You are the Patient Experience

I was fortunate enough to attend the Beryl Institute Conference on Patient Experience in Dallas TX a few days ago. The Beryl Institute is one of the leading institutions worldwide on patient experience and it seemed like over 1000 delegates were involved in the community gatherings as well as special interest communities on Patient Advocacy, Pediatrics, and Physicians.

Healthcare leaders discussed elements of supportive design, University of California in San Francisco and American Academy on Communication in Healthcare and Language of Caring conducted activities on relationship building with patients and strategy maps on effective improvement planning. Communications skills were regarded as advanced physician skills required for the current healthcare climate.

I witnessed an outstanding keynote from  Cynthia Mercer discussing the importance of culture in an organization and how staff want a purpose to work on, not a place to work in. Another keynote from TV show host and healthcare advocate Montel Williams captivated the audience with his inspiring message of overcoming the odds through his personal experiences within the US health system.

He emphasised some of the major healthcare challenges coming in the next few years with predicted acute staff shortages and rising demands from patients with chronic disease. Consumers and patients will still expect a good experience, despite these issues and they will be vocal about it.

I had the opportunity to produce a few more episodes of our Patient Experience Channel. I am experimenting with shorter videos that contain quick tips for insights and implementation. Let me know what you think of these as I interviewed Colleen Sweeney,  patient experience rockstar from the US who is the Founder of the Empathy Project and researched patients’ fears in the health system.

Watch this video to find out patient’s no. 1 fear as they enter the health system (hospital)

On the local front, if you are based in New South Wales, we are sponsoring the Patient Experience Symposium organised by NSW Health at the Australian Technology Park Everleigh on May 5 and 6, 2016. Please come and visit our booth as we are proud to support the patient experience movement in NSW hospitals.


Finally, we acknowledge another happy customer! Sarah from NIB New Zealand had nice things to say about our work to help improve their customer experience.

“Dr Avi and team were very helpful in performing analysis which enabled us to isolate our top customer frustrations. The analysis was delivered in a timely manner, and their knowledge and enthusiasm for the topic was appreciated. The information provided by Dr Avi and team has been a great help to nib in focusing our efforts on improving customer experience.”

If you are having a challenge in your organisation you’d like to discuss , do feel free to reach out to me at Happy to chat!



Do you know the common misconceptions in patient satisfaction?

The pulse of healthcare is now moving into a swing that smells like an Evolution, rather than a revolution. Everyone I speak to is starting to grasp the idea of ‘people power’ and frame it in the context of the healthcare system.

I hear words like patient satisfaction, patient experience, consumer engagement, patient-centred care and an evolutionary term – ‘Patient and Family Centred Care’. The latter is very appropriate as we often forget that children and critically ill patients have no voice for them, and it is the families that act as their voices. I can relate as this happened when my late father passed away in a hospital only 4 months ago.

Nevertheless, I am encouraged by these trends. Whilst many of these terms effectively mean the same thing, it is great to see these metrics embedded in the very fabric and Key Performance Indicators of many of our hospitals and primary care networks.

Watch the video of Australian 1st Real-Time Patient Feedback technology with Emotion analytics

However, not everyone feels this way. I hear objections from Chief Executives, Chief Financial Officers and other financially oriented personnel who do not believe in investing time or money in such initiatives as they perceive them to cost more money and don’t result in any savings or efficiencies.

I also hear objections from some clinicians and healthcare professionals who feel that this is the ‘soft, wishy-washy’ stuff that has no bearing on clinical outcomes for patients.

Both these sentiments are actually unfounded and incorrect.

It is in fact these sentiments and thought patterns that drive increased costs and poorer outcomes as these leaders cannot see the big picture of how change and improvement in healthcare really happens.  

 As a passionate advocate on innovation and patient-centred improvements, I searched globally for a proven solution that can help hospital and community health organisations in Australia (and now Asia) better engage with their patients, clients and consumers and solve many of the challenges they currently experience.

To learn more about this innovation, click here for the video of the MES Experience Debut at Australian Healthcare Week. Hope you enjoy it enough to share with your like-minded colleagues.

A Conversation on Patient Experience – Lessons and Case Studies

Patient Centered Care and Patient Engagement are fast becoming buzzwords in healthcare, particularly as the belts continue to tighten and health institutions choose to invest in things that really matter.

As a leading firm that specialises in the field of patient experience and health innovation, we at Energesse decided to launch a Patient Experience Channel, to complement the Patient Experience Australia LinkedIn Group that launched in 2015.

