The patient journey patient and provider perspectives uk

The Patient Journey:Patient and Provider Perspectives

United Kingdom report 2016

Independent market research

What role should technology play in themodern healthcare journey?

Conducted by Loudhousea division of Octopus Group

Executive summary

Overview

Care perceptions and digital expectations:The patient perspective

The impact of technology on the patient experience

Patient management challenges:The provider perspective

Optimising the patient journey

Conclusion

01

02

03

05

06

07

08

Contents

Executive summary

01Transforming the Patient Journey UK 2016

"UK healthcare providers acknowledge that effective patientmanagement contributes to a better experience throughout

the treatment journey. Indeed, the industry believes that in order tooptimise the treatment process, more needs to be done"

Perceptions around the patient experience have notably changedin recent years. The central premise of ‘diagnosis then treatment’has been replaced by a growing expectation for continuity andlasting support throughout the patient journey. Consumer technologyhas given people an unprecedented level of access to information,and with this, higher expectations on treatment and service. Whenit comes to healthcare, patients wish their treatment to be tailoredand personable, and not simply a commodity which has a definedcourse and conclusion.

Qinec, a leader in care pathway management, commissioneda study to explore the changing nature of medical treatment acrossboth the UK and US. The following report in particular explores thefindings within the UK. In order to build a 360 degree view of thelandscape, the research looks to understand the views and attitudesof both healthcare providers and patients.

UK healthcare providers acknowledge that effective patient managementcontributes to a better experience throughout the treatment journey.Indeed, the industry believes that in order to optimise the treatmentprocess, more needs to be done at the ‘front and back end’ of thetreatment process. Whether this involves speeding up triage oroffering more supportive aftercare, healthcare providers recognisethe need for continuous care and an evolution of how patients aretreated.

For patients, a responsive and well organised service is likely tomaximise their perception of treatment, more so than the outcomeof the treatment itself. As such, managing patient data and recordsmore effectively at every step of the treatment process brings withit a wider benefit to the service. Technology is crucial in helpingsupport this, yet only a minority of healthcare providers have a single,unified system which manages the journey from the point of referralto aftercare. The report concludes that UK providers should takethe initiative in driving a more consistent, joined up and seamlesshealthcare service.

of providers are still storing patientrecords on paper

92%

13%ONLY of patients

reported being contacted by theirhealthcare provider to check on

their wellbeing after care


“The central premise of ‘diagnosis then treatment’ hasbeen replaced by a growing expectation for continuity

and lasting support throughout the patient journey”

Overview

The provider view

61% of IT systems are not sophisticated*, which either havelimited functionality (49%), a lack of cohesion (8%) or rely onmanual processes (4%)

Paper filing (92%), on an onsite centralised system (49%) and in thecloud (37%) are the most popular ways of storing patient records

Nearly half (46%) believe their organisation would benefit from anupgrade to existing systems to better manage prospective andexisting patients more effectively

Patient management challenges

A responsive and well organised service (71%), interest and careover patients welfare (58%) and the usefulness of information (52%)were the biggest reasons for having a good patient experience

Pre consultation (37%) and the aftercare offered (22%) are the stageswhich patients believe require the biggest improvement across thepatient journey

The patient view86% of healthcare providers believe delivering an effective patientjourney from the point of referral to aftercare is becoming increasinglyimportant to them as a healthcare provider

70% believe their organisation could treat people quicker and moreeffectively with better patient data and process automation

Triage (90%), pre-consultation / referral (83%) and aftercare (74%)are the stages which require the biggest improvement

The biggest benefits of implementing technology include savingstaff time (84%), identifying patient benefits more easily (77%) andimproving the overall patient experience (78%)

The most critical functions of patient technology include:


Supporting the delivery of an exceptional patient experience (42%)Allowing remote access and management (33%)Allowing patient self-management (32%)

Research Methodology

Healthcare Providers: 100 UK healthcare professionals with responsibility for the technology and systems which support patient management completeda survey in August / September 2015

Patients: 500 UK patients who have attended either a hospital, a private health clinic or been seen by a family doctor to receive treatment completeda survey in August / September 2015

*sophisticated is defined as highly automated and integrated digital patient management system as opposed to disparate software or indeed papermanagement systems

“Patients perceive the biggest problem to beat the beginning and end of the treatment process.”


