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Dr Anne-Marie Boylan is an NIHR CLAHRC Oxford Research Fellow. Her research focusses on exactly this issue, examining how online patient feedback can be used in healthcare, as part of the INQUIRE project.

In this blog post, Dr Anne-Marie Boylan and Dr Veronika Williams, Senior Researchers at INQUIRE, share some preliminary findings from this work so far.

From blogs, forums, social media and more, the online world offers a wealth of opportunity for people to leave feedback on their experiences with services and products. Whether good or bad, named or anonymous.

Collecting, analysing and responding to online feedback are well-established practices in the retail, travel and hospitality industries – practices considered fundamental to their continued success.

Yet health services often fail to consider or respond to this type of ‘customer feedback’, despite a growing focus on making the NHS more patient-centred.

For health and social care, the online world offers a rich vein of this feedback. Feedback that could be mined, refined and used to improve the experience of the patients that use health services.

The first part of the INQUIRE project involved finding out what kind of research has already been done on online patient feedback and what can we learn from it. To do this, we searched the published literature.

We searched several different databases looking for any research on this topic, from across the world. Because we wanted to establish the state of current evidence, we excluded anything that wasn’t research, such as opinion pieces and editorials.

The result was over 25,000 articles. We reviewed their relevance, and by reduced them down to 70 articles.

So, what has this told us? What do we know about online patient feedback?

Firstly, the vast majority of studies (41) we found were carried out in the US. The next most prolific country was the UK with nine studies.

The initial findings from one German study suggest that public awareness of online feedback and rating sites is lower for healthcare than it is for consumer goods.

Other studies, from Germany and the US, indicate that young people, women and people with higher levels of education are more likely to use healthcare rating and review sites to post reviews or ratings and/or to aid in choosing a health professional.

We also found that older people and those who have a well-established relationship with their doctors tend to leave positive feedback. In fact, perhaps surprisingly, the majority of online feedback is positive and, interestingly, longer comments were more likely to contain negative feedback.

Studies which analysed the content of patient feedback showed that it contained comments on doctors’ knowledge and competency, communication, personal character and professional conduct. It also contained information about the cleanliness of a hospital, how easy it is to schedule an appointment and the length of waiting times.

That’s the patients, but what about the healthcare professionals?

Studies looking at the attitudes of healthcare professionals to online feedback indicate that they have concerns about its usefulness. But it’s worth noting that some studies in the Netherlands concluded that it could be useful to healthcare monitoring agencies (such as the Care Quality Commission here in England).

Healthcare Professionals themselves may also be interested in learning that UK studies have shown a link between the number of patients willing to 'recommend a hospital to a friend' and overall National Inpatient Survey ratings.

Positive online recommendations are also correlated with hospital mortality ratios, and better patient ratings of hospital cleanliness were associated with lower rates of infections.

Through this review, we’ve begun to build up a picture about several aspects of online patient feedback, and it’s clear that we need to explore its potential to make a difference to the NHS. However, questions still remain about how we can best harness this feedback to greatest effect.

Through the range of methods applied and the variety of participants involved (including patients, carers, academics, clinicians, policy makers and commissioners), the INQUIRE project is well-placed to explore these and related previously unanswered questions.


A version of this post originally appeared on the INQUIRE blog, here.

To read more about INQUIRE, click here.

To read more about Dr Boylan’s work with the CLAHRC, click here.

Opinions expressed are those of the authors and not of the NIHR CLAHRC Oxford, the NIHR, the NHS or the Department of Health.

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