The 6 Types of Patients You Will Encounter (& How to Activate Them)


Clinicians are often challenged with ensuring patients adhere to health advice around their treatment, medication, nutrition, exercise, and other activities. Adherence to long-term therapies by patients with chronic illness averages at 50%1. Adherence to advice on lifestyle changes can be even lower at 20-30%2. Verbal or written instructions and follow-ups are not achieving sufficient health outcomes. Communication strategies that allow a clinician to truly engage with the patient can trigger the patient into ‘activation’ i.e. self-motivated adherence, and greater involvement in their care.

I recently attended a riveting talk, by my friend and global personalised medicine expert,
Matt Riemann, on personalised communication and patient activation. In a roomful of doctors at the University of New South Wales, Matt relayed a clear message about how the language we use to communicate with our patients resonates with them in different ways, based on who they are.

Find out more about how you can encourage better patient adherence among Sensors, Crusaders, Activators, Connectors, Guardians and Diplomats by simply TAILORING the way you engage with them. Watch this video of my interview with Matt Riemann, Personal Health Pioneer & Futurist and Founder of ph360.

We’re brimming with ideas to help you improve the patient experience through Engagement and Activation. Email us with your questions or call us at 02 8091 0918 to find out more…

1.  Adherence to long-term therapies: Evidence for Action, World Health Organisation (WHO)2013,
2.  Factors affecting therapeutic compliance: A review from the patient’s perspective, Jing Jin, Grant Edward Sklar, Vernon Min Sen Oh, Shu Chuen Li, Ther Clin Risk Manag. 2008 Feb; 4(1): 269–286. Published online 2008 Feb. PMCID: PMC2503662

How is Money Wasted in Health Measurement?

Everyone knows measuring healthcare performance is important, but sometimes time and money are wasted because of how measurement is being conducted, particularly if its done as a tick-box exercise without sufficient meaningful insights to drive improvement. Here are some key 2015-2016 statistics about Primary Health Networks from the Australian Institute of Health & Welfare Report on ‘Patient Experiences in Australia’.

  • At least 4 out of 5 Australians in all Primary Health Network areas rated their health positively, yet the percentage of Australians reporting a long-term health condition ranged from 43% to 63% across Primary Health Network areas.
  • Australians also reported differences in accessing healthcare services due to cost across Primary Health Network areas, with cost barriers nearly three times as high in some areas compared with others.
  • 19% of adults reported avoiding or delaying dental care due to cost.

These are useful statistics on self-reported health status, use of health services and cost barriers to accessing services. They do provide some high-level signals of where to focus, however, I can’t help but wonder:

Where is the ‘WHY’ behind these results? What are the true patient concerns, frustrations, needs and wants here?

What level of action can we implement when there is an insufficient exploration of the qualitative reasons behind these statistics? In my experience, the solutions we can put in place based on this information are very limited in its effectiveness to create meaningful change. What is needed is more granularity on these issues.

Gathering the context to statistics can be undertaken through open comments made by the research participants (provided there is an opportunity to do so in the survey!). Free-text analysis of those comments, depth interviews and small group discussions (focus groups) can also provide context.

Here’s an example:

“This last 6 months money has become a little tight as we are both attending the Dr quite regularly and with the clinic, we attend not bulk-billing we are required to pay $3.50 per visit… the extra cost per week in the last 2 or 3 months has been approximately $15-$20; this sure makes a hole in the pension…” – qualitative comment from ‘Costs of medicines and health care: a concern for Australian women across the ages’ Report, Nov 2013

Comments like this give us specifics of the cost barrier from a monetary perspective, will aid decision-making, strategy or policy development.

Getting to the heart of health issues in this way enables organisations to transform strategies on meeting healthcare’s Quadruple Aims and maximising their ROI on improving the patient experience and Consumer Engagement. These are vital components of the National Safety and Quality Healthcare Standards: Standard 2: Partnering with Consumers.

If you need some affordable help on how to incorporate the ‘WHYs’ into your measurement, reply to this e-mail OR click here if you’re curious about how to make a bigger social impact with the consumer feedback that you already capture.

We’d love to help you care better for patients, carers, and our communities AND reduce the amount of wasted investment in outdated methods of healthcare measurement.


Patient Experience Training Goes International!

