Blog Post

3 things planners need to know about patient journeys

January 22, 2018

    Consumer journey maps are research-driven product design tools that track how customers interact with a business over time—from experiencing a need, to seeking a solution, to reaching resolution. In health care, patient journeys show how, when, where, and why patients access care. Planners can use these insights to craft their patient acquisition and retention strategies accordingly.

    To understand the best ways to use journey analytics, we're analyzing longitudinal claims data from national commercial payers. Here are three insights from our research so far:

    1. Journey maps illuminate opportunities for patient acquisition, retention, and downstream loyalty

    Journey maps show how patients use care in the market over time. Three main questions can be answered in these journeys:

    • How patients choose a provider: As a measure of acquisition, this segment shows how a patient enters the market and where they go for care.
    • How and where patients complete a care episode: As a measure of retention, this maps how patients move across sites and services for related, necessary care.
    • How patients seek new care needs, unrelated to prior episodes: As a measure of patient loyalty, this shows if patients seek unrelated care with established providers, or if they seek it elsewhere.

    How to win the consumer experience competition

    2. Analysis is most valuable on high-volume, high-revenue episodes

    Some health care interactions provide more insight in a journey analysis than others. In fact, most billable encounters in the market represent one-off care needs that generate limited revenue. As such, planners should narrow their focus on high-opportunity episodes and procedures, rather than mapping the journey of every care episode.

    Specifically, patient journey analysis before and after emergent procedures (such as a stroke) and elective inpatient procedures (like bariatric surgery) can highlight opportunities to attract and retain patients for valuable episodes that often include upstream and downstream care, answering important questions such as:

    • Where did patients go for pre-operative care?
    • Which physicians influence whether patients have the procedure with you vs. a competitor?
    • What percent of patients did you lose between the specialist visit and the procedure? Which competitor did they go to?
    • Where did patients go for post-acute care? What percent resulted in a readmission?

    3. Focus on inflection points for high-traffic utilization patterns, not individual patient journeys

    Despite the notion that patients follow a logical chain from primary care to specialty services and then to surgery, actual utilization patterns show more random interactions. For better insight, we focused our analysis on certain high-volume surgeries. By comparing the journeys of one patient cohort who received surgery to a control group, we identified specific upstream encounters that influence where patients went for surgery. These insights can lead planners to take meaningful action to grow share for these high-volume surgeries—by identifying competitors for a key upstream interaction, targeting a physician for outreach, or considering a post-acute facility partnership, for example.


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