We always get a lot of questions about when and how to send surveys (i.e., survey timing post-discharge, email vs SMS), which questions to use (i.e., general, or condition-specific validated question sets) and what they should look like to be mobile and patient-friendly. But above all else, the questions we seem to get the most are always: “What kind of responses rates do you get?” and “What does a good response rate look like?” Now, these are fair questions. Considerable research is devoted to understanding the importance of response rates and the extent to which factors like selection bias [...]

Due to the plethora of evidence of the value of transitioning from fee-for-service to value-based funding mechanisms in healthcare, funders/payers are increasingly looking to mechanisms providers are paid based on patient health outcomes. Effectively, this means that rewards are given for helping patients improve their health, reducing readmission rates, adhering to medicine and feeling like the result of the process has led them to a better quality of life. However, the path to value-based health care can be long and arduous. Most health systems remain largely measured by key performance indicators (KPIs) and clinical metrics; at present little attempt [...]

Patient-Reported Experience Measures (PREMs) and Patient-Reported Outcome Measures (PROMs) are terms that are easily used and sound the same. However, even though they are complementary, they are also very different, especially when we consider what they measure and can achieve when used effectively. In this article we look at how PREMs and PROMs can work together. Patient-Centred Care There is increasing recognition for the importance of the patient’s perspective in supporting a patient-centred approach to providing quality health care. How many patients have had a good experience from the care they were provided? Did the patients achieve their goals [...]

Health organisations worldwide are recognising the value of incorporating patient-reported outcomes (PROs), or patient-reported outcome measures (PROMs), into their clinical healthcare practices. In particular, orthopaedic clinics are prime candidates for PRO-enhanced care as much of the success of orthopaedic procedures relies on the patient's commitment to follow their recovery programme. However, many clinicians object to the use of PROMs due to the limitations associated with traditional, paper-based PROMs, such as data quality, administration burden, and value of PRO data in a clinical setting. But now, with electronically run PRO programmes or ePROs several of these traditional barriers are removed. [...]

So, I recently had one of my worst fears realised: someone called a survey of mine racist. Now for any survey creator or anyone whose work is shared publicly, in terms of social crimes, when you're criticised of offending or excluding members of society, it doesn't get much worse than that. For some, asking others about demographic information isn't the most fun thing to do. Which means some often shy away from asking questions about sex, gender identity or ethnicity out of a fear of saying the wrong thing, using the wrong term, or in my case, offending someone quite [...]

Patient Reported Outcome Measures (PROMs) are becoming increasingly popular for payers and regulators to assess the value of services being delivered. This can create tension, if the clinical community feels they are being forced down a particular road that is not conducive to better decision making or that cuts across the relationship between doctor and patient. It doesn’t have to be this way though. There is an alternative approach in which PROMs can meet the needs of clinicians and your patients, as well as those of payers. After all, if a patient is going to take the trouble to talk [...]

Today, many of us either know of someone living with a long-term condition or are dealing with one ourselves. Medical advancement and healthier lifestyles enable us to live longer with conditions ranging from arthritis and type-2 diabetes to cancer, which is no longer the death sentence it once was. While this is an achievement, it's also placing more strain on healthcare services. According to a study published by the NHS in 2014, people living with a long-term condition account for 50% of G.P. appointments, 70% of all hospital beds, and 70% of total health and social care costs. At [...]

In our early days, when Cemplicity co-founder Nick Macdonald and I were working out of my garage, we’d say to people, “Give us a go and not only will you reach many more patients, we promise it will cost you less than your current PREMs process”. It was a safe bet because we were guaranteed to save companies the costs of people printing paper forms, stuffing envelopes, buying stamps and spending hours entering results into a spreadsheet. Recently I’ve been reflecting that some things change and others stay the same. I no longer press a button and have 3m wide [...]

Healthcare professionals are always looking for effective and safe ways to improve the level of care, comfort and wellbeing of their patients. Whether it’s the most leading-edge gene therapy or hospital beds with a wireless network of sensors designed to reduce decubitus ulcers (bed sores), we all want to find ways to incrementally improve the quality and success of health care. It is widely recognised that, when patients are actively involved and engaged in their own health situation, the quality of their outcomes is better and the amount of resources can be reduced. They can literally watch where they are [...]

