What buzzwords have flooded the healthcare sector in recent months and triggered a fundamental rethink of the existing healthcare sector? Patient-centricity, improved medical outcomes, and most certainly digitalisation.

New opportunities and fierce competition are forcing traditional healthcare players to reconsider their existing value propositions and innovation efforts. Meanwhile, a disruptive form of patient care is gaining attention: digital health companions for patients [The Rise and Rise of Patient Companions]. These companions offer personalised support along the treatment journey as an end-to-end care model. Despite a growing interest in this technology and its promising effect on patients and their treatment outcomes, only a few market solutions truly accompany patients. Most offer standalone solutions scattered along the treatment journey. This phenomenon can be explained by the complex characteristics of the health sector: strict regulations, a diversity of players, long treatment paths, and multiple unknown unknowns.

In our experience, this complexity can be overcome by adopting a customer journey map to the patient experience and using this map to create digital end-to-end health companions. Over the past year, we had the opportunity to build a health companion with a large German private health insurance company. Motivated to improve the medical care of arthritis patients and the value-based healthcare approach, we created a companion that walks alongside the patient for better preparation, health outcomes, and positive patient experiences (see alley.de for more details).

Based on the experiences we gathered during this process, we’ve mapped out the four key steps required to kick-start the development of a digital health companion.

1. Map out the patient journey

As the name implies, a health companion accompanies patients along their treatment path. To maximise the value created by a health companion, all the players involved in its use — especially patients and care providers (CP’s) — need to be understood. Unlike purchasing items online, the customer journey for medical treatment doesn’t take just a few minutes; it spans months or even years. So, whether it’s the inclusion of a dual perspective, emotional conditions at each step, or a long treatment course, a patient journey map needs to cover it all.

To ensure that all of the above is considered, here is our approach to mapping the customer journey right from the start:

1. Begin by defining the start point in the patient’s journey. This is usually the moment a patient is first confronted with a specific health condition, but it can also be the first symptoms, getting results from a routine check-up, or a discussion with friends and relatives.
2. Horizontally map the journey steps into three levels. This reduces complexity and fosters a thorough understanding. For example, when mapping a journey for arthritis patients, begin by defining large clusters (such as “inpatient” and “outpatient”), then divide each cluster into touchpoints (such as “doctor consultancy” or “surgery”), and finally break down those touchpoints into marginal steps (such as “specialist search” or “clinic search”). At first, the journey you map might only cover a short path, but it will grow steadily with every new insight you gain. Make sure to consider all influencing steps over a large period of time and trust that the correct endpoint will fall into place.
3. Vertically structure the columns to highlight different dimensions of the patient journey. The success of a digital health companion depends on the added value for both patients and CP’s. This means their gains and problems should be mapped separately. To acquire a thorough understanding of each step in the patient journey, uncover and map the emotional state of patients in another row. Other relevant dimensions might include medical data, current solutions, tools, etc.

Throughout this process, flexibility and continuous adjustments are key. This is the moment when you realise that the initial journey you mapped has grown into something much more complex and meaningful. Have a look at the graphic below to get a visual idea of how such a patient journey can be mapped.

2. Map out the problem points along the patient journey

Understanding the ins and outs of each player along the treatment path is tough. While gains are often easy to identify, fully uncovering the problem points can be challenging. From our experience, there are four distinctive types of problems you want to understand.

1. Patients feel frustrated: Imagine that you need a specialist. After many unsuccessful appointments, you search extensively for a new doctor. You’re not a medical expert and you don’t know how to judge these professionals on their skills. Ideally, you read some patient reviews and decide on the best possible option. You arrive for an appointment and experience long wait times, a short appointment slot, and a CP who isn’t focused on your individual needs. These are all typical patient frustrations, but other examples include insufficient treatment offerings and negative surgery outcomes.
2. Patients feel emotionally overwhelmed: Patients are highly dependent on their CP to make the best possible treatment decisions. While some patients might conduct extensive online or offline research about their health condition and potential treatments, the information asymmetry between patients and CP’s remains high. Assessing the trustworthiness of information can lead to information overload and keep patients from being decisive about their own health. This can lead to anxiety and emotional worries.
3. Patients have to manage their own medical documents: Every patient with a medical history can confirm the extensive and exhausting process of going to appointments over the course of months and years and accumulating a vast amount of treatment documentation. More often than not, this documentation is not digitized and transferred between CP’s, which means the patient is responsible for managing their own documents. This loss of oversight isn’t just annoying for the patient; it also hinders the CP’s ability to work efficiently and delay the patients’ treatment journeys. Not to mention the inefficiency of every new CP having to re-enter patient data.
4. Patients don’t know about the latest treatments: This problem point is often unknown to patients, but by comparing the latest treatment possibilities with the current status quo, new improvement areas become clear. These are vital value drivers for payers and ensure a digital health companion that improves the overall medical performance.

To best uncover the specific problem points within these four categories, you’ll need to do some research. Because of the sensitivity that accompanies medical topics (especially for patients) try to look beyond conventional methods to find suitable interviewees. You might use Facebook Groups or attend official patient information events hosted by clinics. Similarly, the timely and challenging process of finding suitable CP interviewees can be bridged by talking to retired CP’s first and understanding how to get doctors for user research. (Make healthcare innovation a reality by improving your hospital interviews)

Can you describe your journey since the first symptoms? How did you feel when you received the diagnosis? What did you do next and why? What are the vital documents required to choose an appropriate treatment?