Both initiatives were driven by the need for Australian healthcare professionals to connect, communicate and educate each other on how to diagnose, improve and monitor patient experience. They also provide very practical tips based on learnings and strategies implemented by practitioners around Australia and overseas.

For this first episode of the Patient Experience Channel, I had a conversation with Bernadette Brady, consultant and trainer with PartneringwithPatients. Bernadette and I are highly passionate about helping hospital and healthcare implement simple measures to transform healthcare to the way it should be – thinking about patients first.

In summary, some of the key learnings we highlighted are:

1. Enable patients to take control of their care and be in charge – ask them how they would like to be treated e.g. times they would want to be seen in hospital.

2. Clinicians should change from a ‘to’ mentality, to a ‘with’ mentality, when it comes to treatment program

3. Committees with patient representatives should have at least two of them on it, to ensure voices are heard

4. Learn to manage risk with patient choices – e.g. allowing early discharge from hospital even if there is a risk to patient staying at home – manage that.

5. The most effective solutions to transform care are simple – Every clinician should introduce themselves first. And always SMILE (when appropriate).

6. Celebrate success in Safety and Quality (rather than just focusing on negative events).

7. Consider the SECOND VICTIM ie. clinicians may need care and some protection too, especially when a bad experience occurs.

8. Know the difference between treating the disease and treating the person, the latter should come first.

9. Walk through the wards as if you were a patient one day – how does it feel and what observations about your environment have you made?

I’d love to hear your feedback on Episode 1 – content, length, quality, etc – what other topics around Patient Care would you like to hear about? Are there any experts in this field you’d like to hear from? Let me know and we’ll see what we can do to serve you…

Are we Ready for One Standard Measure of Patient Experience across Australian health?

Most recently, I had the pleasure of being invited to speak at the Improving Healthcare International Convention 2015 on the topic of Patient Experience case studies from the NHS, UK.

There is a growing body of evidence on patient experience measurement and linking financial incentives to them are starting to influence the thinking around patient experience measurement and improvement in Australia.

The last week I was having coffee with Michael Greco, the CEO of Patient Opinion in Australia. Patient Opinion is a website developed in the UK where patients can place elaborate comments, stories and experiences on a platform, such that it increases the transparency of how services are delivered in hospitals. The technology platform from the UK that Energesse introduced is called MES Experience, a multichannel platform for collecting patient feedback (patient experience/satisfaction) data at point-of-care and reporting meaningful analytics for managers.

As we are both heavily involved in mechanisms for improving patient experience through better data, it dawned on us that one of the major challenges in making a difference in Australia (compared to the UK) was that, we still do not have a single, clear national standardised metric for measuring improvement of patient experience.

Within the NHS there has been implementation of a standard measure of patient experience called the ‘Friends and Family Test’. Whilst there has been much debate about the measure over the last 5 years of its implementation, the one thing it has done is has raised the bar on the conversations and investments on how healthcare services should be measured and delivered in a truly patient-centred way, with input from patients.

Australian public hospitals are required to improve quality metrics around patient experience set around Standard 2, one of the 9 quality standards set by the Australian Commission for Safety and Quality in Healthcare. This standard calls for effective partnerships between consumers, healthcare providers and healthcare organisations which are deemed essential for safe and high quality care in national health policy in Australia.1-3

This standard aims to guide health services to become responsive to patient, carer and consumer needs and actually partners with consumers in the implementation of all other NSQHS Standards. However, according to the Commission reports, some health services have found the implementation of systems to meet the requirements of Standard 2 challenging4.

Private sector hospitals on the other hand are utilising their own divergent set of Patient Reported Experience Measures (PREMs), largely based upon surveys from the US healthcare system (HCAHPS) as well as the incorporating from other major payors such as health insurance funds. I’ve had conversations with several CEO’s and Directors of Clinical Governance who have really taken the lead in this space with patient experience measurement, and have evolved their own systems for managing it.

However, it remains clear that in general, Australian health services and hospitals are still at their infancy in terms of executing the latest strategies to collect, analyse, measure and improve patient experience. The lack of a standard national metric and the complexity of survey questions and aggregated data sources can further confuse management decision-making and budget allocation in this space.

Guidance from organisations such as the Picker Institute and Beryl Institute are helpful, yet implementation of these questions do require tailoring to local needs, such as in translation of survey questions to local ethnic languages. There also needs to be electronic mechanisms in place to complement paper-based collection in order to improve response rates, engagement and obtain meaningful insights in real-time.

