The moment a patient seeks medical care to determine the cause of their symptoms, that patient has begun a journey involving multiple stakeholders. Hospitals, physicians, nurses, insurance companies, pharmacies and medical device companies may all be—at one point or another—involved in this patient journey.
While market research has always been important in positioning the launch of a new medical device, real world evidence from patients is now becoming more relevant in such a competitive marketplace.
What is a patient journey?
The term patient journey refers to the patient experience throughout a single episode of care, starting with the point of entry into the healthcare system and ending with patient discharge or death. This journey includes referrals to imaging centers and specialists, as well as follow-up care and physical therapy.
For example, a patient seeks treatment for an injury at an urgent care clinic, where care providers send the patient to a radiologist. That patient is diagnosed with a broken bone and is told to follow up with their primary care physician (PCP). The PCP may refer the patient to an orthopedic specialist, and the specialist may then refer the patient to a physical therapist for pain management and post-acute care.
This cycle continues as individuals seek treatment and work to resolve their health issues through an episode of care.
What is patient journey mapping?
Patient journey mapping—or healthcare process mapping—is an exercise in which a sales leader leverages medical claims data to identify patient touch points during each stage of the care journey. The information that sales teams derive from this sort of analysis can inform territory planning, identify key opinion leaders, and improve sales messaging. It can also impact how you approach and interact with both patients and providers.
By mapping these pathways, you can gain a more thorough understanding of care priorities and opportunities for ongoing communication between patients and physicians. Patient journey maps can help your team understand what patient diagnosis and treatment journeys look like so you can better understand disease management and where your product fits within that journey. Some key questions to circulate within your organization in order to make the most of this journey mapping strategy include:
- What treatments are the patients receiving before their diagnosis?
- Where are they receiving care before a diagnosis? How long does it take for them to receive your target diagnosis?
- Where are patients receiving care after their diagnosis?
- Where are they going to manage their condition?
Visualization of patient journey mapping
Fig. 1 Image is a visualization of what a patient journey might look like based on healthcare facilities visited, with access to all-payer claims data.
Analyzing all-payer claims data to map patient journeys
In healthcare claims data, there are two primary components: private, commercial insurance claims—primarily for patients under 65—and publicly reported claims from Centers for Medicare and Medicaid Services (CMS), which is primarily for patients over 65.
All-payer data is known to be difficult to access and time-consuming to analyze. However, for an accurate understanding of the entire market, it is vital to explore the full scope of this claims data to gain a well-rounded view of all the different components of care delivery.
With Definitive Healthcare’s Medical Claims database, users can leverage patient claims data to map a patient journey using diagnosis and procedure codes and determine which physicians and surgeons are treating your target population. These results can be further segmented by factors like geography and hospital or health system affiliation.
Pharmaceutical companies or medical device manufacturers looking for highly targeted patient populations will find that the PatientFinder solution enables sales and marketing leaders to find exact populations via diagnoses, symptoms, and treatments. PatientFinder also allows users to search for patients being treated by particular physicians, further easing go-to-market strategy execution.
A tool that grants access to constantly expanding real-world data is crucial in developing a strategy that outranks the competition.
Are you looking for more information on how other organizations leverage medical claims intelligence? Watch our on-demand webinar, How Care Providers Strengthen Their Business with Claims Analytics, hosted by Definitive Healthcare’s Senior Vice President of Strategy, Kate Shamsuddin.
In this webinar, Shamdsuddin discusses how providers use medical claims to:
- Understand population health trends and community healthcare needs
- Cultivate care networks that provide high-value care at low costs
- Pinpoint the strengths and weaknesses of their unique facility