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,

What does a National Health Conference, an “Australian of the Year” and a CEO of a social organization have in common?”

Next week I shall be speaking at the Future of the Pharmaceutical Benefits Scheme Summit in Sydney. I was invited to speak at this conference because of my background having been in clinical medicine as well as being involved in the pharmaceutical industry for many years.

I’ll be speaking alongside leaders of government, pharmacy, CEO’s of pharmaceutical companies, as well as some of the leading academics in this space and I am pretty excited about this. Having worked mostly within the Small-to-Medium Enterprise arena for the last 4 years, this seems a little like going back to ‘play with the big boys’.

It is an honor to be asked for an opinionon the future shape of the industry. You may be aware that in Australia the government funds pharmaceuticals via the Pharmaceuticals Benefits Scheme (PBS). This is a payment scheme that’s seen significant price erosions particularly in the last few years where spending on medicines has declined significantly in order to save the federal government’s tight budget.

The January 2014 Productivity Commission report shows that government expenditure on the PBS in 2012 and 2013 was actually lower than the preceding four years. In fact, the Department of Health’s estimates for 2013-2014 show that PBS spending for the years 2016-2017 will almost be $4B lower than forecast in last May’s budget which shows that there’s incredible savings being made in the pharmaceutical sector.

So what does this mean for the Australian people?

Firstly, we therefore have less spending on bringing in new medicines into the country but not only that, the prices of medicines whether they are the innovator pharmaceuticals or generic medicines are also decreasing. This has an impact on the profits of pharmaceutical companies and pharmacies who now have to look at other ways of developing revenue and continuing to be sustainable.

I only recently interviewed Prof. Ian Frazer, “Australian of the Year” and CEO of the Translational Research Institute, a cutting edge research institute located in Brisbane. Whilst we discussed many issues in our meeting, Prof. Frazer pointed out that having a good healthcare system involves utilizing resources efficiently.

He even went on to say that managing government healthcare is like managing a business and we do need better business models in order to deal with our healthcare more efficiently.

Ian reinforced that “we can’t just manage healthcare and decide on treatments based on costs as some treatments are more expensive but they deliver better patient outcomes. At the same time we need to be equitable to everyone in the community such that everyone has access to these treatments which means we need to allocate resources effectively. We can’t just put away treatments but we do have to make decisions on what we should and shouldn’t treat based on dialogues and discussions with the public.”

Prof. Frazer even went on to say that a good healthcare system is ultimately about changing people’s behavior and getting people to be more responsible for their own health.

The same is also true if you are managing your own healthcare business or an organization with a social cause. I recently coached a CEO of a pioneering new organization called Humanity in Business which has an intention to educate other CEOs and senior leaders on business leadership based on values.

Humanity in Business is an organization that is keen to develop better leaders in business by creating a value-added program with a strong business model for this social purpose such that it can be sustainable over the long term. Its CEO, Muneesh Wadhwa was challenged with trying to figure out this business model and approached me for advice.

Here’s what he had to say after I spent some time coaching him and his organization through these challenges:

“I found Avi’s insights into business strategy extremely relevant and practical. He has a great understanding of the services industry and challenged me to create an offering which will add value to my clients and to my business.”

So there you have it, within the context of a conference, an interview with Australian of the Year or speaking to a CEO of a pioneering organization with a social purpose there is a great need to be able to better manage resources more effectively and create business models that are sustainable in order to benefit the broader population.

If you would like to have a complimentary consultation with me and help you figure your business model out with your organization, I’d be more than happy to hear from you. Simply send an email to

Love your success, health and happiness,







How to Become a Successful International Speaker

Dr. Avi: Hi, I’m Dr. Avi. Today I just wanted to share a few things with you about speaking and public speaking.

Now, I’ve just been accepted to speak at The World Congress of Prevention and Wellness in San Diego, which is obviously a huge international speaking opportunity and one of the biggest platforms in the world in the industry that I work in which is the health and wellness industry.

This really has come about … in fact it’s just two days after I speak in Australia on The Future of the Pharmaceutical Benefits Scheme and my topic is on Innovation and Reform of the Health Care System. Again, a very big topic on how to reform the entire health care system in order to manage the cost and deliver better patient outcomes for people in Australia.

Again, these are very big topics and I’m very privileged and honored to have been asked to speak at forums in Australia and in America in the health and wellness industry, but this did not happen overnight. It has taken me years and years to get these types of speaking opportunities and I really wanted to share with you some of my secrets of how I’ve become such a highly respected and highly sought after international speaker because I’d like you to be able to do that with your message in the health and wellness industry as well.