Most importantly is the need to close the feedback loop and take action from patient experience data. Whilst some ward staff and executives may see this process as a ‘tick-box’ exercise, patient experience data collection is actually a driver for organisational strategy and a source for targeting innovation initiatives with real financial outcomes.


Because from my years as strategist in the corporate health sector (including for very successful pharmaceutical company with over $1bil in annual revenue), I learned one major fact – organisation that is close to its ‘customer’, is the most financially viable over the long term. Hospitals that are sensitive to understanding the needs and wants of its patients, will be the best performing over the long term.

Analysing patient complaints and frustrations may seem like a dreary task, however these ‘warning signs’ are particularly useful when coming directly from patients or front-line staff. Alleviation of patient concerns in an early stage acts as an ‘early warning system’ that can reduce systemic errors and multi-million dollar lawsuits. There are also often many positive stories that can be effectively shared in the organisation to lift morale and staff engagement.

One of the most neglected aspects of patient feedback is the long form narrative where the rich depth of patient insights often lie. In the business world, market research companies understand that these ‘long form narratives’ provide a rich source of insights on how an organisation should innovate its services. However, one of the reasons many surveys tend not to encourage these narratives is that they are difficult to analyse manually in high volumes.

Fortunately, many technologies now exist that can perform automated free text analysis to extract deeper actionable insights from this type of data and to keep service managers updated. Among them are tools like PanSensic, InVivo and SAS, some of which are customised for analysing patient experience data. Some of these tools are also able to analyse compassion, staff attitude and quality of communication.

From helping implementations of patient experience initiatives, here are 8 tips I’ve observed that can help Clinical Governance and Patient Experience managers:

  1. Have a systematic annual strategy and implementation plan that you’ve shared with a cross section of stakeholders in the hospital.
  2. Design your data collection, analysis and dissemination process so the right person gets the right data at the right time.
  3. How you design the questions for local use and ask the questions is critical – some patients/consumers will love doing a survey electronically at point of care, others may want to do it from home post-discharge – give them options.
  4. Analyse data effectively to translate them into actionable insights. Many ‘big data’ technologies that can save managers time, and perform these tasks more objectively and effectively than humans.
  5. Implement changes through a prioritisation process involving a multi-displinary team (that involves ideally 2 consumer representatives).
  6. Visibly demonstrate the results of feedback and management actions to drive culture change, motivation and results over the long term. Front line clinical staff want to know that their daily hard work is appreciated. It also helps them improve the quality of their care and communication if they understand that these aspects can actually be measured via patient feedback.
  7. Finally, monitor experience with a ward’s performance metrics to ensure that interventions are effective are continuously aligned with patient needs – many wards now have visibly transparent performance dashboards on the ward. The right way to do this is to have 3-4 main high priority metrics visible (not 20 metrics that cannot be easily seen by busy staff)
  8. Have the discipline to iterate the process to achieve continuous improvements to outcomes. Repetition is key to behaviour change. For any person, in any industry.

What are your thoughts on developing one standard metric for patient experience in Australia?

Do check out the Patient Experience Australia LinkedIn Community if you’d like to engage other leaders on this topic.


  1. Australian Charter of Healthcare Rights. Commonwealth of Australia, 2008. (Accessed 28 August 2014, at
  2. Australian Safety and Quality Framework for Health Care. Australian Commission on Safety and Quality in Health Care, 2010. (Accessed 28 August 2014, at
  3. Australian Safety and Quality Goals for Health Care Partnering with Consumers: Action Guide. ACSQHC, 2012. (Accessed 28 August 2014, at
  4. Safety and Quality Improvement Guide Standard 2. Partnering with Consumers. Embedding partnerships in Healthcare. Australian Commission on Safety and Quality in Healthcare. (Accessed 4 December 2015,

Executive Guide: 16 Insights Executives Miss in their Customer Data

As both the corporate and healthcare worlds get increasingly consumed with data and analytics, there are many preventable mistakes and lost opportunities that executives experience when determining everyday decisions about their customers or patients. A common scenario is when managers make ‘improvements’ to a product or service, only to find later that their new changes resulted in financial losses, and they don’t really understand WHY.

Often this is due to a lack of developing a deep understanding of customer insights from their own data or research. Commonly, what executives BELIEVE they know about their customers or patients, is largely at a superficial level. In fact, they often ‘don’t know what they don’t know’, and conscious or subconsciously refuse to acknowledge their lack of awareness of customer behaviour. Immature data management leads to a vicious cycle of poor executive decision making.Immature customer data management leads to poor business

The proof of ineffective management decisions lies in the results such as poor customer or patient engagement, low sales volume or high numbers of patient complaints. Mostly these executives also only act when its too late, because they are not fully aware of the ‘preventative’ solutions available to them.

