HackitRx 2026 patient journey
The Patient Journey File
The patient journey, as it is today
An off-hours bleed for an adult with moderate to severe haemophilia, from the first sensation to recovery, mapped from two patient interviews and a haemophilia nurse.
Stage 0
Symptom onset
A warmth, a tightness, a red toilet bowl. On a target joint he knows before it shows. Anywhere else, he does not.
Stage 1
Off-hours triage and severity
"Is it a bleed? Is this serious?"
Current behaviours
Activity traceback
- Recall activity over 24-48 hours
- Correlate sensation with recent activity
Scale severity
- Determine bleed type: spontaneous or trauma
- Identify bleed site
- Evaluate range of motion
- Assess pain intensity, visible signs
- Verify unfamiliar bleeds via search
Emotions
Pain
Uncertain if symptom is a bleed off-hours
- Uncertainty delays time-to-infusion
- Fear of missing high-risk bleeds
Opportunity
- Guided site-specific triage + severity-scaling aid
- Familiar vs unfamiliar symptom prompts
- Risk indicators
Stage 2
Acute decision and treatment
"What should I do?"
Current behaviours
- Choose path: self-manage or visit A&E.
- Route directly: go to SGH, NUH, or KKH.
- Determine dose: use memory and severity matrix.
- Self-infuse factor: single dose for prophylaxis/bleed.
- Risk waiting: delay infusing overnight to avoid burden.
- Apply adjunctive care: use RICE and tranexamic acid.
Emotions
Pain
- Dosing confusion: prophylaxis versus treatment dose.
- Contraindicated meds: high risk taking NSAIDs for blood in urine.
- Tedious infusion: nine vials, difficult vein access.
- Delay treatment overnight: sleep through to avoid infusion error and burden.
Opportunity
- Escalation decision-aid with clear thresholds
- Patient-specific care plan: personalised dose reference (which dose, site-specific)
- HCP-approved / WFH site-specific adjunctive care recommendation
Stage 3
The 24 hours after the dose
"Is the treatment working, and what's next after factor?"
Current behaviours
Post-infusion monitoring
- Guess if bleeding stopped, subjectively
- Assess need for 2nd dose or A&E
- Redose if symptoms persist
- Try reaching nurse (often fails after hours)
- Fall back on WhatsApp, web, memory
*Familiar bleeds: step often skipped
Emotions
Pain
No after-hours point of contact
- Re-dosing ambiguous
- WFH guide buried in long PDF
- WhatsApp advice subjective, bleeds go unlogged
- Some hospitals lack dedicated HCP contact
Opportunity
- Post-infusion timer / timeline
- Symptom check-ins (to track improvement or deterioration)
- Searchable 24/7 curated reference (not a chatbot; no diagnoses)
- Same-site recovery tracking (historical)
- Escalation prompts when symptoms don't improve in 24hr
Stage 4
Post-bleed recovery
"Am I safe to return to normal activity?"
Current behaviours
- Inconsistent bleed reporting: nurse updates often skipped for self-managed target joint bleeds.
- Monitor recovery: track pain and joint mobility.
- Low physio uptake: skipping formal rehab sessions.
- Pause activity: rest joints 1-2 weeks.
- Trial-and-error return: unguided physical activity resumption.
Emotions
Pain
- Incorrect exercises: weight bearing on weakened joints.
- Re-injury risk: prior bleeds prone to recurring.
- Deferred reporting: impairs nurse factor dose titration.
Opportunity
- Site-specific activity guidance
- Care-team prompt to book physio
- Structured post-bleed recovery guidance
Stages 1 to 3 are the off-hours loop, when no clinician is reachable. Stage 4 is the same patient in office hours.
A HackitRx 2026 entry by Team Bleedwise: Ariel Tan, Rachel Koh, Myo Myo Swe Oo and Gerald Ho. See the team.
Lifted from the Hackers' Roundtable deck's patient journey stage. Compiled 13 Sep 2026 for HackitRx 2026 research. Companion to the case files, the interview files and the solution files.