported receiving incomplete, unclear, or contradictory information from different HCPs, sometimes leading to doubts, seeking a second medical opinion, or personal searches for information. A few proactive participants ensured good information transmission by making a copy of the prescription or sending copies of their documents to physicians:

“My GP hasn't received anything from the hospital yet. I’ve sent him the PDF with the medication I take before our appointment […] Yes, It’s the patient that does all the job.” P10.3

 Interprofessional work: a practice highlighted by some participants

Several participants highlighted the interprofessional work they observed in the outpatient setting, especially because they had several comorbidities; therefore, several physicians followed their care:

“My case is very complex! For example, between the cardiologist and the diabetologist, they need to communicate closely because there could be consequences or interactions with the medications I take [for my heart and my diabetes].” P4.2

Health professionals referred their patients to the most appropriate provider for better follow-up (e.g., a nurse specializing in addictology referred a patient to a nurse specializing in diabetology for questions and follow-up on blood sugar levels). Interprofessional collaboration between physicians and pharmacists was noted by some participants, especially for prescription refills or ordering medications.

 Patient-HCPs relationships: the importance of trust

Trust in the care relationship was discussed by the participants regarding different HCPs, especially GPs and community pharmacists. Most participants highlighted the communication skills and active listening of healthcare providers. Knowing an HCP for several years helped build trust and ensure an updated medical history:

“I've trusted this pharmacist for 20 years. I can phone her or go to the pharmacy to ask any question[...] I feel supported.” P3.2

Some participants experienced poor encounters owing to a lack of attentive listening or adapted communication, especially when delivering bad news (new diagnoses or deterioration of health status). Professional competencies were an important aspect of the patient-HCP relationship, and some participants lost confidence in their physician or pharmacist because of inadequate medical or pharmaceutical care management or errors, such as the physician prescribing the wrong medication dosage, the pharmacist delivering the wrong pillbox or the general practitioner refusing to see a patient:

“I think I'll find another doctor… In fact, the day I was hospitalized, I called before to make an appointment with her and she refused to see me […] because I had a fever, and I hadn’t done a [COVID] test.” P6.2

Most participants underlined the importance of their GP because they were available, attentive to their health issues, and had a comprehensive view of their medications and health, especially after hospitalization:

“Fortunately, there are general practitioners, who know everything. With some specialists, the body is fragmented, but my GP knows the whole body.” P14.1

After hospitalization, the GP’s role changed for some participants who saw their GP infrequently but now played a central role.

 Community pharmacist: an indistinct role

Pharmacists and their teams were appreciated by most participants for their interpersonal competencies, such as kindness, availability, professional flexibility, and adaptability to patients’ needs to ensure medication continuity (e.g., extension of the prescription, home delivery, or extending time to pay for medications). The role of community pharmacists varied according to the participants. Some viewed pharmacists as simple salespeople:

“It's like a grocery store. [...] I go there, it's ordered, I take my medication, I pay and I leave.” P23.3

For others, the pharmacist provided medication and advice and was a timely source of information but did not play a central role in their care. For others, the pharmacist’s role is essential for medication monitoring and safety:

“I always go to the same pharmacy […] because I know I have protection: when [the pharmacist] enters the medications in his computer, if two medications are incompatible, he can verify. [...] There is this follow-up that I will not have if I go each time somewhere else.” P10.4

The patient journey mapping methodology, coupled with qualitative thematic analysis, enabled us to understand and shed light on the intricacies of the journey of polypharmacy patients with T2Din the healthcare system after discharge. This provided valuable insights into their experiences, challenges, and opportunities for improvement.

This study highlights the complex pathways of patients with comorbidities by considering the population of patients with T2D as an example. Our population included a wide variety of patients, both newly diagnosed and with known diabetes, hospitalized for T2D or other reasons. Navigating the healthcare system was influenced by the reason for hospitalization and diagnosis. For example, newly diagnosed participants with T2D had a closer follow-up after discharge, participants were more likely to undergo cardiac rehabilitation after infarction, and participants with a former T2D diagnosis were more complex, with more comorbidities and more HCP encounters. Our aim was not to compare these populations but to highlight particularities and differences in their health care and these qualitative data reveal the need for further studies to improve diabetes management during inpatient to outpatient care transition.