I recently had some exciting days in Kuala Lumpur, Malaysia – delivering a highly interactive 2-day workshop to patient experience leaders representing a range of roles and organizations. We had hospital executives, senior management, doctors, nurses, finance managers and board members, marketing and customer service staff from key private hospitals across the Malayan Peninsula and as far as Sabah and Sarawak.

We showed participants how to use Energesse’s 6E Framework – to measure, improve and evolve patient experience in hospitals and healthcare providers.

Of particular interest to participants was how to engage clinicians and non-clinicians in improving the experience of the patients they interact with on a daily basis. They valued the opportunity to learn about key communication tools, the Ikigai (a Japanese concept around the ‘reason for being’) and the WIIFM (What’s In It For Me?).

6E Framework: Leading Training Program for Improving the Patient Experience, Customer Service and Financial Outcomes in Healthcare

We have continued to engage and support our training participants in helping them change behaviours at the front line, with significant impact within days of attending! Here’s some of the feedback we’ve already received:

‘I managed to listen better to a patient’s voice and assisted in concluding a long hanging case amicably by making two parties happy……I am energetic, motivated and a caring a new self following the workshop….an extraordinary workshop revealing the importance of 6Es.’
-Diane R., Parkway Pantai Private Hospital

‘I’ve learnt a lot in your training and now I can feel the difference when I started implementing the new knowledge. Had difficulties when the system went down for 1.5 hours. (Received) negative feedback on FB… within 2 minutes; live!. However, we managed to control the situation as per your guidelines!’
-M.Fauzi, Tun Hussein Onn National Eye Hospital

If you want to find out more about our 2 day, 1-day or half-day 6E Patient Experience Workshop, I’d be happy to send you more info on what we delivered.

Simply call 02 8091 0918 or email me

The Return on Investment on Empathy in Measuring Patient Experience

Empathy in healthcare is both a traditional concept as it is a new-age buzzword. That’s because it has never lost its importance as a legitimate element of a patient’s healing process.

Simply defined, empathy is the capacity to walk in the shoes of another. Essentially, the ability to understand, appreciate and relate to someone else’s emotions. There is more chatter in the industry now about defining, teaching, learning and measuring empathy in healthcare than there has ever been.

Making emotions a visible part of your (formal or informal) measurement validates the feelings of patients which in turn, promotes patient satisfaction, enhances the quality and quantity of clinical data, improves adherence and generates a more therapeutic patient-physician relationship.

Ultimately, it all links back to the Net Promoter Score (NPS) or the Friends and Family Test (FFT). A key HCAHPS question, the NPS or FFT asks the patient point-blank if they would recommend the hospital to family and friends.

There’s your ROI.


Human emotions are core to every patient experience. At every stage of the patient journey, there is a feeling, sentiment or attitude that will, collectively, define the experience for the patient at the end of their engagement with a healthcare setting.

Hospitals are often obsessed with benchmarking against other hospitals in term of their respective performance indicators, however there is a need to first benchmark against the EXPECTATIONS of your own patient population:

  • If the experience < expectations, then you have a satisfaction deficit which leads to frustration and anger
  • If the experience > expectations, then you have a satisfaction profit which leads to delight and excitement

Frustration and anger are detractors to the patient experience. If these emotions are experienced, then you can be sure that the patient is on their way to relay their negative experiences to others or not return, or both! Feelings of delight and excitement on the other hand naturally motivate patients to ‘promote’ your healthcare setting to others.


Measuring emotions is key part of our 6E Framework, a step-by-step guide to producing a true holistic picture of patient experience. Its measurement impacts the full spectrum of this framework:

Understanding the real patient EXPERIENCE through EMOTIONAL data ENERGISES staff in their purpose and EXECUTION of solutions. Successes are repeated to produce EXCELLENCE in delivery and organizational capability in patient experience EVOLVES.

How do you draw these emotions out of a patient so you can understand, measure and respond appropriately? Some state it boldly, some hide their emotions through seemingly rational questions or casually drop a comment about their emotions, to test the waters on how it would be received in the healthcare setting. Pick up on these clues, don’t ignore it or change the topic.

For the uncertain and non-forthcoming patient, surveys are a great way to get emotional data. One would imagine that a survey asking about their emotions would not only surprise them but send a clear message that there is a space in that setting to talk about emotions, that a culture exists that encourages and supports emotions.