These are only a few of the questions that you will want to ask. They will lead you to insights such as the journey steps, the patient’s feelings and frustrations, or the CP’s processes (see problem point 1–3). If you want the details of problem point 4, however, you’ll need to do some in-depth desk research and get in touch with healthcare thought leaders.

3. Evaluate the importance of each problem point

Once you’ve achieved a thorough understanding of a treatment journey’s current problems, the next step is to evaluate the importance of each issue. It’s simply not feasible to target all identified pain points, especially not thoroughly and immediately. To build a successful patient companion, it’s crucial to focus on the most critical pain points.

In order to do this, two key questions should be asked:

1. Is solving this problem strategically relevant? When developing a patient companion, the primary focus should, of course, be on facilitating the lives of patients, doctors, and other stakeholders along a treatment path. It is also necessary to keep the viability of the digital health companion in mind. Developing a solution that doesn’t provide either a direct or indirect financial benefit to its initiator won’t be on the market for long and won’t be able to solve any problems at all. To prevent the development of idealised products, it’s crucial to take a step back and check whether the solution to an identified problem is actually in line with the intended corporate goals.
   Depending on the initiating company, the motives to build a patient companion can differ substantially. A health insurance company might want to increase their access to patients and deliver an empathic user experience that is actually patient-centred in order to set themselves apart from the competition. A pharmaceutical company might be more interested in collecting relevant health data to better understand patients’ conditions throughout their treatment.
2. Does solving this problem provide value to relevant stakeholders in addition to patients? Despite being used primarily by patients, health companions depend on interaction with other stakeholders like physicians, nurses, or administrative support staff. Identifying relevant stakeholder groups early on and ensuring that their problems are addressed as well, is important for a patient companion’s practical functioning.
   A digital health companion can be as innovative and beneficial as can be, but if it doesn’t provide significant value to CP’s, it simply won’t be used. At least that’s the experience we’ve had with in- and outpatient orthopedists.

Once the problems that are aligned with the above questions have been identified, they need to be ranked. Which problem is most severe? Which one best addresses the two issues above? Ultimately, a patient companion can only be successful if it creates a win-win-win situation between patients, care providers, and the company developing it.

4. Identify a precise starting point along the patient journey

Having identified and highlighted the important pain points of all relevant stakeholders along the treatment journey, the final step in getting a patient companion off the ground is choosing the ideal starting point.

As mentioned at the beginning of this article, patient journeys within the healthcare industry can be quite extensive. In order to cope with this complexity, it is important to choose one precise step along the journey that functions as a starting point for the patient companion. Following this vertical approach enables a focus on delivering a solution of significant value to a specific problem along the patient journey instead of providing small solutions with little benefit and adoption throughout the whole journey. Furthermore, this simplifies the identification of product-market fit and builds a solid foundation, allowing for a later horizontal expansion.

In order to find the most ideal starting point, one should begin by looking at the steps along the patient journey where patients feel the strongest pains and are therefore desperate for solutions. As the severity of a pain increases so does the patients’ urge to search, adapt and adhere to new solutions. Focusing on the highlighted pain points from step 3 should thus be your first step. Ideally, a step of the patient journey already pops up at which a majority of strong problems occur.

Should the intended care companion require the cooperation of further stakeholders like doctors or administrative staff, then also their pain points should be considered. As briefly described in step 3, doctors will be more likely to support and use a patient companion if they see a direct benefit for them. Choosing a starting point that provides value to both patients and doctors is thus necessary to secure a companion’s success.

Another consideration to make is the alignment with the intended got-to-market strategy. Whether patients are to be addressed directly or through stakeholders can have quite a substantial impact on choosing a starting point. Similarly, to the point above, the value would need to be delivered to any stakeholder that is needed to attract patients. In the case of a direct to patient model, a step along the patient journey would need to be chosen, that includes strong pain points and is not dependent on the interaction with another stakeholder. In this case, often so-called decision points function as a great step in which to target patients. As they are decisive for the ongoing journey and require actions to be taken, patients tend to be more engaged at these times and are therefore more receptive to new solutions.

Lastly, one remark one should be aware of is that the earlier the starting point is along the patient journey, the easier further continuous extensions become.

Conclusion

Despite present challenges and complexities within the healthcare industry, we can see that realising a health companion that truly accompanies patients along their treatment journeys, improves the interaction with relevant stakeholders and thus improves health outcomes is possible if the necessary considerations are made. Following the above-mentioned steps not only adds structure to a task, that at first might seem overwhelming but also increases the predictability of success.

Truly understanding the treatment journey, both from the patients’- as well as the stakeholders’ point of view is indispensable when building a patient companion. Here, it really comes down to identifying procedural, emotional, and medical pains and gains in great detail as they build the foundation for any future developments. Similarly, a clear focus should be set on creating a win-win-win situation, that provides equal value to patients, doctors and the initiating company.

Building a treatment encompassing patient companions is possible. So let’s disrupt the status quo together and change the lives of thousands of patients, by shedding light into what is the dark for most today!

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