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SELECTED CASE STUDY

Ontario Health

A 7-Step Approach to Enterprise Journey Management

Making a Complex Service Journey Visible, Measurable & Manageable

Proprietary information has been removed, anonymized or recreated for portfolio presentation.

Ontario Health's eReferral initiative is part of the province's Patients Before Paperwork program — a large-scale effort to modernize how referrals move between primary care, specialists, hospitals and other healthcare services.

1.24M eReferrals processed
in 2024/25
12,000+ providers and service-provider organizations
62% of Ontario family physicians onboarded
30,000+ clinicians engaged across the ecosystem

Publicly reported program-scale figures retained from the previous portfolio version; proprietary project information is excluded.

MY WORK — AT A GLANCE

200+ Operational steps mapped within a complex service workflow
10+ End-to-end use cases documented and expanded
5+ Service journey stages incorporated into VoC research and measurement planning
3 Levels of service-blueprint detail established for executive, working and operational audiences
20+ Journey and operational change points identified for 3+ teams to prioritize and action

THE CHALLENGE

Large-scale digital transformation is rarely a single customer journey.

It is a connected system of customer and employee experiences, operational workflows, technologies, policies, handoffs, measures and organizational responsibilities.

Working within Ontario Health's Patients Before Paperwork transformation, my role involved helping make that complexity visible and actionable across initiatives supporting healthcare service delivery.

The challenge was not simply to create a journey map. It was to create a shared understanding of how the service works end-to-end and front-to-back — connecting the experience of people using the service with the operational work required to deliver it.

01

VALUE PROPOSITION DEFINITION

What game are we playing?

Before mapping a journey, establish what the service is trying to make possible — for the people using it and for the organization delivering it.

Value proposition and service definition framework
Step 1 — Value proposition and service framing.

This framing creates the reference point for everything that follows. It keeps research, journey stages, workflows and measures connected to an intended service outcome rather than becoming disconnected artifacts.

What value is the service intended to create?

For whom is that value being created?

What problem or outcome is the transformation trying to address?

What must be true operationally for that promise to be credible?

What evidence would tell us whether the service is succeeding?

02

ORGANIZATIONAL ARCHAEOLOGY & RESEARCH COLLECTION

What do we need to play the game?

Complex organizations already contain a large amount of knowledge about the service — but that knowledge is usually fragmented across documents, teams, systems and previous initiatives.

Organizational archaeology and research synthesis
Step 2 — existing evidence → synthesis → validation.

I start by collecting and interpreting what the organization already knows: existing research, requirements, system information, workflow descriptions, screenshots, use cases, standards, prior artifacts and SME knowledge.

This organizational archaeology creates an evidence base before new research begins. It helps reveal where knowledge is strong, where sources disagree, and where targeted interviews or validation will add the most value.

To fill identified gaps, I led interviews and surveys with 20+ health-system professionals, including senior regional medical directors and provincial clinical leads, to identify Jobs-to-be-Done, unmet needs, persona roles and current-state workflow challenges. I also led usability studies with the UX designer across three vendor solutions, documenting usability pain points and behavioural observations for further journey, workflow and service-design analysis.

Existing-system analysis Artifact analysis Workflow discovery Requirements discovery Customer interviews Surveys Usability studies Jobs-to-be-Done Collaborative validation Cross-source synthesis

03

PERSONAS & ACTORS

Who are the players?

Enterprise services are rarely experienced or delivered by a single user. They involve multiple people with different goals, responsibilities, levels of authority and operational constraints.

Personas and actors across the referral journey
Step 3 — personas and actor ecosystem.

Persona and actor models helped make those differences visible and prevented the journey from being reduced to a generic “user” perspective.

The actor model clarified who interacts directly with the service, who performs work behind the scenes, what each actor is trying to accomplish, where responsibilities change, and which information or systems each actor depends on.

Those roles then remained traceable across journeys, workflows and service blueprints.

04

JOURNEY MAPPING

What is the playing field?

The journey provides the shared end-to-end view of the service: the stages through which people move, what they are trying to accomplish, and where experience and operational complexity accumulate.

End-to-end referral journey map
Step 4 — anonymized end-to-end journey.

Complex enterprise journeys rarely live inside one application, department or organizational chart. The journey therefore had to look across touchpoints and organizational boundaries rather than treating each interaction in isolation.

Discovery Conversion Decision Sign-Up Setup Training Usage Support

The journey acted as the common playing field: a stable enough structure for teams to locate research, operational detail, moments that matter and measures while still allowing the underlying evidence to evolve.

05

OPERATIONAL WORKFLOWS

How is the game actually played?

Frontstage experiences depend on backstage operations.

Detailed operational workflow showing current and future referral states
Step 5 — operational workflow showing roles, handoffs, decisions and systems.

A seemingly small improvement to a customer or clinician touchpoint can create additional work somewhere else. Removing information from one interaction, for example, may simplify that moment while increasing downstream clarification, administrative effort, delays or rework.

I therefore connected journey-level experience views with detailed operational workflows showing how work actually progresses through roles, decisions, systems, state changes and handoffs.

Experience Goal Operational activity Role Information & systems Upstream / downstream impact
“What happens to the entire service if we change this touchpoint?”

