Can Digital Health Technologies Improve Health Literacy?


A recent article in the AMA News cites a 2003 health literacy study by the US Department of Education which surveyed more than 19,000 Americans. It found that over one-third had trouble reading and understanding basic medical information. Not surprisingly, people with low health literacy have worse medical outcomes, make more medication errors, have lower adherence to regimens, and are 50% more likely to be hospitalized (National Patient Safety Council). The worst part is that 75% of health illiterate patients will not tell their physicians about it. The biggest issues I see with health literacy are that patients are intimidated to discuss their low health literacy with the provider and to challenge care recommendations (which is not usually in a shared decision context), physicians do not speak in lay terms, and do not have enough time for ample, free-flowing discussions. In addition, low health literacy is not appreciated by providers and therefore the problem is a self-fulfilling one.
Among the tips in the article to improve health literacy are recommendations to have people, not machines make appointments, have patients make a list of medications, and prepare and write questions for the provider in advance of an appointment. I found it interesting and embarrassing that there was no mention of technologies in recommendations put forward by the authors.
Technology can improve health literacy. Information may be transmitted either in auditory or written mode, and educational materials about disease management, medications, instructions for caregivers, and appointments may be presented in native languages, with illustrations. The patient portal then becomes the common communication tool, which may contain prescribable links from the provider for the patient to view. Patients without PCs at home may watch in the provider’s office, log in at the library, or a smart phone. This type of technology has an ROI that’s hard to demonstrate on a commercial level, but clearly evident on a medical and ultimately gross economic one. Let’s use common sense, get with the 21st century, and improve the patient relationship literacy of our medical students, physicians, and other providers.
When we discuss wireless health technologies we often think about fancy tool which collect data from our bodies, even show us our DNA. But if health literacy is not improved, the messages which other mHealth technologies deliver will never have their impact. You may view the AMA article at: (http://www.ama-assn.org/amednews/2012/03/19/prsa0319.htm ).

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About davidleescher

David Lee Scher, MD is Director at DLS HEALTHCARE CONSULTING, LLC, which specializes in helping digital health technology companies, their partners and clients. As a former cardiac electrophysiologist and pioneer adopter of remote patient monitoring, he is uniquely qualified to address both clinical and operational concerns of clients. Scher was Chair of Happtique's Blue Ribbon Panel which established standards for certification of medical apps in the categories of safety, operability, privacy, and content. He is a well-respected expert in mobile and other digital health technologies and lectures worldwide on technology and its impact on patients and healthcare systems.
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4 Responses to Can Digital Health Technologies Improve Health Literacy?

  1. Pingback: mHealth meets p(ublic)Health « mHealth Strategy

  2. Brenda Bell says:

    One question I would ask is whether or not low-health-literacy patients are motivated to improve their health literacy. Almost everyone I know from my parents’ generation, unless s/he has a medical or related degree or related job experience, accepts physician prescriptions and advise as if it came from G-d or some other equally exalted source, and will not question the doctor’s opinion.

    A second question concerns the economic and residential conditions of low-health-literacy patients. I would venture that many — particularly low-income immigrants (documented or not) — will not have access to computers, either at home or in public libraries (presuming that public libraries exist in their neighborhoods and that they are accessible without needing a car, and during the hours that these people are not at work).

    • Brenda, both good questions. Regarding health literacy, the issues we are discussing are not high level academically-related ones, and from my clinical experience can easily be discussed and transmitted to average older people. The transmission MUST be in everyday 8th grade level terms to be digestible. Therein lie most of the communications problems in medicine today. Health literacy, I believe is more a function of the communicator-provider’s ability to transmit the information well, than the patient’s intellectual capacity. The second question may be addressed by the diffuse adoption of smartphones, as well as the burgeoning industry of telemedicine which will bring medicine and hopefully increased health literacy to remote and poor areas.

  3. Pingback: Can Digital Health Technologies Improve Health Literacy? | Digital Health Journal

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