As nations around the world begin to emerge from lockdown and assess the economic, social, and mental ravages of the COVID-19 pandemic, there is no doubt that some nations were more successful in limiting the spread and damage of the virus than others. It has been a surreal experience, sitting in my home office in London and talking daily to my Cemplicity colleagues and family in New Zealand and Australia. It’s difficult to reconcile the news and statistics from Downunder with that of the UK, and the Cemplicity team is finding itself having very different conversations with clients in each [...]

Over past months, our healthcare workers have been asked to sacrifice their family life and personal health to care for our vulnerable loved ones. It is a powerful reminder that a healthcare system is only as good as its dedicated carers. Around the world nurses, doctors and carers are currently reporting unprecedented levels of mental and physical stress, disengagement, and fear. Staff engagement, or the measure of how people connect to their work and feel committed to their organisation, is under threat. Now is the time to act not only because we care about our carers, but because this demanding [...]

A workforce under pressure With increasing pressure on the healthcare workforce, the issue of staff engagement is coming more sharply into focus. Across all sectors, the physical and mental wellbeing of employees are predictors of desirable organisational outcomes such as effectiveness, productivity and innovation. They can also predict undesirable outcomes such as absenteeism and staff turnover. And in healthcare, employee engagement has further crucial effects on patient safety, quality of patient experience and health outcomes. Measuring employee wellbeing, attitudes and engagement gives valuable insight into these factors. Cemplicity is known for its deep understanding of the field of Patient-Reported Measures [...]

Evidence is clear that if you listen to patients and improve their experiences you will achieve better clinical outcomes and safer care.. But in spite of this evidence, actively measuring patient experiences is sometimes still thought of as an optional extra, involving grumbles about car parking, hospital food and delayed appointments.  Clinical effectiveness, patient safety and dealing with formal complaints are being seen as higher priorities, carrying higher risk. Forward-looking healthcare providers understand that times are changing.  Better experiences lead to fewer readmissions, better adherence to medication regimes and better health outcomes so with an ageing population, and growing numbers [...]

While the benefits of Patient Reported Outcome Measures (PROMs) programmes are well established and significant, at Cemplicity we often hear frustrations from health providers about how they can’t agree on how best to deliver PROMs across their organisation. The challenges arise because PROMs programmes are typically trying to solve two valid, but often conflicting, objectives: System-level quality improvement, value assessment and service redesign Improved clinical outcomes for individual patients Typical Example A scenario we often come across is a hospital executive team wants to implement a system-level process to get a sense of the quality improvement delivered by all [...]

There are literally thousands of survey tools out there designed to allow patients to self-report on their own health outcomes. Their names don’t roll off the tongue – consider PROMIS-29, CAW, AQOL-4D, EORTC QLCC-30 … It’s pretty clear that these names originated from the academic community, not from marketing. That said, there was a healthy dose of dark humour shown by Washington University when they named their sino-nasal survey tool “SNOT-22”.  As a health provider who wants to measure and improve health outcomes for their patients, how do you find the right survey tool?  It’s not always that easy. Patient Reported Outcome Meausure (PROMs) tools are a niche area and the survey owners are often within smaller academic bodies with little budget for self-promotion. Cemplicity work with a couple [...]

  At Cemplicity, our vision is not just about building great technology, it's about enabling genuine improvement in patient experiences of care. As such, we are constantly learning from how our client's implement programmes. We look at what mistakes they made in the past and how they can get better. Over the years, this has lead us to develop "4 Best Practice Pillars" that all organisations should consider when implementing a new patient experience programme. Specifically, those pillars are: 1. Asking the Right Questions Enable your patients to talk about what matters most to them and allow them to use [...]

Cemplicity's incubator was the New Zealand health system. Within this respected, high functioning yet small system, we have had the opportunity to engage with people across the sector, from the Ministry of Health to ward staff and GPs. We have co-designed national methodologies and seen the the results of our work through participation in governance groups and close feedback loops. As we step out onto the international stage, we realise how fortunate we have been to have started in NZ. Priorities are clearly articulated in the NZ Health Strategy, and funding lines and improvement frameworks encourage alignment between secondary and [...]