The real tragedy is that customer data is often readily available within an organisation’s own databases and data centers. However, many executives simply don’t know where their data is kept, who to get it from and how to connect the pieces strategically to solve everyday problems. The common excuses are:

16 insights bubbles

Failure to utilise data effectively often translates into poor return on investment on staff time, budgets and resources. On an individual level, executives are penalised, reprimanded or even fired for underperforming and making costly mistakes that they should have picked up on. On an organisational level, it also leads to inability to solve problems or transform outdated business and care models – the lag indicator is when the Chief Financial Officer starts complaining about an unhealthy bottom line.

In our busy worlds, we are inundated with multiple channels of data and information from customer feedback, patient surveys, focus groups, social media posts, emails, website forms, call centers, mobile chat, etc. Many executives don’t know how to effectively make sense of all these valuable data sources particularly with the quantity, speed and variety at which data is coming at us.

In these more demanding environments where customer and patient expectations are greater than ever, what’s often missing is the ability to translate all the data ‘noise’ into meaningful insights and wisdom that changes executive decisions, actions and improve results. It’s often tricky to see the ‘wood from the trees’, particularly when an executive has been in a role for over a year.

Here are 16 of the common mistakes we’ve seen executives, even experienced senior managers, make over and over again. Can you relate to any of them?


Data Gathering

1.  We’ve found that most organisations vastly underutilise their existing data. Reasons for this can be lack of technical expertise, lack of awareness of available insights tools and methodologies or lack of time and money. Conversely, many executives spend excessive amounts of time and money implementing poorly researched projects or solutions, which could be greatly enhanced by utilising data and insights currently available.

2.  There is often confusion that more volume of data = better insights. Whilst this can be the case, deep insights come from a combined analysis of quantitative and qualitative data focused on the solving a specific problem. In the current era of ‘big data’, higher volumes provide greater accuracy and new insights, but they can also cause more confusion if the right filters are not applied.

3.  For those that are more data-savvy, there is a heavy reliance on ‘hard’ quantitative data to measure performance. However, in our interviews with leading CEO’s, many are starting to understand that measuring ‘soft’ KPI data measures like culture, compassion, staff attitude and customer frustration provide much better lead indicators to problems like patient complaints, high staff turnover and poor customer retention.

Data Analysis

4. Once datasets and data sources have been aggregated and are easy to access, some executives think “its now time for the data to tell us what to do!” That’s an incorrect way to think about data; its far more effective to think “What are our major business problems or current priorities that we can now use this data to help solve”. This initial approach may then uncover unexpected trends.

5. Actually speaking to customers and patients also = data! Stories and text verbatim from face-to-face meetings, observations, and long answers in surveys are goldmines for WHY problems keep recurring. Whilst such anecdotal data shouldn’t be generalised, it also shouldn’t be ignored completely. These case studies are often the key insights to innovation and improving products and services

6. Executives often do not dig deep into the emotional analysis and root cause of customer frustrations and delights; they often deal with problems at a superficial level and implement quick, superficial solutions. As we move into an era of better understanding of human behaviour, deep emotional analysis of customer and patient experience is fundamental to transforming processes and systems.

7. Once data is organised, they should be used to inform an organisation’s measures of success and how incentives are allocated. However, it’s important to understand which data points are most appropriate for a measure, and that they are collected in a consistent fashion over time.

8. Some executives often extrapolate general industry behavioural data to its own customers – and implement solutions because “everybody else in the industry is doing it”. Customer segments can behave very differently e.g. Gen Y purchasers of health insurance have significantly different expectations to Baby Boomers. A mass-approach loyalty program may only be partially effective, without deep customer understanding.

9. It’s important to integrate perspectives (datasets) from multiple stakeholders to make the best decisions. Relying on purely on senior management instinct or front line staff feedback, may not give you accurate picture of what your customers/ patients think and feel (and vice versa).

10. When it comes to gathering qualitative data (from surveys, etc), many executives either ask the wrong questions or ask the right questions in the wrong way. The emphasis is often on closed questions or Likert scale responses, which are simple to analyse, rather than open questions with rich experiential information from customer narrative or verbatim patient responses.

