Bridging the health literacy gap in the digital age

It’s crucial to improve educational methods to achieve innovations and enable many to capitalize on the promise of value-based care.

The intersection of technology and health literacy has promised progress, but it creates barriers for those with low health literacy.

Low health literacy among adults is a hidden problem within the healthcare system. According to the National Assessment of Adult Literacy, 80 percent of respondents reported struggling with interpreting documents such as forms and charts. In addition, 68 percent of participants reported difficulty understanding numbers and making calculations.

These findings are worrisome for both patients and caregivers. This issue can create problems such as inadequate access and can be exacerbated by app design flaws. Interoperable systems and the transformative potential of value-based care offer potential solutions.

Digital barriers to integration

The digital healthcare revolution, while promising, inadvertently creates barriers for those with low health literacy. Limited access to digital resources disenfranchises a significant portion of society, with one in five U.S. households not having access to the internet at home. Economic disparities exacerbate the issue, leaving many on the outskirts of vital health information. Bridging this gap requires more than technological inclusivity – it is a pivotal step in democratizing healthcare knowledge.

Health apps hold promise, but they pose challenges for those with low health literacy because of complex navigation and medical jargon. Research shows that low eHealth literacy (eHL) is associated with less use of patient portals. Designing apps with a user-centered approach, including plain language and intuitive design, is critical for democratizing access and fostering digital literacy.

Navigating via interoperability

Interoperable health systems, with the capacity to seamlessly integrate data from diverse touchpoints, open avenues for understanding patient behavior beyond the confines of traditional appointments. By delving into behavioral cues, healthcare providers gain insights into the nuanced facets of health literacy.

Patterns of engagement with digital health platforms, responses to educational materials and participation in interactive health modules contribute to a comprehensive understanding of an individual's health literacy journey. This beyond-appointments approach enables the creation of tailored interventions that meet patients where they are, fostering a more effective and patient-centric approach to health education.

In promoting health literacy, normalizing teach-back via interoperable systems is vital. This approach, where patients repeat information, becomes embedded in healthcare interactions. Interoperability captures and analyzes teach-back instances, offering feedback on communication effectiveness. This normalization fosters mutual understanding and ensures information comprehension at different literacy levels, breaking communication barriers.

Here are some tips for implementing the teach-back method. Keep in mind that this method is not a test of the patient's knowledge, but instead a way to assess how well the concept was explained.

Plan your approach. Think about how you will weave in teach-back questions naturally into your workflow.

"Chunk and Check.” By asking teach-back questions throughout the patient’s visit, you avoid overwhelming the patient.

Clarify and check again. If you uncover a misunderstanding, explain the directions or condition in a different way and repeat the teach-back process.

Start slowly and use consistently. Implement this method by trying it with the last patient of the day.

Practice, and use the show-me method. This method can be particularly useful for patients who struggle with medication adherence or patients who are prescribed a new medication or a change in dosage. Asking patients to act out how they plan to take their medicine helps reinforce these critical directions.

Use handouts along with teach-back. Providing handouts is an effective way to fortify the teach-back method. You can allow patient to reference handouts when teaching-back, but make sure they use their own words to describe the concepts.

How to promote the teach-back method

Plan to have insights shared. Designate someone in each staff meeting to share a teach-back "Aha!" moment, serving as a reminder of the consistent importance of using teach-back.

Educate nonclinical staff. Teach-back methodology should extend to nonclinical staff members who engage with patients. For instance, staff responsible for scheduling appointments can employ teach-back to confirm patients' understanding of upcoming requirements — arrival time, necessary insurance documentation, medication preparation, fasting instructions and information about referrals to other clinicians.

Share positive teach-back experiences.

In addition to the teach-back method, implementing internal health literacy programs can reshape patient education through interoperable systems. This holistic approach taps into diverse touchpoints, offers insights into behavioral cues beyond traditional appointments, enables tailored interventions and fosters a patient-centric strategy.

Here are some keys to success in initiating health literacy programs:

  • • Define clear objectives.
  • • Align with organizational values.
  • • Involve key stakeholders.
  • • Leverage technology.
  • • Prioritize behavioral insights. 
  • • Invest in training.
  • • Use accessible resources.
  • • Adapt language appropriately.

These initiatives aim to establish a more accessible and empathetic healthcare communication environment.

The impact of value-based care

Value-based care represents a transformative approach to healthcare delivery, emphasizing holistic patient outcomes over traditional volume-centric models. This shift toward patient-centric care recognizes the importance of addressing medical needs and the broader social determinants of health (SDoH).

The Centers for Medicare & Medicaid Services plays a pivotal role in advancing healthcare by actively collecting data on SDoH. This federal-level initiative has significant implications for health literacy programs, as it underscores the interconnectedness of social factors and patient care. Addressing gaps in patient care requires an understanding of the complex relationship between SDoH and health literacy.

In the era of value-based care, health data analytics emerges as an essential tool for evaluating the impact of health literacy initiatives. Data plays a central role in assessing patient outcomes, but quantifying the precise impact of health literacy on value-based care presents unique challenges. Nevertheless, leveraging analytics provides an avenue to identify correlations between health literacy levels and clinical outcomes, offering valuable insights to refine and optimize patient-centric care strategies.

Tackling digital barriers in healthcare is necessary to democratize knowledge. Solutions, from user-friendly apps to teach-back methods via interoperable systems, aim for inclusivity. Embracing the shift to value-based care acknowledges the link between social determinants and patient well-being. To navigate this landscape successfully, it is crucial to integrate technology and promote health literacy for a healthier society.

Doreen DeGroff, CPHIMS, is senior director at CereCore.

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