Using Journey Mapping to Visualize Patient Experiences for Quality Improvement Initiatives

Journey mapping is a powerful user experience tool depicting customers’ interactions with an enterprise. This paper shows how the U.S. Department of Veterans Affairs (VA) Office of Mental Health and Suicide Prevention (OMHSP), and the Veterans Health Administration (VHA) Office of Health Informatics (OHI) Human Factors Engineering Group, utilized journey mapping to discover patients’ psychotherapy experiences. The team conducted semi-structured interviews with Veterans, Caregivers, and Psychotherapy providers; and focus groups with OMHSP stakeholders, presenting successive iterations of four journey maps. The study used interview data to produce maps detailing representative depression patients’ mental health care experiences including: a patient suffering from coronavirus (COVID-19); a patient experiencing homelessness; a highly functional patient navigating implicit racial bias; and a patient resistant to therapy and his caregiver. The study identified areas of success and opportunities for improvement. Key findings included the importance of primary care in referrals; the desire to include family members in treatment; travel concerns in patients’ decisions about their care; the importance of viewing mental health care as part of a holistic view incorporating Veterans’ infrastructure (housing, employment, technology access, etc.); and varying levels of comfort toward technology and telehealth. The data also show opportunities to utilize health information technology to improve psychotherapy data collection and effect targeted quality improvement.