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How health systems can improve communications and health literacy.
Accurate health information can directly impact one’s personal healthcare decision-making and affect their health outcomes. However, there is great disparity in the access to credible information sources, further complicated by the sources that patients prefer and trust. This places tremendous importance on patient education and engagement.
Patient engagement is defined as “actions individuals must take to obtain the greatest benefit from the healthcare services available to them,” according to the Center for Advancing Health (PDF). This degree of engagement is of paramount importance when it comes to taking medications. After all, as a Yoruba proverb says, “Medicine left in the bottle can’t help.”
Despite the best efforts from many healthcare providers, patients are not always fully engaged when it comes to taking medications. In fact, medication is not taken as prescribed 50% of the time. This non-adherence leads to 10% of all hospitalizations, 26% of all preventable readmissions (PDF) and 125,000 deaths per year. In addition to these health-related consequences, the lack of patient engagement also incurs a cost to the U.S. health system of as much as $300 billion per year.
These challenges are partially caused by the lack of access to healthcare information and consumer preferences. Most consumers are passive receivers of health information until they become actively engaged and seek information relevant to their particular concern.
Health information is distributed from a wide variety of sources, including healthcare providers, broadcast media, print media, the internet, family and friends. Preferences of health information sources are generally associated with age, education level, insurance, race/ethnicity and socioeconomic status. For example, older consumers are more likely to use print media as a source of health information, while the uninsured are less likely to have access to healthcare providers.
Pharmaceutical companies have used broadcast television and print media to reach a wide audience and educate consumers. However, these efforts are reaching a diminishing number of passive consumers as user preferences move away from these communications channels.
In contrast, the internet is a growing, active distribution platform for health information, particularly on mobile devices. According to a recent survey by the Pew Research Center, 96% of Americans own a cellphone, and 81% are smartphones. Additionally, 37% of US adults say they mostly use smartphones when accessing the internet.
Users who access the internet for healthcare information tend to be younger and more educated. In addition, patients without access to healthcare providers are also more likely to turn to the internet as their primary source of health information. Although the internet provides a ubiquitous channel for health information, it is not an option for all patients. Factors such as low health literacy and limited English proficiency are major barriers for some patients to use the internet for healthcare and medication information.
Another huge challenge with using the internet as a source for health information is sifting out discredited information. This is an important aspect of health literacy. For example, click-bait scams that advertise quick, cheap alternatives can be enticing to many individuals. Health literacy is a personal skill that includes the ability to gather, understand and then act on appropriate health information.
Patients with low health literacy have difficulty with one or more of these steps. Each step is important because an inability in any step detrimentally affects subsequent steps. Health literacy is such an important skill that it is a stronger predictor of health than age, income, employment status and race.
Healthcare providers are trusted primary sources of health information and should explore new ways to provide accurate information to all patients. It is important that the information presented to patients incorporates health literacy approaches that are culturally appropriate. Consider offering handouts to vulnerable populations that are written clearly in a culturally appropriate way, in the patient’s preferred language.
Another way to accomplish this is by providing easily accessible links in patient portals to credible health information, as consumers are increasingly encouraged to use these portals. Links to additional resources available in their languages, such as videos, should be accessible on the healthcare system’s patient portal as well.
The willingness of healthcare providers to answer questions, their ability to appreciate their patients’ preferred sources of health information, and an effort to guide patients to navigate the internet to useful sources of information can reduce these disparities to accessing credible health information.
Understanding barriers to access, preferred routes and trends can provide healthcare providers and policymakers with the tools to improve effective communication by increasing focus on populations with low access to healthcare information.
The ultimate goal is to meet patients where they are with information that will make it more likely that they twist the cap, take the medications out of the bottle and use it as instructed — thereby improving their health and well-being.
Dr. Charles Lee has been a leading national advocate for simplifying and making medical information more understandable for patients. Dr. Lee is Sr. Advisor on health literacy and language barriers at First Databank (FDB). He has extensive experience in patient-centered healthcare communication, language barriers, health literacy, and instructional design.
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