Health and Care in a Capitalist Economy: Understanding Your Maturity

Any successful business can only be sustained by the continuous “win-win” outcome of the provider-consumer interaction. The health and care marketplace is the litmus test that determines not only success, survival, and advancement, but also discrepancies in the win-win balance that can deteriorate the relationship and portend for failure. This is particularly true in an era where the patient (customer) experience is growing in importance in hospitals, general practices and allied health providers. Consumer-directed care is also embedded in the funding structures for the aged care sector as well as the National Disability Insurance scheme (NDIS).

Such discrepancies can be due to:

  • the experience the consumer has,
  • his/her emotional judgment based on that experience,
  • provider engagement to identify or ignore gaps in person-centered care and implement or disregard remedies,
  • whether there is execution of such remedies in service recovery, quality improvement and policy change
  • the culture of quality or service excellence (or the lack thereof) that results in an evolution (or not) of consumer-centered maturity.


Evolution is a maturation into any department or organisation’s vision and mission statement, while the status quo is the path to failure.

Separating the trees for the forest – Measuring What Matters

With so much at stake, many organisations struggle to know what to measure and as well as how to measure what matters. Many are undertaking customer, patient or client survey, with a wealth of data and information fed back through manual or digital channels. Whilst drowing in data, many managers are starving of wisdom; with measurement systems in place, the challenge then becomes knowing HOW to improve the consumer experience.


The answer lies in an individual, department or organisation’s capabilities for improvement. There is a need to develop audits and tools to identify capabilities for improvement and potential pitfalls in the win-win formula. At Energesse, we have spent the last 7 years developing a scientific methodology, underpinned by an emerging algorithm that leverages six categories (each an “e”):

E1 – Experience

E2 – Emotions

E3 – Engagement

E4 – Execution

E5 – Excellence

E6 – Evolution


While this ‘6e’ categorisation may seem as if it were plucked out of life intuitively, it actually has been developed from forensic outcome analyses that best identify gaps in the provider/consumer interaction and best predict their respective remedies. It has the potential to become a ‘gold standard’ methodology for health & care experience improvement, similar to how 6sigma/ lean methodology has become applied to process improvement.


Data accrued via systematic surveys, from all levels in the provider/consumer experience, encompass all of the disparate parameters at work in any complex interaction of care. The tangled web of interactions vs misconnections at patient, provider and organizational level and the arithmetic of synergy vs crossed paths are thus combed and preened.  This so that a meaningful input of qualities and quantities of targeted capabilities can be used to construct tangible results that are addressable. Hospitals, practices, aged care homes and disability care centres have significant resource constraints and can’t do everything. Focus and targeting is the key to successful improvements, particularly at the front-line of care, where it matters most.


The many facets of a dynamic, however, can become daunting without perspective. If trouble brewing from a multifactorial dysfunction (e.g. uncompassionate leadership, misguided policy, poor environment) is threatening a down spiral, where does the fix start? If a provider entity is successful, how does one maintain this to prevent the seeds of dysfunction?


Distinguishing the forest for the trees – What Matters Most to YOU

To understand which capabilities matters most to your department, clinic, hospital or center, data from our PXme evaluations are inserted into the Energesse tool to produce a result that can be displayed visually as a snapshot of the general health of the patient experience capabilities and gaps. Any win-win relationship is a partnership, and the data from our surveys canvasses a sample of stakeholders delivering the experience, from administrators to providers to consumer representatives. As such, all members of the “partnership” contribute.


The resulting graphic presentation—the Energesse Patient Experience Maturity Map

—depicts an instantly informative gestalt of the health of the provider/client partnership, which internal capabilties are strongest, and which need the most attention.


The architecture behind the Maturity Map graphic is based on the Energesse Patient Experience Maturity Model, which is a scoring system determined by comprehensive explorations into the provider/client partnership; that is, identifying the specific patient population or populations (target), wards, healthcare facility, or even community where improvement is needed in the experience of care:

One “e” at a time

While e1 = Experience is the first priority in terms of developing your experience measurement capability, each “e” is essential. As such, the above presents an excerpt of the Model only. In subsequent editions each of the 6 e’s will be explored while keeping the motif of the multifactorial whole of a health & care organization always in perspective when it comes to experience improvement.

Such is the value of Patient Experience Maturity Evaluation (PXme) as a starting point and an accelerator towards a more person-centered industry.

To learn more about the PXme, contact my team at We’d love to hear from you.



Perspectives from the Patient Experience Symposium 2018

Energesse and our partner, Patient Opinion, were the major co-sponsors of the NSW Health symposium again this year. We don’t normally sponsor events but I’m never one to miss supporting our awesome clients, which are Western Sydney Local Health District and South Western Sydney Local Health District, very large health services within NSW Health. I also loved the symposium – a buzzing event full of 600 consumers, experts, clinicians and speakers passionate about the patient experience!

