How many systems does a single patient journey involve?

A patient usually only sees a small part of what happens behind the scenes. An appointment is scheduled, treatment is delivered, and later perhaps a follow-up check-up takes place. For the patient, this feels like a single process.

For a healthcare organisation, it's very different.

Behind every patient journey lie dozens of processes, departments and systems that must work together. As long as everything runs smoothly, this hardly becomes apparent. But as soon as a change or disruption occurs, it becomes clear how interdependent everything has become.

More than just an electronic patient record

It is often assumed that the Electronic Patient Record (EPD) is the central system where everything comes together. In reality, the EPD is merely one component of a much larger whole.

A patient journey might involve an appointment scheduling system, a referral application, laboratory software, imaging systems, a planning solution, medication management, billing, a patient portal, and various systems for data exchange with other healthcare organisations.

Each system fulfils a specific role. Together, they support the entire healthcare process. It is precisely this collaboration that makes the landscape complex.

Every step has consequences

Take a relatively simple appointment at a polyclinic.

A referral is received, an appointment is scheduled, the patient receives a confirmation, data is verified, the healthcare provider prepares, investigations may be requested, and after the consultation, reports are submitted, follow-up appointments are arranged, and a declaration is issued.

For staff, this feels like a single logical process.

Technically, data is continuously exchanged between different systems along the way. A change in one component can therefore have ripple effects on multiple subsequent steps.

Complexity grows unnoticed

The unique aspect of digital complexity is that it usually develops gradually.

A new system is introduced to solve a specific problem. An existing application is replaced. A connection is extended because new information needs to be available. On their own, these are logical developments.

Over time, however, a landscape emerges with hundreds of interdependencies. Often, no single person is accountable for the entire picture, as each department primarily focuses on its own part of the process.

As a result, complexity grows without being truly visible.

The problem is not the number of systems

A healthcare organisation will always use multiple applications. That is logical and often necessary.

The real challenge lies not in the number of systems, but in the interdependencies between them.

The better the processes align with one another, the easier changes can be implemented, and the less likely a disruption will spread like an oil slick throughout the organisation.

Ultimately, it's not about technology, but about visibility.

Insight prevents surprises

Many organisations know exactly which applications they manage. Less often is it clear which processes depend on them and what the consequences of a change could be for other departments.

Exactly this insight is becoming increasingly important. Not only to respond faster to disruptions, but especially to manage changes carefully and ensure continuity of care.

Because the more complex the digital landscape becomes, the more important it is to not only know the systems, but also the processes that connect them.

In the following article, we look at a topic that many healthcare organisations recognise: why small changes can sometimes have unexpected impacts on daily practice.

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