Data Management

11. Understanding security requirements for how data should be collected, shared and stored is a speciality in itself and most executives do not understand these aspects at all. Many do not really want to either. This is often the realm of the IT and Legal departments and even then it is a highly specialised space requiring specific knowledge of the organisation’s data security protocols. When in doubt – delegate (or outsource) to trusted experts, especially with regard to data security and compliance.

12. Privacy is a related issue – it is important to understand the privacy policy for your organisation. However, privacy can often also be used as an excuse for not sharing information on customers with third parties. This can ultimately lead to resistance to progress, especially when executives are trying to improve a whole customer journey. When deciding on which data to share, it is best to think about what is the ‘highest good’ for customers/patients or no. 1 objective of the organisation. With that principle in mind, one can determine how to best filter, cut and use the data to serve that purpose, within ethical business boundaries.

Actioning Data-Driven Decisions

13. When it comes to decision-making, the process of prioritising solutions to a problem can often be based on subjective insights expressed in a management meeting (e.g. loudest voice, length of tenure, organisational politics, who plays golf with the boss, etc). These decisions may ignore objective feedback from key stakeholders such as customers. This often hurts organisations when they have to look back and try to rationalise why things were done, without any evidence to back the decision.

14. Human beings are obsessed with predicting the future, and things are no different with data. Predictive analysis of data is helping many organisations make big strategic decisions such as ‘which new market do we do diversify into’ as well as tactical decisions such as ‘how to best deploy a new machine asset in our diagnostics area’. However, organisations need to build up to this capability and it is no sense having predictive capabilities if basic operations and customer service are not performing well. Basic operational performance is influenced by how culturally accustomed staff are at using data in their decision-making. This is a capability that can be nurtured over time.

15. Remember, that having valuable insights from your data is are critical starting points in a change journey, and one that need to fundamentally improve in the healthcare industry. Nonetheless, there is no substitute for courageous leadership and sound judgement that comes from experience, and knowing when to ‘believe’ there is adequate data and insights at hand to make a timely decision, and when to look for more information before making one. This is where it is important to be guided by a big picture, holistic view of the organisation and account for other problems or strategic priorities that can influence a final decision.

16. To keep up with the pace of change, health organisations need their data collection, analysis, and decision-making processes to be systemised in order to be effective over the long term. Obtaining useful insights from data is a better start, but having skilled, trained people to take the right actions is absolutely critical.

If you are experiencing challenges with data or would like to have a conversation with us about your business priorities, please contact us. I’d be happy to answer your questions or explore how we may be able to help you use your data to solve your healthcare or business issue.

How do we solve future health workforce needs with digital technology?

Over the past few months, a number of organisations across the healthcare ecosystem have engaged Energesse to help overcome challenges with the common theme of ‘needing to do more with less’.  It is unsurprising terminology for players in health system that is undergoing increased service demands but increasingly scarce funding supply. Hence we’ll be covering this in our Executive Breakfast in Melbourne in a few weeks.

The interesting fact is that this common problem emerges whether I’m speaking to a hospital CEO, a healthcare recruiter, a pharmaceutical industry executive or a healthcare technology vendor.

One of the stressors of this challenge in maintaining the existing business model and deliver services is that there is a need to maintain a significant workforce, whether it is doctors, nurses, HR, recruitment staff, accountants, sales reps and many more. At all levels of the ecosystem, the need for increased workforce is largely appears true, yet it forms one the most significant parts of the cost base of most organisations. And it is no longer sustainable.

As such, many organisations have spoken to me about how they can disrupt and innovate their own business or service model with technology, in order to manage the increasing cost and need of the workforce. However, most executives are challenged with exactly how to do this, and what thought process is required to start disrupting their own models digitally.

The answer is – it starts with your ‘customer’. One has to understand who the actual customer is in your part of the value chain and really understand their needs. The ‘customer’ may be the doctor, the patient, the pharmacist, the consumer/taxpayer, whoever it is your part of the organisation has to deliver value to.

One of the biggest mistakes is trying to adopt new digital technology solutions, is the tendency to jump to solutions (i.e developing a website or mobile app,or telehealth solution) , without really understanding who the customer is, and mapping out exactly where their needs, frustrations and pain points are in the customer journey. IT and digital solutions should target those pain points.