Figure 1: Stages which patients told us require most improvement

Pre-consultation(E.g.Booking anappointment/ orbeing referred)

Triage (The pointwhen treatment

options are decided)

Consultation Diagnosis Treatment Billing*Aftercare oroutcome

(Once treatmentis complete)

37%

8% 9% 9% 12% 22% 2%

Care perceptions and digital expectations:The patient perspective

Treatment process

The digital world has changed how patients perceive the servicethey receive. Nearly half (45%) believe services they receive fromother service providers, such as retailers, utility providers and travelcompanies, have raised their expectations on how they should bedealt with as a patient. Indeed, 57% believe their expectation of howhealthcare providers use technology to improve the patient experiencehas increased as a result of how they use technology in day-to-day life.

Seven in ten (69%) felt their overall treatment experience was excellent.However, as seen with healthcare providers, patients perceive thebiggest problem to be at the beginning and end of the treatmentprocess. Pre-consultation (37%) and patient aftercare (22%) are thestages which require the most improvement across the patient journey(see figure 1). Amongst those who received a good level of treatment,a well organised and responsive service (71%), and interest shownover patient welfare (58%) were the biggest reason for it, more sothan the treatment itself (51%) (see figure 5). A lack of follow up fromproviders (36%) was seen as the biggest reason for having a poortreatment experience.

It is also worth noting that fewer than 1 in 10 patients had access toany sort of web-portal for making online bookings, updating personalinformation or receiving updates. Two-thirds (67%) experienced havingto provide the same information more than once, throughout their carejourney.

Patients recognise the role technology plays in supporting a bettertreatment process. As little as 36% agree that technology has noreal impact on improving their overall patient experience. Importantly,patients see a role for technology across each stage of their treatmentjourney. After treatment (55%) and diagnosis (54%), patients believetechnology plays the most important role in supporting pre-consultation(50%), including booking appointments and being referred.

44% of patients would like to use technology, such as apps andonline tools, more to improve their engagement with healthcareproviders.

of patients stated a well organised andresponsive service was the reason behind

a good healthcare experience

71%


Despite the contrasting healthcare systems which exist betweenthe US and UK, both patients and providers experience a similarstory when it comes to the patient journey. The digital age has givenrise to greater expectations around patient service. With this, healthcareproviders recognise the need for a more consistent and lastinghealthcare experience throughout the patient journey. However, thegrowth in ‘digital expectation’ is most prominent within the US. Indeed,US patients are more likely to believe their healthcare expectationshave increased as a result of the technology they use in their everydaylife.

Whether driven by greater patient demand or not, the systems andprocesses US healthcare providers have in place are generally moreadvanced than in the UK. Although such systems ultimately supportthe patient journey, UK providers admit their processes often havelimited functionality and integration. Against this backdrop, NHSorganisations report a greater challenge in accessing patient recordsand data, which in turn, serves to undermine the flexibility of theirhealthcare service. Indeed, UK providers, and patients, believe thetreatment experience could be improved more at the beginning of thejourney. However, for US and UK providers alike, patient managementremains key to the service proposition, not least for the ‘customerexperience’, but contributing to a better clinical outcome.

Two regions – One challenge

Figure 2: Biggest reasons for good treatment experience US UK

The service was responsive and well organised

I felt that my HCP* was interested in my welfare

My HCP provided effective treatment

I felt I was given useful information by my HCP

My records were reviewed thoroughly

My HCP checked up on me after my treatment

I was asked my opinion as to the quality of the experience

*Health Care Provider

71%75%

58%64%

52%50%

52%50%

40%47%

30%32%

14%19%

UK

69%of UK patients

rated their healthcareexperience as excellent

US

75%of US patients

rated their healthcareexperience as excellent

Patient experience:The impact of technology

“a good healthcare experience means more than simplythe quality of time spent with the individual doctor

and the end clinical result.”


