Online feedback about care: the new normal?

In September 2016, I blogged about evidence showing that US patients are now more likely to see online patient comments about healthcare than they are to see clinical metrics or patient experience measures.

And now we have evidence of the growing significance of online patient feedback in the UK too. The Inquire UK study, based at the University of Oxford, is examining use of and attitudes to online feedback by patients and professionals, and its findings are now emerging.

A representative survey of UK adults

One of the first outputs of the Inquire UK study is A cross sectional survey of the UK public to understand use of online ratings and reviews of health services.

In this study Michelle van Velthoven, Helen Atherton and John Powell surveyed 2,036 UK adults, and asked them whether they had read or written feedback about health services, professionals, treatments or tests in the past year.

90% of the survey respondents were Internet users and, of those, 42% had read feedback, and 8% had written feedback, in the past year.

People with a long-term condition, and frequent Internet users, were both more likely to read and write such feedback.

Why do people read or write healthcare feedback online?

The survey also asked people about their reasons for reading or writing feedback online.

Top three reasons for reading feedback

1. Find out about a particular drug, medical treatment or test
2. Choose where to have my treatment
3. Choose a healthcare professional

Top three reasons for writing feedback

1. Inform other patients
2. Praise the service received from my doctor or other healthcare professional
3. Improve standards of care in the NHS

The authors note that "writing a review to provide praise for a service was a far more common motivation for 147 ‘writers’ (36%) than to complain about a service (6%), treatment (5%) or professional (4%)".

What are the implications?

Like all good research, this study answers some questions and raises more.

We now have a reliable baseline figure for how many people are reading or writing online feedback – and you may be surprised that approaching half of all adults who use the Internet have read online feedback about healthcare in the past year.

Similar surveys in future will be able to track how things are changing.

We also have some idea of why people post online. As the authors point out: "Encouragingly, users are motivated to become more informed, to make choices, to provide praise, and to improve standards of care." This is certainly consistent with our own experience at Care Opinion. (I will blog about the findings of our own author surveys soon.)

This is now a widespread phenomenon

There are important implications here for health service policy and management too. "Policymakers should note that this is now a widespread phenomenon", the authors say, recommending that health services "need to understand how best to harness feedback, and what the opportunities are to encourage it and engage with it, and investigate how it can be used for service improvement".

But there is still much we don't know, and the authors themselves raise new questions. How do people hear about online feedback or decide to post their own? How do they choose a platform, and what features of online feedback are they aware of? Who do they want to read their feedback: are they writing for themselves, other patients, or staff – or all three?

Is receiving a response important? (See my last blog post for a study of what people see as important in a response.) And, to go further, how important is seeing some impact from the feedback you post?

Fortunately, there is a growing community of researchers from a range of disciplines, in the UK and overseas, now addressing these and other questions.

At the Health Services Research UK 2018 conference in July I'll be chairing a research symposium where researchers from Edinburgh, Sussex and Plymouth universities will be sharing their own findings, including further results from Inquire UK.

I'm really looking forward to it – and maybe I'll see you there? In the meantime, feel free to post a response to this blog if you have further evidence to share, or indeed questions to ask.