It was a great opportunity to share our learnings in a Workshop called How to Connect with Patients so They ‘Feel Heard’ and Engage staff in Improving Patient Experience. We also connected with a range of healthcare staff, current and future clients and even our competitors – all driven to change the world in our own ways.

If you missed the symposium this year, I’ve captured the hive of activity and some key learnings in my video below. If you were there, you might spot yourself in the background!

The Patient Experience Symposium or any other patient experience event for that matter, is a great way to re-energise and re-motivate yourself in what you’re trying to achieve in improving your service delivery and care experience.
Energesse is an expert at pointing you in the right direction – call or email us if you need any specific assistance with patient experience measurement, implementing quality improvement or if you just need help making a start!

How to Integrate Digital Technology and the Patient Experience

Almost every technology vendor or platform provider in healthcare aims to be patient-centred or use the patient-centred term as a buzzword. Yet how do we really know that a platform is patient centred unless you actually ask a patient?

Patients don’t want technology, they want solutions to their problems. Often, I have found that in working with many healthcare organisations from hospitals to clinics to insurance companies, it is often assumed that we know what patients and consumers really want in their solutions. Yet, the truth is we often either do not ask the question or we don’t go deep enough into the emotional insights behind the needs and wants of patients. It is time to recognise that there is a two-tiered transformation occurring in health.

The first is a transformation occurring at a health system level – organisations like hospitals are trying to keep up with a pace of change that is unparalleled in the digital world yet struggling to meet those changes in an effective and coordinated manner.

The second change is a consumer-driven transformation – consumers are adopting Fitbits, wearables and internet of things at an extravagant pace yet often find themselves unable to either make sense of the data from these tools nor integrate them with the digital infrastructure of the health system (including hospital health records).

Whilst significant integration activities such as the international nationalisation of health records are taking place on the part of organisations (small organisations through to government agencies), some key elements need to be taken into consideration in the implementation of more human-centered approaches into IT:

  1. Selecting the right starting point: From a system redesign perspective, it is important to first start with mapping out the patient journey and outcomes you want to achieve relative to the patient journey. The mistakes some health IT professionals make in this space is starting with system architecture design rather than patient journey design.
  2. Don’t try to look at what we’ve got and make it better: Instead, let’s look at what experiences and outcomes consumers want to achieve and redesign the system to achieve those goals.
  3. Link data in the journey, not systems: Instead of trying to link data between systems, think about linking the data between different points of the patient journey to improve the experience, insights and outcomes for patients on those points of the journey.
  4. Consider the patient’s entire eco-system: Aim for a future state where we can create mass behavioural personalisation within each technology system, so the lack of integration is not even noticed. Here’s what I mean by this. As the world of technology moves on, systems become more fragmented with multiple different devices and software tools that cater to various different niches. This then creates a challenge for the consumer in terms of integrating it with all the other technology they utilise. For example, a type 2 diabetic patient might have their own application (or app) for dealing with complications such as ulcers. While incredibly useful for the patient, he or she is challenged as to how to integrate it with all the other health apps, tools or software that he or she utilises. Solution vendors are often more vested in getting initial uptake and design their solutions with a very niche and siloed purpose. They care less about integrating it with other solutions within that patient’s technology ecosystem and environment. In the case of type 2 diabetic patient – if a more user-centred approach to systems is undertaken, the focus would be in mapping out the patient journey and ecosystem of technologies that surround that diabetic patient in order to make the entire experience as meaningful as possible.
  5. Health practitioner’s needs what consumer’s value. This final point is really a summarisation of the above. Once you’ve created a solution (ideally using a lean start-up approach), it is important to combine that with an evidence-based approach in terms of features and functionalities that are most appropriate for that diabetic patient. Remember that what health practitioners value in terms of the data collected is not always equivalent to what consumers value in the utilisation of a technology solution. Hence, we need to find the right balance or formula

Ideally, as the health system continues to bridge the gap between health professionals, organisations and consumers, we integrate the requirements from these various stakeholders and truly create patient-centred adoption of solutions that are aligned with organisational strategy, quality and safety objectives and patient experience key performance indicators (KPIs).

If you’d like to have chat with me about your thoughts on the digital patient experience, feel free to reach out to


Breaking News! Winner of the Energesse Patient Experience Awards

We are thrilled to announce the winner of the Energesse Patient Experience Award (Asia)…

Bagan Specialist Centre (BSC) in Penang, Malaysia

Here’s a bit of background on their journey….

In August 2017, Energesse undertook a two-day 6E training session for 30 different public and private hospitals in Malaysia. After the training session, the participants were challenged with planning, developing and implementing a patient experience improvement initiative in their settings, using Energesse’s 6E Framework. In the 3 months following the training, Bagan Specialist Centre engaged the 6Es – Experience, Emotions, Engagement, Execution, Excellence, Evolution – in the improvement of the patient experience in Food Services.

