One Method, Many Names: The Problem of Terminological Fragmentation in the Patient Journey Mapping Literature

Introduction: Why Naming Matters

The maturity of a research method is measured not only by how frequently it is applied, but also by how clearly its conceptual boundaries have been delineated. Viewed from this perspective, patient journey mapping — the method used to visualise how patients and their families experience care processes in health services — appears to be an emerging field that, despite its rapid diffusion, has yet to reach terminological consensus. The scoping review by Davies et al. (2023), covering 81 studies, documents the method’s momentum over the past decade by showing that 76.5% of the publications appeared after 2015; yet the same review also signals a cost of this rapid growth: the inconsistency of the terms used to name the concept and the absence of reporting standards (Davies et al., 2023).

The aim of this text is not merely to describe this terminological fragmentation, but to problematise it as a genuine concern — opening for discussion its conceptual, methodological, and, above all, bibliometric consequences.

Mapping the Terminological Plurality

The literature refers to one and the same method by at least ten different terms. These terms carry the traces of the various disciplines (service marketing, engineering/human factors, health informatics, design) from which the method draws. The table below presents the principal labels encountered in the literature, together with their Turkish equivalents and disciplinary origins.

Davies et al. (2023) list the terms process mapping, patient journey modelling, journey mapping, and client journey mapping directly as evidence of this inconsistency. Joseph, Kushniruk, and Borycki (2020), in classifying the visual mechanisms used to analyse the patient journey, distinguish the tools experience map, spatial map, customer journey map, and service blueprint; they further note that, although not explicitly represented in the literature, the notion of a mental model diagram is implicitly included within patient journey analysis.

The Roots of the Fragmentation: Interdisciplinary Borrowing

This terminological plurality is not accidental; it is a direct consequence of the method’s hybrid intellectual genealogy. The method originated essentially as a customer journey concept within the service marketing literature (Lemon & Verhoef, 2016) and was transferred from there into healthcare. In the course of this transfer, it came into contact with the vocabularies of three distinct disciplines.

First, the engineering and human factors tradition associated the method with the terminology of “process mapping” (Trebble et al., 2010) and of systems safety (e.g., the SEIPS framework; Holden & Carayon, 2021). Second, the service design tradition introduced, alongside concepts such as “touch point” and “pain point,” tool names such as “experience map” and “service blueprint” (Clatworthy, 2011). Third, health informatics conceptualised the method as an “ontology” or “modelling” practice (McCarthy et al., 2016). Because each discipline carried its own terminological inheritance, a single method became dispersed across a multi-centred and fragmented naming space.

Why Should We Be Concerned? Three Consequences of the Fragmentation

Terminological inconsistency is not a harmless matter of style; it concretely impedes the cumulative scientific progress of the field.

First, conceptual ambiguity. When the same term denotes different things, and different terms denote the same thing, the comparability of studies is weakened. “Process mapping” most often models the intended workflow, whereas “patient journey mapping” centres lived experience and affect; although these two approaches are epistemologically distinct, they may be subsumed under the same heading. This makes it difficult for a reader to discern from a study’s title what, exactly, has been mapped.

Second, methodological and reporting inconsistency. Davies et al. (2023) found the reporting of the reviewed studies to be inconsistent and largely non-compliant with established reporting guidelines. The absence of a common terminology is one of the obstacles standing before a common reporting standard, because standardisation first requires the concept to be fixed under a shared name.

Third, and most critical from an applied standpoint, bibliometric invisibility. For a researcher conducting a systematic review or a bibliometric analysis, terminological dispersion is a direct retrieval problem. A researcher whose search string uses only the term “patient journey mapping” will miss a substantial proportion of the studies that name the same method “client journey mapping,” “customer journey map,” or “service blueprint.” This leads to under-representation of the literature, to the fragmentation of impact measures (citation networks, co-citation clusters), and ultimately to the field appearing smaller than its true size.

Towards a Solution: An Umbrella Term and an Inclusive Search Strategy

Two complementary ways of addressing this problem may be proposed. At the conceptual level, it can be argued that the expression “patient journey mapping” should be adopted as an umbrella term, with the other labels positioned beneath this canopy as sub-types or disciplinary variants. Indeed, studies classifying the field propose distinguishing the method not by a single label but according to six types of application (mapping the key experiences across a disease period, mapping by location of care, by events, by stakeholder roles, by multiple perspectives, and by event timelines) (Davies et al., 2023). This typology makes it possible to view the terms as complements rather than rivals.

At the methodological level, bibliometric and systematic review studies must construct their search strings so as to encompass all of these synonymous terms. In Boolean search logic, for instance, combining these terms with the OR operator secures full representation of the literature. Otherwise, terminological fragmentation ceases to be merely a described problem and turns into a trap that undermines the researcher’s own findings.

Conclusion

Patient journey mapping is a rapidly growing method with strong potential for the human-centred redesign of health services. Yet this growth has outpaced the development of a shared conceptual language; as a result, a single method has come to be known by at least ten different terms. This terminological fragmentation weakens conceptual clarity, the reporting standard, and — most concretely — the bibliometric visibility of the literature. The maturation of the field requires not only more applications, but also a deliberate “concern” with this naming dispersion — that is, agreement on an umbrella term and the standardisation of inclusive search strategies.

References

• Clatworthy, S. (2011). Service innovation through touch-points: Development of an innovation toolkit for the first stages of new service development. International Journal of Design, 5(2), 15–28.
• Davies, E. L., Bulto, L. N., Walsh, A., Pollock, D., Langton, V. M., Laing, R. E., Graham, A., Arnold-Chamney, M., & Kelly, J. (2023). Reporting and conducting patient journey mapping research in healthcare: A scoping review. Journal of Advanced Nursing, 79(1), 83–100. https://doi.org/10.1111/jan.15479
• Fennessy, R., Paterson, A., Ward, J., Clarkson, P. J., & Bowers, B. (2026). Mapping patient journeys: Exploring patient and informal carer experiences of injectable anticipatory medication care in the community to identify opportunities for practice improvements. Palliative Medicine. https://doi.org/10.1177/02692163261437596
• Holden, R. J., & Carayon, P. (2021). SEIPS 101 and seven simple SEIPS tools. BMJ Quality & Safety, 30(11), 901–910.
• Joseph, A. L., Kushniruk, A. W., & Borycki, E. M. (2020). Patient journey mapping: Current practices, challenges and future opportunities in healthcare. Knowledge Management & E-Learning, 12(4), 387–404.
• Lemon, K. N., & Verhoef, P. C. (2016). Understanding customer experience throughout the customer journey. Journal of Marketing, 80(6), 69–96.
• McCarthy, S., O’Raghallaigh, P., Woodworth, S., Lim, J. W., Kenny, L. C., & Adam, F. (2016). An integrated patient journey mapping tool for embedding quality in healthcare service reform. Journal of Decision Systems, 25(sup1), 354–368.
• Trebble, T. M., Hansi, N., Hydes, T., Smith, M. A., & Baker, M. (2010). Process mapping the patient journey: An introduction. BMJ, 341, c4078.