  I want to draw attention to a study recently published in the New Zealand Medical Journal on non-response bias to a national hospital inpatient experience survey run using Cemplicity technology.  The study was conducted by Michael Thomson, Megan Pledger, Richard Hamblin, Jackie Cumming and Essa Tawfiq (2018) and can be read in full here. Response rates is one of the most common topics of discussion we have with clients. Getting a good response rate to a survey is critical for two reasons. Firstly, to ensure the sample size of respondents is large enough to be statistically reliable. Secondly, to ensure the results are representative of the universe that has been surveyed.   However, there is [...]

Some years ago, Southern Cross Health Society embarked on a journey to enable each of their 850,000 members to provide feedback about their quality of life and health experiences. Not only did they intend to capture the feedback from every patient, but to share that feedback across a broad network of specialities with over 1,000 providers, in a way that drives improved outcomes for patients. Inspired by their ambition, Cemplicity set about making this vision a reality. It wasn't easy - Southern Cross provided us with a number of member and user stories, which outlined how they wanted each key [...]

Every now and then we come up against the argument that “you cannot use email for contacting patients about feedback”. We tend to hear this immediately following a story of an elderly relative who once refused to look at a smart phone - though it is still a valid point. As a result of this, I often see providers reverting to a paper-first approach to collecting patient feedback. Paper that needs to be printed and put out in reception or posted to patients in the mail. Paper that patients have to physically hand back to those involved in their [...]

As a starter for 10, who said the following about a healthcare system? “cause people often talk about being scared of change but for me I’m more afraid of things staying the same cause the game is never won by standing in any one place for too long” Actually, I don't think the writer was really talking about a healthcare system if I'm to be completely honest.  I’m sure he’s a patient occasionally, though I doubt he spends countless hours staying up late, cup of tea in hand, leafing through BMJ and thinking about the machinations of health policy.  Notwithstanding, [...]

 Big changes are afoot in how Australians give feedback on their experiences as patients of local health services, moving away from the traditional US based patient feedback approaches. Partly, this shift is driven by the availability of a new high quality, locally developed survey. It's also a result of technology advances that are allowing providers to adopt a strong improvement methodology without sacrificing valuable benchmarking.Australian Hospital Patient Experience Question SetLed by the Australian Commission for Quality and Safety, a four year project involved Australians from every walk of life. The goal was to understand what matters most to Australians. Rather than assume [...]

Why capture patient feedback on healthcare services? Here at Cemplicity, we specialise in helping healthcare organisations capture and use robust, actionable patient reported measures. We deliver simple service transformation programmes for small community providers, as well as large-scale, government led integrated care improvement projects. But how do we know capturing patient feedback has an impact? Are patient experience and clinical outcomes correlated? First, significant literature exists to support the impact of patient feedback on clinical outcomes and service efficiencies. A study by the Imperial College London, published in the BMJ in 2013, explored the link between patient experience, clinical safety and clinical [...]

It’s a fascinating experience to become a patient of a different health system. Having recently moved to the UK from New Zealand, I’ve discovered this first hand. The pride UK citizens have in the NHS was apparent in the last Olympic Games. I’ve never come across a public institution so valued by its people. Perhaps reflecting this close relationship, the NHS was one of the first health systems globally to recognise the importance of patients’ experiences of care, and that systematic patient feedback can result in harm reduction and improved outcomes. The Friends and Family Test The NHS introduced the [...]

Perspective on the EY Future of Health Survey 2018. Something that caught my eye out of the US last week was EY’s most recent Future of Health Survey. In this US survey of 2,455 consumers, 152 clinicians and 195 executives, EY sought to understand how people think digital technologies will improve overall population health and which strategic initiatives are the priority. Among the findings, the survey found that 91% of US healthcare businesses have undertaken or plan to undertake a technology initiative to improve the patient experience in the next 12 months. This is a startlingly high figure and shows [...]

I spend much of my time talking to clinicians and hospital managers about the benefits of asking patients about their own health through patient reported outcome measures programmes. However, we also encounter scepticism that, by enabling patients to rate their own health, better outcomes will be achieved. A new study, Basch (2017 pp.197-198)1, shines a clear light on the fact it is not whether you should implement PROMs, it’s how you implement it that will have the impact. Frustrated frontline teams who understand the value of patient feedback yet who cannot secure the budget or management attention for patient reported [...]