The decision to invest in new technology can be a difficult one. Overhalf (59%) believe it can become expensive and time-consuming ifnot managed correctly. However, organisations recognise the benefitsthat new tools and systems can bring to the patient’s journey. Indeed,health professionals believe new technology can save staff time (81%),identify patient benefits more easily (79%) and improve the overallpatient experience (76%).

When it comes to supporting the treatment process as a whole,healthcare providers believe technology should ultimately support thedelivery of an excellent patient experience (91%), allow analysis ofpatient data between departments or locations (80%) and allow patientsto book, cancel or move their own appointments (78%) (see figure 3).

Furthermore, three-quarters (75%) believe it’s important for technologyto automate patient bookings and follow up notifications. In light of thedeficiencies seen in the front and back end of the patient journey, theneed for continuous patient management is critical. Under halfof patients reported receiving a text message (42%) and just a smallminority received an email (8%) reminding them about their medicalappointment. Similarly, after their treatment, just 28% were directedto important sources information surrounding their condition.

Given how patient satisfaction is defined, providers should take greaternote of how technology can drive the overall patient experience.Although providers identified outcome (92%) and quality of clinicalteam (90%) as the most important factors impacting patient satisfaction,patients rated ‘a well organised and responsive service’ (71%) aheadof clinical factors (see figure 2). This is an important distinction, as itindicates that a good healthcare experience means more than simplythe quality of time spent with the individual doctor and the end clinicalresult; it’s the end-to-end service that people remember.

Technology can have greatest impact on patient satisfaction if itaddresses the entire care pathway, from first point of enquiry, throughto smooth transition to aftercare, making each stage more integratedswifter and efficient.

Figure 3: Most important functions of patient technology

Very Important Quite Important Neutral Not very important Not important at all

Supports the delivery of an excellent patientexperience

Allows analysis of patient data betweendepartments or locations

Allows patients to book, cancel or movetheir own appointments

Allows for remote access and management

Automates patient booking and follow upnotifications

Integrates with other informationmanagement systems

Compiles reports and analysis quickly

42%

28% 52% 16%

32% 46% 19%

33% 42% 19%

25% 50% 24%

35% 36% 28%

24% 47% 24%

49% 10%

5%

5%

6%

1

12

1

1

What did patients report receiving?

web-portalaccess

emailreminder

42%SMS

reminder

8% 9%

Patient management challenges:The provider perspective

“Aligning resources with patient needs (31%), accessibility of patient data (31%) and tracking patients throughout

their journey (29%) are felt to be the biggest challenges.”


Just 39% of UK healthcare providers have a sophisticated system inplace to manage the patient journey which is both automated andintegrated at a systems level.

For the large part, the processes in place are often disjointed and siloed.Such systems are considered to have either limited functionality (49%),a lack of cohesion (8%) or rely on manual processes (4%). If thetreatment process is to be optimised, providers recognise the needfor a more integrated patient system. Nearly half (47%) believe theirorganisation would benefit from an upgrade to their existing systemsto better manage prospective and existing patients more effectively.

In light of this challenge, providers report more tangible challengeswithin their patient management. Aligning resources with patient needs(31%), accessibility of patient data (31%) and tracking patients throughouttheir journey (29%) are felt to be the biggest challenges with managingthe patient process (see figure 4).

Despite 69% of providers saying they provided follow up to patients,in reality, just 13% of patients were contacted to check on the statusof their wellbeing after care. The storage of patient data is furthercompounding the situation. Indeed, nearly all UK healthcare providers(92%) manage their patient records through paper filing. Although thislinks in with ‘legacy’ systems, such data storage undermines theavailability of patient data. Onsite centralised systems (49%), in thecloud (37%) and stored locally on devices (22%) are further methodsused for storing patient records.