When the clinician and non-clinician are able to recognize the emotions around a patient, it allows them to be more authentic and honest in the support given to the person (not patient).

Clinicians are able to view the person’s emotions within a more accurate context and address it in specific ways:

  • Learning: Where the patient is fearful because of a lack of information, there is an opportunity for staff to help educate the patient to reduce his fear
  • Empowerment: Where the patient feels helpless in the face of his health, there is an opportunity for staff to develop the patient’s sense of power over the situation through education, tools and technology
  • Self-discipline: Where the patient is frustrated over their personal management of their health, there is an opportunity for staff to help the patient develop discipline through motivation, tools and technology
  • Feelings of control: Where the patient is overwhelmed with the amount of information around their diagnosis, there is an opportunity for staff to ensure that the communication of information is at a pace and volume that the patient is comfortable with and to involve the patient’s family members or friends in managing overwhelm.

When an organization can undertake the above in a systematic way, an ‘energy’ or a vibe starts to infiltrate through the ranks. Clinicians and non-clinicians start to discover or re-discover the meaning in their roles and the organization becomes more congruent with its purpose.

What’s the vibe like where you are?



1. Identified/adapted/Inspired from information from a) Chapter Abstract from Patient Emotions and Patient Education Technology:  and b) Empathy and Emotional Intelligence: What is it Really About?’, International Journal of Caring Sciences, Volume 1 Issue 3, Alexander Technological Education Institute of Thessaloniki, Greece:
2. “Let me see if I have this right…”: Words That Help Build Empathy, Coulehan JL, Platt FW, Egener B, Frankel R, Lin CT, Lown B, et al. (2001).


The 3 Key Steps to Cultural Transformation – You’ll want to know this!

A couple of weeks ago, I was in Denver, USA, attending the Beryl Institute Patient Experience Conference 2017. I had the opportunity to interview Dr Jeremy Blanchard, who is the Chief Medical Officer at the Language of Caring on the pre-aspects to cultural change and creating mastery in patient experience. Watch the video below to find out more!

Contact me for tips on how to engage your physicians in improving patient experience!

If you’re ready, call me directly. If you’re not, you can help advance the patient experience movement (and your own knowledge) by clicking on our survey!




An Interview with Gerard Ratnam on Patient Experience

Nothing spoke to my passion more than the events that took place in the last couple of weeks. I was invited to speak at the Malaysian Cancer Care Conference in KL and was then interviewed on prime time TV about patient experience. The experiences of cancer survivors who attended the conference helped spread the word about consumer empowerment. I emphasised this key message in my engagement with both the conference and media audience – asking patients to push to get the support they need and to the health provider and clinician in measuring and delivering a better experience for the patient.

Watch the video below to find out more.

If you’re struggling to engage your clinicians in improving the patient experience, call or email us NOW for answers!




6 Ways to Unbungle THAT Cancer Bungle



You would have seen the recent headlines about ‘Patients left in the dark after Federal Government secretly bungled new national cancer screening programs’, namely, a delay of 6 months of the rollout of new cervical and bowel screening programs, potentially risking thousands of lives. Let’s leave out the sensationalism and look at this case study from the lens of the 6E patient experience framework:



[icon name=”search” class=”” unprefixed_class=””] Experience:  There are no safeguards in the interim to counter the delay. Research conducted on 212 cancer patients in Canada has shown that increased wait times affect perceptions of information, instructions, and the overall treatment provided by physicians. Essentially, the initial perceptions of what would have been a very positive government move are now likely to put patient perceptions of all stakeholders and drivers of the program, at risk. A robust communications strategy and associated PR plan would advise key stakeholders, including patients, of issues that might impact them and this needs to include monitoring and management of social media.

[icon name=”search” class=”” unprefixed_class=””] Emotion: Women are unable to access the new human papillomavirus screening and have limited access to the old Pap smear program which is ‘already being wound down’. Patient emotions around this lack of access are likely to run the gamut of anger, frustration, worry and uncertainty. The ideal way to address this is through clear and transparent communication around causes of the delay and most importantly, what is being done to address the needs of the high-risk segment in the interim.

[icon name=”search” class=”” unprefixed_class=””] Engagement:  The Department of Health and Telstra (awarded the contract to roll National Cancer Screening Register) are working together with the states and pathology companies to find a solution. In ensuring that these talks don’t take place in silos, they can also be complemented with discussions with patient representatives from high-risk and low-risk groups. Getting buy-in from the start with patients ensures greater buy-in during the path to resolution and the resolution itself.