Customer Journey mapping is often done too narrowly in healthcare, and the questioning and analysis of real needs is actually done very poorly, if done at all. This results in enormous wasted financial resources on IT projects as well as not really solving the customer problem in healthcare. It certainly does not help manage the increased workforce requirements.  Similar insights on IT projects in healthcare were captured in research by Michael Porter and Bob Kaplan in Harvard Business School

If you’d like to learn more about this, do come along to our Executive Breakfast on  on Oct 30, 2015, 7.30 AM to 10.30 AM (AEST).  Download the brochure here.  Our breakfast event in Sydney was a great success, so if you happen to be in Melbourne, please join us if you are available, and feel free to pass on this invitation to your colleagues in healthcare. Click here to REGISTER

The Importance of Patient Experience – More than Comments on Hospital Food?

3308600_c71c6e180e_mThe last 2 weeks was a great opportunity to share much the latest research that we had conducted over the last 2 years on Patient and Customer Experience in Healthcare.

The healthcare sector is certainly coming alive this month as I recently completed one of my busiest schedules having delivered 4 consecutive speeches at the Health Insurance Summit, the Health Informatics Society of Australia conference, an Executive Breakfast on Sustainable Patient-Centred Healthcare and the CPA Australia Health and Aged Care Sector conference.

In my travels, I was amazed to learn that many healthcare executives are still trying to get their heads around understanding the importance of patient experience.

Intuitively, everyone believes it is the right thing to do.

Yet, often in Australia there is a sense that if you ask a patient about their hospital experience, then the answers that are likely to come back are comments about the food.

Nothing could be further from the truth.

In 2009, the Mid-Staffordshire crisis in the NHS showed that one of the major reasons for multiple service failures and safety issues was the lack of transparency and disconnect between senior management and front-line staff and patients. Feedback from patients on safety and quality issues were largely ignored.

It began a whole ‘patient revolution’ in the NHS that mandated the need to collect and analyse feedback from patients, and turn the insights into meaningful actions for improvement.

Whilst this may seem like ‘additional work’ for already busy ward staff, according to Sir Robert Naylor, CEO of University College London Hospitals, measuring patient experience provides an early indicator of safety and quality, helping to prevent them from occurring.

The philosophy of being sensitive to front line experience, feedback and comments in order to improve organisational performance may be relatively new to healthcare, but it is well known in the business world.

At one of the conferences, it was mentioned that a former CEO of ANZ bank had a direct line to the Head of the Complaints Department, and wanted a daily update of what customers were complaining about, so he could clearly understand the customers voice through all the ‘noise’ from management layers in his organisation. Steve Jobs, founder of Apple, was also known for reading and responding to customer feedback e-mails himself, so he could get his team to make improvements in Apple products fast, before any major reputational damage.

Indeed, there is a clear trend that smart leaders with decision-making ability need to obtain front-line feedback fast, so improvements can be made quickly. Digital platforms such as the MES Experience platform, which we’ve brought in from the UK and are currently pilot in Sydney Local Health District, is allowing deeper insights from patient experience feedback to be collected, and sent to senior management in real-time.

I’d love to know how you are measuring and analysing patient experience in your hospital and how that’s working for you. Simply leave a reply below.

7 Calamities of Call Centre Insights

We recently completed an analytics project for a major insurer, and in that process learned a number of key lessons regarding insights gained in call centres. Many of these lessons were validating our research findings that we discovered through the development of our Customer Experience and Retention White Paper which was published in May this year.

As a medical doctor who has now moved into the business of ‘healing’ organizations, I found that you can check on the pulse of an organization through the behaviour of front line staff and the interactions within an organisation’s call centre. In many ways the call centre is much like the skin of the human body, being the major touch point with the external environment of an organization.

In conducting our work, there are 7 key issues we found that limited the ability of call centres to serve its customers, particularly from an insights perspective. Here are some of our findings or ‘calamities’ as we call them.

1.   The vast majority of all call centre analytics and KPI’s are quantitative, leaving out the ‘WHY’ customers behave the way they do. They also often leave out the ‘WHY’ these problems are occurring and recurring, thereby missing the opportunities on how to solve them with more targeted customer experience solutions.

2.   Existing qualitative categorization of calls is largely basic and only mention a top line reason for the call e.g. ‘Billing’. Front-line staff do not have the time to record any deeper reasoning e.g. ‘Billing delay, fraud, refund requested, wrong billing, bill not paid, etc’.

3.   Reasons for the call are merely structured to one or two high levels only and not distilled into sub themes or root causes of customer issues. An example may be that billing delay was due to website down-time on that day due to a virus attack.

4.   Call centre teams cannot easily identify actionable insights that arise from customer frustrations, contradictions, conflicts, and interrelationships between causes. They are too busy trying to deal with the immediate issue, with immediate tools are their disposable.

