Anatomy of a Care Journey: What Happens Before the Search

Most navigation vendors describe members using one word: engaged. A member who logs in, searches, or calls counts as engaged. It’s a useful metric, but it can’t tell a member who’s casually browsing from one who’s about to choose where to get care. 

What’s missing is a way to say where a member is in her decision. Here’s one, using the member from earlier in this series, who was searching for a knee MRI.

The five stages of the care journey:

1. Latent: Before she searches for anything, she sees her doctor about knee pain and leaves with an order for an MRI. Once the visit is processed, it shows up in her claims, where the need is visible. But she hasn’t asked anyone where to go for the scan, so no one’s helped her weigh her options. 

2. Expressed: Now she starts looking. She types “knee MRI near me” into her benefits app, or asks JOY, HealthJoy’s virtual care assistant, where to go. The need is now in front of something that can help her choose. 

3. Deliberating: She opens the two locations and compares them. That’s the shift from looking something up to weighing a choice. 

4. Committed: She picks the one closer to work.

5. Care: She has the scan.

Not every journey shows every stage. Some members go right from a doctor’s visit straight to the scan without ever searching or asking. For them, the first thing anyone sees is the care itself.

Where most vendors first see her

Most navigation vendors first see a member at the third or fourth stage, when they’re comparing providers or has already chosen one. That isn’t a flaw in any one product. It follows from how reactive navigation works. The member starts the conversation, so the vendor’s view starts there too.

The result is the window from the first piece in this series. Between the moment a need becomes visible and the moment they choose, the decision is still open. A vendor whose view begins at deliberation arrives when that window is nearly closed.

Looking earlier, honestly

HealthJoy looks for the signal in the first two stages, Latent and Expressed, before a member starts comparing providers. For Latent, that means claims: the care a member has already received, which can point to what’s likely next. For Expressed, it means what members tell us directly, in searches, in conversations with JOY, and in our member survey where they share their health goals and the care they expect to need in the upcoming year.

Neither source works alone. Claims are reliable, but they arrive after the fact. What members tell us comes early, but only when they choose to share it. Because both sit under one member identity, each fills in what the other can’t, and together they reach earlier than either could on its own. Not every journey shows up at every stage, but looking across sources brings more of it into view. 

Different stages, different help

Knowing the stage matters because the right help changes with it. Early on, a member may simply need to know that where she gets care is a choice. In the middle of a comparison, she may need the options laid side by side. Sometimes the right move is to stay out of the way, because she’s already found a good option on her own.

A question to ask

If you’re evaluating a navigation vendor, start here: at which stage do you first see a member and how do you know?

A vendor whose answer starts at the search bar is working from the middle of the story. One who claims to see all of it is probably overstating. The useful answer names the stages, names the sources behind them, and says where the gaps are.

Her search took a few minutes. Her journey started before it. The better question for any navigation program is how much of that earlier part it can see, and what it does with it.