[icon name=”search” class=”” unprefixed_class=””] Execution:  Indicative reasons for the delay include a lack of specialist staffing (only 1 in 5 pathologists available beyond May) and technical problems around the National Cancer Screening Register. These barriers, which seemed to be identified too late, illustrate a potential lack of planning (forecasting specialist resources) and insufficient risk mitigation strategies (foreseeing technical risks and winding down the old screening program too quickly). The most urgent element currently is to investigate solutions for high-risk groups. Seeking assistance from private hospitals could be key to the solution.

[icon name=”search” class=”” unprefixed_class=””] Excellence:  Continued monitoring of media, building open and transparent communication lines through patient and stakeholder engagement platforms, risk mitigation and flexibility in solution development, would allow for a smoother implementation of the program when ready and (hopefully!) override its initial negative publicity around ‘over-promising and under-delivering’.

[icon name=”search” class=”” unprefixed_class=””] Evolution:  There is an opportunity to roll out the program more broadly, to tap into other pre-existing registries that may have overlapping resources.  There is also the need to keep in mind that screening is just one step of the patient journey; there are a myriad of touch points for a new cancer patient that requires equal focus. In fact, I presented at the Malaysian Cancer Care Conference just a few days ago that included an audience of cancer survivors who were calling for the government and healthcare providers to consider their needs across the whole journey.

One of the many lessons we can take from the ‘cancer bungle’, is that it is better to do everything you can to get it right the first time – or risk having to clean up an (unforeseen) mess.

Find out how Energesse can help you get it right from the start – reach out to us now!


1 Patients left in the dark after Federal Government secretly bungled new national cancer screening programs’:
2Use of screening tests, diagnosis wait times, and wait-related satisfaction in breast and prostate cancer

Can Virtual Reality Tech Change the Patient Experience?

Virtual reality technology brings new meaning to the phrase ‘walking in one’s shoes’. If clinicians and non-clinicians could truly experience what it is like for patients with conditions like dementia and Alzheimer’s, think about how much more empathy would ensue in a hospital and the transformations that would result.

Watch this video of my chat with Liam from Opaque Interactive.



Thank you to those who filled out our Energesse Experience Survey recently – we’re already actioning your suggestions.

We want more stuff on physician engagement. ????

Look out for our Staff Engagement Protocol in a couple of weeks! ????

If you haven’t filled out our survey yet, it’s not too late! We do this survey to understand how we can help you be successful in your roles – the closer you get to your personal and professional success, the more successful we are in our vision to transform patient experience in this country. So help us help you by clicking on the survey link below.


Australian Healthcare Firm Energesse To Enter Malaysian Market

KUALA LUMPUR, Jan 23 (Bernama) — Australian healthcare technology firm, Energesse, is making its debut in Malaysia after a successful foray into the United Kingdom (UK) and the United States (US).

Energesse was founded in 2012 by Chief Executive Officer, Dr Avnesh Ratnanesan, a Malaysian national.

He said among the solutions that Energesse had in mind for the Malaysian market is the Membership Engagement Services (MES) Experience software platform which collects patient feedback and reports in real time.

This enables front-line staff to manage complaints and respond quickly.

The technology uses a sophisticated PanSensic machine-learning algorithm which can analyse trends in attitudes, communication and compassion.

“This empowers front-line staff to understand issues at granular level and make effective improvements for patients, consumers and their families,” Dr Avnesh told Bernama recently.

He said Energesse has received funding from a Malaysian private investment fund.

“We are in serious discussions with stakeholders and senior executives of Malaysian private hospitals at present.

“They have asked for proposals on how our technology services can be rolled-out in their hospitals,” he said.

According to Dr Avnesh, Energesse will be introducing technology solutions that have helped organisations in developed markets reduce costs and improve the quality of healthcare treatment.

“Energesse has led projects in hospitals, among health insurers, healthcare companies and the public sector across the US,UK and Australia,” he said.

He said there are significant opportunities to raise the maturity of patient experience in hospitals in Malaysia in line with developed nations.

“We are introducing the first ‘real-time feedback’ technology in the country that can analyse patient emotions and opinions through feedback surveys,” he added.