Let me first start of by saying what are the benefits of speaking on stage, in forums such as this, I say there are three main benefits, number one when you speak on stage particularly at forums such as this you get to build credibility and build authority around yourself. That’s really, really important in a time when we’re getting more and more information put out there, particularly in health care and we don’t really know who to go to find trusted information.

Speaking on stage really elevates your profile so more people want to listen to you and believe your credibility and trust in what you’re saying particularly if you’re an ethical person and you are of integrity and you really have a genuine desire to serve the world.

The second benefit I see is also building awareness, not just about yourself but around your message. That’s really important because if you have an important message that you want to share, speaking on a stage helps you reach audiences that particularly you may not have been able to reach before.

Thirdly, it’s also the advantage of just meeting new people and from speaking opportunities I’ve managed to meet some fantastic business partners, some fantastic alliance partners … I’ve managed to meet people that I’ve hired to do work for me and I’ve also managed to meet some fantastic people who’ve hired me to do work for them. It’s really a fantastic opportunity to connect with amazing people as well. I really encourage you to seek out speaking, if this is something … if this is a channel that you can really start focusing on for your health and wellness business.

Here’s a few tips to get really good speaking gigs. The way I see it there’s really two main things that you need to do in order to get really, really fantastic speaking gigs and the first thing I say is work internally and the second thing I say is work externally. What do I mean by that?

Working internally, what I mean is that working on yourself, working on aspects of yourself to improve your speaking ability. How do you do this? I actually went through a lot of courses, even though at the age of 18 I’d already been speaking to an audience of … I think it was close to 2,000 people in my school. Some way to say I was a natural speaker. I’ve actually spent thousands of dollars on my own training to become speaking. Now, that’s not something you necessarily have to do but I do advise to invest in training or coaching to speak.

I’ve done courses on Professional Speaking. I’ve done courses on Acting. I’ve done various other courses to improve my articulation and how I speak in a public audience, even though I had a decent level of talent moving in to the speaking space. This is something anybody can do. Even if you have fears of standing and speaking in public, in fact I believe this is one of the first or second commonest fear that people have, is fear of public speaking.

These things can be addressed through methods such as tapping, which is as you know is tapping on different points of your body and I’ve written some content on my blog around tapping as well. Feel free to reach out to me if you have some questions on that. That’s one of the major things around working internally.

The second thing I would say around working internally is practice. Once you’ve developed your content, your slide deck, or what it is you’re going to say, just go out and practice, practice, practice. Practice in front of the mirror first. Then practice in front of friends, and then practice in front of other audiences. You can even practice in front of a small audience first, if you want to do that before going out and speaking to a big audience. It really depends on which level you’re at as a speaker but practice is really important.

Two things with working internally, number one invest in training or coaching and secondly is practice.

What about working externally?

This is around how do we go out and actually get those speaking gigs. If you’re a CEO in a company or you can already start doing this by actually creating video content for your employees. You can actually speak to your employees. Start by speaking at a camera and tell them what it is you’re doing and what the mission on your company and the priorities of your company are. That’s a great way to do it, just shooting into video.

This applies to anybody who practices the health and wellness industry and you want to get your message out there. Video and online media is a great way to start speaking and just getting that practice into the camera first of all before you talk to a larger audience.

The second way to go out and get that practice is actually just by networking, actually going out and meeting different people in the industry that you work in. For example, if you work in massage therapy, if your company is in fitness and massage, for example, then go out and network at those events and actually say to people that you are a speaker. That you do speak at audiences and you don’t have to go out and get paid to speak all the time. Do some free speaking gigs because it’s great exposure anyway. Start by doing that and then over time you may start to get those fantastic speaking gigs not just locally but even internationally. It’s all a journey and it depends on where you are at right now.

The third thing I would say is run your own events yourself. If you can’t get in to other people’s events but I’m sure you can … I would say to compliment that run your own events. It could even be small events to start off to get yourself up there, get the practice you need to speak. This can be a corporate event where you get up on stage and speak. It could be another corporate event or external event or it could be a small gathering that you just want to get practice at and you want to speak. Run your own events and that’s a great way to get speaking gigs.

Finally, I just want to leave myself open and available to serve you if you have any questions about speaking and you want some advice, just feel free to get in touch with me. My email address is right here, it’s If you’re in the health and wellness space I’d love to have a chat with you and find out more about how I can help you, particularly in the area of speaking.

That’s it for me. I’m Dr. Avi, bye for now.