The variability in discharge practices and coordination with outpatient care highlights the lack of standardization during and after hospital discharge. Some participants had a planned appointment with their GP before discharge, others had a telephone call with a hospital or ambulatory physician, and some had no planned follow-up, causing confusion and stress. Although various local or national guidelines exist for managing patients discharged from the hospital [ 36 , 37 , 38 , 39 ], there are no standard practices regarding care coordination implemented in the setting of this study. The lack of local coordination has also been mentioned in other studies [ 5 , 40 , 41 ].

Our results also raise questions about the responsibility gap in the transition of care. Once discharged from the hospital, who is responsible for the patient until their first medical appointment? This responsibility is not clearly defined among hospital and outpatient care providers, with more than 25% of internal medicine residents indicating their responsibility for patients ending at discharge [ 42 , 43 ]. Importance should be given to clarifying when and who will take over the responsibility of guaranteeing patient safety and continuity of care and avoiding rehospitalization [ 44 ].

The first visit with the community pharmacist after discharge and the referring physician were the key encounters. While the role of the GP at hospital discharge is well-defined, the community pharmacist’s role lacks clarity, even though they are the first HCP encountered upon hospital discharge. A meta-analysis showed the added value of community pharmacists and how their active participation during care transition can reduce readmission [ 18 ]. A better definition of the pharmacist’s role and integration into care coordination could benefit patient safety during the transition and should be assessed in future studies.

Our findings showed that the time elapsed between discharge and the first medical appointment varied widely (from 1 to 27 days), correlating with findings in the literature showing that more than 80% of patients see their GP within 30 days [ 45 ]. Despite the first medical appointment being within the first month after discharge, some patients in our study reported a lack of support and follow-up during the first few days after discharge. Care coordination at discharge is critical, as close outpatient follow-up within the first 7–10 days can reduce hospital readmission rates [ 46 , 47 ]. Furthermore, trust and communication skills are fundamental components of the patient-HCP relationship, underlined in our results, particularly during the first medical appointment. Relational continuity, especially with a particular HCP who has comprehensive patient knowledge, is crucial when patients interact with multiple clinicians and navigate various settings [ 48 , 49 ].

Navigating the outpatient healthcare system after discharge was complex for most participants and relied heavily on patient involvement and responsibility. While some participants who received clear information felt more empowered and engaged in their care, others highlighted the difficulty in organizing their care during this vulnerable period. Such difficulties in case management have been described previously [ 50 , 51 ]. Moreover, services proposed by HCPs (e.g., home assistance) do not always correspond to patient needs and are sometimes refused. This highlights the tension between HCPs’ medical recommendations, priorities, and patient expectations. This tension between medical priorities and patient needs was felt during hospitalization and shaped the 2 months following discharge. HCPs need to assess patient needs and preferences during hospitalization and transition for follow-up services. They must also ensure that the offered services meet at least the most relevant of patients’ perceived needs to improve seamless care and patient safety [ 52 , 53 ].

Examples of a lack of communication and information transfer were described in our results at different levels among HCPs, between participants or family caregivers, and HCPs, and these findings correlate with the literature [ 3 , 54 , 55 , 56 ]. Although family caregivers play an important role in supporting patients in the healthcare system, they are also additional interlocutors, leading to missed opportunities for patient-pharmacist interactions when dispensing discharged medication. Therefore, it is paramount to integrate and involve family caregivers in shared decision-making and communicate with patients remotely when they are not present [ 57 ].

Opportunities to improve the discharge of patients returning home after discharge without home care are highlighted in this article. Our insights can serve as a valuable foundation for healthcare providers and policymakers seeking to optimize patient experience and quality of care in the post-discharge phase. Different professionals should be integrated into standard practice through guidelines to ensure improved collaboration from hospital discharge to outpatient care. During hospitalization:

an appointment should be scheduled with the referring physician shortly after discharge to guarantee continuity of care

a hospital discharge interview should be conducted in a systematic way to summarize and securely close the hospitalization

the community pharmacist should be informed before the patient’s discharge to prepare and reconcile medications before and after hospitalization

In outpatient care:

an in-person or phone encounter with the pharmacy team should be scheduled for the patient and/or caregivers at discharge

a contact point (phone number, email, or virtual chat assistant) or scheduled follow-up should be implemented to answer questions and redirect patients before they can meet with the referring physician

a long-term and active communication channel between HCPs should be established.