He said, Energesse is working with UK partner MES, a communications consultant, on its software platform, to help boost the customer service capability of Malaysia’s private hospitals.

This is to cater specifically for medical tourists from overseas as well as Malaysian patients wanting high-quality healthcare.

“Australia and the UK were the first two countries where Energesse and MES successfully implemented the MES Experience software technology,” he highlighted.

Dr Avnesh said the technology was deployed in the Western Sydney Local Health District with a population of about 900,000 residents.

The MES technology, he said, can raise healthcare performance in Malaysia with hospital services responding faster to patient feedback and complaints.

“This is premised on research findings demonstrating that hospitals with high-quality patient experience and customer service are more than 2.5 times more profitable than those delivering poor service.

“We see Malaysia as having significant growth potential to upgrade its service offerings and patient care in the healthcare system,” he added.

Dr Avnesh is of the opinion that Malaysia has strong potential in medical tourism with the availability of highly trained doctors and specialists, as well as English-speaking medical staff.

“Medical procedures are also relatively cheaper here compared to other western countries,” he added.

However, he explained that rising healthcare costs means there is a need for an efficient reduction and to identify areas that need investment as well as improvement.

Dr Avnesh has roots in the Malaysian healthcare industry.

His late father, Dr Ratnanesan Arumugam was a prominent Malaysian dental surgeon, having held roles as President of the World Dental Federation, Commonwealth Dental Association and served seven years at the helm of the Malaysian Dental Association.

“I am inspired by his extraordinary achievements and believe Energesse can become a world leader in the healthcare industry in future,” he said.

Dr Avnesh, who trained as a medical doctor in the UK and worked as a medical practitioner in Australia, is also passionate about making a significant contribution to the healthcare industry and patients in Malaysia.

He hoped to have a greater impact on the Malaysian health industry through his extensive experience in the biotech and pharmaceuticals industry with leading organisations such as Pfizer Australia.

Dr Avnesh emphasised that since 2012, Energesse had impacted about 107,140 lives through its services and solutions in the healthcare industry.

He said Energesse had undertaken projects in Australia for health insurance giants such as BUPA, Australian federal government agencies, and specialist fertility clinics.

“We are aiming to impact a billion people globally by 2040 through our healthcare solutions and raise standards in the industry to provide efficient services and enhanced patient experience,” he added.

Western Sydney Local Health District launches Australian-first Patient Survey


Feedback from patients, carers and their families staying in some of western Sydney’s busiest hospitals can now be offered and addressed in real-time via a new Australian-first digital platform.
Western Sydney Local Health District (WSLHD) is now running the My Experience Matters survey using cutting-edge feedback technology, allowing staff to instantaneously analyse patient experiences in their hospitals.


The survey, which was officially launched at Westmead Hospital on January 17th, 2017, has already been rolled-out to some wards at Westmead and Auburn hospitals, allowing patients to provide their feedback via hospital iPad or online.


WSLHD Patient and Carer Experience manager Kay de Ridder said hospital staff immediately received the survey responses, allowing them to address any issues in real-time.

“It could be a simple thing like fixing a banging door that is keeping a patient awake – staff get that feedback from a patient and they can immediately go up and fix it; feedback like that helps us improve the care we provide,” she said.

“We want to know what matters to people so we can improve our services; we are committed to learning from our patients, carers and their families.”

Ms de Ridder said Westmead Hospital patients involved in preliminary use of the survey last year had recommended a range of measures to improve services.

“On one ward, about 80 per cent of patients said they had been personally greeted by nursing staff each day during their visit. The ward’s nursing unit manager wanted to bring that score up to 100 per cent so she held a session with the staff to ensure they were all introducing themselves to their patients; it’s just little things like that,” she said.

“This feedback is critical to service planning and improvement; we’re also working with units and staff to assist them in linking in with existing quality improvement structures to make changes.”

The My Experience Matters survey is now live on Westmead and Auburn hospitals webpages:


The survey takes just three minutes to complete and all responses are anonymous.

WSLHD chief executive Danny O’Connor said the district was committed to genuine patient-centred care.

“We want to provide the best quality care for all patients in our hospitals, clinics and community health centres,” she said.

“Gathering honest feedback and being responsive to any issues is critical to ensuring every patient has a positive experience in our facilities.”

The survey will be rolled-out to all facilities across the LHD over the next three years.