06

SERVICE BLUEPRINTS

What's the game plan for playing together?

A service blueprint is where the different views begin to operate as one system — connecting the experience people have with the actors, activities, processes, systems and dependencies required to deliver it.

Level 1 executive service blueprint showing the end-to-end service across journey stages, frontstage and backstage activities
Level 1 — Executive service blueprint. A concise end-to-end view connecting the journey with the major frontstage and backstage elements of service delivery.
L1 — Executive

A concise representation of the overall service and major stages for leadership understanding and decision-making.

L2 — Working

A collaborative service-design view connecting actors, experience, activities and major operational dependencies.

L3 — Operational

Detailed workflows showing how work moves through roles, processes, systems, state changes and evidence.

The views served different purposes while describing the same underlying service. This allowed teams to move from 30,000-foot understanding to operational detail without losing the relationship between the two.

Level 3 operational service blueprint showing detailed frontstage and backstage activities, state changes, evidence, systems, ownership, risks and measures
Level 3 — Operational service blueprint. The same service expanded into detailed activities, state changes, evidence, backstage operations, systems, ownership, risks and measurement.

At the operational level, the blueprint becomes more than a visualization of the experience. Each meaningful step can be inspected through the work performed, the state change it creates, the evidence that confirms it occurred, the supporting technology, ownership, risks and associated measurement signals.

I treated these artifacts as boundary objects: shared representations that allow leaders, product teams, researchers, designers, operations and technology teams to inspect the same service from the level of detail they need.

07

VOC & MEASUREMENT

How well are we playing — and how do we improve?

A journey should be measurable.

VoC and journey measurement framework
Step 7 — journey stages connected to research and measurement.

Understanding what happens is only one part of Journey Management. Organizations also need to understand how well the journey is performing, where friction is emerging and where intervention may be required.

I developed a consolidated VoC research and measurement approach connected to identifiable stages and moments within the service, rather than treating VoC as a separate research stream.

Experience evidence What are people telling us?
Behavioral evidence What are people actually doing?
Operational evidence What is happening within the service?
Outcome evidence Is the service producing the intended result?

Measurement becomes more useful when a signal can be understood in the context of where it occurs in the journey, which actors are affected, and what operational activity surrounds it.

WHAT THE 7 STEPS ENABLE

From artifact production to Journey Management.

The seven steps are not seven isolated deliverables. Their value comes from the connections between them.

Value Research People Journey Workflows Blueprints Measures Decisions

This changes the question from “Is the journey map finished?” to “How will the organization keep its understanding of the journey current and useful as the service changes?”

It also makes the artifacts decision-grade: executives can look for major experience and operational risks; product teams can examine priorities; operations can inspect what happens when a state changes; and researchers can see what is known, what evidence supports it and what still needs investigation.

GOVERNANCE

Visible. Inspectable. Sequential. Actionable.

As the number and complexity of artifacts increased, consistency itself became an important design problem.

VISA governance framework
Governance — VISA: Visible, Inspectable, Sequential, Actionable.
VISIBLE

See the system

Can people see the important actors, activities and dependencies?

INSPECTABLE

Go deeper

Can teams examine the underlying detail when they need it?

SEQUENTIAL

Follow the work

Can people understand how work progresses through the service?

ACTIONABLE

Support decisions

Does the artifact help someone make a decision or take action?

THE NEXT LAYER — AI-ENABLED JOURNEY OPERATIONS

What happens when the journey becomes queryable?

As journey-management systems accumulate research, workflows, measures, decisions and organizational knowledge, maintaining the connections manually becomes increasingly difficult.

AI-enabled journey management concept
Concept — AI as a knowledge and acceleration layer over a structured journey-management system.

That creates an opportunity for AI — not simply to generate another journey map, but to help organizations maintain and interrogate the journey-management system itself.

What changed in this workflow since the journey was last updated?

Which journey stages have research evidence but no defined measure?

What downstream activities could be affected by this proposed change?

Which insights have not yet been connected to a product or service decision?

What has changed that frontline teams need to know?

The opportunity is to use AI as an acceleration and knowledge layer over a well-understood service system — not as a replacement for understanding the system in the first place.

JOURNEY MANAGEMENT PRINCIPLE

A journey is not simply something to map. It is something to manage.

Journey Management requires connecting customer and employee experience with the operational reality underneath it.

Value + People + Journeys + Workflows + Systems + Research + Measures + Ownership + Decisions

The seven-step approach provides a way to structure that complexity without pretending the work is linear. Teams can move between layers, add evidence and revise the model as the service evolves.

The goal is not to create seven artifacts. The goal is an organization with a shared, evidence-based and continuously actionable understanding of how its service actually works.

MY ROLE & CONTRIBUTION

Enterprise Service Design / Journey Management / Experience Research

Research & Framing

Service and value framing, organizational archaeology, research planning, synthesis, SME collaboration and validation.

Journey & Operations

Personas and actor modelling, journey architecture, use cases, operational workflow mapping and service blueprint architecture.

Management & Governance

VoC and measurement planning, L1/L2/L3 blueprint governance, decision-grade artifact design and AI-enabled journey-management exploration.

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