The difference between Patient FLOW and Patient JOURNEY

Patient flow and patient journey: what is the difference?

A patient flow is a quantified picture of a patient population. A patient journey is the sequence of steps a patient goes through in order to be diagnosed, treated and to comply with therapy. The flow tells you where the patients are. The journey tells you what happens to them, and why so many never reach the next step.
 

What a patient flow shows

In chronic diseases, a patient flow is a quantified picture of where the prevalent patient population sits: the prevalence, the share diagnosed and undiagnosed, and how the diagnosed patients split across treatments. For example 40% diagnosed and 60% not, and of those diagnosed, 80% on treatment X and 20% on treatment Y.

In acute diseases it counts the patients passing through a given stage during a given period: the number of myocardial infarctions in a year, or the number of patients treated in a particular line of therapy. For example an incidence of 10,000 patients, 5,000 testing positive on a biomarker, 3,500 receiving first line therapy, and 2,000 surviving to a second line of chemotherapy.

For strategy and tactics the numbers do not have to be precise. Whether 58, 60 or 62 per cent of patients are diagnosed rarely changes the decision. What matters is that the flow is visually simple enough for the whole cross-functional team to read it and reach a shared view.

Forecasting is a different use, and that one does need precise market data. In specialty care with several subpopulations, a flow accurate enough to forecast with can become very complex.
 

What a patient journey shows

A patient journey follows the steps a patient goes through in order to be diagnosed, treated and to stay on therapy. In schizophrenia, for example: family members notice unusual behaviour and ask a primary care physician for advice, the physician is not certain what is driving it and refers the patient to a specialist, the specialist makes the diagnosis and prescribes a classic antipsychotic, later switches the patient to an atypical antipsychotic and discharges them, and family members then help the patient comply with the therapy.

The journey also captures the perceptions, beliefs, behaviours and pain points at each of those steps. Family members may feel uncomfortable describing the behaviour to a prescriber. Symptoms may be present one day and absent the next, so a consultation on a day without symptoms makes diagnosis very difficult. That is why patients drop out at the very first step, before a primary care physician suspects that anything is wrong.

Pharma has long focused on prescribers, regulators and payers. The patient journey is a way of making the organisation more sensitive to patients and to their experience. For a single brand, the purpose is more practical: to find the pain points that have to be addressed in order to maximise patient outcomes.
 

From patient flows and journeys to Critical Success Factors