Articles and Case Studies

Effective Patient Engagement in the 21st Century

11 Sep 2013

by A Prof Michael Greco and Dr Lesley Palmer

In the Autumn 2013 issue of Defence Update, A/Prof. Julian Rait wrote about the rising tide of the patient’s voice in helping health organisations improve their safety and quality performance. There is now clear evidence of the association between patient experience, clinical safety and effectiveness, and health outcomes.1,2 The challenge for health professionals and organisations is how to gather patient feedback in real-time that is meaningful and useful in driving quality improvements.


Photo: Left: A/Prof. Michael Greco and Dr Lesley Palmer

This is why Patient Opinion was established in the United Kingdom in 2005 by two doctors (Dr Paul Hodgkin and Dr James Munro). It is now the leading not-for-profit online site for patients throughout Britain to share their healthcare experiences, and for health services to subscribe to its services.

The Patient Opinion platform is now operating in Australia ( It makes it safe, easy and effective for the Australian public to give their feedback to the health services they rely on, and in doing so, encourages those services to become more open, transparent, responsive and patient-centred. Herein lies the challenge. With the advent of social media, health services are now under greater public scrutiny than in the past.

The power for the patient voice to be heard lies in having a platform that allows transparency and an opportunity for health services to be fearless in publicly addressing concerns and telling their patients in an open forum that they are listening and value their feedback (good or bad). When the health service truly engages with their patients in a non-confrontational environment, patients have tangible evidence that they are being listened to. This on-line form of engagement can be a scary prospect for the health service but pales in comparison to the angst a vulnerable patient might feel when addressing issues on a personal level with the health service.

Our experience at Patient Opinion shows that often patients do not want to complain about their healthcare experience, but would rather offer a comment anonymously, whether good, bad or indifferent. Such comments have been shown to be linked to actual hospital performance3. Furthermore, there is evidence that comments posted upon the Patient Opinion website lead to less complaints by patients because they have had the opportunity to “be heard”.4

The impact of this transparent and public form of engagement is clearly evident in the experience of British health services. They are now engaging in constructive conversations with their patients, and demonstrating improvements to their services. The following three stories are examples of this.

The question is not whether Australian health services will participate with online public and independent platforms. Patients are already posting their comments online. What health services are encouraged to do is to become part of the conversation rather than simply be the topic of the conversation.

A/Prof. Michael Greco is the founder and Chief Executive of Patient Opinion Australia and Dr Lesley Palmer is a Board Member.

1 Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open 2013; 3:e001570;doi:10.1136. Available at:
2 Matthew P, Manary MSE, Boulding W et al. The patient experience and health outcomes.. N Engl J Med 2013; 368:201-203. Available at:
3 Greaves F, Pape UJ, King D et al. Association between web-based patient ratings and objective measures of hospital quality. Arch Intern Med 2012; 172: 5. Available at:
4 Research findings from the University of Birmingham and Tavistock Institute, involving over 1200 people who had used the Patient Opinion website. Available at



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