In other countries, several outpatient services are already available for patients discharged home to enhance continuity of care and patient safety after discharge. The telehealth-based Transitional Care Management Programme, a local initiative in a New York hospital, involves contacting discharged patients 24 to 48 hours after discharge to support understanding of discharge instructions, medication access, follow-up appointments, and social needs [ 58 ]. The Australian Government has introduced the Transition Care Program that provides short-term care for older people, including social work, nursing support, personal care, and allied health care [ 59 ]. In England, the NHS has introduced the Discharge Medicines Service (DMS) in community pharmacies, which aims to improve communication between hospitals and community pharmacies and to ensure that patients understand changes to their medications [ 60 ].

Limitations

This study has several limitations. First, the accuracy of the encounter dates with HCPs, as described by the participants, could not be verified using a second data source (e.g., medical or pharmacy records). Additionally, recall biases cannot be excluded, especially during interviews 3 and 4, which took place at longer intervals (20 days between interviews 2 and 3 and 30 days between interviews 3 and 4). Nevertheless, our findings express a patient's representation of their healthcare system navigation experience. Secondly, these results may not be generalizable to populations with other long-term diseases, even though we recruited patients with different reasons for hospitalization, including age, sex, and comorbidities. In addition, the study region is predominantly an urban area with a high density of HCPs, which may influence patient journeys in the healthcare system. Finally, we excluded patients whose medications were managed by HCPs because these patients might have had different experiences, difficulties, and needs. This exclusion criterion was chosen because our objective was to investigate patients’ medication self-management, as described in another article [ 28 ].

A patient’s journey in the 2 months following discharge is unique for each individual and constitutes a complex and adaptive process. Despite the active role of numerous HCPs, navigation in outpatient care after discharge relies heavily on the involvement and responsibilities of polypharmacy. The findings of this study highlight the need to standardize the approach for discharge planning and post-discharge care in partnership with patients and caregivers. Preparation for discharge, the first visit to the pharmacy, and the first appointment with the GP are key moments for all patients, along with the involvement of other medical and nurse specialists, as needed. Standardizing practices, clarifying responsibilities, integrating community pharmacists during the transition, empowering patients, and enhancing interprofessional communication and collaboration should be explored and implemented to achieve better patient outcomes and a more seamless healthcare journey for individuals transitioning from the hospital to the community.

Availability of data and materials

The qualitative codes in French and anonymized patient datasets are available from the corresponding author on reasonable request. Individual patient journeys are provided in the Supplementary Files.

Abbreviations

General practitioner

Healthcare professional

type 2 diabetes mellitus

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Acknowledgments

The authors would like to thank all the patients who took part in this study. We would also like to thank the Geneva University Hospitals Patients Partners +3P platform as well as Mrs Tourane Corbière and Mr Joël Mermoud, patient partners, who reviewed interview guides for clarity and significance.

Open access funding provided by University of Geneva This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Giacomo Gastaldi

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Contributions

LS, GG, and MS conceptualized and designed the study. LS and GG screened and recruited participants. LS conducted the interviews. LS, GG, and MS performed data analysis and interpretation. LS drafted the manuscript and LS and MS worked on the different versions. MDS contributed its expertise and external opinion as a clinical psychologist and linguist. All authors read and approved the final manuscript.

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Supplementary Information

Additional file 1..

Interview guides.

Additional file 2.

Individual patient journey mappings from discharge to 2 months after discharge.

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Solh Dost, L., Gastaldi, G., Dos Santos Mamed, M. et al. Navigating outpatient care of patients with type 2 diabetes after hospital discharge - a qualitative longitudinal study. BMC Health Serv Res 24 , 476 (2024). https://doi.org/10.1186/s12913-024-10959-4

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DOI : https://doi.org/10.1186/s12913-024-10959-4

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