We travelled to Penang to present the award to them and saw first-hand the improvement BSC Food Services made to provide healthy food on-the-go to patients during the temporary closure of their cafeteria. They initiated the improvement after measuring patient Experience and Emotions regarding lack of dining options (which was negatively affecting patients’ experience at wait times). Staff Engagement at team departmental meetings resulted in ideas to address the issue. Execution of the solution involved transforming an old abandoned trolley into a mobile food cart offering a variety of nutritious meals. It was wheeled around the hospital outpatient and inpatient units by food services staff. BSC achieved Excellence when they saw a 10.2% decrease in the amount of feedback and an average patient satisfaction score of 3.5 which exceeded the hospital’s target rating of 3.0. In a bid to see constant Evolution of their solution, monthly analysis of the sales of food items and food costs were performed to ensure that mobile food cart items offered to BSC patients and visitors were culturally appropriate and sustainable.

Here are some pics from the Training and Award presentation… 

Congratulations Bagan Specialist Centre!

Watch this space for the Australian winner of the Energesse Patient Experience Award…

If you want to find out more about how the 6E Framework can help you with your patient experience initiatives, talk to us!

The Energesse Patient Experience Awards is an award established to recognise the efforts of a health setting in improving the patient experience through the utilisation of the Energesse 6E Framework. The judging panel for the Award was made up of Dr Avi Ratnanesan (CEO, Energesse), Michael Greco (CEO, Patient Opinion Australia), Simon Kimber (MES UK), Nick Goodman (MES UK), Ashok Rudy (Director, Energesse Malaysia) and Kiran Nair (Research Manager, Energesse).


A Patient Story to Inspire You Today…

Happy New Year everyone! Hope you’ve come back refreshed from the holidays and ready to start the year off with a bang! Here’s an inspirational story to help you – with your New Year resolutions, your own personal health or your understanding of the patients and consumers you encounter everyday.

I met Alana Henderson, a patient advocate, at a HISA talk late last year. A woman who had a stroke at the age of 59 (not to mention diabetes and cancer) who changed her life by project managing her health like an engineer. Find out more about how she transitioned out of her dire health circumstances (for less than AUD$300!) through her book ‘Out of the Fog’ (available on Amazon) OR watch the interview below now…

Alana’s key message to practitioners and providers is to ‘not be afraid of what patients do for themselves’. Support the involvement they have in their own care and you can be assured of delivering a meaningful patient experience.

Talk to us now if you are thinking of spearheading initiatives this year around just that! We’ve all the advice, support, training or technology you might need.


5 Tips to Up the Patient Experience When You’re Down on Staff

Christmas is upon us! If you’re like us, you’re probably thinking ‘Where did the year go?’ and if you’re in a high-pressured health environment, your second most immediate thought is ‘How are we going to cope with skeleton staff this season?!’

    1. Here are some ideas on how to maintain patient experience during the silly (and scary) season:Ensuring clear communication with patients. If waiting times are going to be longer, ensure the patient is informed of this, and is updated on the wait time frequently. The ‘why’ is important – perhaps the doctor had to deliver some bad news to a family or staff are away. Be specific if the patient won’t be called in before a certain time.
    2. Make wait areas comfortable. Stock up on the magazines, provide complimentary coffee and tea, make sure the wifi is working or provide TV entertainment. This can go a long way in optimizing patient satisfaction even when the wait time is not ideal.1
    3. Ensure busy staff are not giving off ‘cues of indifference’. Here are some examples:
      • Healthcare professionals avoiding eye contact with “civilians.” Med students hurrying self-importantly down the halls, nearly running down the slow-moving patients who won’t get with the program. Patients ignored by nurses who haven’t yet clocked in and therefore don’t realize they are already (poorly) representing their institution. Doctors in the hallway loudly carrying on about the relative benefits of different vacations they’ve taken. Two radios playing at once from two administrative areas (with the waiting area for patients and their families located equidistant to both). Vending machines that are left out of service indefinitely. Vending machines that require exact change, but there’s no change machine.
    4. Empathy and communication in busy wards. Continue to bring up patient experience survey outcomes at morning staff huddles, motivate staff with small rewards and comments of appreciation to ensure they are still focused on communicating and caring for patients with empathy, even during periods when the ward is short-staffed.Get help! If patient experience measurement is just adding to ward workloads – consider using volunteers to survey patients or automate your patient experience measurement.

We’ve first hand experience with helping health settings do this so just ask us!



1. patient-wait-times

2. icahsolomon/2015/01/11/8-ways- to-improve-patient-satisfactio n-and-patient-experience-and- by-the-way-improve-hcahps- scores/#6452bf4d5191


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.


