The Future Patient Journey

Abstract

The healthcare sector has reached a turning point in which the patient stands central during the continuum of care. Erasmus MC is a leading hospital in health care innovation and thrives on pioneering this shift towards value-based care. Value-based care is a philosophy of delivering optimal care for the patient while reducing costs.

To reach this, Erasmus MC has implemented a five-year strategy focused on dedication and technology. Dedication emphasizes the importance of providing a patient with the right treatments and supporting them in the process. Technology is seen as an enabler in both the procedures as well as improving patient experience. The question now is how to create the perfect balance between dedication and technology to optimize the patient experience while streamlining the journey for Erasmus MC staff. This project focuses on the specific case of the Transcatheter aortic valve implantation (TAVI) procedure. This procedure involves the implantation of valve prostheses in the native aortic valve of the patient’s heart by percutaneous puncture via their transfemoral artery. It is a minimally invasive procedure under local anesthesia, meaning they are vividly awake during the procedure. TAVI patients are, on average, 80 years old.

This project evolved from a problem identified by an interventional cardiologist at the Erasmus MC. He noticed that technological advancements were improving the procedure; however, the patient experience was not progressing.
The majority of the patients were anxious and uninformed prior to the procedure. This is a problem because pre-operative anxiety affects the interaction between cardiologist and patient, it hinders the person from processing information (Cammen, 2021), affects the post-operative recovery process (Yuzkat et al., 2020), and decreases overall patient satisfaction (Herrera et al.,2009). Therefore, the challenge was: Design a tool to improve the patient experience by reducing pre-operative anxiety of patients who undergo a TAVI.

To tackle this, extensive user research was conducted on the journey of TAVI patients. This led to a reliable patient experience curve identifying the pain and success points as well as the reasons for these peaks. Concurrently, the enablers of positive patient experience are defined through a literature review. This led to the concept proposal, an improved TAVI patient journey. The new patient journey consists of (1) several new touchpoints throughout the continuum of care that ensures the patient feels recognized and improves the continuity, (2) a physical care package (Zorgpakket) delivered to the patient's doorstep, supporting the patient by providing them with the right tools to prepare themselves for the procedure, and (3) a 3D animation of the TAVI procedure, creating an accessible manner for elderly patients to use technology which has an added value for the patient journey.
An extensive validation study has proven that the new patient journey, specifically the Zorgpakket, helps the patient feel at ease by providing the tools to form the right expectations and increase trust through empathy and professionalism. The aimed long-term effect is to eliminate the pain points in the experience curve.
The proposal is a desirable solution that fits the patient's needs while streamlining the workflow of the healthcare professionals. The different aspects of the project are applicable in other areas within the healthcare sector and will serve as inspiration within Erasmus MC to reach the goal of value-based care.