In the patient journey, time is not simply a waiting period. It is a clinical variable that can influence diagnostic accuracy, treatment timing, and ultimately patient outcomes. When the interval between symptom onset and access to the right treatment becomes prolonged, both disease burden and pressure on healthcare systems may increase.
This issue becomes especially visible in rare diseases. The International Rare Diseases Research Consortium (IRDiRC) has set a goal that patients with a known rare disease should receive a diagnosis within one year, yet systematic reviews show that this target is often not achieved. In Spanish national patient registry data, 56.4% of patients experienced diagnostic delay, with a mean time to diagnosis of 6.18 years.
Why does this happen? Rare diseases often do not present through a single defining symptom. Instead, they may emerge through fragmented signs across specialties, timepoints, and clinical settings. Qualitative studies have shown that many patients undergo multiple consultations, repeated investigations, and temporary treatment attempts before receiving the correct diagnosis.
The importance of time is not limited to rare diseases. In acute care settings, minutes and hours can directly shape survival outcomes. In patients with sepsis, each hour of delay in antibiotic administration has been associated with increased in-hospital mortality.
Stroke care provides another clear example. In acute ischemic stroke, shorter door-to-needle times are associated with better functional outcomes, and the benefit of intravenous thrombolytic therapy is strongly time dependent.
In oncology, delays are more than operational challenges. A major systematic review and meta-analysis found that every four-week delay in cancer treatment was associated with increased mortality across several tumour types and treatment modalities.
Taken together, these findings highlight a clear message: reaching the right treatment matters, but reaching it quickly also matters. As disease progresses, therapeutic windows may narrow, complications may increase, and the psychological burden of uncertainty may grow alongside physical symptoms.
For this reason, patient journey analysis should not focus only on whether a diagnosis was eventually made, but also on how efficiently patients were guided through the pathway. Earlier recognition of red flags, faster referrals, streamlined testing processes, and well-designed clinical pathways are all essential in reducing lost time.
Ultimately, time should not be viewed as a background detail in healthcare delivery. It is part of treatment quality itself. When the right diagnosis, the right treatment, and the right timing come together, patient outcomes can meaningfully improve.
IRDiRC Goals: https://irdirc.org/
Spanish Rare Disease Study: https://pmc.ncbi.nlm.nih.gov/articles/PMC9670379/
Sepsis Mortality Study (Kumar et al.): https://pubmed.ncbi.nlm.nih.gov/16625125/
Stroke Quantification Study (Saver): https://pubmed.ncbi.nlm.nih.gov/16339467/
Cancer Treatment Delay Meta-Analysis (Hanna et al.): https://www.bmj.com/content/371/bmj.m4087