Patients are central to healthcare delivery, yet all too often their perspectives and input have not been considered by providers.1 ,2 This is beginning to change rapidly and is having a major impact across a range of dimensions. Patients are becoming more engaged in their care and patient-centred healthcare has emerged as a major domain of quality.3–6

At the same time, social media in particular and the internet more broadly are widely recognised as having produced huge effects across societies. For example, few would have predicted the Arab Spring, yet it was clearly enabled by media such as Facebook and Twitter. Now these technologies are beginning to pervade the healthcare space, just as they have so many others. But what will their effects be?

These three domains—patient-centred healthcare, social media and the internet—are beginning to come together, with powerful and unpredictable consequences. We believe that they have the potential to create a major shift in how patients and healthcare organisations connect, in effect, the ‘perfect storm’, a phrase that has been used to describe a situation in which a rare combination of circumstances result in an event of unusual magnitude creating the potential for non-linear change.7

Historically, patients have paid relatively little attention to quality, safety and the experiences large groups of other patients have had, and have made choices about where to get healthcare based largely on factors like reputation, the recommendations of a friend or proximity.8 Part of the reason for this was that information about quality or the opinions of others about their care was hard to access before the internet.

Today, patients appear to be becoming more engaged with their care in general, and one of the many results is that they are increasingly using the internet to share and rate …