5.   Call centre agents are not always incentivised to make improvements within the centre particularly with an outsourcing centres, which can influence customer feedback loops. Whilst this is not always the case, some call centres are not incentivised to reduce call volumes to achieve efficiencies.

6.   Frontline agents have variable understanding of codes, often leading to inconsistent coding amongst them.

7.   Voice-to-text tools can be useful however many are limited by their transcription accuracy and ability to analyse the depth of insights from customer conversations. For example, a 80% transcription accuracy rate (which may seem high), could still translate to “Hello, I am calling about my will (bill) which I received late (eight) days ago’.

What we’ve discovered is that these above limitations can severely limit the organization’s ability to respond and improve customer experience and get to the root cause of why customers are leaving them. Often manual labour is extensively required in the form of consultants or internal staff to analyse this issues and solve the problems.

In our learnings from this project as well as Customer Experience and Retention White Paper, we have found that tools like Pensensic are able to as attain deep insights from customer conversations by analysing the conversation in a text format and ascertaining the root cause in an automated fashion. This saves time, money, frustrations on behalf of frontline staff and customers as well as provides senior management with a more targeted approach to solving customer issues.

I’d love to hear your thoughts on whether you’ve come across the above 7 issues in your experience with customer call centres.

Customer Retention ~ A ‘Complex Systems’ Problem for Health Insurers

Australia now has a relatively mature Private Health Insurance industry with 34 private health insurers and over 11 million members. The number of people with PHI has been growing steadily, with annual increases of 2.5% over the last decade. In 2014, 47.2% of the population was covered for hospital treatment and 55.2% covered by general treatment policies.

The health insurance industry is expected to grow to over $21bn in annual revenue in 2015, with projections of 4-5% annual growth predicted leading up to 2020. It is now the largest individual segment in the insurance sector in Australia. There is an industry ‘centre of gravity’ with the 5 largest insurers (Medibank, BUPA, HCF, NIB and HBF) accounting for over 82% of policies, and the remaining 18% distributed across 29 other companies, mainly not-for profits. The larger funds therefore have the most to gain financially from improving retention strategies.

The evolving Australian insurance market is growing in complexity. Consumers have access to a choice of over 17,000 different policies and over 25,000 policies currently in use in the market. Policy products have become increasingly diverse with a complicated level of cover, exclusions, restrictions, excesses and co-payments. It is almost impossible for consumers to “compare apples with apples” and make rational purchase decisions.

A number of insurers experience lapse rates that exceed 20% of customers. This equates to lost revenue exceeding $2bn per annum from an estimated 940,000 members who switched funds in the 2013-14 financial year. Such high lapse rates have a significant financial impact on insurers due to the relatively tight net profit margins of most funds i.e. an average of 4.1% across all funds in 2013-146. Additionally, insurers and customers waste a significant amount of time negotiating and resolving issues related to poor purchasing and claims experiences, consuming significant financial resources in call centres and branches. At the same time, consumer expectations of value are increasing. They want to be better understood and have access to products and services that specifically meet their needs.

In theory, the broad range of products now available in the market enables more choice in trade-offs between price and coverage for consumers. This strategy is intended to attract different segments of the market to PHI. From an insurer’s perspective, product design also supports diversity of risk in their age and health profiles and is intended to improve the claims experience. Traditional actuarial determination of product design therefore assumes that consumers choose policies based on their expectations of future healthcare needs and their risk profiles relative to premiums. It is questionable whether current methodology is adequately consumer-centric in practice, as noted by the increasing lapse rates.

“Choice is not always a good thing for customers”

~ Harriet Wakelam, Head of Customer Experience, Medibank

From a consumer perspective, it is a difficult stretch to believe that consumers can really understand, much less predict, their future health needs. It is also doubtful that this is an actual driver to purchasing or retaining policies with an insurer. Whilst each customer segment behaves differently, expert contributors to the Customer Experience and Retention for Private Health Insurance White Paper acknowledge that today’s customers, particularly Gen Y, demonstrate a greater propensity to switch funds if they are dissatisfied with their experience. This suggests that the current complex environment is leading to poorer customer experience overall.