Figure 4: Biggest patient management challenges over the last 24 months

Being able to align resources to patient needs

The accessibility of patient data

Ability to track patients throughout their journey

Being able to contact patients at short notice

The transfer of patient data between departmentsor locations

Patients missing appointments

31%

29%

28%

26%

11%

None of these 14%

31%

Resourcing Accessto patient data

Tracking patientsthroughout the journey

TOP

patient management challenges are:

3


“Despite a recognised need for a consistent patientjourney, not all parts of the service are

felt to be of the same standard.”


The focus of healthcare has moved beyond simply providing timelydiagnosis and successful treatment. Industry leaders have recognisedthe need to maintain a consistent treatment process. Nearly nine inten (86%) believe delivering an effective patient journey from the pointof referral to aftercare is becoming increasingly important to them asa healthcare provider. Two-thirds (65%) believe effective patientmanagement contributes to better health outcomes for patients.This doesn’t solely mean the medical treatment they receive, butalso the experience of being cared for across the journey. If healthcareproviders are to fulfil this, having available access to patient recordsis critical. Seven in ten (70%) believe their organisation could treatpeople quicker and more effectively with better patient data andprocess automation.

Despite a recognised need for a consistent patient journey, not allparts of the service are felt to be of the same standard. While providersare broadly happy with the quality of their ‘core’ service, the front andback end of the patient journey demands attention. Triage (90%),pre-consultation / referral (83%) and aftercare (74%) are seen as thestages which require the biggest improvement along the process(see figure 1). A further 71% believe their booking and administrationsystem requires further improvement in order to enhance the overallexperience, rising to 77% amongst NHS organisations.

If the patient journey is to be optimised, healthcare providers cannot simply rely on the efficacy of medical treatment alone. More needs tobe done to manage patients more effectively in the build up to theirtreatment and how they are cared for afterwards. Six in ten (60%)believe patient management software is intrinsic to delivering a positivepatient experience.

Figure 5: Stages which require most improvement

Significantly improve Improve to some degree No improvement needed

Triage

Pre-consultation/referral

Aftercare or outcome (e.g when a patientreturns for continuing treatment or isdischarged from care)

Administration/Booking

Consultation

Diagnosis

Treatment

41%

46% 37%

83%

17%

36% 38% 26%

33% 38% 29%

17% 52% 31%

19% 36% 45%

9% 41% 50%

49% 10%

74%

71%

69%

55%

50%

90%sum of top two boxes

Expectations of care and welfare have changed significantly in recentyears. Patients now perceive care quality to be more than just theoutcome of their clinical treatment, prioritising the need for continuouscommunication and support. Whilst this shift can be attributed to agrowing demand for better ‘consumer experiences’, the role technologynow plays in people’s lives has broken down information barriers andheightened expectation.

Both healthcare providers and patients agree more needs to be doneat the start and end of the patient’s journey. Indeed, patients oftencite difficulty in confirming appointments and a lack of support duringtheir aftercare. With patient records stored in many different waysacross the organisation, most notably through paper filing, healthcareprofessionals do not always have the required data available to offera joined-up service. Subsequently, UK healthcare providers strugglewith aligning resources, accessing patient data and tracking thepatient journey.

Conclusion

“For transformation to be long lasting and effective,change needs to happen at the core of

how we model care pathways.”


Intelligent use of data throughout the journey not only improvesthe experience for patients, but also for clinical-led teams. With thecorrect capture and validation of data, employees can provide a moreefficient, interconnected and hassle-free service which simplifies theprocess for all key stakeholders. Now is the time to use technologyto improve the entire patient journey experience, from enquiry toaftercare, rather than trying to solve problems in a piecemeal fashion.Healthcare providers should look beyond the confines of theirtraditional institutional hierarchies to create an agile, personalisedservice from start to finish. For transformation to be long lasting and effective, change needsto happen at the core of how we model care pathways. Only byrethinking the processes and systems around this can technologythen enable teams to work in a highly integrated, organised andcollaborative manner. The result will engage patients, improve bothpatient and provider experience, and ultimately deliver better careat lower cost.