By Sara Heath, Patient EngagementHIT | August 28, 2018

As healthcare professionals continue to focus on patient engagement, they face an onslaught of varying and often confusing terminology. Between phrases that sound the same and phrases that sound like they should mean the same thing, it is easy to get caught up in the vast web of patient engagement keywords.

What is patient engagement, and how is it different than patient empowerment? And what about patient satisfaction versus patient experience, or population and public health? These terms all play an important role in developing patient-centered care initiatives but are often used interchangeably or are conflated.

Below, PatientEngagementHIT.com clarifies these key phrases and discusses the role they play in the healthcare space.

PATIENT ENGAGEMENT, EMPOWERMENT

According to HIMSS, patient engagement is the act of the patient and provider working together to improve health. Patient engagement is the teamwork that happens between all healthcare stakeholders and care team members with the end goal of making a patient healthier.

This is a significant task, and thus includes several strategies that pertain to different aspects of the healthcare system.

READ MORE: 5 Patient Engagement Terms Shaping Value-Based Care

Patient engagement can include better education, better motivation, creating a better healthcare experience, and driving better and shared decision-making.

Using strategies that incorporate the patient as a part of the care team will ideally create better clinical outcomes, HIMSS says.

“A patient’s greater engagement in healthcare contributes to improved health outcomes, and information technologies can support engagement,” the organization says on its website. “Patients want to be engaged in their healthcare decision-making process, and those who are engaged as decision-makers in their care tend to be healthier and have better outcomes.”

Because the term “patient engagement” includes so many parts of the patient care experience, it can often serve as an umbrella term for different initiatives within patient-centered care. Patient data access, patient access to care, or patient communication may all be categorized as part of patient engagement, but include more specific steps to achieve a more specific goal.

Patient empowerment, on the other hand, is a unique way to refer to a patient’s agency in a healthcare interaction.

READ MORE: What is Different Between Patient Experience, Satisfaction?

When a patient is empowered, she is able to participate in healthcare decision-making, understand her own health, seek out further resources when she needs more information, and advocate herself in most healthcare situations.

In short, patient empowerment is the ideal end result of a patient engagement strategy.

Clinicians can create patient empowerment by improving using patient education techniques, informing patients of the role they play in their own healthcare, improving patient skills in managing their own healthcare, and creating a welcoming environment that invites patients to participate in care.

Patient empowerment is unique from other patient-related terms because it speaks to the ideal outcome of patient engagement strategies. Ultimately, providers aim to create a level of patient self-efficacy and empowerment that allows patients to maintain their own health and participate in health-related decisions.

When patients are empowered and are able to manage their own health, they are more likely to remain healthy and avoid high-cost and potentially invasive health episodes, thus delivering on the promise of more value-based care.

PATIENT SATISFACTION, EXPERIENCE

READ MORE: The 3 Building Blocks Supporting Patient Engagement Strategies

Patient satisfaction refers to how a patient perceived her healthcare encounter compared to her expectations for that encounter, according to the Agency for Healthcare Research and Quality (AHRQ). Two patients could have identical care encounters but have different levels of satisfaction based on their expectations for their care interaction.

Conversely, patient experience is a set of objective measures related to a care experience, AHRQ adds.

“Patient experience encompasses the range of interactions that patients have with the health care system, including their care from health plans, and from doctors, nurses, and staff in hospitals, physician practices, and other health care facilities,” the Agency explains on its website.

“As an integral component of health care quality, patient experience includes several aspects of health care delivery that patients value highly when they seek and receive care, such as getting timely appointments, easy access to information, and good communication with health care providers.”

Providers can determine whether a patient experience was good by asking patients whether something that is indicative of a good experience occurred. For example, many patient surveys ask whether there was clear patient-provider communication. If the patient responds that communication was poor, providers know that was an objectively subpar patient experience.

These two terms are indeed related, and often used interchangeably. However, these two distinct terms refer to two different functions in the healthcare space.

Patient experience refers to the protocol that providers must carry out across the care continuum. Patient satisfaction refers to how a care encounter lives up to a patient’s expectations, and can vary without any change in provider behavior.

POPULATION HEALTH, PUBLIC HEALTH

Population health and public health, two key terms in the patient engagement and value-based care space, are likewise often confused and conflated.

Experts largely agree on a 2003 definition of population health, posed by David Kindig and Greg Stoddart in an American Journal of Public Health article.

“We propose that the definition be ‘the health outcomes of a group of individuals, including the distribution of such outcomes within the group,’” the pair wrote. “We argue that the field of population health includes health outcomes, patterns of health determinants, and policies and interventions that link these two.”

Populations can include different patient groups, from a population of individuals receiving care at a certain facility, to individuals with a certain chronic illness, to individuals living in a certain geographic region. Each of these groups are impacted by health policies and strategies that can impact their ability to be well.

Population health management includes the act of identifying health trends among patient cohorts and developing strategies to mitigate risks, improve clinical outcomes and health metrics, and otherwise address health needs within the group.

Public health “promotes and protects the health of people and the communities where they live, learn, work and play,” according to the American Public Health Association, and is therefore tied to the social determinants of health.

Public health can include initiatives to increase vaccinations, improve patient education about alcohol or drug use risks, or school nutrition programs to ensure children have access to good food.

The healthcare industry’s increasing focus on the social determinants of health – or the factors that influence health that expand beyond the four walls of the hospital – have given rise to public health. Healthcare organizations are increasingly creating community health partnerships that deliver on the above-mentioned public health projects.

Both public health and population health look at the ability to be healthy for groups of patients. Under both terms, those groups can be of varying size or health need. Many experts agree that the difference between population health and public health lay in the service line and even the preferences of the speaker.

Typically, individuals working in hospitals and other clinical spaces trend toward using “population health,” while individuals working in community or government offices trend toward using “public health.”

Healthcare terminology can often seem like a game of semantics, especially with so many terms that sound alike. Between patient engagement and empowerment, patient satisfaction and experience, and population and public health, it is difficult to juggle multiple keywords.

However, as the push for better patient engagement in the value-based care environment becomes stronger (and the use of these words becomes more frequent), nuances in terminology may become more pronounced.