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

The Often Overlooked Clinician Element in Patient Experience

energesseIt’s not the narrow furrow of compensation plans, salary scales or allowances that keeps the doctors on the right side of patient experience.

It’s the broader view of ‘engagement’ – actions that invite doctors into the fold of strategic and operational plans, perhaps training that allows them to engage fully and more effectively in their purpose or asking the right questions around THEIR daily experience at the hospital.

A highly engaged clinician feels connected to their purpose and aligned to their career, their place of work, and their colleagues. As a result, they are able to approach each patient as an individual with physical, mental and emotional needs and cater their care around these needs.

The Greenslopes Private Hospital Network (GPHN) in Queensland did a great job at clinician engagement recently. We helped them undertake a research project around understanding the level of satisfaction among 300 junior doctors’ within the GPHN training programme.

We helped them design an online survey, choose its mediums, analyse and benchmark survey outcomes and provide recommendations for their training programme, based on the comments and suggestions made by the doctors.

There were some great wins in the form of a 50% response rate (highly unusual!), responses that exceeded expectations in quantity and quality, and useful feedback (nothing was held back!) about every element of the GPHN training programme.

Yes, our Energesse survey techniques worked. In addition, Greenslopes did these right:

  • They had already been building a foundation of transparent and honest communication between doctors and the HR management team
  • All doctors were informed about the survey from the beginning and its purpose was communicated well and frequently
  • A number of follow-up calls were made to some key doctors – who were then more than likely to have ‘spread the word’
  • Doctors who had already left Greenslopes for several years also responded to the survey
  • Upon completion, the GPHN Management thanked the doctors for their feedback and reiterated how they were going to use the responses and next steps
  • There was also one clear overall result – the GPHN private training programme had higher ratings when benchmarked against Australian public hospital training programme ratings

The survey was not compulsory, but there was a strong connection between the doctors and the management that kept them engaged enough in GPHN’s purpose to listen, to understand and to respond.

Jim Houston, the Director of Medical Services at Greenslopes, was very happy with the results. Here’s his testimonial. He is also presenting the outcomes at the upcoming Workforce Planning Healthcare Conference on the 5th of December 2016.

Here are a number of ways we can help you reach out to YOUR clinicians:

  • Research (surveys, interviews, focus groups) around clinician thoughts, needs and opinions
  • Training workshops to align clinicians to hospital goals such as patient experience
  • Granular monitoring of patient experience outcomes in real-time through our MES Technology

We would be happy to give you an overview via a presentation at your team meeting or grand round (monthly meeting). Just send me an email.


Seeds of Change from the Patient Experience and Choice Conference 2016 (Part 1)

On the 10th and 11th of October 2016, the seeds of change were sown in Australian healthcare, particularly in relation to improving patient experience and choice. Energesse came on as knowledge partner to support AventEdge, an event organizer that held a 2-day pioneering conference on how to improve Australian healthcare for all Australians.

The event attracted a small group of determined stakeholders from not only Australia, but as far as Malaysia and the UK. I was proud to chair the conference and open the stage for our international keynote speaker, David McNally, who is the Head of the Experience of Care for NHS England.

David reiterated the definition of patient experience from the Beryl Institute which is ‘the sum of all interactions, shaped by an organization’s culture that influence patient perceptions across the continuum of care’. He talked about the work of Dr Kate Granger in the UK, a doctor who became a patient herself and began the ‘Hello, My Name Is…’ Campaign – a campaign which encouraged health practitioners to introduce themselves before touching or communicating with a patient. It was a simple lesson yet such a powerful element of what we miss when we take our jobs for granted in healthcare.

He reemphasized Dr Kate Granger’s words which were:

“I firmly believe that it is not just about knowing someone’s name but it runs much deeper.  It is about making a human connection beginning a therapeutic relationship and building trust. In my mind, it is the first rung on the ladder to providing compassionate care.”

That perspective led to significant initiatives and effort within the NHS – one of which was that patient and carer partnerships would focus on four elements, particularly:

·         Improving the experience of care

·         Professional education

·         Service design and redesign

·         Quality design, improvement and checking

The following speaker was Michael Krieg, the CEO of St John of God Ballarat Hospital who talked about building internal capability and training his internal staff to be able to improve patient experience and work on projects themselves.

Beth Masling related her own story from the Western NSW Local Health District about when she met with an accident and became a patient herself at her own hospital. Her key points were to continue to help people connect with the WHY in their lives: WHY did they enter the profession of healthcare and how important it is to translate the statistics that healthcare practitioners look at everyday into what it means for an individual person.

These messages really resonated with me particularly in the work that we do to coach practitioners in this space.

Do you feel that our workforce and practitioners in healthcare are clear on their purpose?