Patient journey stages mapped to Agentforce Health data models
Key Takeaway
Break the patient's journey into stages, then match each stage to its Agentforce Health data model before you build anything new.
A data model is a collection of objects and fields and the way they relate to each other. Agentforce Health has several data models, each built to support a specific healthcare business process. A consultant designs a solution by breaking a patient's journey into stages, then matching each stage to the data model built for it. Knowing the models tells you what the product already does before you build anything new.
How to map a patient journey to data models
Knowing the data models keeps you from creating custom objects and fields that duplicate existing functionality. Knowing them also lets the org take advantage of new and enhanced functionality as it releases.
- Break the patient's journey into stages, such as diagnosis, care plan creation, scheduling or preauthorization.
- Match each stage to the data model built for it.
- Review data model enhancements with each release before you design custom objects. Data models change when Agentforce Health aligns with new industry standards or adds capabilities.
| Stage | Data model |
|---|---|
| People and organizations who support a patient's care, such as a spouse, a health plan or a transport company | Household |
| A hospital visit where the doctor runs tests, makes a diagnosis and prescribes medication | Clinical |
| Enrolling a patient in a care program, such as a program for everyone prescribed a certain medication | Care Program |
| Creating a care plan for the enrolled patient | Integrated Care Management |
| A social barrier, such as a patient who has no car and can't pick up prescriptions on time | Social Determinants of Health |
| Finding a provider, such as a physical therapist | Provider |
| Booking an appointment with that provider | Intelligent Appointment Management |
| Insurance entitlement to services, and filing a claim | Health Insurance and Claims |
| Submitting a preauthorization request to the health plan | Utilization Management |
| Verifying the patient's benefits before filing a claim | Benefits Verification |
| Managing patient and member forms from intake through processing | Intelligent Document Automation |
| Managing data from devices issued to patients or program members, such as smart watches and heart monitors | Remote Monitoring and Device Registration |
| Storing score data and supporting contextual prompts for users to act on | Unified Health Scoring |
Watch for neighboring stages that map to different models. Creating a care plan is a separate stage from enrolling a patient in a care program. Booking an appointment is separate from finding the provider. The three payer-related stages map to three different models: Health Insurance and Claims, Utilization Management and Benefits Verification.
Intelligent Appointment Management fits organizations that work with multiple scheduling source systems running on different electronic health record (EHR) platforms.
Tomas goes to the hospital. His doctor runs tests, diagnoses diabetes and prescribes medication, so the visit maps to Clinical. Next, he enrolls in a program for patients on that medication, which maps to Care Program. His care plan maps to Integrated Care Management. Tomas has no ride to the pharmacy and misses refills, so the barrier maps to Social Determinants of Health. He also needs a dietitian. Finding one maps to Provider, and booking the visit maps to Intelligent Appointment Management.