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Patient journey mapping: exploring the clinical and the emotional journey

By Chris Hodgson, Neil Rees, Sumira Riaz and Karen Petticrew While we can all agree that the value of developing a patient journey map cannot be underestimated when exploring the care pathway for a patient, there appear to be inconsistencies within the same pharmaceutical organisations as to how patient journey mapping is defined.

There can often be a dichotomy in scope, content and delivery; for some, mapping the patient journey is to determine the clinical transactional pathway, while for others, the focus is to define the psychological experience of the emotional journey of patients and caregivers from diagnosis and beyond.

The adoption of one approach over another is entirely dependent on the needs of the stakeholders and the business requirements within the organisation. However, by considering both rational and emotional parameters, creating a patient journey map that fuses the clinical and psychological experience of the patient and relevant influencers can provide the organisation with a basis for a blueprint to enhance the journey with appropriate interventions.

As a starting point, understanding how patients proceed through the healthcare delivery system, using validated real-world data is essential.

The production of a clinical pathway can be achieved by analysing Hospital Episode Statistics (HES) data: a records-based system that covers all NHS Trusts in England.

While all data is pseudonymised to ensure patient confidentiality, the data collected follows patients’ clinical touchpoints during their time under the care of a physician based in the NHS.

The data collected in HES includes, but is not limited to:

  • Patient details – age, sex, ethnicity and location
  • Clinical details – diagnoses,investigations/tests, operative procedures, consultant and specialty
  • Administrative details – NHS Trust, GP, admission/discharge date and method and referrer.

Mapping patients along the entirety of a pathway, from initial referral through further diagnostics to first definitive treatment, enables an understanding of the efficiency of care delivery and where opportunities exist for improvement.

There are various aspects of the patient journey elicited from HES data that can shape any subsequent exploration into the psychological experience, such as:

  • The approximate time between the first and last step? - from first appointment to diagnosis to first treatment
  • Where are the longest delays?
  • The approximate time between each step?
  • How many steps are there?

Identifying aspects such as time to diagnosis and time to initiation of treatment can shape how you approach developing a picture of the psychological journey of the patient.

The clinical pathway can highlight the HCP types involved in the journey, gathering their perception along with patients, carers and PAGs to help to identify and define the variety of emotions experienced at each touchpoint, thereby providing the psychological dimension.

A starting point to build the emotional perspective of the journey is to collate available information. Immersing yourself in existing information, such as previous market research or exploring the disease area on social media platforms supports an initial data immersion exercise that can feed into a bespoke qualitative research approach.

Using tailored methodologies and projective techniques to elicit deep-rooted feelings throughout the journey will help us understand the lived experience of the patient and specifically the psychological impact of clinical milestones previously identified.

Furthermore, it can be extended to include the emotional response of caregivers at each key milestone, thereby permitting a further layer of insight beyond that of the patient and the healthcare professional.

In addition to mapping clinical patient pathways, the use of HES data can support the development of innovative solutions and service improvement, track outcomes and provide real- world evidence.

These data sets are used for the purposes of providing supporting information for business cases, epidemiological research, burden of disease analysis, health economic research, predictive analytical modelling, NICE submissions and quality & outcome analysis.

The aim is to improve patient care and support enhanced access to services and innovative solutions, which is additionally supported through an understanding of the patient’s emotional well-being.

The data immersion and bespoke market research used to better understand the psychological journey can aid identification of unmet needs, leverage key information points and assist in facilitating tactical solutions around services to improve patient care and support healthcare professional education.

Overlaying the clinical journey with the emotional journey will provide brand teams with a truly holistic view of the patient journey.

Understanding the unmet needs, drivers and barriers for change along the journey will enable brand teams to develop interventions, for patients, healthcare professionals or other relevant stakeholders. Such support can improve the journey for the patient, leading to improved patient outcomes.

Chris Hodgson is Operations Director, Neil Rees is Head of Research, Sumira Riaz is Head of Health Psychology and Karen Petticrew is Research Director, all at OPEN Health.

11th November 2019

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