To add fuel to the fire, the 6.2% average premium rise in 2015 was the second highest health insurance premium increase in a decade, setting the stage for a “perfect storm” of unprecedented lapse rates in the industry. Consumers may also switch in record numbers due to ‘disruptive’ switch campaigns such as Onebigswitch (backed by media conglomerate and the growing adoption of brokers such as,, and

The irony is that switching funds can actually raise premiums as it increases the costs of acquiring new customers10. These costs can then be indirectly passed on to consumers. Along with rising medical claims costs, this phenomenon thereby creates and reinforces a ‘vicious cycle’ of rising premiums in the industry. This negative cycle may be further supported by traditional theories and potentially dated industry ‘myths and assumptions’ about how modern customers actually perceive, value, purchase and retain private health insurance.

In a ‘complex system’ such as the health insurance market, the root causes of issues are often multifactorial. The paper describes those multiple factors from the consolidation of inputs from interviewees. It also adopts a ‘systems thinking’ approach in consolidating those issues and making a more accurate diagnosis of the underlying conditions. This exercise was further aided by PanSensic’s text analytics capability.

As an introduction, ‘systems thinking’ is a sophisticated more complete approach to problem solving. It involves viewing ’problems’ in the holistic manner of an overall system rather than in its individual parts or silos in isolation. Systems thinking or ‘system science’ concerns an understanding of a system by examining the linkages, interactions and relationships between individual elements within PHI and the broader health system. Insurers that react to specific parts, silos or company structures ignore the effects on the overall market and consumer outcomes. This potentially contributes to further development of ’the problem’ such as the ‘vicious cycle’ of premium rises and increasing lapses.

Events such as consumer lapses and bad experiences are often caused by cyclical relationships in a system rather than linear cause-and-effect. It allows executives to see problems as they really are – dynamic processes of change rather than ‘one-time’ snapshots of events. This leads to a search for types of systems structures that are recurring and deeper patterns underlying negative events for insurers and consumers. A systems thinking approach therefore identifies not one root cause or solution, but a set of practices within a system that have become dysfunctional over time. Such an approach provides more advanced insights in diagnosing complex problems.

Future Solutions in Customer Experience and Retention for Private Health Insurance

The ‘Future Solutions in Customer Experience for Health Insurers White Paper’ is a research paper developed to help Australian health insurers deliver greater customer experience and customer retention. This White Paper is aimed for CEO’s, General Managers, marketers, sales and customer service leaders as well as analysts, policymakers and researchers in the industry. It is a ‘how to’ guide for getting closer to the consumer from a more complete, holistic perspective in order to drive strategic and tactical decisions.

Insights in this Paper were compiled from analysis of in-depth interviews and presentations from representatives of 10 Australian Private Health Insurance companies. Australia now has a relatively mature Private Health Insurance industry with over 11 million members and over $21bn in annual revenue in 2015. However, industry growth occurs in an evolving Australian market, which is increasingly complex. Consumers have to choose between over 17,000 different policies currently available for sale and over 25,000 policies currently in the market.

 Download the White Paper

Lapse rates can rise to over 20% of customers with some insurers (13). This equates to lost revenue (or switching of sales) exceeding $2bn per annum from lapses of an estimated 940,000 members up to 2014. These considerably high lapse rates have a significant financial impact on insurers due to the relatively tight net profit margins of most funds. In addition, insurers and customers waste a significant amount of time negotiating and resolving issues related to poor purchasing and claims experiences.

Applying a Systems Thinking approach to this complex, problem, we find a Vicious Cycle occurring in the industry in relation to customer retention and experience. From the consolidated analysis of contributor interviews, the real reason for poor customer experiences can be summarised into these 4 major themes. These include customer perceptions of confusion and lack of value, regulatory and competitive forces, sub-optimal systems, processes and data management as well as health system dynamics.

Following the analysis of interviews with industry experts, themes of solutions were consolidated. The solution model must also be robust, resilient to unpredictability and enable an organization to learn over time. In short, its execution must be a ‘Virtuous Cycle’ of CX Solutions, which is as follows:

  1. Define & Refine CX with Vision, Strategy and Objectives
  2. Align Leadership and Culture with Change Management
  3. Implement Systems and Capabilities to support CX
  4. Translate Perceptions into CX Insights & Priorities
  5. Apply CX strategically across portfolio, product design and marketing channels
  6. Extend CX across healthcare ecosystem

For some organisations, the implementation of all these solutions may take months to years and significant financial investment. As such, for those organizations that are time poor and can only do ONE THING to begin moving in the right direction, it would be to start understanding their customer perceptions much better than they are doing now. Every step of the Virtuous Cycle is largely defined by having deep psycho-emotional insights into customer perceptions. It all begins with the customer in mind, or rather ‘the customers mind’.