OBJECTIVES : Rheumatoid arthritis (RA) is a chronic disease with a high treatment burden. To align patient preferences and value with healthcare delivery, mapping patient journeys by means of a Care Delivery Value Chain (CDVC) has gained interest. The objective of this study was to define a process map for RA patients and increase the transparency of care delivery.

METHODS : Data was collected from electronic patient records and interviews with involved staff. To map the care cycle of RA patients, several steps were undertaken. First, resources and activities utilized by the RA patients were reported. Secondly, activities were outlined according to the CDVC. Lastly, timeframes, location, decisions and staff were appended to the patient journey. The detailed process map was validated by a delegation of the medical staff and the RA patient panel.

RESULTS : The CDVC included resources and activities concerning the rheumatology department, laboratory, pharmacy and diagnostics. The number of steps per CDVC stage ranged from four to twelve (mean = 9). The emphasis of the activities lies in the intervening and recovery stages. Despite the clustering in CDVC steps, many performed procedures are homogenous. Yet, the focus of divergent process steps vary. Minor suggestions related to the patient journey were proposed at the focus groups of both patients and providers.

CONCLUSIONS : Mapping the CDVC provided insight and transparency in the RA patient journey. The aim of future research is to analyze the healthcare costs related to the RA care cycle, contributing to the transition to a value-based healthcare system.